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BACK IN LINE CHIROPRACTIC CENTER 6991 W. BROWARD BLVD PLANTATION, FL 33317 954584BACK (2225) LETTER OF PROTECTION TO: Attorney: RE: PATIENT: I do hereby authorize the above doctor and corporations
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How to fill out letter of protection
How to Fill Out a Letter of Protection:
01
Begin by writing your full name and contact information at the top of the letter.
02
Provide the date when the letter is being written.
03
Address the recipient of the letter, which is typically the healthcare provider or facility that will provide the necessary medical treatment.
04
Clearly state the purpose of the letter, which is to inform the healthcare provider that you are requesting medical treatment on a lien or attorney letter of protection basis.
05
Include the name of your attorney or law firm representing you in the case.
06
Provide the details of the underlying legal case, such as the case number, names of involved parties, and any relevant court information.
07
Outline the specific medical treatment or services you are seeking. Be as detailed as possible to ensure there is no confusion.
08
Include any relevant documentation or records that support your need for the medical treatment, such as medical bills or physician referrals.
09
Clearly state that payment for the medical services will be made either through settlement proceeds or insurance coverage.
10
Express your gratitude for the healthcare provider's consideration and cooperation in treating you under the conditions stated in the letter.
Who Needs a Letter of Protection?
01
Individuals who have been involved in accidents or incidents that have resulted in injuries and require ongoing medical treatment.
02
Individuals who have filed a personal injury lawsuit and are seeking medical treatment while awaiting settlement or judgment.
03
Individuals who do not have health insurance or sufficient means to pay for medical treatment upfront but have legal representation and are pursuing compensation for their injuries.
04
Individuals whose attorneys recommend obtaining a letter of protection to ensure that the healthcare provider will be paid from the settlement or judgment proceeds.
05
Individuals who want to secure necessary medical treatment without the immediate financial burden of paying for it out of pocket.
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