Letters of Protection: Getting Medical Care Without Upfront Payment

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An injured person who has no insurance or money for treatment may be offered care that the provider expects to be paid for out of a later settlement or judgment. Georgia’s medical expense statute, OCGA 51-12-1.1(d), names that arrangement: “a letter of protection or any other arrangement by which a healthcare provider renders treatment in exchange for a promise of payment for the plaintiff’s medical and healthcare expenses from any judgment or settlement of a civil action to recover damages resulting from injury or death to a person, regardless of how such arrangement is referred to.” The statute’s concern is disclosure: it lists what becomes relevant and discoverable when such an arrangement is used.

What Subsection (d) Makes Relevant and Discoverable

Under OCGA 51-12-1.1(d), “[i]n any claim for medical and healthcare expenses rendered under” such an arrangement, “the following shall be relevant and discoverable”:

  1. “A copy of the letter of protection”;
  2. “All charges for the plaintiff’s medical and healthcare expenses, which shall be itemized and, to the extent applicable, coded according to generally accepted medical billing practices”;
  3. “If the healthcare provider sells the accounts receivable for the plaintiff’s medical and healthcare expenses to a third party at less than the invoice price,” both “[t]he name of the third party” and “[t]he dollar amount for which the third party purchased such accounts receivable”; and
  4. “Whether the claimant was referred for treatment under a letter of protection or other similar arrangement and, if so, the identity of the person who made the referral.”

The Reasonable-Value Standard Around It

The rest of the statute frames how that information is used. In an action for injury or death, special damages for medical care are recoverable only as the Code section provides, and they are limited to the reasonable value of medically necessary care, as the trier of fact determines it (OCGA 51-12-1.1(a), (b)). For a plaintiff with public or private health insurance, the evidence of reasonable value includes both the amounts charged and the amounts actually necessary to satisfy them under the insurance contract (OCGA 51-12-1.1(c)). Subsection (d) makes a discounted sale of the account, the itemized and coded charges, and the referral source relevant within that framework.

Frequently Asked Questions

Does the statute cover a crash that happened before April 21, 2025?
No. Under Section 9(b) of the Act, as passed, Sections 6 and 7, which include OCGA 51-12-1.1, reach only causes of action arising on or after the Act’s effective date, and earlier ones stay under prior law; the Code’s history note for OCGA 51-3-57, enacted in the same Act, gives the effective date as April 21, 2025.

Can either side challenge the charges?
Yes. The Code section does not limit the right of a plaintiff or defendant to present evidence challenging the reasonableness of medical expenses, incurred or projected, or the medical necessity of any treatment (OCGA 51-12-1.1(f)).

Does the statute end the collateral source rule?
Only in part. The General Assembly’s stated intent is that the section abrogates the common law collateral source rule to the extent necessary to introduce the evidence the section describes, and the court may still give appropriate jury instructions on the role of collateral source payments (OCGA 51-12-1.1(e)).

Does the insurance evidence rule apply if the plaintiff’s insurance was never used?
Yes. The amounts necessary to satisfy the charges under the insurance contract are relevant regardless of whether the health insurance has been used, is used, or will be used to pay them (OCGA 51-12-1.1(c)).

  • OCGA 51-12-1.1(a), (b), (c), (d), (e), (f)
  • Senate Bill 68 (2025), as passed, Section 9(b); OCGA 51-3-57 (history note)

Disclaimer

This article provides general information about the Georgia statute that addresses letters of protection. It is not legal advice and does not create an attorney-client relationship. What the statute makes discoverable depends on the date the cause of action arose and the facts of the claim. Anyone considering medical treatment under such an arrangement should consult a licensed Georgia attorney promptly about the particular situation.

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