Detailed answer
This article explains how medical providers commonly agree to treat injured people under a lien or a “letter of protection” (LOP) in Indiana, what that arrangement means, and practical steps you can take to find a doctor, clinic, or facility that will provide care on that basis.
What “treating on a lien” means
When a provider treats you on a lien or under a letter of protection, the provider agrees to defer payment now and look to any future recovery (a settlement or judgment) in your personal injury case for payment. The agreement usually must be written. Many providers will accept a signed LOP from your attorney promising that medical charges will be paid from the proceeds of your claim.
How this typically works in Indiana
- You receive medical care following an injury caused by someone else.
- You or your attorney asks a provider to treat you on an LOP or medical lien.
- The provider accepts a written agreement that it may be paid from any recovery you obtain in the claim.
- When you settle or obtain a judgment, the provider submits its bill and enforces the lien or LOP against settlement proceeds, often after negotiation.
Indiana law does not stop parties from agreeing to LOPs or contractual liens between a patient and provider. For specific statutory liens (for example, certain hospital or government liens), consult the Indiana Code at the Indiana General Assembly website: https://iga.in.gov/.
Who will treat on lien
Providers vary. Commonly willing providers include:
- Independent urgent care centers and some specialty clinics
- Orthopedic groups and physical therapy clinics with experience in personal injury claims
- Some hospitals or hospital-affiliated clinics (often only with written contractual arrangements)
- Individual physicians who have experience with personal injury cases
Large hospital systems may impose stricter rules or require partial payment. Smaller clinics often offer more flexible lien arrangements because they regularly work with personal injury attorneys.
Practical steps to find a provider in Indiana who will accept a lien
- Call personal injury attorneys for referrals. Many attorneys maintain lists of providers who commonly accept LOPs. If you have not retained counsel, ask for a free consultation and request provider referrals during that meeting.
- Ask providers directly. Call doctors, urgent care centers, specialists, and physical therapy clinics and ask whether they accept treatment on a medical lien or letter of protection. Ask what documentation they require and whether they accept LOPs from attorneys.
- Contact billing offices. The medical-records or billing office often handles lien arrangements. Ask about their lien agreement form, billing rates, and whether they will reduce billed charges if the case settles.
- Get any promise in writing. Do not rely on verbal assurances. Ask the provider to give a written LOP or lien agreement that explains who is responsible for payment if you do not recover money.
- Consider an attorney to issue an LOP. Many providers will accept an LOP only from a licensed attorney. Hiring counsel early makes it easier to secure care and to coordinate billing and settlement steps.
- Search for clinics that advertise lien/LOP services. Some clinics state on their websites that they accept medical liens or letters of protection for personal injury patients.
- Verify scope and limits. Ask whether the lien covers only specific services and whether the provider will place a lien on the settlement or record the lien locally. Get time limits and conditions in writing.
Important legal and practical considerations
- Responsibility if you do not recover. If you do not win or settle your claim, you may become personally responsible for medical bills the provider deferred. Ask the provider what happens in that situation and whether it will pursue you in collections.
- Negotiation and reductions. Providers sometimes accept less than billed amounts at settlement. Ask whether they will negotiate and whether they require a particular portion of the net settlement (after attorney fees and costs).
- Attorney involvement. An attorney can protect your interests: negotiate medical liens, attempt to reduce medical bills, and structure a settlement so providers are paid from proceeds before you receive net funds.
- Document everything. Keep copies of all lien agreements, bills, records of conversations, and any letters of protection.
- Priority of liens. Different liens may have different priority rules. If government entities, hospitals, or other claimants assert statutory liens, the ordering can be complex. For statutory questions, review Indiana statutes at https://iga.in.gov/ or talk to an attorney.
Example (hypothetical)
Suppose you are in a motor-vehicle crash and need orthopedic care but lack insurance. You call a local orthopedic clinic. The billing manager says they will accept a written LOP from a personal injury attorney. You speak with a lawyer, the lawyer issues an LOP to the clinic, and you begin care. After a settlement, the clinic is paid from the settlement proceeds according to the LOP terms. If you had no attorney and no recovery, the clinic would expect payment or might send the account to collections.
Helpful hints
- Ask providers up front if they accept letters of protection and what documentation they require.
- Try to retain an attorney early. Attorneys commonly coordinate LOPs and protect your ability to receive care without immediate payment.
- Request any lien or LOP in writing before receiving extensive treatment.
- Confirm whether billed charges or discounted amounts will be claimed from any recovery.
- Keep clear records of: medical visits, bills, communications about lien terms, and any signed lien/LOP documents.
- Be aware that some providers will not accept LOPs and may require insurance or payment up front.
- If you face a hospital or government lien, consult an attorney to understand statutory priorities and enforcement — you can start by reviewing the Indiana Code at https://iga.in.gov/.
Disclaimer: This information is educational only and not legal advice. It does not create an attorney-client relationship. Laws change and every case is different. For guidance about a specific situation in Indiana, consult a licensed Indiana attorney who handles personal injury cases.