Letter of Protection for Transportation in Illinois: A Guide

A Letter of Protection (LOP) is a written commitment from a personal injury attorney promising to pay a medical provider — or a medical transportation vendor — out of the client's eventual settlement. In Illinois, LOPs are a common mechanism for extending treatment to clients who cannot pay up front and do not have insurance that covers the service. This post explains how LOPs work for medical transportation, when to use one, and when Retainer or Firm-Pay is a cleaner alternative. Dream Care Rides supports LOP-backed trips under our legal transport program. Call (708) 505-6994.

What a Letter of Protection Actually Is

An LOP is a letter from a plaintiff's attorney to a provider or vendor that (a) identifies the client and the case, (b) commits the attorney to protect the provider's bill from settlement proceeds, and (c) authorizes the provider to extend service. It is not a lien by itself, and it is not a contract of insurance. It is a private agreement backed by the attorney's professional reputation and, in some cases, by a separate lien document filed under the Illinois Health Care Services Lien Act (770 ILCS 23).

What an LOP typically contains

• Attorney's firm letterhead, signature, and bar number
• Client name, date of birth, and case caption
• Identification of the provider (Dream Care Rides, for example)
• Services authorized (wheelchair transport to PT, for example)
• Commitment to notify the provider of settlement and to pay the outstanding balance from proceeds
• Acknowledgment by the client, typically with signature, authorizing the arrangement

How LOPs Interact with Illinois Law

Illinois law on LOPs is anchored in two places: ethics rules governing attorney advances, and the Health Care Services Lien Act.

IRPC 1.8(e) — attorney advances of case expenses

Illinois Rule of Professional Conduct 1.8(e) permits an attorney to advance court costs and litigation expenses on behalf of a client, with repayment contingent on the outcome of the matter. Medical transportation for injury-related treatment is widely treated as a reasonable litigation or case expense when the client needs access to medical appointments to document and treat the injury in question. A firm advancing transportation through an LOP or through direct Firm-Pay is operating within 1.8(e). For the full case-expense analysis, see transportation as a litigation expense in Illinois.

ISBA Opinion 95-06 — nuance on medical expense advances

ISBA Advisory Opinion 95-06 addresses attorney payment of medical expenses and counsels caution about attorneys becoming the payor of medical bills in a way that could be characterized as financial assistance beyond litigation expenses. The opinion is fact-specific and has been read narrowly over time, especially as modern case management has made provider advances common. Most Illinois practitioners treat transportation-to-treatment as a standard 1.8(e) expense rather than a medical expense of the type 95-06 restricts. That said, firms with complex matters should consult Illinois ethics counsel.

770 ILCS 23 — the Health Care Services Lien Act

If a transportation vendor files a formal lien under 770 ILCS 23, it competes with medical provider liens within the 40% individual / 60% aggregate caps. An LOP by itself is not the same as a filed lien — it is an attorney commitment — but some LOPs are paired with a formal lien filing. Firms should understand which is which. Dream Care Rides does not file liens under 770 ILCS 23. When we accept an LOP, we are relying on the attorney's commitment to pay from settlement, and the obligation sits with the firm, not the settlement pool.

When an LOP Makes Sense for Transportation

LOPs are most useful in these situations:

• New PI matters where liability is strong but cash flow is tight. Client needs to see the orthopedic surgeon next week; carrier is not paying yet; firm is still setting up the file.
• Single-case, non-recurring relationships. A firm that does not run enough transport volume to justify a Retainer can use an LOP to authorize a specific course of treatment.
• Matters bundled with other LOP services. If the client is already on LOP with a pain management group or an imaging center, adding transportation under the same framework is administratively simple.

When Retainer or Firm-Pay Is a Cleaner Choice

For firms that handle any meaningful volume of cases needing transportation, Retainer or Firm-Pay is usually the better fit:

• No per-case paperwork. An LOP is a one-off document that has to be executed, filed, and tracked. A Retainer covers every client automatically.
• No ambiguity about lien status. Retainer and Firm-Pay are vendor invoices, period. Not liens, not loans, not consumer products.
• Faster dispatch. Retainer clients get same-day service with no verification step. LOP trips may involve faxing paperwork before the first ride.
• Simpler settlement math. Firm-Pay invoices show up on the standard case-expense ledger at settlement. No separate lien reconciliation.

For a full comparison of these billing models, read retainer vs net-30 vs lien for medical transport law firms and how law firms pay for client medical transportation.

How Dream Care Rides Handles LOPs

We accept LOPs from Illinois plaintiff's firms for transportation services. To submit an LOP or talk through whether it is the right fit, call (708) 505-6994. Our process:

1. Attorney sends the LOP on firm letterhead, signed, with client details.
2. We create a file, confirm the service level needed (ambulatory, wheelchair, or stretcher), and schedule the first trip.
3. Every trip is itemized under the LOP file and invoiced monthly to the firm for tracking purposes.
4. At settlement, the firm pays the balance. Dream Care Rides does not file a separate lien; the commitment is between the firm and the vendor.

Illinois Pricing Under an LOP

An LOP does not change the published Illinois rate ranges:

• Ambulatory: $35 – $65 base, $2 – $4 per mile
• Wheelchair: $65 – $115 base, $3 – $6 per mile
• Stretcher: $300 – $525 base, $5 – $16 per mile

Weekends 1.5×, holidays 2.25×, wait time $15 – $30 per 15 minutes, oxygen $25, stair-chair $25. Rates are the same whether the payor is a retainer block, a Net-30 firm invoice, an LOP, or a carrier.

Frequently Asked Questions

What is a Letter of Protection in Illinois personal injury?

It is a written commitment from the plaintiff's attorney to protect a provider's bill from settlement proceeds. It is not a filed lien by itself, and it is not insurance. For transportation, an LOP authorizes Dream Care Rides to extend service on the understanding that the firm will pay from settlement.

Is an LOP the same as a lien?

No. An LOP is an attorney commitment. A lien is a formal legal filing against the settlement. Some providers pair the two; Dream Care Rides does not file separate liens. Our LOP files are paid by the firm directly.

Does Dream Care Rides require an LOP for all PI matters?

No. Most firms we work with use Retainer or Firm-Pay Net-30, which do not require LOP paperwork. LOPs are an option, not a requirement.

How does 770 ILCS 23 affect an LOP?

770 ILCS 23 caps aggregate health care provider liens at 60% of the settlement. If a transportation vendor files a formal lien under 770 ILCS 23, it competes inside that cap. An LOP alone (without a filed lien) is an attorney commitment, not a statutory lien, and does not count against the cap directly — though it still has to be paid from the settlement as an attorney obligation.

Can a client use an LOP if they also have workers' comp or MedPay?

Generally no — if there is a carrier available, Insurance Direct billing for workers' comp transportation is the first choice. LOPs are for gaps in coverage or contested cases. See our posts on workers' comp transportation coverage and workers' comp doctor appointment transport.

What happens if the case loses?

If there is no settlement, the LOP obligation still runs to the law firm under IRPC 1.8(e) contingent-expense principles. Dream Care Rides' expectation is that the firm will honor the commitment. We do not chase clients for payment on LOP files.

Submitting an LOP to Dream Care Rides: Practical Checklist

• Firm letterhead, attorney signature, Illinois bar number visible
• Client name, date of birth, case caption, case number (if filed)
• Identification of the injury and the general course of treatment
• Authorization of transportation services at the appropriate level (ambulatory, wheelchair, or stretcher)
• Date range or treatment milestone that the LOP covers
• Commitment language obligating the firm to pay the outstanding Dream Care Rides balance from settlement proceeds
• Client acknowledgment and signature

We do not require a specific template — most Illinois firms have their own. If you want a sample LOP that works smoothly with our Firm-Pay billing, call (708) 505-6994 and we will email one over.

LOP Settlement Timeline — What to Expect

Most Illinois PI matters that run through an LOP take 9 to 24 months from first treatment to settlement funding. During that period, Dream Care Rides holds the transportation invoices in open status under the LOP file. We send the firm a monthly statement summarizing open balances by client, which helps the firm track case expenses in real time and avoid surprises at settlement. When the case funds, the firm remits payment from the settlement ledger. If a specific trip is disputed at settlement, we resolve it with the firm directly — we do not bill the client.

Book an LOP-Backed Ride or Set Up a Retainer

Call (708) 505-6994 to submit an LOP or to discuss whether Retainer or Firm-Pay is a better fit for your firm's caseload. Dream Care Rides is based at 20000 Governors Dr Suite 103H, Olympia Fields, IL 60461 and serves all of Illinois — see our full coverage area. Visit our legal transport program or book online.

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Disclaimer: This article provides general information about medical transportation services. It is not legal advice. Law firms and clients should consult Illinois counsel regarding fee arrangements, IRPC 1.8(e) obligations, and applicable state regulations.