Legal LOP Document

LEGAL LETTER OF PROTECTION (LOP)

This Letter of Protection (the "Agreement") is entered into as of by and between Attorney Firm Name: representing Client Name: whose address is (collectively, "Attorney" and "Client"), and Healthcare Provider Name: located at ("Provider"). Attorney and Provider are referred to herein collectively as the "Parties."

RECITALS

WHEREAS, Client sustained injury on or about (the "Incident") and has retained Attorney to pursue claims arising from the Incident.

WHEREAS, Provider has rendered and may render medical and related services to Client for injuries sustained in the Incident and requires assurance of payment from any recovery in Client's claim; and

WHEREAS, Attorney is willing, subject to the terms and conditions set forth below, to protect Provider's lien or claim against proceeds of any recovery obtained on behalf of Client.

NOW, THEREFORE, in consideration of the mutual covenants contained herein, the Parties agree as follows:

1. DEFINITIONS

1.1 "Recovery" means any and all sums recovered by settlement, judgment, arbitration award or otherwise in connection with claims arising from the Incident, whether designated as compensatory damages, settlement proceeds, or otherwise, before or after deduction of costs and attorney's fees.

1.2 "Protected Charges" means the reasonable and customary amounts due to Provider for services rendered to Client related to the Incident, as documented in Provider's billing records and accepted by the Parties under this Agreement.

2. PROVIDER OBLIGATIONS

2.1 Provider shall render further necessary treatment to Client, consistent with Provider's customary standards of care, subject to Provider's internal policies. Provider acknowledges that continuation of non-emergency treatment is provided pursuant to the protections and limitations set forth in this Agreement.

2.2 Provider shall prepare and maintain contemporaneous medical records and itemized billing statements detailing services and charges related to the Incident, and shall produce such records to Attorney upon reasonable request in order to verify Protected Charges.

3. ATTORNEY OBLIGATIONS

3.1 Attorney agrees to protect Provider's claim for payment from any Recovery obtained for Client by: (a) preserving Provider's lien or equitable claim to the proceeds of any Recovery to the extent of Provider's Protected Charges; (b) holding in trust for Provider such portion of any recovered funds as are necessary to satisfy Provider's Protected Charges, subject to the terms of this Agreement; and (c) refraining from disbursing settlement or judgment funds to Client or other creditors until Provider's claim has been satisfied or otherwise resolved as provided herein.

3.2 Attorney shall provide written notice to Provider within ten (10) days after any offer of settlement, arbitration award, or judgment is received that would give rise to Recovery, identifying the proposed gross Recovery amount and proposed distribution of funds, and shall allow Provider at least seven (7) calendar days to assert any dispute in writing prior to disbursement.

4. PATIENT AUTHORIZATION AND ASSIGNMENT

4.1 Client hereby authorizes Provider to furnish Attorney with copies of medical records, billing statements, and other documents reasonably necessary to establish Provider's charge and to pursue reimbursement from any Recovery. Client further authorizes Attorney to withhold and disburse Recovery proceeds as required by this Agreement.

4.2 Client assigns to Provider, to the extent necessary to secure payment of Protected Charges, an interest in any Recovery and authorizes Provider to assert and record any lien, charge, or security interest permitted by law.

5. LIEN; PRIORITY; SUBROGATION

5.1 Provider's right to payment under this Agreement constitutes a claim against the Recovery. Where permitted by law, Provider may record and enforce a lien against settlement proceeds or a fund arising from Client's claims. Provider shall take reasonable steps, consistent with applicable law, to perfect such lien.

5.2 Any insurer, tortfeasor, or third party making payment of Recovery shall be entitled to rely on Attorney's representations regarding outstanding Protected Charges only if Attorney has provided written notice to the payor and provided a reasonable accounting of amounts withheld.

6. PAYMENT AND DISPOSITION OF FUNDS

6.1 From Recovery proceeds actually received by Attorney, Attorney shall first pay reasonable and documented costs and expenses incurred in obtaining such Recovery to the extent permitted by law and by prior agreement with Client, then attorney's fees as agreed with Client, and thereafter remit to Provider the amount of Provider's Protected Charges, unless Provider and Attorney agree otherwise in writing.

6.2 In the event the Recovery is insufficient to satisfy all claims and obligations, Provider's recovery shall be limited to the remaining funds after payment of statutory liens, costs of litigation, and reasonable attorney's fees, unless Provider's lien is otherwise legally senior.

7. LIMITATIONS; EXCLUSIONS

7.1 This Agreement does not obligate Attorney to accept an offer of settlement nor to pursue claims to judgment. Provider acknowledges Attorney's duty to act in Client's best interests and consents that Attorney may compromise claims subject to meeting Client's instructions and legal obligations.

7.2 Provider's assurance of payment hereunder shall not extend to services unrelated to the Incident unless expressly stated in writing and signed by both Parties.

8. REPRESENTATIONS AND WARRANTIES

8.1 Each Party represents and warrants that it has full authority to enter into this Agreement, that the execution and performance hereof will not violate any other agreement, and that the signatory executing this Agreement on its behalf is authorized to do so.

9. INDEMNIFICATION

9.1 Provider shall indemnify and hold harmless Attorney from and against any claims arising from Provider's negligence, malpractice, or breach of this Agreement. Attorney shall indemnify and hold harmless Provider from and against any claims arising from Attorney's negligent misrepresentation of amounts withheld or disbursed contrary to the terms of this Agreement.

10. NOTICES

All notices required or permitted under this Agreement shall be in writing and delivered by hand, certified mail (return receipt requested), or nationally recognized overnight courier to the addresses set forth below or to such other address as either Party may designate by written notice.

11. AMENDMENT; WAIVER; COUNTERPARTS

11.1 This Agreement may be amended only by a written instrument signed by both Parties. No waiver of any breach or default shall be deemed a waiver of any subsequent breach or default.

11.2 This Agreement may be executed in counterparts, each of which when so executed and delivered shall be deemed an original, and all of which together shall constitute one and the same instrument.

12. GOVERNING LAW

12.1 This Agreement shall be governed by and construed in accordance with the laws of the state of without regard to its conflict of law principles.

13. ENTIRE AGREEMENT; SEVERABILITY

13.1 This Agreement constitutes the entire understanding and agreement between the Parties with respect to the subject matter hereof and supersedes all prior agreements, negotiations and understandings, oral or written.

13.2 If any provision of this Agreement is held to be invalid, illegal or unenforceable by a court of competent jurisdiction, the remaining provisions shall continue in full force and effect.

14. DISPUTE RESOLUTION

14.1 The Parties agree that any dispute arising out of or relating to this Agreement shall first be the subject of good faith negotiations between senior representatives of the Parties. If the dispute is not resolved within thirty (30) days, the Parties may proceed to mediation. If mediation fails, either Party may pursue any remedy available at law or in equity.

ADDITIONAL TERMS

Provider will hold Client's account open and continue non-emergency treatment pending resolution of Client's claim, subject to Provider's clinical judgment and this Agreement.

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