Posted on 25 Jun 2025

Medical Negligence Claims in Australia: What You Can Claim and How the Process Works

What is a medical negligence claim?

A medical negligence claim involves suing a doctor, hospital or other medical professional for poor treatment. It’s also known as a medical malpractice case.

To make a successful claim, you’ll need to show that their care fell below a reasonable standard, and you were injured as a result.

Some of the most common examples of medical negligence claims include:

Surgical errors.
Misdiagnosis or delayed diagnosis.
Insufficient post-operative care.
Birth injury and pregnancy complications.

Paediatrics and gynaecology errors.
Improperly inserted implants.
Failure to advise of medical risks.
Referral errors by GPs.

Don’t worry if your situation isn’t listed — these are just a few examples of medical negligence claims we’ve helped clients win. If you’ve been injured due to a medical mistake, poor care, or treatment that just didn’t feel right, you could have a claim. Get in touch for a quick, free assessment, and our lawyers will let you know where you stand.

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How much compensation can I claim?

Medical negligence claim payouts can vary a lot depending on your specific circumstances. Things like how serious your injury is, how it affects your daily life, and how badly the medical provider failed in their duty of care all play a role.

If your injury is less severe, like a delayed diagnosis that caused short-term health issues, payouts often fall between $100,000 and $200,000. But if the negligence was extreme, such as a surgical error that led to permanent disability or the need for lifelong care, you could receive up to $10 million.

Depending on your case, your compensation could cover:

Lost income: including past wages, future earnings, and super contributions.
Care and support: whether from professionals or unpaid help from loved ones, plus extra compensation if you’re no longer able to care for someone who depends on you.
Other expenses related to your condition: such as medical treatment, travel, rehabilitation, or home and vehicle modifications.
Non-economic loss: also known as pain and suffering, this reflects the emotional toll of your injury.

In some states, you’ll need to meet a minimum threshold before you can claim compensation for non-economic loss. That means an independent medical assessor will evaluate your condition and give you a rating — known as Whole Person Impairment (WPI), Injury Scale Value (ISV), or Most Extreme Case (MEI), depending on where you live.

The more severe your injury, the higher your payout for non-economic loss. But keep in mind, many states have a cap on how much you can receive. Check the table below to see the threshold requirements and maximum amounts in your state.

State	Requirements for claiming non-economic loss	Maximum compensation for non-economic loss
NSW	Your injury must be assessed at over 15% of the Most Extreme Case (MEI).	$761,500
Victoria	You must meet the 'significant injury' threshold, which is either: • 5% or more Whole Person Impairment (WPI) for physical injuries, or • 10% or more WPI for psychological injuries.	$478,500
Queensland	Your injury will be awarded an Injury Scale Value (ISV) between 1–100. Your ISV must be 5 or more to qualify for non-economic damages.	$456,950
South Australia	Your injury will be given an Injury Scale Value (ISV) between 1–60. You can only claim damages with an ISV of 11 or more.	$478,500
Western Australia	• Your injury must be assessed at over 5% Whole Person Impairment (WPI), and • Your claim must be worth over $25,500. This amount increases every year with inflation.	No cap on damages.
Tasmania	Your claim must be worth more than $6,000. This minimum value increases every year due to inflation.	No cap on damages.
ACT	No requirements for claiming non-economic loss.	No cap on damages.

Who can you make a medical negligence claim against?

You can make a medical negligence claim against any registered healthcare provider in Australia. This includes:

Hospitals.
Surgeons.
General Practitioners (GPs).
Specialists.
Nurses.
Dentists.

Oncologists.
Radiologists.
Pharmacists.
Midwives.
Allied health professionals, including physiotherapists and occupational therapists.

Not sure if your provider is registered? You can search the national register on the Australian Health Practitioner Regulation Agency (AHPRA) website. Alternatively, just get in touch with one of our medical negligence lawyers and we’ll check for you.

How to claim for medical negligence

To claim for medical negligence, you’ll need to prove four key things:

‘Duty of care’ is a legal duty that requires certain people to act for the welfare and safety of others. Some special relationships automatically carry this duty, including doctor/patient and teacher/student. This means if you were treated by a registered medical professional, it’s likely they owed you a duty of care.

A breach of duty of care can happen in two ways — through a negligent action or failure to act. An example of a negligent action might be a surgeon accidentally leaving a scalpel inside your body after an operation. On the other hand, a negligent failure to act could be your GP failing to refer you to a specialist when you show signs of a serious condition.

To figure out whether your doctor breached their duty of care, we use what’s called the ‘reasonable standard of care’ test. This means asking: would another medical professional have done the same thing in that situation? If the answer is no, then your doctor probably breached their duty of care.

Medical negligence compensation claims require more than just a breach of duty — you need to show a direct link between the breach and your injury or illness. This involves meeting two criteria:

Causation: your injury or illness directly resulted from your medical professional’s actions or inactions.
Foreseeability: your injury or illness was a ‘reasonably foreseeable’ outcome of the treatment (or lack thereof) provided by your medical professional.

The final step is to show that you suffered ‘loss’ as a result of your injury or illness. This could be lost income, medical expenses, or pain and suffering.

Medical negligence claims are extremely difficult to prove, especially when you’re dealing with complex medical details and strict legal requirements. That’s why our lawyers undergo decades of training in both medicine and law. This rare combination of expertise means they can prove negligence in even the most complicated cases.

How does the medical negligence claim process work?

Every claim is slightly different, but the average medical negligence claim procedure follows these steps:

In your free consultation, you’ll speak directly with one of our expert medical negligence lawyers about what’s happened. We’ll let you know if you’re likely to have a claim, give you an idea of how much compensation you could receive, and talk through your chances of success. There’s no pressure to go ahead — but if you do decide to move forward, you’ll be protected by our No Win No Fee guarantee.

Your lawyer will begin by carefully reviewing your medical records and history to understand exactly what went wrong. If needed, we’ll bring in one of our trusted medical experts to assess your condition. We cover all the costs for these assessments, and you won’t pay a cent unless we win your claim.

We’ll also notify the medical professional (and any others involved) and request a full copy of their records to support your case.

We team up with trusted medical experts — like GPs, surgeons, and liability specialists — to gather detailed reports and key evidence that support your case. If your injury affects your ability to work or cuts down your hours, we’ll also bring in vocational experts to assess how it impacts your earning capacity now and into the future.

Once we’ve built strong expert evidence, we kick off court proceedings by filing the required documents and sharing evidence with the insurer. From there, your case moves to mediation, where our lawyers negotiate confidently and strategically to get you the best possible compensation.

Most medical negligence cases are resolved at mediation, without the need to go to court. At this stage, your lawyer handles all the negotiations, using the evidence we’ve gathered to push for the best possible result. If a settlement isn’t reached, we’ll guide you through your options and support you every step of the way.

Examples of medical negligence claim payouts

Sam wins $10mil for severe negligence during surgery

Sam was a healthy, working father before a botched surgery left him unable to speak, walk, or swallow. He now requires round-the-clock care from his wife.

Our lawyers engaged top medical experts who confirmed that the hospital’s negligence caused Sam’s quadriplegia. Using this evidence and our deep experience in medical negligence cases, we challenged the hospital’s defence and negotiated a $10 million settlement. This substantial amount ensures Sam and his family get the lifelong care and support they need.

Read Sam's full story

Hospital liable for $2.5mil despite warning Amy about risks

After surgery to remove her ovaries and fallopian tubes, Amy was left permanently disabled due to an undetected bowel perforation. Though she was warned of the potential risks, our lawyers suspected the hospital had acted negligently.

Our lawyers brought in leading medical experts who confirmed the hospital failed to take proper precautions and missed Amy’s injury during surgery. Armed with this evidence, we began proceedings in the Supreme Court. The hospital originally denied fault, but after we provided further expert evidence, they eventually admitted responsibility. In the end, we secured Amy a $2.5 million settlement to support her care and recovery.

Read Amy's full story

Do time limits apply to medical negligence claims?

Time limits apply to every medical negligence claim in Australia, but the exact deadline depends on which state you’re in:

NSW, VIC, SA and TAS	3 years of realising you have a claim
QLD, WA, NT and ACT	3 years from the injury date

If you’re outside the time limit, don’t worry — you may still have a medical negligence claim. Several key exceptions apply to time limits, like not knowing your injury was caused by negligence or being out of state.

Our expert lawyers know the rules in every state and can help determine which exceptions fit your situation. Over the years, we’ve helped hundreds of clients get their delayed medical negligence claims approved.

How long does a medical negligence claim take?

How long your medical negligence claim takes depends on a few factors, like how complex it is, the severity of your injuries, and how well your claim is prepared. But generally speaking, most medical negligence claims are resolved within 12 – 18 months.

To get a better idea of how long your claim could take, get in touch for a free consultation. Once we know the facts of your situation, our medical negligence lawyers can provide a more accurate timeline.

Is making a medical negligence claim worth it?

Deciding to pursue a medical negligence claim can feel overwhelming, especially during such a difficult time. But at Monaco, we believe it’s always worth holding medical professionals accountable and standing up for your rights as a patient.

When you make a medical negligence claim, you can expect:

Financial compensation: this covers medical bills, lost income, ongoing care, and the negative impact of the injury on your life.
Accountability and change: this ensures healthcare providers are held responsible, helps prevent future errors, and improves the quality of medical care for all Australians.
Support and closure: if you need help around the house, a medical negligence claim can ease the burden on your loved ones by covering the cost of professional care or compensating those who support you. It can also bring much-needed closure and peace of mind for you and your family.

How can a lawyer help with my medical negligence claim?

Medical negligence claims are complex, requiring a deep understanding of both law and medicine. To succeed, you need a lawyer who can pinpoint what went wrong, explain how your treatment fell short of professional standards, and clearly link that failure to your injury.

When you work with one of our experienced medical negligence lawyers, we will:

Listen carefully to your story and offer practical legal advice on your rights.
Gather strong evidence to prove negligence and the full extent of your losses.
Challenge the other side’s evidence using expert reports and medical testimony.
Offer a second opinion if another lawyer has said that you don’t have a case.
Identify extra claims that could boost your total payout, like Total and Permanent Disability (TPD).
Fight to get you the maximum compensation you’re entitled to.

Our team is specially trained in medical negligence and backed by a trusted network of doctors and experts. This means we have the skill and experience to take on even the biggest healthcare insurers — and win.

Can I make a No Win No Fee medical negligence claim?

Yes, you absolutely can. We’re proud to offer a genuine No Win No Fee guarantee for all medical negligence claims. That means we cover every upfront cost, and you won’t pay anything unless your claim succeeds.

What sets us apart? Many firms only cover their legal fees, leaving you to pay for things like expert reports, court fees, and medical assessments if your case doesn’t succeed. In contrast, our No Win No Fee guarantee covers every cost related to your claim.

Plus, if your claim is successful, our fees are capped at just 30% of your total payout — far below the industry standard of 50%. And in most cases, we recover our fees from the other side, so you keep more (if not all) of your compensation.

For a more precise estimate, contact us today. In a free consultation, we’ll explain your options and provide a transparent cost breakdown for your medical negligence claim.

Frequently asked questions

To prove a medical negligence claim, strong evidence is absolutely essential. Our general rule with evidence is ‘more is more’, so make sure to collect everything that could be relevant to your injury or treatment. This may include:

Your medical records: such as hospital and GP records, specialist reports, scan results, surgical notes, prescriptions and discharge summaries.
A timeline of events: a detailed log of what happened and how your symptoms developed, including dates.
Expert medical evidence: reports from medical experts in a similar field to your medical professional, outlining how their treatment fell below a reasonable standard.
Psychological assessments: showing how the injury had negatively impacted your mental health and daily function.
Payslips: to show your past income and how much you’ve lost as a result of your injury. It’s also helpful to provide copies of past tax returns.
Receipts related to the injury: including medical treatment, medication costs, hospital stays, and any other costs you’ve incurred.
Photos or videos: showing your injury and its progression, as well as any changes you’ve made around the house to accommodate your condition.

Importantly, you don’t need to gather all this evidence yourself. Our lawyers know exactly what’s needed to build a strong medical negligence claim and will handle the process for you. We’ll collect the right records, arrange expert assessments, and deal directly with doctors, hospitals, and government bodies — so you can focus on recovery.

Medical negligence claims are generally only available to people who’ve been directly injured. So, if your loved one passed away due to a medical professional’s mistake, you can’t make a claim on their behalf. But that doesn’t mean you can’t seek compensation — there are just different types of claims available.

Depending on your circumstances, you may be eligible to make one (or more) of the following claims:

Dependency claims: if you relied on the deceased for financial support.
Nervous shock claims: if you developed a psychiatric illness due to their death.
Loss of services claims: if they provided unpaid help, like cleaning or childcare.

These claims can offer meaningful financial relief, especially during an incredibly tough time. Let’s explore each of them in more detail.

Dependency claims

If you depended on your loved one’s income to cover daily expenses, you may be able to make a dependency claim. Eligible people typically include spouses, de facto partners, children, parents and siblings. However, other people who were financially dependent on the deceased may be covered, too.

Your compensation amount will depend on:

Your age and relationship to the deceased.
Their income before passing.
How much they contributed to your living expenses.
Any future financial needs, like education or care.

Essentially, the goal is to replace the financial support you would’ve continued receiving if they were still here.

Nervous shock claims

If the loss of your loved one caused you to develop a psychiatric condition, such as PTSD, depression or anxiety, you may be able to make a nervous shock claim.

It’s important to know that emotional distress or grief alone isn’t enough. You must have a formal psychiatric diagnosis.

Compensation may cover:

Medical treatment and counselling.
Lost income caused by your condition.
Pain and suffering.

Loss of services claims

If the person who passed away used to help with tasks like cooking, childcare or school drop-offs, you may be entitled to claim for the loss of these ‘gratuitous services.’

To calculate this, the court looks at:

How much time they spent helping each week.
The nature of their assistance (e.g. were they your child’s primary carer?).
How the burden now falls on others in the household or requires paid help.

If you’re unsure which of these claims may apply to your situation, we’re here to help. Our specialist medical negligence lawyers will listen to your story, explain your options, and guide you through the process.

Medical negligence and medical malpractice are just two names for the same type of claim. The term ‘malpractice’ is more often used in the US, while ‘negligence’ is more commonly used in Australia. However, they both refer to situations where a healthcare provider fails to meet the expected standard of care, and someone is harmed as a result.

To make a successful claim under either term, you’ll need to prove the same key elements: that your medical professional breached their duty of care, that this breach caused your injury, and that the injury led to physical, emotional or financial loss.

In most medical negligence claims, you need to prove that:

The medical professional acted below the standard of care, and
Their action directly caused your injury.

But in failure to warn claims (also called lack of informed consent claims), the focus is on what the doctor didn’t do — specifically, not warning you about a known risk of the procedure or treatment.

To succeed, you generally need to prove three things:

The doctor didn’t warn you about a ‘material risk’. This is one that a reasonable patient would want to know about, such as the likelihood of a potential injury, its potential severity, and any alternative treatment options.
If you had known, you would have declined or delayed the treatment.
The risk actually occurred and caused your injury.

Failure to warn claims can be harder to prove than standard medical negligence cases. That’s because the focus is on what didn’t happen — what your doctor failed to tell you, and what you would have done differently if you’d been properly informed. These kinds of claims involve more hypotheticals and subjectivity, so they often require extra evidence to succeed.

If you’ve been injured or suffered a negative outcome because a medical professional didn’t properly warn you of the risks, you may be entitled to compensation. Get in touch with our expert medical negligence lawyers today. We’ll explain your rights and how much you could claim, completely free of charge.

Medical negligence claims in Australia are generally governed by the Civil Liability Act in each state or territory. For example, medical negligence claims in Sydney are covered by the Civil Liability Act 2002 (NSW), while medical negligence claims in Perth fall under the Civil Liability Act 2002 (WA).

This legislation sets out important rules about:

Whether a healthcare provider breached their duty of care.
Whether that breach caused your injury.
How your compensation is calculated.

Since the laws vary slightly between states, it’s important to have a lawyer who specialises in medical negligence in your state. At Monaco, each member of our medical negligence team focuses on a specific state, so they know the local laws inside out. This means they can clearly explain your exact entitlements and get you the maximum compensation possible for your state.