How much compensation will I get for a medical negligence claim?

Quick answer

How much compensation you receive for a medical negligence claim depends on:

  • The severity of your injuries.
  • The state you live in.
  • The strength of your negligence claim.

You’re entitled to compensation for lost wages, medical expenses, domestic assistance, as well as the pain and suffering your injury has caused you.

For free advice on what you may be eligible to claim, call us today.

In depth answer

In a medical negligence case, there are a number of different components to your compensation. This includes ‘economic losses’, ‘non-economic losses’, necessary medical treatment and equipment, as well as the cost of care and assistance.

While ‘economic losses’ are the income you’ve lost due to your injury, ‘non-economic losses’ relate more to the negative impact the injury has had on your life.

In some states, non-economic loss does not have a specific dollar value attached, meaning could receive a substantial lump sum payment. In other states, non-economic loss is capped by legislation.

Before starting your claim, it’s crucial to speak to an experienced medical negligence lawyer. We have a strong understanding of how medical negligence differs between states, and will provide free advice tailored to your individual situation.

What you can claim

Non-economic losses

  • Pain and suffering.
  • Loss of opportunity.

Economic losses

  • Lost income (both past and future).
  • Lost superannuation (both past and future).

Medical treatment and equipment

  • Medical treatment and expenses (both past and future).
  • Travel between home and medical treatment appointments.
  • Modifications to your home and vehicle.

Care and assistance

  • Professional in-home care or unpaid assistance by a loved one. This also includes loss of capacity of care for someone who depends on you.

In most cases, you will be entitled to compensation for medical treatment and equipment. If you’ve been forced to stop work because of your injury or illness, you will also receive compensation for your economic losses.

To be eligible for non-economic losses — as well as care and assistance — you must meet your state’s specific criteria.

Below, you’ll find our state-by-state guide to medical negligence compensation.

In NSW, the current maximum compensation for non-economic loss is $722,000. This amount was set on 1 October 2023 and increases every year according to inflation.

Your compensation is calculated by comparing your injuries to the ‘Most Extreme Case’ (MEC). Your injuries must meet a minimum threshold of 15% of the MEC before you’re eligible for non-economic loss compensation. The exact amount you get depends on your MEC percentage.

If your MEC is above 35%, you receive 1% of the maximum compensation for every 1% of MEC. For example, an MEC of 50% would entitle you to 50% of the maximum compensation. Currently, this is $361,000.

If your MEC is between 15 – 33%, your payout is based on the table in Section 16 of the Act. These calculations are similar to the 1% rule but increase in 0.5% increments instead.

Importantly, if your MEC is below 15%, you can still claim for economic loss.

In Queensland, your non-economic loss compensation (known as ‘general damages’) is determined by your Injury Scale Value (ISV). After your injuries are assessed by a medical expert, you will be given an ISV between 0 and 100.

An ISV of 0 indicates that you have completely recovered, and your injury will have no lasting effects. An ISV of 100, on the other hand, is reserved for clients with severe, permanent incapacity, such as quadriplegia or a significant brain injury.

Your total compensation is calculated by adding together your ‘base compensation amount’ (for past losses) and ‘variable compensation amount’ (for future losses).

Your base compensation is an amount set out in the legislation and based on your ISV.

In contrast, your variable compensation amount is calculated according to this formula: (ISV – 5) x $1,970.

Say, for example, you have an ISV of 6.  Your base compensation amount is set at $8,450. Your variable compensation calculation is then (6 – 5) x $1,970, leaving you with $1,970. In total, you will receive $10,420.

For the full compensation calculations table, see Schedule 7 of the Act.

In Victoria, $713,780 is currently the maximum compensation for non-economic loss. This amount was set on 1 July 2023 and increases every year with inflation.

At the start of your claim, your Whole Person Impairment (WPI) must be assessed by a medical practitioner. You are only entitled to compensation if your WPI is:

  • 5% or more (for spinal injuries).
  • Greater than 5% (for other physical injuries).
  • 10% or more for psychiatric injuries.

In addition, certain ‘significant’ injuries automatically entitle you to a non-economic loss claim. These include:

  • Loss of a breast.
  • Loss of a foetus.
  • Psychiatric injury that results from losing a child before, during or immediately following birth.

Once you’ve met the minimum requirements, the court will determine the amount of compensation you receive.

In the ACT, there is no cap on the amount of compensation you can receive for non-economic loss.

Whilst you don’t have to meet a minimum impairment threshold, your compensation is based on impact of the injury on your life. The court will also look at previous decisions similar to your case.

You can read more about the ACT’s limitations on non-economic loss in section 139F of the Act.

Unlike other states, Western Australia has no limit on compensation for non-economic loss. However, you must meet two minimum thresholds to be eligible for compensation:

  1. Your Whole Person Impairment (WPI) must be assessed at 5% or more. If you’re under this, you can only claim for economic losses.
  2. Your claim value must be $23,500 or more.

Once you’ve met both thresholds, your total compensation depends on exactly how much your claim is worth:

  • $23,500 – $68,000: you receive the value of your claim minus $23,500.
  • $68,000 – $91,500: you receive the value of your claim minus a percentage of the first $23,000.
  • $91,500 and over: you receive the exact value of your claim

The only exception is if you’re making a ‘gratuitous services’ claim. These are unpaid domestic tasks such as childrearing, cleaning and cooking. In this case, the minimum claim value is only $7,000.

In South Australia, $406,420 is currently the maximum compensation for non-economic loss. This amount applies to claims in 2023 and increases each year with inflation.

To be eligible for compensation, you must meet one of two requirements:

  • The injury ‘significantly impacted’ your life for at least 7 days, or
  • Your medical expenses have reached the ‘prescribed minimum’ (currently $4,720).

Once you’ve met either requirement, your injuries will be examined by an independent medical practitioner. They will assign you an Injury Scale Value (ISV) between 0 and 60.

Your total compensation is then determined by a sliding scale outlined in Part 8 of the Act.

Tasmania has no cap on non-economic compensation.  However, you will need to meet a minimum claim value threshold of $6,000.

For claims worth between $6,000 and $35,000, your compensation is based on the following calculation: (your claim value – $6,000) x 1.25.

For claims worth over $35,000, you’re entitled to that exact amount of compensation. This figure was set on 1 July 2023 and increases annually with inflation.

If your claim is worth less than $6,000, you’re only entitled to compensation for economic loss.

How can a lawyer help me get more compensation?

An experienced medical negligence lawyer will secure you maximum compensation for your injuries.

In our experience, insurers treat unrepresented claimants poorly, often making unreasonable requests or pressuring them to accept unfair offers. A specialist medical negligence lawyer understands these scare tactics and can help you counter them. They will also handle all negotiations to ensure you get the best possible settlement.

On top of this, we will make sure your impairment assessment results are accurate and fair. This is essential as your results can greatly impact your final compensation. If the assessment is unfair or inaccurate, we’ll challenge the decision using our network of medical experts.

As part of our No Win No Fee guarantee, we cover all upfront costs related to your claim, including medical reports, medical records, attendances at assessment appointments, and any other expert evidence which may be required to prove your claim. If we’re unsuccessful, you will never receive a bill from us.

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