Part 3: How much is my claim worth? – Medical Expenses

Emily Billiau

Principal

Medical Expenses are a crucial part of all claims for compensation. 


Why? Well apart from the obvious fact they pay for the cost of any medical treatment...


... compensation for medical expenses allows you to recover to your fullest extent as it removes the stress of working how you are going to afford it. 


It also gives you access to the tools needed to get back on with life, if you are unlikely to make a full recovery. 

We are continuing our four-part series on discovering the areas that your can claim under. 

Understanding these areas, will allow you to estimate how much your claim is worth. 

In this article, we unpack what medical expenses you can claim for, some example claims and the evidence you will need when approaching the insurers.

Don't forget to read  Part 1 on future economic loss and Part 2 on care costs

What are medical expenses?

Without stating the obvious too much, medical expenses relate to the costs of rehabilitation following an injury.

The expenses include both past fees that were already paid for, as well as future medical costs.


How much can you claim?

As is the case in every other area of compensation, the amount that can be recovered will vary depending on the individual’s treatment plan and care needs.

Some real-life case examples have been provided.

Example 1 - Slip & fall, permanent brain injury

Adam was cycling home from work one afternoon when a car failed to see him ahead and collided into the rear of Adam's bicycle.  Adam was throvn over his handlebars and landed heavily on his right shoulder. The force of the fall smashed his head into the ground. Despite the fact he was wearing a helmet, Adam suffered a brain injury. He was kept in hospital for a week to monitor his head and other injuries.

Adam has substantial memory deficiencies now. He finds it difficult to concentrate and had to relearn basic skills including walking and talking. 

Beyond that, he has significant post-traumatic stress disorder after the accident and cannot be in a car, let alone a bicycle. 

To facillitate his recovery, Adam requires comprehensive rehabilitation including physiothereapy, pyschology and others. He also needs the help of various assistive technologies to aid his walking.  

Because his life was irrevocably changed at such a young age and he requires significant ongoing treatment and assistive technology, Adam was awarded $409,000 toward his medical expenses.

Example 2 – pedestrian accident, ongoing hard damage

John was cycling along Moggill Road when a driver suddenly exited their driveway onto the road, taking John out with them. 

John flew over the back of the car. He landed heavily on the road, breaking his left ankle in the process.

The significant impact also caused nerve damage to his right arm. After much rehabilitation, John's nerve damage still causes him constant pain. He now requires regular doses of pain killers to manage his ongoing injury. 

John was awarded as part of his compensation a total of $32,496 for the cost of his past and future medical expenses (including medical appointments, medications and rehabilitation treatment).


What can you claim?

Some typical medical expenses that are included in a compensation claim include:

  • Hospital bills
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    Diagnostic testing expenses (laboratory fees)
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    Surgery costs
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    Therapy and rehabilitation costs (including physio, massage, psychology and much more)
  • Cost of prescription medicines
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    Cost of future home modification
  • Cost of any assistive technology required (crutches, wheelchairs, modified cars etc.)
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    Pain management

For this reason, it's essential to be very thorough when documenting injuries in your claim file so that it is possible to calculate damages to account for future problems.

It is also important to attend all medical appointments or therapy sessions.


What evidence will you need?

Proving these expenses may require the help of an expert medical professional. Usually, thorough documentation is needed to calculate the total costs of medical treatment. These may include the presentation of various items of evidence in court, such as:

  • Hospital bills;
  • Chiropractor or medical therapy costs;
  • Medical treatment receipts;
  • Pharmaceutical bills; or
  • Any other documents showing the costs of the medical expenses

Keeping a clear record of items related to your injury is paramount to maximising your compensation amount.

As the old bible saying goes – Ask, and you shall receive.


There are many cases we have seen where critical medical expenses have been left out of a person’s compensation because of inadequate documentation, or they just forgot to include it.


It is crucial to gain expert advice from occupational therapists and doctors on likely requirements you will need in the future.


Small expenses such as assistive technology and home modifications are often overlooked but can be so important to an injured person’s quality of life.

Emily Billiau

Principal

Keeping a record of the medical expenses (treatment costs, medications, assistive technology) you had due to your injuries is very important, as it can mean the difference between having a claim for care and assistance, or not having a claim at all.

Keep a spreadsheet that details the following:

  • Type of service or item
  • Service or item provider (doctor surgery or pharmacy)
  • Date of service/purchase
  • Cost of service/item
  • Will the service/item be required in the future and how often

To help ensure that you maximise your damages, keep in mind the following helpful tips:

  • Buy all of your prescriptions/dressings/painkillers etc. from the one pharmacy and ask your pharmacist to record all of your purchases.  When it comes time to claim your damages, you can simply obtain a printout from the pharmacy;
  • Keep receipts for any purchases that you have made;
  • Photocopy or scan those receipts, in case they get lost or destroyed;
  • Consistently fill out the table as each service is provided.

Next Steps...

Don't miss out on other aspects of your claims...

...read the other blogs in the series below.

Part 1: How much is my claim worth? – Future Economic Loss
Emily Billiau Principal ​Most people have heard of personal injury claims but very few would understand what quantum is. …and[...]
Part 2: How much is my claim worth? – Care Costs
Emily BilliauPrincipalCare costs can be the single most significant component of a claim. Particularly when the injured party doesn’t work (therefore[...]
Part 4: How much is my claim worth? – Pain & Suffering
Emily Billiau Principal It is a significant part of a compensation claim. Particularly for those who cannot claim wage losses,[...]

Written by Emily Billiau | Principal

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