Past and future medical, therapy and rehabilitation costs may be recoverable when they are reasonable and connected to the negligently caused injury. Claims rely on records, receipts and expert recommendations. Not every expense is recoverable, and Medicare or NDIS issues may arise.
Documenting the treatment history
Past treatment costs are proven largely through records. This includes hospital admissions, specialist appointments, allied health sessions such as physiotherapy or speech pathology, medications and travel to appointments. Families can request health records, and both public and private providers have access processes.
Gaps in records are common in long claims. Bank statements, health fund statements and diaries can help reconstruct out-of-pocket expenses.
Future treatment recommendations
Future costs depend on professional opinions about what treatment the person will reasonably need. Experts may recommend ongoing therapy, surgery, assessments or medication over many years. These recommendations should come from qualified professionals, not assumptions. Recommendations for children may be revised as they grow and their needs become clearer.
Cost evidence
Once needs are identified, someone must put a price on them. Evidence may include current fee schedules, quotes from providers and economist calculations converting future costs into a present value. The other side may challenge frequency, duration or price.
- Itemised invoices and receipts
- Medicare and private health insurance statements
- Pharmacy records
- Therapy plans showing frequency and goals
- Provider quotes for proposed treatment
Relatedness to the injury
Only costs linked to the injury caused by negligent care are generally recoverable. If a child has several conditions, some unrelated to the delivery, experts may need to separate which treatment arises from which cause. Treatment must also be reasonable; experimental or unsupported therapies may be disputed. Families should not assume every expense will be included.
Government recoveries
Where Medicare paid for injury-related services, it may seek recovery from compensation. NDIS-funded supports may also be affected by compensation rules. Understanding these amounts helps families see what remains for future treatment.
For your next conversation
- Request hospital and allied health records for all treating providers
- Collect receipts and health fund statements for out-of-pocket costs
- Obtain written therapy plans from current therapists
- Ask treating specialists about anticipated future procedures
- List treatments funded by Medicare or the NDIS
Common questions
Can we claim for therapies our child tried that didn't help?
Possibly, if the therapy was reasonable to try at the time given professional advice and the child's needs. Expenses for therapies without professional support or clear connection to the injury may be challenged. Keep records showing who recommended each therapy and why.
How do experts estimate treatment costs decades into the future?
Experts identify likely future treatments based on current condition and expected progression, then price them using current fees. Economists may convert those future costs into a present lump sum using rules applying in the relevant jurisdiction. Estimates involve uncertainty and may be contested.
Sources & further reading
- OAIC: access health information (opens in a new tab)
- NDIS: compensation calculator (opens in a new tab)
- Services Australia: Medicare compensation recovery (opens in a new tab)
These references support the topic’s starting points. They do not determine the facts, standard of care or law applicable to an individual matter.