The Scotsman

State of the art prosthetic­s providing real progress in personal injury claims

For those unfortunat­e enough to have sustained such serious injuries, there may at least be a brighter future to look forward to, says Bruce Goodbrand

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Many personal injury practition­ers will be familiar with a famous illustrati­on from a magazine article in the 1890s. It shows silhouette­s of amputees, and the various levels of compensati­on that could be expected at that time for lost limbs.

Awards ranged from £210 for a below knee amputation of one leg, to £1000 for losing both legs above the knee. The author even had the temerity to suggest claimants could make a “handsome” profit, since the cost of replacemen­t limbs was much lower than the compensati­on. Mercifully, times have moved on, both in terms of the levels of compensati­on that can be expected, and the attitudes of those involved today.

The guiding principle in damages is “restitutio in integrum”, or “restoratio­n to the original condition”. Clearly that cannot be achieved where a limb is missing, but medical science means we can now get closer than ever before.

There have been two developmen­ts in this field in recent years that are significan­t. Firstly, there have been exponentia­l advance sin the prosthetic­s themselves, partly driven by the horrific injuries suffered in the Iraq and Afghanista­n conflicts of recent decades. Artificial limbs are no longer just simple constructs to bear weight or provide cosmetic benefit. They are now an array of finely engineered bespoke equipment, which can restore function to levels that were previously unimaginab­le. developmen­ts such asosseo integratio­n( a structural and functional connection­between living bone and a load bearing surface) have opened up a world of possibilit­y.

Secondly, leading insurers have recognised the value of early engagement with claimant’s representa­tives to provide support. Provision of state of the art prosthetic­s, with a fully funded support programme, typically yields a better outcome in terms of potential future employment and care requiremen­ts etc.t hat in turn limits long term cost.Fo rt heun for tunate claimant who has lost a leg or an arm, the primary considerat­ion is how good a level of mobility and function they can recover. Proactivit­y and a tailored rehabilita­tion programme will almost certainly give better results than the alternativ­es. In prosthetic­s, one size does not fit all.

The results can be astounding. In one case our firm was involved with, a young man who suffered an above knee amputation was placed on such a programme within weeks of the index accident. with support and a fully funded programme a suitable prosthetic was identified and customised. After a few short months he was walking. Shortly after that he had progressed to running, then cycling, and the whole claim was capable of resolution much faster than might otherwise have been the case.

In all of this the key factor is the requiremen­ts of the individual, as shown in the leading case of Wagner v Grant & Arla Foods [2015] CSOH 51. The case involved a 24 year-old motorcycli­st who suffered a below knee amputation. l or dui st ruled that the guiding principle in assessing damages would be what was“reasonably necessary ”. a proposed“Rolls Royce” arrangemen­t that had not even been trialled was held not to be a reasonable basis on which to award damages. The converse would also undoubtedl­y apply. And herein lies the point. When assessing damages for prosthetic­s a court will wish to know what is suitable for a given individual, with an evidence based approach.

When one thinks back to the attitudesa­nd values of the1890s, clearly some things do change for the better. Developmen­ts in this field continue a pace, along with the willingnes­sof insurers to engage early. For those unfortunat­e enough to have sustained such serious injuries,there may at least bea bright er future to look forward to.

Bruce Goodbrand is a partner in Clyde & Co, based in their Edinburgh office and Chair of the Forum of Insurance lawyers (FOIL) Scotland

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