What are future care costs in a catastrophic injury claim?

Future care costs are the projected lifetime expenses of caring for a seriously injured person, claimed as special damages in a personal injury claim. They cover professional nursing, personal assistance, therapies, specialist equipment and the support an injured person will rely on for the rest of their life. The principle behind them is restitutio in integrum: the law tries to restore the injured person, so far as money can, to the position they would have been in without the injury.

This applies across every cause of serious injury. A spinal cord injury from a road traffic collision, an acquired brain injury from a workplace fall, and a severe head injury from a public liability accident all generate future care claims built the same way. The cause changes how the claim is started and who the defendant is. It does not change how lifetime care is valued.

Future care is different from future medical treatment. Care covers the people and support that keep someone safe day to day. Medical costs cover ongoing treatment, surgery and medication, which we deal with separately in future medical and travel costs. Both are uncapped, and in catastrophic cases the care element is usually far larger.

In a typical multi-million euro catastrophic settlement, general damages account for under 10 percent. The rest funds lifetime care, lost earnings and adapted accommodation.

How Irish courts calculate future care costs

Courts calculate future care by multiplying the annual cost of care by a life-expectancy multiplier, then discounting it to a present-day sum. This is the multiplicand and multiplier method. The annual cost of the care regime is the multiplicand. An actuary applies a multiplier drawn from the Central Statistics Office Irish Life Tables. That multiplier is then reduced for the "vicissitudes of life", usually between 10 and 25 percent, to reflect ordinary mortality risk.

The figure is then reduced by a discount rate, because a lump sum awarded today can be invested before it is spent. Irish courts apply 1 percent to future care costs and 1.5 percent to other future losses such as lost earnings. These rates come from Russell v HSE [2015] IECA 236, where the Court of Appeal held that without a reduced rate a catastrophically injured person would face unjust and unacceptable investment risks with their care fund. The rates were retained by the Minister for Justice in July 2024 after an expert review found no material evidence to justify a change. Department of Justice (Updated July 2024) [1].

The lower the discount rate, the larger the award, because a cautious investor cannot safely earn high returns. The July 2024 reforms also introduced a review of the rate at least once every three years, plus trigger events for an earlier review if economic conditions shift sharply [1]. We keep the mechanics brief here. For the full worked calculation, see future care costs in medical negligence claims and the overview of actuarial evidence and multipliers.

Life expectancy is the most contested figure in the calculation, because it sets the multiplier. A longer life expectancy means more years of care and a much larger award, so the defendant and the injured person often produce conflicting medical evidence on it. The judge has to choose between them. A difference of a few years in the accepted life expectancy can change a catastrophic care award by hundreds of thousands of euro. That is why precise, well-supported medical evidence on prognosis matters so much.

What a cost-of-care report must contain

A cost-of-care report is the document that values the care claim, prepared by an independent care expert. In Ireland this report is usually called a cost-of-care report or future care needs report. The international term is a "life care plan", but the document Irish solicitors commission is governed by Order 39 of the Rules of the Superior Courts. It is prepared by a senior occupational therapist, registered nurse or experienced case manager, working from current Irish commercial rates. This is what people searching for a "care needs assessment injury claim" are looking for.

The care expert prices the regime. They do not prove how the injury was caused, and they do not set life expectancy, which are matters for medical consultants and actuaries. A good report typically covers:

Who can provide the report? It must be an appropriately qualified expert with genuine experience in catastrophic injury. The detail of how they assess a person at home, and their qualifications, belongs on our page about care experts and life care plans.

What future care actually costs in Ireland

The annual cost of care, the multiplicand, is built from real Irish care rates, not a round number. Most guides quote a lump range and stop. In practice the care expert prices each element at current Irish commercial rates, which is what makes one schedule far larger than another. The figures below are indicative 2026 market rates, used to show how a multiplicand is built. They are not a quote, and your figure depends on the care actually required.

How does this become a multiplicand? Take a person needing daytime care plus waking-night cover. Daytime care at, say, eight hours a day across a year, plus a nightly waking rate, builds an annual figure that can run from roughly €120,000 to €250,000 or more in severe cases before the multiplier is applied. The care expert sets the real hours and grades. The actuary then applies the multiplier. For agency premiums on weekends and bank holidays, see how these feed into the schedule in our guide to care and assistance costs.

Ireland uses its own life expectancy tables, not the UK Ogden Tables. The multiplier comes from the Central Statistics Office Irish Life Tables, adjusted for the vicissitudes of life. This matters because UK guidance and UK figures do not transfer directly to an Irish claim, a point competitors who reuse UK material often get wrong. The mechanics of the multiplier are covered in actuarial evidence and multipliers.

Tax relief reduces the net cost of paid care, within a limit. Where the injured person is totally incapacitated, the cost of employing a carer can attract income tax relief at the payer's marginal rate, up to €75,000 per incapacitated person in a tax year, on the private amount actually paid. Revenue, Employing a carer (Updated 2026) [5]. Relief does not apply to HSE-funded support, and relief already claimed has to be accounted for once the same cost is compensated, to avoid double recovery. This interaction should be modelled when the care claim is built, not discovered afterwards.

Types of care you can claim

Future care covers several distinct models, and the model chosen is one of the biggest drivers of cost. Families are often surprised by how much the type of care, not just the hours, changes the figure. The main categories are set out below.

Night cover: waking-night versus sleep-in

Night care comes in two forms. Waking-night care means a carer stays awake all night, monitoring breathing, seizures or the need for repositioning. Sleep-in care means a carer is present and sleeps, available if needed. Waking-night cover costs substantially more, because it is a full working shift. Where a serious injury brings a risk overnight, such as respiratory difficulty or nocturnal epilepsy, waking-night care is often the single largest line in the schedule.

How carers are engaged: agency, directly employed, or case-managed

Care can be bought from a nursing agency, provided by carers the family employs directly, or coordinated through a professional case manager who builds and runs the whole package. Agency care carries the highest hourly rate but the least administration. Directly employed carers can cost less per hour but bring employer duties. A case-managed package adds a coordinator's fee, justified where the regime is too complex for the family to run.

Handling needs: single-handed versus double-up

Some injuries require two carers at once for safe moving and handling, known as a two-to-one or double-up ratio. This doubles the staffing cost for those tasks and is common in high-level spinal and severe brain injuries.

Gratuitous care provided by family

Care given free by family members is recoverable, because relatives often give up work and income to provide it. The care expert values it at the commercial rate for an equivalent carer. To value it properly the family needs a contemporaneous record. We explain how to keep one on our page about care and assistance costs.

Award ranges and worked examples by cause

Future care awards in catastrophic cases commonly run into the millions, driven by the care regime rather than pain and suffering. The examples below are illustrative only and not predictions. Every claim depends on its own medical evidence, the injured person's age and life expectancy, and the care actually required.

Two cases can need similar daily care yet settle very differently, because age and life expectancy change the multiplier. A younger person needing care for fifty years generates a far larger figure than an older person needing the same care for ten. Where the figure sits within the wider award is explained in our guide to damages in Irish personal injury law.

Expert evidence and the Duffy v McGee rule

A care report only works if the expert is genuinely independent, or the court can throw it out entirely. The defendant, often the State Claims Agency or a large insurer, will challenge the carer grade, the hourly rates and the hours claimed. The expert's job is to assist the court, and that duty overrides any obligation to the side paying the fee.

The Court of Appeal made this a hard rule in Duffy v McGee [2022] IECA 254. Mr Justice Noonan held that where an expert acts as an advocate or strays beyond their field, their evidence can be excluded as inadmissible, not merely given less weight. Court of Appeal, Duffy v McGee (November 2022) [2]. For a catastrophic claim the consequences are severe. If the care report is excluded, the foundation of the special damages claim can collapse with it.

What does this mean in practice? A care expert who drifts into debating how the injury was caused, or predicting life expectancy, breaks the rule limiting them to their own expertise. The practical lesson is that a care report must be objective, acknowledge pre-existing conditions and reasonable cost savings, and avoid reading like a one-sided wish list.

The sections above cover how future care is valued and proven. The sections below cover what is often missed, and how the award is structured, managed and protected once the figure is agreed.

What most guides miss

Most coverage stops at "an actuary works it out", and skips the parts that decide whether the money lasts. Three points are routinely left out, and each one can change the outcome for a family.

• The care model is a cost driver, not a detail. Whether night cover is waking or sleep-in, and whether carers are agency or directly employed, can change the annual figure by multiples. Most guides quote a single annual number as if the model were fixed.
• The award has to be managed after it lands. Where the injured person lacks capacity, a Decision-Making Representative must be appointed and paid for, and that cost belongs in the claim. Coverage that ends at the payout misses this entirely.
• Expert objectivity is now a survival issue. Since Duffy v McGee, a one-sided care report can be excluded, not just discounted. Firms that still market "sympathetic" experts are describing a risk, not a strength.

Lump sum versus periodic payments: the 2026 position

A lump sum pays everything at once and leaves the risk with the injured person. A periodic payment order spreads payment over life and shifts the risk to the defendant. A lump sum carries two risks for the injured person: investment risk, if returns fall short of the actuary's assumption, and longevity risk, if they live longer than the life tables predicted and the fund runs out. A periodic payment order, or PPO, avoids both by paying an index-linked amount each year for life.

PPOs were introduced by the Civil Liability (Amendment) Act 2017, then stalled. In Hegarty v HSE [2019] IEHC 788 the High Court found that linking payments to general consumer inflation alone would under-compensate claimants, because care wages rise faster than ordinary prices. Ms Justice Murphy held that no judge protecting a plaintiff's interests could approve a scheme indexed only to consumer prices, leaving the legislation widely described as a dead letter. After that ruling, claimants reverted to lump sums.

In July 2024 the Government accepted a new indexation formula to fix this: 80 percent based on the annual rate of change in hourly health earnings, and 20 percent on the Harmonised Index of Consumer Prices [1]. From 2026, Central Statistics Office health-sector wage data is intended to feed the formula. As of mid-2026, the regulations to bring this into force were still in preparation. Until they are signed, lump sums remain the practical default. A solicitor should model both options. Read more on the Civil Liability (Amendment) Act 2017.

What happens if the injury gets worse than predicted

Ireland has no provisional damages, so a lump sum is final even if the injury later deteriorates beyond what the care report predicted. A future care award is a once-and-for-all payment. Unlike England and Wales, Ireland has no mechanism to return to court for more money if a specified deterioration occurs. If the care report under-estimates how the condition will progress, the fund cannot later be topped up.

This is why the prognosis and the care plan have to be as complete as possible before the figure is fixed. Two tools help manage the risk. An interim settlement can pay for a defined period while the prognosis stabilises, leaving the final care figure to be set later. A periodic payment order, once the regulations are in force, can adjust to the person's actual lifetime rather than a one-off estimate. Both reduce the danger that a single fixed sum proves wrong. The choice of structure is covered in the Civil Liability (Amendment) Act 2017.

Managing the award and the Assisted Decision-Making (Capacity) Act 2015

A large care award has to be managed, and where the injured person cannot manage it themselves, the law now sets out who can. This is the part most guides ignore. A multi-million euro fund has to last decades and pay rotating carers, therapists and equipment bills. Where the injured person has capacity, professional fund or trust management can help make it last. Where they do not, a formal arrangement is required.

The old Ward of Court system has been replaced by the Assisted Decision-Making (Capacity) Act 2015, which came into full effect on 26 April 2023. Where an adult cannot manage the award because of a catastrophic brain injury, the family or solicitor applies to the Circuit Court, which can appoint a Decision-Making Representative to handle the funds. Citizens Information, Assisted Decision-Making (Updated 2026) [3]. Oversight sits with the Decision Support Service, part of the Mental Health Commission.

This has a direct effect on the claim itself. The cost of running this arrangement, including the Decision-Making Representative's fees and the court application, is itself recoverable and should be built into the future care claim from the start. For the statutory detail, see the Assisted Decision-Making (Capacity) Act 2015. Where the injury is a brain injury, our overview of head and brain injury claims sets out the wider picture.

Court approval and tax on the care fund

A care award for a child or an incapacitated adult must be approved by the court, and the income it earns when invested can be tax-free. Two protections sit around the fund once the figure is agreed.

First, court approval. Any settlement for a person under 18 needs court approval through an infant ruling under Order 22, rule 10 of the Rules of the Superior Courts, and the money is generally held by the court until the child turns 18. Settlements for an adult who lacks capacity are approved in the same protective spirit. This stops a large care fund being settled too cheaply or paid out without oversight.

Second, tax. A personal injury award is not itself taxed. Where the injured person is permanently and totally incapacitated, the income and gains from investing the award are also exempt from income tax and capital gains tax under section 189 of the Taxes Consolidation Act 1997, provided that investment income is their main income. Revenue, Investment income exemption (Updated 2026) [6]. Periodic payment order payments are exempt from income tax in the same way. This matters for fund survival, because tax-free investment returns help the care money last the lifetime it was calculated to cover. Tax advice usually accompanies a catastrophic settlement, because the exemption depends on the person's circumstances.

How compensation interacts with State supports and tax relief

Compensation does not always sit neatly alongside State supports, and the interaction needs to be modelled early. Means-tested supports and HSE services can be affected by a large award, and double recovery is not permitted where a cost is already met. Tax relief on qualifying medical expenses can also apply, but relief already claimed may need to be accounted for once the same expense is compensated. Citizens Information, Tax relief on medical expenses (Updated 2026) [4]. The detail of how recoverable benefits are offset is covered in future medical and travel costs. The practical point is that a care fund modelled without considering these interactions can leave a family short later.

Common mistakes that undervalue future care claims

Most undervaluation comes from weak evidence rather than weak law. The recurring problems we see are practical ones, and each is avoidable with the right preparation. The main ones are:

• Settling before a full cost-of-care report is ready. An early settlement can lock in a care budget that proves far too small as needs become clear.
• Underestimating night care and relief cover. Waking-night care and cover for carer absence are routinely missed, and they are among the largest costs.
• Not recording family care. Without a contemporaneous note of hours, gratuitous care is hard to value and easy for an insurer to dispute.
• Ignoring fund management and capacity costs. The cost of a Decision-Making Representative and professional fund management is recoverable but often left out.

Common questions

Related questions

References

1. Department of Justice, Reports on index and discount rates for payments to catastrophically injured people (Updated July 2024).
2. Court of Appeal, Duffy v McGee [2022] IECA 254 (November 2022).
3. Citizens Information, Assisted Decision-Making (Capacity) Act 2015 (Updated 2026).
4. Citizens Information, Tax relief on medical expenses (Updated 2026).
5. Revenue, Employing a carer: tax relief (Updated 2026).
6. Revenue, Investment income exemption, section 189 TCA 1997 (Updated 2026).
7. Judicial Council, Personal Injuries Guidelines (April 2021).
8. Irish Statute Book, Civil Liability (Amendment) Act 2017.

This information is for educational purposes only and does not constitute legal advice. Every case is different and outcomes vary. Consult a qualified solicitor for advice specific to your situation.