Summary: In a catastrophic personal injury claim, a periodic payment order (PPO) lets a court pay compensation for lifelong care as a secure annual sum for life, instead of one lump sum. PPOs were created by the Civil Liability (Amendment) Act 2017 for catastrophic injury cases. But after the 2019 Hegarty ruling found the original inflation measure would badly under-fund care, courts stopped approving them. A fix was legislated in 2023 and a new index rate recommended in 2024 — yet as of June 2026 the regulations needed to switch it on have still not been signed, so a lump sum remains the practical route for most claimants right now. Understanding both options is part of pursuing fair compensation for injury in Ireland when the care will last decades.

What is a periodic payment order?

In brief: A periodic payment order is a court order that pays compensation for future care as a secure yearly sum for the rest of a person's life, rather than as a single lump sum.

A periodic payment order is one way an Irish court can structure the compensation in a serious personal injury claim. Instead of handing over one large capital sum to cover decades of future care, the court orders the paying party to make an index-linked payment every year for the injured person's lifetime. The mechanism was introduced by the Civil Liability (Amendment) Act 2017, which inserted a new Part IVB into the Civil Liability Act 1961. Civil Liability (Amendment) Act 2017 [1]

The idea behind it is simple and humane. A lump sum has to guess how long someone will live and how fast their care costs will rise. A PPO removes that guesswork: the money keeps arriving for as long as the person needs it. PPOs were designed to answer the single biggest fear many families carry into a catastrophic injury settlement — that the money, however large it looks on the day, might one day run out.

This page explains the financial mechanism itself. For the detailed statutory framework, our guide to the Civil Liability (Amendment) Act 2017 walks through the legislation section by section.

Who qualifies for a periodic payment order?

In brief: PPOs are restricted to catastrophic injuries — permanent disabilities needing lifelong care and assistance with daily living.

The 2017 Act does not make PPOs available in every personal injury claim. It limits them to cases of "catastrophic injury", which the legislation defines as a personal injury "of such severity that it results in a permanent disability requiring the person to receive life-long care and assistance in all activities of daily living or a substantial part thereof". Activities of daily living include dressing, eating, walking, washing and bathing. Department of Justice (2017) [2]

In practice that threshold is met by the most severe injuries: a severe acquired brain injury, a high-level spinal cord injury causing paralysis, or the kind of profound birth injury that leads to cerebral palsy. These are conditions where round-the-clock care will be needed for the rest of a person's life — exactly the situation a lifelong payment stream was built for. The point a PPO turns on is the severity and permanence of the injury, not how it was caused.

What can a periodic payment order cover?

In brief: A PPO can cover future medical treatment, future care, and assistive technology. Future loss of earnings can be included only if both sides agree.

The legislation is prescriptive about which parts of an award can be paid periodically. A court may order a PPO in respect of three heads of future loss: the future medical treatment of the injured person, their future care, and the provision of assistive technology or other aids and appliances connected with that care. Damages for future loss of earnings can be paid by PPO only where both the injured person and the paying party consent in writing; without that agreement, future earnings are capitalised into a lump sum. Civil Liability Act 1961, s.51I (Revised) [3]

This is the boundary that keeps a PPO distinct from the rest of a settlement. General damages — the award for pain, suffering and loss of amenity — are not paid by PPO. They are subject to the €550,000 general damages cap and are almost always paid as an upfront lump sum. A PPO deals only with the open-ended, uncapped future cost of care. A typical catastrophic settlement therefore combines an initial lump sum (capped general damages plus past losses) running alongside a PPO that funds future care for life.

Periodic payments vs lump sum: which is better for lifelong care?

In brief: A lump sum gives finality and control but carries the risk of running out; a PPO removes that risk but gives up flexibility and depends on a fair inflation measure.

For most catastrophic claims this is the central decision, and there is no single right answer — it depends on the person's age, prognosis, and how much certainty their family needs. A lump sum is paid once, calculated on the person's predicted life expectancy and a judicial discount rate. Its great strength is finality and control: the family holds the capital and decides how to use it. Its great weakness is risk. If the person outlives the prediction, the fund can run dry; if they die early, an unspent balance passes to the estate. A PPO reverses that bargain — it transfers the longevity and investment risk to the paying party, pays for exactly as long as the person lives, and stops on death so there is no windfall or shortfall.

One honest caveat runs through the whole comparison. A PPO is only as good as the index used to uprate it. That is exactly where the Irish system broke down — and why, in 2026, the choice is more constrained than the law on paper suggests.

Why have periodic payment orders been so rare in Ireland?

In brief: The 2017 Act tied annual increases to consumer prices (HICP). In 2019 the High Court found this would badly under-fund care, so judges stopped approving PPOs.

When PPOs were introduced, the 2017 Act required the annual payment to rise in line with the Harmonised Index of Consumer Prices (HICP) — a general measure of shop prices for everyday goods and services. The trouble is that the cost of catastrophic care is not driven by shop prices. It is driven by wages: the pay of carers, nurses and therapists, which historically rises faster than general inflation. Tying a lifelong care payment to consumer prices therefore meant its real value was bound to slip further behind the actual cost of care every year.

This came to a head in Hegarty (a minor) v Health Service Executive [2019] IEHC 788, taken on behalf of a child who suffered a catastrophic brain injury after birth at Cork University Maternity Hospital. The expert evidence on both sides accepted that an HICP-linked PPO would leave the child significantly under-compensated for the cost of care over his lifetime, because care costs rise with wages rather than consumer prices. Ms Justice Deirdre Murphy concluded that no judge charged with protecting a catastrophically injured plaintiff's best interests could endorse a PPO on that basis. She also confirmed the courts retained their power to make lump sum awards — the PPO scheme was meant to add "another string to the bow of the High Court", not to replace that power. Hegarty (a minor) v HSE [2019] IEHC 788 (BAILII) [4]; Irish Legal News (November 2019) [12]

The practical effect was severe. PPOs were described in court as "a dead letter", and the most vulnerable claimants were pushed back into either a lump sum or a gruelling cycle of interim payments — returning to court every few years, with fresh medical assessments each time, while everyone waited for the law to be fixed.

This left Ireland as an outlier. In England and Wales, PPOs for care costs are typically index-linked to a care-sector earnings measure (the ASHE 6115 occupational earnings series for care assistants and home carers) — precisely the wage-based approach the Irish High Court said was needed. Ireland had no equivalent earnings index in its original scheme, which is the gap the 2024 reform is meant to close.

What is the status of periodic payment orders in Ireland in 2026?

In brief: The 2023 Act fixed the indexation rule in principle and a hybrid rate was recommended in 2024, but as of June 2026 the regulations to switch it on have not been signed — so PPOs remain effectively unavailable for most new claims.

This is the part most existing guides get wrong, because they stopped updating years ago. Here is where things actually stand.

First, the law was changed. Part 3 of the Courts and Civil Law (Miscellaneous Provisions) Act 2023 [5] amended the 1961 Act to remove the hard-wired link to the HICP. In its place, it allows the Minister for Justice — with the consent of the Minister for Finance — to set the indexation rate by regulation, and requires the Minister to have regard to the real cost of care, medical expenses, and wage inflation when doing so.

Second, a rate was recommended. In July 2024 an interdepartmental working group recommended a hybrid index: 80% of the annual change in nominal hourly health-sector earnings, plus 20% of the HICP. A separate group recommended leaving the discount rate unchanged at 1% for future care and 1.5% for future financial loss. The Minister approved these recommendations and confirmed that regulations were being prepared. gov.ie (July 2024) [6]

Third — and this is the live reality — the regulations have still not been signed. The Government's action plan, which flows from the Review of the Administration of Civil Justice (the Kelly Report), targets finalisation of the PPO indexation rate around the second half of 2026, alongside other personal injury reforms. Until the Minister signs and commences those regulations, the workable index does not exist in law, and the High Court continues to approve lump sums and interim payments rather than PPOs. Irish Legal News (2024) [7]

The delay remains under active political pressure. In December 2025, the Minister for Justice was asked directly in the Dáil for the current status of the revised indexation mechanism, the reason for the hold-up, and a firm commencement date — confirmation that, as of late 2025, the new framework had still not been switched on. Houses of the Oireachtas, Parliamentary Question (December 2025) [11]

How does a periodic payment order work in a real claim?

In brief: A PPO is usually raised at settlement, supported by actuarial and care evidence, and must be approved by the court as secure and in the injured person's best interests.

Catastrophic claims usually pass through the Injuries Resolution Board (IRB) stage and then proceed to the High Court, because the board does not assess this kind of complex, lifelong future loss. When PPOs are available, the question of structure typically arises during settlement negotiations or mediation, once liability is resolved or admitted. The future care figure is built from detailed evidence — care expert reports, case manager assessments, and actuarial calculations — and independent financial advice usually informs how the award should be structured. The order can be made on consent between the parties, or, in defined circumstances, without full consent.

Before approving any PPO, the court has to be satisfied of two things in particular: that the continuity of the payments is reasonably secure for the decades ahead, and that the order is in the best interests of the injured person, having regard to the nature of the injury and the form of award that best meets their needs. Civil Liability Act 1961, s.51I (Revised) ³ In our work supporting families after life-changing injuries in Dublin and across Ireland, this is often the most important conversation in the whole case: not just how much the settlement is, but how it will actually fund care over a lifetime rather than a few years.

What protections are built into a periodic payment order?

In brief: PPO payments must be reasonably secure, are exempt from tax, and are protected if the paying insurer becomes insolvent.

A lifelong income stream is only safe if it cannot be eroded by tax or lost if the payer fails. The legislation addresses both. On tax, the 2017 Act inserted Section 189B into the Taxes Consolidation Act 1997, which exempts qualifying periodic payments for personal injuries from income tax. This sits alongside the long-standing exemptions for catastrophically injured people, under which compensation — and the income and gains from investing it — is also disregarded for tax purposes, so the payment a family relies on is not reduced by income tax. Taxes Consolidation Act 1997, s.189B [13]; Revenue (Tax and Duty Manual) [8]

On security, the court can only make a PPO if satisfied the payments are reasonably secure. Payments are treated as secure where they are backed by the State under the Clinical Indemnity Scheme or General Indemnity Scheme — which covers most medical negligence cases against the HSE. Where a private insurer pays, the payments are protected through the Insurance Compensation Fund if the insurer fails, or backed by the Motor Insurers' Bureau of Ireland (MIBI) in motor cases. The 2017 Act specifically amended the Insurance Act 1964 to lift earlier limits on payments from that fund for PPOs. Civil Liability Act 1961, s.51J (Revised) ³

One protection that is notably absent, and a point plaintiff lawyers continue to press, is a general power to vary a PPO if the person's condition deteriorates unexpectedly. Stepped payments handle foreseeable changes, but the Irish scheme does not yet provide a broad variation mechanism for the unforeseen. This is another point of difference from England and Wales, where the courts can build a variation provision into a PPO to allow a return to court if the injured person's condition changes in a defined way. Scotland, too, put PPOs on a statutory footing through the Damages (Investment Returns and Periodical Payments) (Scotland) Act 2019. Ireland's narrower scheme leaves it the most constrained of the three.

It is also worth understanding what a PPO locks in. The trade-off for that lifelong security is rigidity: the payments are designed to fund care, not to be turned back into capital. A PPO generally cannot be sold, assigned, or used as security to borrow against, and it cannot be commuted into a lump sum at will. For a family weighing the two routes, that is the real choice — the certainty of a protected income stream on one side, against the flexibility and control of capital on the other.

How do periodic payment orders fit with future care costs?

In brief: A PPO is a way of paying the future care bill; the size of that bill is worked out separately in the future care assessment.

It helps to keep two questions apart. The first is how much future care will cost — that is calculated in detail from care reports and actuarial evidence, and we explain it in our guide to future care costs. The second is how that cost is paid — as a lump sum, or as a PPO. A periodic payment order is one delivery mechanism for the future care figure, not a different way of calculating it.

Because catastrophic injuries are where these lifelong care figures arise, PPOs are most relevant in claims involving severe brain injury and spinal cord injury. The same principles can matter for visitors injured in Ireland too: where an Irish court structures part of an award as periodic payments, the tax-exempt, index-linked nature of that income can be valuable for an injured US visitor facing decades of high care costs at home. The case law on how large future-care awards are structured — including Russell v HSE and Morrissey v HSE — sits alongside this mechanism.

Questions to ask your solicitor about settlement structure

In brief: A short checklist helps families pressure-test whether a lump sum or periodic payments better suits a lifetime of care.

When the time comes to decide how a catastrophic settlement should be paid, these are the questions worth raising. They are designed to open the conversation, not to replace tailored advice on your own case.

Common questions about periodic payment orders

References

1. Civil Liability (Amendment) Act 2017 — Irish Statute Book (statute; accessed June 2026) [1]
2. Minister announces passage of Civil Liability (Amendment) Bill 2017 — Department of Justice (December 2017) [2]
3. Civil Liability Act 1961, Section 51I — Revised Acts, Law Reform Commission (statute; accessed June 2026) [3]
4. Hegarty (a minor) v HSE [2019] IEHC 788 — High Court of Ireland (BAILII) (judgment, 14 November 2019) [4]
5. Courts and Civil Law (Miscellaneous Provisions) Act 2023 — Irish Statute Book (statute; accessed June 2026) [5]
6. Minister publishes reports on index and discount rates for catastrophically injured people — gov.ie (July 2024) [6]
7. Periodic payments in catastrophic injury cases to increase with inflation — Irish Legal News (July 2024) [7]
8. Taxes Consolidation Act 1997, Part 7 — Notes for Guidance (income tax exemptions, including personal-injury payments) — Revenue (guidance; accessed June 2026) [8]
9. People injured through negligence seek change to payments — RTÉ News (April 2026) [9]
10. First injury settlement with lifelong payments approved — RTÉ News (February 2019) [10]
11. Personal Injury Claims, Parliamentary Question — Houses of the Oireachtas (3 December 2025) [11]
12. High Court: periodic payment order legislation 'a dead letter' in its current form — Irish Legal News (22 November 2019) [12]
13. Taxes Consolidation Act 1997, Section 189B — Irish Statute Book (statute; accessed June 2026) [13]

Related guides: catastrophic injury claims • future care costs • Civil Liability (Amendment) Act 2017 • the €550,000 general damages cap