Future medical care is projected, costed, and then discounted to what that stream of payments is worth today. On serious injuries it is frequently the largest single component of the claim, and the assumptions behind it move the number far more than the list of treatments does.
The life care plan
A life care planner — often a rehabilitation nurse or physician — builds an itemised schedule of what the person will need and for how long: physician follow-up, therapy, medication, durable equipment and its replacement cycle, home or vehicle modification, attendant care, and anticipated future procedures such as joint revision.
Each line needs a medical foundation. A plan that lists care no treating physician has recommended is vulnerable, and the defence will work through it line by line looking for items that reflect the planner’s judgement rather than the treating record.
Costing and inflation
Each item is priced, usually against regional charge data, then projected forward. Medical inflation has historically outpaced general inflation, so the growth rate chosen has an outsized effect over a long horizon. A modest difference in assumed medical inflation compounds into a very large difference across decades.
Present value — where the argument really is
A defendant pays once, now, for care delivered over many years, so the total is reduced to present value: the sum that, invested at an assumed rate, would fund the future payments. The discount rate is the most contested number in the entire calculation. A higher rate shrinks the award substantially; a lower rate expands it. Two economists using the same care plan can produce very different figures purely from this assumption.
Life expectancy is the second lever. Standard tables provide a baseline, adjusted for the injury and for comorbidities, and the defence will argue for a shorter horizon while the plaintiff argues that good care extends it.
What frequently gets missed
- Equipment replacement cycles — a wheelchair or prosthesis is not a one-time purchase.
- Care that increases with age as independence declines.
- Home modification and the cost of moving if adaptation is not possible.
- Transport to a long schedule of appointments.
- Case management — someone has to coordinate complex care.
Liens and how it is paid
A future-care award interacts with what has already been paid on the injured person’s behalf, and with programmes that may pay later. See medical liens and subrogation, and structured settlement versus lump sum for how the money is actually delivered — a structure is often used precisely because it matches payments to the care schedule.
Related: Medical and Catastrophic.
General information only, not legal advice, and not a medical or financial opinion.