A court decision supporting a compensation claim involving higher costs for home care has provided much-needed clarity on the issue of “reasonableness”, Clyde & Co lawyers say.

“For insurers and defendants, the ruling broadens the scope of compensable care,” partners Luke O’Kane and Janine Clark said. “Home-based care may now be recoverable, even where institutional care is cheaper and clinically sufficient, unless it can be shown that the plaintiff acted unreasonably in declining that alternative.”

The High Court decision settled a dispute over compensation for a man who had treatment for nausea and abdominal pain but was catastrophically injured due to negligence by the Metro North Hospital and Health Service in Queensland.

He was discharged from hospital to a nursing home, where it was difficult for his son and dog to stay with him. He was miserable, his condition deteriorated and he wanted to live in his own home.

The initial trial judge heard home care costs were estimated at $4.9 million, compared with an improved aged care alternative of $1.08 million, and they found the higher sum would be unreasonable after balancing “health benefits” and the expense. Damages awarded totalled $2.1 million.

But the High Court ruled the lower court’s approach to “reasonableness” was wrong, and the starting point should be compensation that, as far as money could, returned someone to a position as if the negligence had not happened.

A reasonableness evaluation “was not discharged by balancing only the health benefits against the increased cost” and the hospital service did not show the institutional alternative was unreasonably refused.

“A choice by a severely injured plaintiff to receive care at home is, today, one that is not unusual, especially given the improvement in levels of care that can be provided at home or in a home setting,” the judgement says.

“In his circumstances, the choice of home care ... was a reasonable means of repairing the consequences of the tort.”

Clyde & Co says the decision confirms the restoration of ordinary life as a central consideration to the assessment of “reasonable necessity”.

“The High Court made clear that the inquiry is not confined to a balance of health benefits, and that evidence of psychosocial and quality-of-life factors will be pivotal in demonstrating whether a care model is a reasonable response to the consequences of the tort,” Mr O’Kane and Ms Clark said.

The decision is available here.