High Court Decision Redefines ‘Reasonableness’ in Personal Injury Damages for Care Needs
On 3 September 2025, the High Court of Australia delivered a landmark judgment that reshaped how courts assess damages for long-term care in catastrophic injury cases.
The case of Stewart v Metro North Hospital and Health Service [2025] HCA 34 stands as one of the most significant developments in personal injury law in decades. It alters the test for “reasonableness” when a plaintiff seeks compensation for care arrangements aligned with their pre-injury lifestyle, even where those arrangements come at a much higher cost.
Background to the Case
Before his injury, Mr Stewart lived in his own home with his brother. His son and dogs would often stay with him, forming a central part of his daily life.
In 2016, following negligent medical treatment by Metro North Hospital and Health Service, he suffered life-changing injuries requiring high levels of care.
When the Queensland Supreme Court assessed damages, a question arose: should compensation be calculated based on ongoing care in the nursing home where he was living (Ozanam) with external carers, or should it reflect the cost of providing that care in his own home?
The financial difference was stark: approximately $1.08 million for institutional care at Ozanam (with external carers), compared to $4.91 million for equivalent care provided at home.
At trial, the judge concluded that the health benefits of at-home care did not significantly outweigh those offered at Ozanam, and therefore awarded damages based on the cheaper option. The Queensland Court of Appeal agreed, effectively treating the question as a cost–benefit exercise in which the cheaper option prevailed.
Mr Stewart then appealed to the High Court — and won.
The High Court’s Key Findings
Importantly, the Court unanimously found that both the trial judge and the Court of Appeal had applied the wrong approach to assessing “reasonableness.”
The correct question, their Honours said, was this:
The Correct Legal Test
Was Mr Stewart’s choice to live in his own home a reasonable response to restoring, as far as money can do, the consequences of the respondent’s negligence?
The Court reaffirmed the compensatory principle long established in Haines v Bendall: the injured party should receive compensation that will, as far as money is capable, place them in the same position they would have been in had the wrong not occurred.
Applying that principle, the Court said reasonableness should not be reduced to a mere comparison of costs. Instead, the focus must be on whether the claimed arrangement truly restores the plaintiff’s lived circumstances before the injury.
For Mr Stewart, returning to life in his own home — where his son and dogs could visit freely, and where he could maintain an environment familiar and emotionally significant to him — was a far closer restoration of his pre-injury existence than institutional care, regardless of the cost difference.
Why This Decision Changes the Landscape
As a result, this ruling marks a departure from almost 50 years of common law shaped by Sharman v Evans, which often placed significant weight on whether the costs of a preferred arrangement were “reasonable” compared with cheaper alternatives.
In that earlier era, courts frequently sided with defendants where institutional care (such as nursing homes or residential facilities) provided basic needs at a lower cost, even if it diminished quality of life.
The Stewart decision recognises modern community values: that dignity, autonomy, family connection, and the psychological benefits of home are not luxuries — they are legitimate and compensable elements of restoring a life after injury.
Key Principles from the Stewart Decision
The judgment makes clear that:
- The burden is on the defendant to prove that a plaintiff’s choice is unreasonable.
- Significantly higher costs will not automatically disqualify a claim for home care.
- Courts must give weight to emotional, social, and mental health benefits, not just physical outcomes.
What This Means for Injured Individuals and Their Families
For those living with catastrophic injuries, the Stewart decision opens new opportunities to claim damages for home-based care arrangements (even when institutional care, such as nursing homes or residential facilities, is substantially cheaper) if strong evidence shows that such arrangements best replicate pre-injury life.
In other words, care plans can now be tailored to the unique preferences, relationships, and personal circumstances of the injured person. The law offers a clearer path to funding dignified, supportive living environments outside institutional settings.
At AX Compensation Lawyers, we welcome this decision as an overdue recognition of the human dimension in personal injury damages. For years, severely injured plaintiffs have faced the uphill battle of proving that quality of life should take precedence over cost efficiency. The High Court’s ruling changes the balance, ensuring that the goal of compensation reflects what has been lost — not merely what is cheapest to provide.
The Importance of Expert Legal Guidance
Therefore, while the Stewart decision expands opportunities, success in these claims still depends on meticulous preparation.
Expert medical, occupational therapy, and psychological evidence will be critical in showing the tangible benefits of home living. Early legal advice is essential to shape your claim from the outset, ensuring the strongest possible case for the care arrangement you deserve.
If you or someone you love has suffered a catastrophic injury, this case could have a life-changing impact on the amount of compensation recoverable — and, more importantly, on your daily quality of life.
Speak to our experienced team at AX Compensation Lawyers for strategic, compassionate, and expert guidance on securing the care arrangement that best restores your life.
* This information is of a general nature and should not be relied upon as legal advice. For advice tailored to your circumstances, please contact AX Compensation Lawyers.
Ready to Discuss Your Claim?
At AX Compensation Lawyers, we provide compassionate support and expert legal representation to individuals injured in accidents across Queensland. Our dedicated team is committed to helping clients navigate the personal injury claims process with confidence and peace of mind.
