State liabilities for personal injuries claims rise fourfold in decade

Clinical claims in health service account for 75% of €4.5bn in liabilities, Comptroller and Auditor General report finds

The State’s outstanding liabilities for personal injury claims have increased fourfold in the past decade, according to a report by the Comptroller and Auditor General.

Most of the increase is driven by rising claims in the health service, particularly in maternity.

The total outstanding liability grew from €1.1 million in 2012 to €4.5 billion in 2022, the report says. Over this period, the number of claims alleging negligence or property damage also grew, from 5,755 to 11,408.

Personal injury claims against the State are managed by the State Claims Agency (SCA), which operates two indemnity schemes – the clinical indemnity scheme for the health service and the general indemnity scheme.


At the end of last year, clinical indemnity scheme claims comprised one-third of claims being handled by the SCA, but accounted for over 75 per cent of the total outstanding liability.

The cost of managing these claims was €357 million, of which €76 million related to legal costs.

Over the decade, the liability for clinical claims increased by €2.4 billion to €3.4 billion.

Maternity services

Over 60 per cent of these claims related to claims made against the maternity services and, within this category, cerebral palsy claims alone accounted for 40 per cent of the outstanding liability (€1.4 billion).

There were 163 active cerebral palsy claims related to maternity services at the end of 2021.

It is taking longer to finalise claims; the average duration of a maternity claim increased by half, to over five years.

Hospitals and other agencies are legally required to report incidents to the SCA; increased reporting is associated with lower levels of litigation. However, only one-quarter of claims received between 2017 and 2021 had previously been reported to the agency.

The report calls on the SCA to work with bodies with the poorest reporting records to adopt measures to bring their reporting levels “to an acceptable level”.

According to the report, the main cost-driver behind the increased liabilities in the clinical indemnity scheme is the average damages awarded. “The estimated CIS liability is influenced by a small number of high-value claims, involving cases of catastrophic injury in a clinical setting, in particular those relating to cerebral palsy.”

In 2021, there were 335 active cases relating to catastrophic injury, with an estimated outstanding liability of €2.4 billion. The average liability per catastrophic injury claim is €7.24 million, compared to €300,000 for other clinical negligence claims.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times