The High Court of Australia has unanimously overturned a Queensland Court of Appeal decision in the case of Stewart v Metro North Hospital and Health Service, providing new guidance on how damages for future care are assessed in catastrophic injury cases under the Civil Liability Act 2003 (Qld).
Michael Stewart, who suffered severe injuries after negligent treatment at Redcliffe Hospital in 2016, was left with profound brain damage and required around-the-clock care. After his discharge from hospital, Stewart was placed in institutional care at Ozanam Villa Aged Care Facility. Restrictions at Ozanam made it difficult for him to maintain contact with his family and pets, and his condition worsened due to limited therapy.
At trial, Stewart’s litigation guardian sought damages that would allow him to live in a rented home with professional carers, arguing this arrangement would better support his dignity and quality of life. The cost of home-based care was estimated at $4.91 million—significantly higher than institutional care. However, both the trial judge and the Queensland Court of Appeal determined that this additional expense was not reasonable given that similar care could be provided at Ozanam.
The High Court granted special leave to appeal to consider whether “reasonableness” in assessing damages should focus solely on clinical outcomes and cost-benefit analysis.
On September 3, 2025, the High Court allowed Mr Stewart’s appeal. The justices found that both lower courts had erred by limiting their assessment to health outcomes and costs. Instead, they reaffirmed that damages should aim to restore plaintiffs as closely as possible to their pre-injury position.
“The High Court confirmed that the ‘reasonableness’ of a Plaintiff’s choice to receive at-home care must be assessed holistically, with proper weight given to restoring the Plaintiff to the position they would have been if the tort had not been committed.”
The judgment clarified two key aspects: first, plaintiffs must show their chosen steps (such as home care) are reasonably required; second, once established, defendants must prove any refusal of cheaper alternatives is unreasonable.
Applying these principles, the court concluded that returning Mr Stewart to a home environment closely matched his pre-injury life and was therefore reasonable. The Metro North Hospital and Health Service did not prove he acted unreasonably by declining enhanced institutional care.
“Prior to his injury, he had lived at home with his family and pets, and returning to such a setting offered him a far closer restoration of his pre-injury life than continued residence in institutional care,” noted the court.
As a result, the case will return to the Supreme Court of Queensland for assessment of damages based on this broader interpretation.
The ruling is expected to influence future claims involving catastrophic injuries by placing greater emphasis on restoring ordinary life rather than limiting compensation strictly according to cost or clinical benefit. It also clarifies that evidence about psychosocial factors will play an important role when determining what constitutes “reasonable necessity” for future care arrangements.
For insurers and defendants, this decision means home-based care may now be recoverable even if institutional options are less expensive or clinically sufficient—unless it can be shown plaintiffs acted unreasonably in rejecting those alternatives. The burden rests with defendants going forward.
Finally, for courts applying precedent from Sharman v Evans (1977), this case recalibrates how “reasonableness” should be interpreted: “The starting point remains the compensatory principle: restoring the plaintiff so far as money can… If it is [a reasonable way], the onus will then shift to the defendant to prove that a cheaper alternative was unreasonably refused.”