Traffic accident injuries, amputations, maintenance and training fees for prosthetics can be supported?

Lufa Case [2024] 706

As we all know, if you are injured in a traffic accident, after the division of responsibilities, you can require the causing party and the insurance company to compensate for losses such as medical expenses, disability compensation, lost wages, nursing expenses, nutrition expenses, etc.; if some serious traffic accidents cause serious injuries to the victim, leading to limb amputation, you should also compensate for the cost of assistive devices, etc. After installing a prosthetic limb, can the maintenance and training costs of the prosthetic limb be claimed from the tortfeasor in a traffic accident?

Introduction to the case

In the summer of 2023, Aunt Li was hit by a small truck while driving an electric bicycle and was hospitalized for 42 days. Her left leg was amputated due to the injury, and she spent nearly 100,000 yuan in medical expenses. The traffic police department later determined that Aunt Li was not responsible for the traffic accident. In July 2024, Aunt Li filed a lawsuit with the court for the losses caused by the accident, requesting the driver and an insurance company that insured her car insurance to compensate for losses such as medical expenses, disability compensation, appraisal fees, mental damage consolation funds, and to bear the maintenance and training fees for her prosthetics.

According to judicial appraisal, Aunt Li’s left lower limb was damaged after amputation, and her rib fracture and transverse process fracture constituted one level 7 and two level 10 injuries respectively. The Prosthetic Appraisal Center determined that Aunt Li’s left calf stump needs to be equipped with a “commonly suitable” modular calf prosthesis, which costs 26,000 yuan each time; a silicone sleeve needs to be equipped, which costs 5,000 yuan each time; the annual maintenance fee for the configured left calf prosthesis is 6% of the prosthetic value, and the replacement cycle of the left calf prosthesis is 4 years. The replacement cycle of rubber sleeves is 1 year, and the number of replacements is calculated based on the average life span of Shandong Province, the prosthetic replacement cycle and the age of the person being appraised; in addition, functional adaptability training is required for 30 days for the first installation of a prosthetic limb, and the functional training fee for the prosthetic limb is 260 yuan/day. Subsequent replacement of prosthetic limbs does not require functional training and no training fees are incurred.

Court hearing

The court found after hearing that Aunt Li was 73 years old when she installed the prosthetic limb. Referring to the appraisal opinion, the average life expectancy of people in Shandong Province and the plaintiff’s treatment situation, it should be determined that the fee for assistive devices for disabled people includes: installation fee 87 000 yuan (lower limb prosthesis 26,000 yuan/time x 2 times + silicone cover 5,000 yuan/time x 7 times), maintenance fee 11,700 yuan (26,000 yuan Based on the determination of other losses, the court finally ruled that the insurance company should compensate Aunt Li for a total of more than 360,000 yuan in medical expenses, disability compensation, nursing expenses, disability assistive device expenses, mental damage consolation funds and other losses within the liability limits of compulsory traffic insurance and commercial third party insurance.

The judge said

Disability assistive device fee refers to the compensation for the loss of organs when the victim is disabled due to personal injury. , the self-help appliances purchased and configured to assist the victim to take care of himself or engage in productive labor, such as the purchase of prostheses, wheelchairs, etc., are by nature necessary expenses incurred by the victim for living needs, and the loss of such expenses has a considerable causal relationship with the infringement. According to the function of personal injury compensation to compensate for the damage, compensation should be provided to the victim to compensate for the victim's loss. If it is necessary to prepare functional devices for compensation due to disability, the amount of compensation shall be calculated based on the cost of universal devices based on the certificate of the medical institution or the opinion of the judicial expert, combined with factors such as the user's age, average life expectancy, and the age of the device.

Disabled assistive devices require repair and maintenance during normal use. Maintenance fees, disabled assistive device fees and installation fees are included in the cost of disabled assistive devices. In addition, if Aunt Li in this case needs professional training after installing a prosthetic limb, the training fee can also be calculated. However, there are differences in the quality of different products. In trial practice, according to the provisions of judicial interpretations, the maintenance costs and replacement cycles of disability assistive devices are usually determined with reference to the opinions of the manufacturing agency.

Legal Links

Article 1179 of the "Civil Code of the People's Republic of China" stipulates that whoever infringes upon others and causes personal injury shall be compensated for reasonable expenses such as medical expenses, nursing expenses, transportation expenses, nutrition expenses, hospitalization food subsidies, etc. for treatment and rehabilitation, as well as the loss of income due to missed work. If disability is caused, assistive device fees and disability compensation shall also be compensated; if death is caused, funeral expenses and death compensation shall also be compensated.

Article 13 of the "Interpretation of the Supreme People's Court on Several Issues Concerning the Application of Law in the Trial of Personal Injury Compensation Cases (2022 Amendment)" stipulates that the cost of assistive devices for disabilities is calculated according to the reasonable cost standards of ordinary applicable devices. If the injury requires special needs, you can refer to the opinions of the assistive device dispensing agency to determine the corresponding reasonable fee standards. The replacement cycle and compensation period of assistive devices shall be determined with reference to the opinions of the dispensing agency.

Content source: Dongming County People’s Court