‘Ordinary consequence’ as a factor in treatment injuries

When we check a treatment injury claim, one of the aspects we look at is whether the injury was an ordinary consequence of the treatment provided. 

When considering this, we take into account: 

• the clinical knowledge at the time of treatment 
• any underlying health conditions the patient may have had at the time 
• the clinical findings at the time of the treatment. 

What counts as an ‘ordinary consequence’ of treatment is currently unsettled. For now, we're applying the test outlined by the High Court in November 2018 to all treatment injury claims currently being investigated for cover, and to all claims which are subject to a current review or appeal.  

We're appealing the decision, to seek clarity. If this test is changed by a higher court, we may need to reconsider “ordinary consequence” decisions made during this period.