Expert Witness Journal Issue 67 June/July 2026 - Flipbook - Page 36
What are periodical payment orders
(PPO) in medical negligence claims?
by Susan Brown, Partner at Boyes Turner LLP.
The di昀昀erence between a PPO and a traditional
lump sum settlement is in the way the compensation
is structured, which is why settlements involving
PPOs are sometimes called ‘structured settlements’.
A periodical payment order or PPO is a structured
method of paying compensation, commonly used
to provide for the lifelong care needs of a severely
disabled child in a cerebral palsy, birth injury, or
neonatal brain injury claim.
Not all claims are suitable for settlement with a
periodical payment order, but PPOs should always
be considered in cases where a large proportion of
a severely injured claimant’s compensation must
provide for their lifelong care or other essential
long-term needs.
A PPO requires the defendant to pay the injured
claimant a regular income, at a pre-determined,
agreed rate, for the remainder of the claimant’s
life. PPO payments are based on medical and care
experts’ assessments of the claimant’s current and
future needs and are usually protected from the
long-term impact of in昀氀ation by linking them,
for example, to the Annual Survey of Hours and
Earnings (ASHE).
Does a lump sum or PPO settlement make
better provision for a severely disabled
child’s future care?
PPOs are not new. At Boyes Turner we have been
using them in appropriate cases to meet our clients’
lifelong needs for almost 20 years.
A totally dependent, severely disabled claimant’s
compensation must provide a lifetime’s worth of
nursing care, specialist therapies and equipment,
assistive technology and adapted housing in order
to put them (in so far as money can) back in the
position that they would have been but for the
negligence which caused their injury.
When should a PPO be considered in
the settlement of a medical negligence
compensation claim?
Periodical payment orders (PPOs) are most
commonly recommended for claimants who have
su昀昀ered severe permanent disability, such as
children with cerebral palsy birth injury or other
types of neurodevelopmental disability caused by
brain injury around the time of their birth or in
their early years.
The law requires an injured claimant’s lump sum
compensation to be calculated according to agreed
principles which assume that it should run out
on the day the claimant dies, having met all their
additional needs that were caused by the defendant’s
negligence at the time that those needs arise. This
principle of 100% compensation, which governs
the way lump sum compensation for future loss is
valued, is designed to ensure that the injured person
is neither under-compensated nor over-compensated
for the negligently-caused injury. In practice,
even with careful professional management of the
claimant’s compensation, it is impossible to ensure
that the claimant’s compensation will last until the
date of their death but not a day more.
Claimants with severe, permanent disability
caused by birth injury and other types of medical
negligence remain dependent on others for their
care throughout their life. Boyes Turner’s specialist
high value claims lawyers carefully consider with
our experts and our client’s family the best way to
provide for the injured person’s long-term needs,
and whether their settlement should be paid as a
lump sum, a PPO or a combination of both.
EXPERT WITNESS JOURNAL
Our specialist birth injury solicitors are experts
at ensuring that every foreseeable element of an
injured child’s future loss is identi昀椀ed and correctly
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JUNE 2026
