Amputation claims: Looking back on 2025

This is the first of two articles focusing on amputation claims. This article will look back over some key themes in amputation claims over 2025 and consider what we can learn from them; and the second part will look ahead to the themes we expect to develop in 2026.

Causation issues regarding the amputation  

We are aware of only one reported case concerning an amputation claim in 2025 - which is perhaps itself evidence of the likelihood that these cases will be settled pragmatically, despite a common feature of amputation claims being that claimants and defendants often start negotiations very far apart due to differences in expert opinion as to the necessity of top-of-the-range prosthetics including microprocessors; the number of specialist limbs being sought on top of the core limb for a variety of different purposes/hobbies; and other big ticket items such as accommodation adaptions or assistive technology. We saw throughout the year that identifying the right experts is therefore crucial for amputation cases where the differences in the value of the claim can be significantly affected by which expert is preferred.  

Key case in 2025: Haley v Newcold Ltd [2025]

Returning to 2025’s only reported case, Haley v Newcold Ltd [2025] EWCC 57, we saw that causation following an elective amputation must always be closely tested. You can read our article discussing the decision and its implications for more detail, but in summary the claimant’s elective below the knee amputation, which was said to be due to accident-related pain, was found to have not been clinically required and therefore the defendant was not liable for post-amputation losses. As we reflect in the more detailed article, this case shows that causation should always be investigated by obtaining strong expert evidence and considering surveillance where appropriate.  

The importance of investigating causation is a theme we saw throughout the amputation claims we worked on in 2025. For example, causation issues arising from previous health conditions such as type II diabetes, respiratory conditions arising from smoking, and vascular issues, frequently create a double-edged sword for causation. One on hand, there may be an argument that a claimant would have been at risk of amputation in any event but for the accident; but on the other hand, there is the risk of causation being established and insurers being faced with a claim from a double amputee. The medical history therefore requires to be considered closely in every case.  

Exploring alternatives to amputation

We also had success in scrutinising whether there are alternatives to amputation, such as surgery to try to save the limb, and also in looking for contributions from the NHS or treating consultants where the loss of the limb has been partially caused by clinical negligence. We hosted a number of events across our offices this year, including a  talk from members of the clinical team at  the Oxford Bone Infection Unit (“OBIU)”, to learn about the work they do in managing bone infection and limb reconstruction, with a view to understanding how limb viability can be preserved. This highlighted the importance of early intervention, but also even if that is not achieved, how referral to specialist units such as the OBIU can change the course for the better, and lead to positive outcomes and limb preservation. 

There are therefore a variety of ways in which investigating both causation and potential treatment options, can lead significant savings for insurers who are faced with amputation claims.  

Partial limb amputation 

We observed throughout 2025 that we are seeing an increasing number of cases where expensive prosthetics are claimed for partial upper limb amputations. Digit/partial digit prosthetics often come at a high price compared to the level of functional improvement which can be expected to be achieved with them. We know that the reality is that these prosthetics may often not be used after the first cycle of provision for a variety of reasons, including the appearance; the ability of users to adapt to function without the need for the prosthetic; and the poor functionality as compared with the benefits gained from other larger prosthetics. The court’s approach is not to focus on the (sometimes exorbitant) cost, but on the possible improvement in quality of life/function. These cases are therefore another area where obtaining clear expert evidence is crucial.  

The role of early rehabilitation 

Throughout the year we saw that early rehabilitation can lead to positive outcomes for both claimants and insurers. Early comprehensive rehab input, especially where there is an expensive prosthetics regime being proposed, is important to ensure that recovery is maximised. We also had success in using information gained during the rehab process to make early offers and engage the claimant’s agents in negotiation, with a number of cases settling in under a year post-accident due to rehab evidence giving a clear steer on the value of the case.  

Technological advancements  

Amputation claims continued to be affected by developments in technology. The potential for advancements to improve the quality of life for those with amputations is significant. We acted in claims involving the fairly new technique of osseointegration (which involves a prosthetic adaptor being surgically fixed to the limb), and we have seen that there are continuing developments in how osseointegration can be used. We understand that 2025 saw clinical trials such as use of 3D printing to create functional scaffolds for the bone and use of new coating on the titanium implants to minimise the risk of infection. Osseointegration has benefits including improved stability and strength, and a more normal gait, so continued advancements in the effectiveness of this are encouraging.  

We also commented on a recent research trial involving a bionic knee, which involves artificial muscle electrodes to be fitted to the muscle, allowing the user to walk and move their prosthetics as unthinkingly as anyone else. This research has obvious potential benefits for those using prosthetics going forwards.  

The potential for AI to reshape and advance all aspects of life has become clear in 2025 and prosthetics are no exception. We highlighted how AI is being used in limb loss treatment for a range of improvements from prosthetic design to assessing limb viability.  

Finally, 2025 also continued to see tragedies unfolding in the Ukraine War, including many people suffering limb loss. This led to the development of a prosthetics sector where advanced limbs are being produced at lower costs, which may have wider impacts on the global prosthetics market.   

Conclusion 

In short, we saw in 2025 that amputation claims require early and proactive management to secure the best outcomes, whether that is through starting the rehabilitation process, investigating causation, or looking for early settlement negotiations. We also saw that the best results are achieved through working closely with others involved in the case, including the right medical and prosthetics experts.