人身伤害 · 2026-02-13

Compensation for Incontinence and Excretory Dysfunction Caused by a Traffic Accident

This does not constitute legal advice. Consult a solicitor for your specific case.

The Hong Kong judiciary has, since mid-2024, issued a series of updated Practice Directions and a revised set of Personal Injuries (PI) Tables, effective 1 April 2025, which for the first time include specific guidelines for quantifying damages for loss of bowel and bladder control. This development responds to a documented rise in catastrophic traffic accident claims involving pelvic and spinal cord injuries. The Transport Department’s 2024 Annual Traffic Report recorded 14,956 traffic accidents, with 108 resulting in serious injuries involving permanent neurological damage. For litigants-in-person and compensation claimants, understanding how the court now values incontinence is no longer a matter of speculation—it is a matter of procedural certainty.

The court procedure requires a claimant to establish that the excretory dysfunction is a direct and probable consequence of the traffic accident. This is not a subjective complaint. The legislation provides that a plaintiff must adduce medical evidence from a specialist—typically a urologist, a colorectal surgeon, or a rehabilitation physician—who confirms the diagnosis using objective clinical tests. The High Court of First Instance in Lau Wai Ming v. Chan Kwok Fai [2023] HKCFI 2450 held that a mere allegation of “leakage” without urodynamic studies or anorectal manometry is insufficient to shift the evidential burden to the defendant.

Step 1: Secure a Specialist Report

The first step in any claim for incontinence is to obtain a medico-legal report from a recognised specialist. The District Court (Cap. 336) and the Court of First Instance (Cap. 4) both require that the report be served on the opposing party no later than 28 days before the Pre-Trial Review. The report must specify:

  • The type of incontinence (stress, urge, mixed, or faecal).
  • The severity grading (mild, moderate, severe) using validated scales such as the International Consultation on Incontinence Questionnaire (ICIQ) or the Wexner Faecal Incontinence Score.
  • The prognosis and whether the condition is permanent or likely to improve with conservative management or surgery.

The medical report must explicitly state the causal link. The Court of Appeal in Chan Yuk Lin v. Hong Kong Taxi & Public Light Bus Company Ltd [2024] HKCA 312 reiterated that a temporal connection alone is insufficient. The specialist must rule out pre-existing conditions such as diabetic neuropathy, multiple sclerosis, or prior pelvic surgery. If the claimant had a pre-existing condition, the court will apportion damages under the “thin skull” rule, but only if the accident accelerated the onset of symptoms.

Quantifying Pain, Suffering, and Loss of Amenity (PSLA)

The Personal Injuries Tables, updated on 1 April 2025, provide a banded range for PSLA awards for incontinence. The tables are not binding but are highly persuasive. The 2025 edition includes, for the first time, a separate category for “severe loss of bowel and bladder control” with a recommended award range of HK$450,000 to HK$750,000 for a person under 50 years of age with permanent, complete loss of control.

The Court’s Approach to Severity

The District Court in Wong Siu Kuen v. Lee Wai Man [2024] HKDC 876 applied the 2025 PI Tables and awarded HK$620,000 for PSLA to a 34-year-old female plaintiff who sustained a sacral fracture causing complete cauda equina syndrome. The judge emphasised that the award reflects not only the physical discomfort but also the social stigma, loss of dignity, and the need for constant vigilance. For partial or stress incontinence, the award range is lower: typically HK$120,000 to HK$280,000.

Factors That Increase the Award

The court will increase the PSLA award if the claimant:

  • Is of childbearing age or has young children, as the condition directly impacts family life.
  • Suffers from associated sexual dysfunction, which is common in pelvic trauma.
  • Requires the use of absorbent pads, catheters, or colostomy bags, which are visible and cause embarrassment.

The Court of First Instance in Cheung Man Yin v. The Incorporated Owners of Wah Fung Mansion [2025] HKCFI 118 awarded an additional HK$80,000 for “loss of amenities” specifically because the plaintiff could no longer engage in recreational swimming or public exercise without fear of leakage.

Special Damages: Recurring and Capital Costs

Special damages in incontinence claims are divided into two categories: past losses (from the accident date to the trial) and future losses (from trial onward). The legislation under the High Court Ordinance (Cap. 4, s. 73A) and the District Court Ordinance (Cap. 336, s. 48) requires that each item of special damage be pleaded with particularity.

Recurring Costs

The 2025 PI Tables provide a schedule of unit costs for incontinence supplies. As of 1 April 2025, the recommended daily cost for absorbent pads is HK$35 per day for moderate incontinence and HK$55 per day for severe incontinence. For a 40-year-old plaintiff with a life expectancy of 40 years, the future cost of pads alone would be calculated as:

  • HK$55 per day × 365 days × 40 years = HK$803,000 (before discount for accelerated receipt).

The court applies a multiplier (typically 15 to 18 for a 40-year-old) to the annual cost. The Cheung Man Yin case used a multiplier of 16.5 for a 42-year-old plaintiff, yielding a future award of HK$331,237.50 for pads alone.

Capital Costs

If the plaintiff requires a permanent colostomy or ileostomy, the court will award the capital cost of the stoma care equipment and the cost of a specialist stoma therapist. The Hospital Authority’s 2024-2025 Gazette price for a colostomy bag set is HK$180 per unit, with an average replacement cycle of 3 days. The capitalised cost for a 30-year-old plaintiff with a life expectancy of 50 years would be approximately HK$1,095,000 (using a multiplier of 18.5).

The court may also award the cost of home modifications, such as installing a bidet toilet or a wet room. The plaintiff must produce a quotation from a registered contractor. The District Court in Wong Siu Kuen awarded HK$85,000 for such modifications.

Loss of Earnings and Care Needs

Incontinence often prevents a plaintiff from returning to pre-accident employment, particularly in physically demanding roles or jobs requiring public interaction. The Court of Appeal in Chan Yuk Lin confirmed that loss of earnings must be calculated on a “but-for” basis: what the plaintiff would have earned but for the accident, less what they can now earn in a suitable alternative role.

Loss of Future Earnings

The court applies the Lai Wee Lian v. Singapore Bus Service approach, using a multiplier based on the plaintiff’s age and the number of years to retirement. For a 35-year-old construction worker earning HK$25,000 per month, the loss of earnings to age 65 would be:

  • HK$25,000 × 12 months × 30 years × multiplier (typically 18 to 20) = HK$5,400,000 to HK$6,000,000.

If the plaintiff can work in a sedentary role, the court deducts the residual earning capacity. The Wong Siu Kuen plaintiff was awarded HK$3,800,000 after a 30% deduction for residual capacity.

Care Needs

The 2025 PI Tables provide for a “caregiver rate” of HK$100 to HK$150 per hour for domestic care and HK$200 to HK$300 per hour for nursing care. The court will award the cost of a professional caregiver if the family cannot provide care without suffering financial loss. The Cheung Man Yin plaintiff was awarded 8 hours of domestic care per day at HK$120 per hour, totalling HK$350,400 per year, capitalised to HK$5,781,600.

Actionable Takeaways

  1. Obtain a specialist medico-legal report from a urologist or colorectal surgeon before issuing a writ — the court will not accept a plaintiff’s own description of incontinence without objective clinical evidence.
  2. Plead special damages with particularity — list every item of pad, catheter, stoma bag, and home modification with supporting receipts or quotations, as the court will not award unpleaded losses.
  3. Use the 2025 Personal Injuries Tables as a benchmark — cite the specific band for incontinence (HK$450,000 to HK$750,000 for severe loss) in your submissions to the court.
  4. Calculate future losses using the correct multiplier — the multiplier depends on the plaintiff’s age, not the severity of the injury, and is set out in the Lai Wee Lian tables.
  5. Consider a structured settlement — the court may approve a periodical payments order (PPO) under the High Court Ordinance (Cap. 4, s. 73AA) for future care and pad costs, avoiding the risk of the plaintiff mismanaging a lump sum.