In a previous article on the Lacey Solicitors website we discussed how interim payments in personal injury claims in Northern Ireland can provide vital financial support to injured victims while litigation progresses through the courts.
Interim payments are particularly important in catastrophic injury and medical negligence claims, where the injured party may require urgent funding for accommodation, rehabilitation, treatment or care long before the case reaches trial.
A recent decision of the High Court of Justice in Northern Ireland — Sarah Stewart v Northern Health and Social Care Trust [2026] NIKB 2 — provides a useful and detailed illustration of how the courts approach applications for large interim payments and the caution that judges may exercise when the likely value of a claim remains uncertain.
Background to the Case
The case arose from a claim for damages following an alleged failure to diagnose cauda equina syndrome, a serious spinal condition requiring urgent surgical intervention.
The plaintiff presented to hospital in January 2018 with a number of concerning symptoms including:
- numbness below the level of the umbilicus
- back pain
- heaviness in the legs
- altered sensation
- urinary and bowel symptoms
Despite these symptoms, she was discharged following her attendance at hospital. Two days later she attended the Royal Victoria Hospital where an MRI scan revealed a large ruptured disc compressing the spinal cord, and emergency surgery was carried out.
The plaintiff subsequently issued proceedings alleging that the delay in diagnosis and treatment had caused significant long-term neurological injury.
The defendant Trust admitted a breach of duty in failing to diagnose the condition when the plaintiff first attended hospital, although causation and the extent of the resulting damage remained disputed.
The Application for an Interim Payment
During the course of the proceedings the plaintiff applied for an interim payment of £500,000 pursuant to Order 29 of the Rules of the Court of Judicature (Northern Ireland).
The Trust had previously offered an interim payment of £50,000, but the plaintiff argued that a substantially larger payment was justified given the seriousness of her injuries and the likely value of the claim.
The Master initially granted the application and ordered the Trust to make the payment.
The Trust subsequently appealed that decision to the High Court.
The Legal Framework for Interim Payments
The High Court reviewed the provisions contained in Order 29 of the Rules of the Court of Judicature (Northern Ireland).
In personal injury actions the court may order an interim payment where it is satisfied that:
- the defendant has admitted liability;
- judgment has been obtained with damages to be assessed; or
- if the action proceeded to trial, the plaintiff would obtain judgment for substantial damages.
If those conditions are satisfied, the court has a discretion to order a payment not exceeding a reasonable proportion of the damages likely to be recovered at trial.
Importantly, the court must effectively place itself in the position of the trial judge and ask whether, on the evidence currently available, the plaintiff is likely to succeed and obtain a substantial award.
Expert Evidence in the Case
In the Stewart case, the court had the benefit of a joint minute between two medical experts addressing the issue of causation.
Those experts agreed that if the plaintiff had undergone MRI scanning and surgery on the earlier date when she first presented at hospital, she would likely have experienced a significantly better outcome.
Among the consequences identified were:
- worsening lower limb weakness
- persistent sensory disturbance
- dysaesthetic pain
- bladder dysfunction
- bowel difficulties
The plaintiff also claimed substantial future financial losses, including loss of earnings and accommodation needs.
A forensic accountant retained by the plaintiff estimated the total potential claim to be between £2.46 million and £3.29 million, depending on various assumptions regarding disability and care requirements.
Why did the Court Refuse the Interim Payment?
Although the judge accepted that the plaintiff would recover damages if the case proceeded to trial, the court ultimately refused the application for an interim payment of £500,000.
The key difficulty was that too many uncertainties remained regarding the likely value of the claim.
In particular:
- the defendant had not yet produced its own forensic accountancy evidence
- expert evidence on several aspects of the claim had not yet been tested
- the eventual calculation of special damages could vary significantly depending on the outcome of expert meetings and further reports
The judge noted that attempting to estimate the final value of the claim in these circumstances would be “a foolish exercise”.
While it was possible that the final award might exceed £500,000, the court was not satisfied that the figure represented a reasonable proportion of the likely damages, which is the legal test required by Order 29.
Because the application before the court sought only the specific figure of £500,000, the judge had to either grant or refuse that application.
The appeal was therefore allowed and the interim payment application dismissed.
Clarification on the Role of “Need”
An interesting aspect of the judgment concerned the argument that interim payments should be linked to the immediate needs of the plaintiff, particularly in relation to accommodation. This was an approach taken in Eeles v Cobham Hire Services Ltd [2009] EWCA Civ 204 where the Court of Appeal in England set out a new two stage test for interim judges to consider when making a decision on applications for interim payments.
The High Court in Belfast rejected that approach.
The judge observed that Order 29 does not require the court to consider an individual’s financial need when determining whether to order an interim payment.
Instead, the focus must remain on the statutory test – namely whether the proposed payment represents a reasonable proportion of the damages likely to be recovered.
The court distinguished earlier authorities such as Eeles v Cobham Hire Services Ltd, noting that those decisions largely concerned cases involving periodical payment orders which differ to interim payments.
Practical Lessons for Personal Injury Solicitors
The decision provides several useful insights for practitioners involved in serious injury litigation in Northern Ireland.
Courts adopt a cautious approach
Judges are likely to take a conservative approach when assessing the likely value of a claim at an early stage in proceedings.
Evidence is crucial
Large interim payments are more likely to succeed where:
- expert evidence is fully developed
- accountancy evidence has been exchanged
- the likely value of the claim can be assessed with greater confidence.
The amount sought must be justified
Where an application seeks a specific figure, the court must be satisfied that it represents a reasonable proportion of the likely final award.
If that cannot be demonstrated, the application may fail entirely.
Interim Payments in Catastrophic Personal Injury Litigation
Interim payments remain an important feature of serious injury and medical negligence litigation in Northern Ireland.
Where liability is admitted or where an individual is likely to succeed at trial, the courts have the power to order payments that allow injured individuals to access treatment, accommodation and rehabilitation while their case proceeds.
However, the decision in Stewart v Northern Health and Social Care Trust demonstrates that the courts will exercise that power carefully, particularly where the overall value of the claim remains uncertain.
