Valuing a Lifetime of Care: Inas Faiqah and the Rise of Birth-Injury Awards

When a child is left with a permanent brain injury at birth, the hardest question in court is often not who was at fault but what a lifetime of care will cost. In Inas Faiqah bt Mohd Helmi v Kerajaan Malaysia & Ors [2016] 2 MLJ 1, the Federal Court explained how sure a judge must be before awarding money for losses that lie decades ahead. Since then, appellate awards in birth-injury claims have climbed to a reported record of RM9.45 million.

A damages-only trial after liability was conceded

The plaintiff was born in a government hospital and suffered severe brain damage. She developed spastic quadriplegic cerebral palsy, a form of cerebral palsy that affects all four limbs. Suing through her father, she alleged negligence before, during and after her delivery. Liability was conceded, so the trial was about one thing only: the amount of compensation.

According to the published summary of the case, the High Court’s award was about RM1.19 million, but several items of future care were rejected or trimmed because they had not been sufficiently proved. The Court of Appeal affirmed that result, and the case went to the Federal Court on a question of principle.

How certain must the future be?

Personal-injury damages in Malaysia are awarded once and for all, as a single lump sum; section 28A of the Civil Law Act 1956 contains some of the governing rules. For a severely disabled child, most of that sum relates to things that have not happened yet: therapy, equipment, nursing help, adapted transport, a parent’s time. Nobody can prove the future with the precision of a receipt for a bill already paid.

The question before the Federal Court was whether future loss must be strictly proved, or whether it is enough to show a possible likelihood that the loss will occur, an approach found in English and Canadian authority.

The Federal Court’s answer

The court held that the standard of proof for future loss is still the balance of probabilities, the ordinary standard in civil cases. What differs is the degree of certainty required about whether the loss will occur. A court may act on a substantial possibility or risk that an expense will be incurred. It may not act on speculation.

On the facts, the Federal Court found that the trial judge had not applied too strict a standard. The items that failed did so for lack of evidence. Even so, the court increased the award in some respects. As reported, the adjustments concerned parental care, an adapted vehicle and caregiver training.

Analysis: less certainty is required, not less evidence

Two messages come out of the decision. The first helps claimants: a future-care item should not be refused simply because no one can be certain the cost will arise. A real and substantial chance is enough. The second helps defendants: the burden of proof stays with the claimant, and every item needs an evidential foundation, such as a care plan, a treating doctor’s or therapist’s recommendation, and a quotation or costing. Inas Faiqah lowers the certainty required; it does not remove the need for evidence.

The awards that followed

The most prominent example is the claim of Thaqif Asyraf Khairol Nizam against the Government of Malaysia. The High Court in Penang awarded RM7.6 million. On 25 September 2024 the Court of Appeal dismissed the Government’s appeal, allowed the plaintiff’s cross-appeal and raised the total to RM9.45 million. That sum included about RM8 million for future care, RM735,000 in special damages (financial losses already incurred) and RM400,000 in general damages (pain, suffering and loss of amenity). Press reports and legal commentary have described it as the highest medical negligence award in Malaysia, and it was reported that the Government did not seek leave to appeal further within time.

In the claim of Nur Adeena Mohd Syahmir against the Government, which concerned a birth-related spinal cord injury at Hospital Selayang and in which liability was admitted, the Court of Appeal on 27 March 2024 increased the award to RM8.6 million.

On 3 September 2026 CodeBlue reported that RM9.45 million remained the record, followed by RM8.6 million. The same report stated that the Ministry of Health paid out about RM189 million in medico-legal cases between 2012 and 2021, and treated the absence of periodic payments in Malaysian law as a live policy issue. Because a single lump sum has to last a lifetime, the evidence on future care carries great weight for both sides.

Practical takeaways for families, doctors and hospitals

• Families and patients: prepare the future-care claim item by item. Care plans, therapists’ recommendations and quotations for equipment, home help and transport are what turn a substantial possibility into an award.

• Families and patients: an admission of liability does not end the case. The assessment of damages can be a full trial of its own, with experts on both sides.

• Claims against government hospitals: the Government of Malaysia is sued under the Government Proceedings Act 1956, and section 2(a) of the Public Authorities Protection Act 1948 sets a 36-month time limit. Do not assume that a child’s age extends that period; take advice early.

• Doctors: where liability is not in dispute, the real contest is the size of the award. Accurate contemporaneous records and an early, realistic assessment of the case help everyone, including the family.

• Hospitals and the Government: seven-figure lump sums are now common in catastrophic birth-injury cases. Each future-care item is better tested with the defendant’s own expert costings than by general objection, and indemnity arrangements should be reviewed against current award levels.

• Other practitioners, including aesthetic practitioners: the approach to future loss is general. It applies to any personal-injury claim, whether the injury happens in a labour ward, an operating theatre or a clinic.

Authorities and sources

• Inas Faiqah bt Mohd Helmi (an infant suing through her father and next friend, Mohd Helmi bin Abdul Aziz) v Kerajaan Malaysia & Ors [2016] 2 MLJ 1 (Federal Court)

• Thaqif Asyraf Khairol Nizam v Government of Malaysia (High Court, Penang; Court of Appeal, 25 September 2024)

• Nur Adeena Mohd Syahmir v Government of Malaysia (Court of Appeal, 27 March 2024)

• Civil Law Act 1956, s 28A; Government Proceedings Act 1956; Public Authorities Protection Act 1948, s 2(a)

• Free Malaysia Today report carried by Daily Express, and SAYS, on the Court of Appeal’s decision of 25 September 2024

• CodeBlue, 3 September 2026

• Published law-firm commentary by Mah Weng Kwai (2024 medical negligence round-up; brain-injury damages) and RDS (19 November 2025)

This article is general legal information only and is current as at 19 September 2026. It is not legal advice and does not create a solicitor-client relationship. Court decisions may be appealed and the law may change; please seek advice on your own circumstances. — Chris & Partners, Advocates & Solicitors