Losing a finger, hand, arm, foot or leg can change your life profoundly. If someone else is liable for the accident, the personal injury claim should not look only at the initial medical costs. Prostheses, adaptations, assistance, work and future needs may also be relevant. The extent varies considerably from person to person and from one amputation to another.
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Written by Onur Arslan, attorney at Arslan Advocaten. Registered in the specialisation register of the Netherlands Bar for employment law and personal injury. Last updated: 17 September 2026.
Appropriate compensation starts with a careful picture of what you need to live as independently as possible. Medical, practical and financial questions must fit together. Which facilities help, who pays which part and which costs recur? In this article you will read how to map out those questions together with the experts involved.
In brief
- After an amputation, the loss consists mainly of long-term costs: prostheses, replacement, maintenance, aids, housing, transport and care.
- Losing a finger, hand or leg leads to very different consequences; your occupational situation carries considerable weight.
- Future losses may be assessed now; record the assumptions about lifespan, replacement frequency and price level explicitly.
- Health insurance and the Wmo (Social Support Act) often cover a basic facility. The difference from the facility that suits you may be recoverable loss, provided you substantiate that the more expensive facility is necessary and reasonable in your situation. The price difference alone is not automatically your loss; the added value must be demonstrated in functional terms.
- Hold off on a full and final settlement until your future needs have been mapped out with an expert.
Liability and the cause of the amputation
An amputation may follow, for example, a road traffic accident or an incident involving a machine. Before compensation can be paid, it must first be established who is legally liable. In a workplace accident, the employer’s duty of care may be central; in a traffic incident, the circumstances of the accident and the conduct of those involved.
Keep evidence of the event, such as witness details, photographs, an accident report and information about work equipment. If the amputation only becomes necessary after treatment, the connection with the original injury must also be clear. That passage of time does not automatically rule out attribution, but it does require medical substantiation.
If a dispute arises about possible medical negligence, that is a separate investigation. A necessary amputation after serious injury does not automatically mean that the healthcare provider fell short. The cause, the treatment and the professional standard must be carefully distinguished from the original accident.
Losing a finger is not the same as losing a leg
The location and extent of the amputation partly determine which functions are affected. With hand or finger injuries, gripping, fine motor skills and the use of tools may be important. With a leg amputation, mobility, balance and access to your home play a role, among other things. Your doctor and rehabilitation team assess your individual capabilities.
Your occupation and daily life also make a difference. A craftsman who works with small components may be specifically restricted by the loss of a finger. Someone with a leg prosthesis may function well in certain activities, while other tasks require extra effort or support. General assumptions about complete incapacity or complete recovery are therefore of no use.
Describe what you did before the accident and what changes you experience now. The aim is not a list of everything that is impossible, but a realistic overview of capabilities, limitations and support needs. That overview forms the basis for a targeted assessment of the loss.
Rehabilitation and practical goals
Rehabilitation focuses on your functioning and may include various forms of support. The practitioners decide with you which goals are appropriate. For the claim, it is useful to make clear which facilities or adaptations contribute to those goals and what costs they involve.
Ask for relevant information about the expected course of your recovery. What is provisional, which options are still being explored and when can a more lasting assessment take place? These questions help to avoid basing a settlement proposal too early on uncertain assumptions.
Your legal process should not place an unnecessary burden on your recovery. Agree who gathers information and which questions are put to which expert. Medical reports do not need to be drawn up again each time if existing information is sufficient. At the same time, changes with financial consequences must be kept track of.
Prostheses and the question of which costs are reimbursed
A prosthesis can be important for mobility or hand function, but suitability is personal. The type, fit, intended use and load capacity are discussed with experts. The most expensive facility is not automatically the right one; equally, a choice based solely on the lowest price may not be appropriate either.
Limb prostheses fall under the medical aids cover of the basic health insurance: your health insurer is the first to pay, under the Health Insurance Act (Zorgverzekeringswet) and the Health Insurance Regulation (Regeling zorgverzekering). This sets out which medical aids are covered by the basic insurance and on what conditions. So this is not the municipality: the Wmo mainly comes into play for home adaptations, transport facilities and domestic help, and the UWV, the Dutch employee insurance agency, for facilities you need in order to work. Bear in mind prior approval, an authorisation, the compulsory excess and any personal contribution.
For the claim, it must also be clear which facility is medically and functionally indicated and what is available through health insurance or other schemes. If a reasonable need is not fully covered by a facility, a remaining head of loss can be investigated. This requires substantiation of the added value and the extra costs.
Ask for an itemised estimate. Distinguish between components, fitting, training, maintenance and any repairs. This makes it possible to assess which costs are one-off and which recur. An overall quotation without explanation makes a future calculation more difficult.
Facilities and replacement: assumptions and funding
Future losses become verifiable as soon as the assumptions are on the table. This table is the basis on which an actuary calculates the present value. Fill it in with your own quotations; the figures below are a fictitious example.
| Facility | Cost per item | Lasts | First payer | What remains as loss? | Assumption you record |
|---|---|---|---|---|---|
| Everyday leg prosthesis | € 18,000 | 4–5 years | Health insurer (Zvw) | Extra cost of a functionally necessary version above the reimbursed model | Replacement frequency and whether the added value is medically substantiated |
| Liner and socks | € 900 per year | Consumable | Health insurer | Compulsory excess and any personal contribution | Recurring annually until the statistical end age |
| Maintenance and repair | € 600 per year | Ongoing | Partly health insurer | Uncovered maintenance and fitting adjustments | Annual amount, indexed |
| Second (shower or sports) prosthesis | € 7,500 | 6 years | Rarely reimbursed | Usually in full, if the necessity is established | Whether a second facility is reasonable in your situation |
| Home adaptation | € 25,000 | One-off, components 10–15 years | Wmo (municipality) | The difference between the amount granted and the actual costs | Replacement cycle of stairlift, shower and door openers |
| Adapted car | € 9,000 adaptation | 8 years | Wmo or UWV | Purchase of the car itself; adaptation on replacement | Driving distance and time of replacement |
| Domestic help | € 3,500 per year | Ongoing | Wmo | Hours above the allocation; care provided by family members | Number of hours and hourly rate |
Replacement, maintenance and additional aids
A facility may need to be adjusted or replaced over time. The frequency depends on use, technical lifespan and changes in your situation. Do not assume a universal replacement period. Ask the supplier and practitioner for a substantiated expectation.
In addition to a prosthesis, other aids may be needed, for example for personal care, transport or certain daily tasks. Investigate whether facilities complement or overlap each other. An aid for sport has a different purpose from a facility for everyday mobility; reasonableness must be assessed for each need.
Record who bears the costs and how applications are handled. If an application is refused, keep the decision and the reasons given. That information may be relevant to an objection against the decision on the facility as well as to the personal injury claim, but both procedures have their own rules and time limits.
Home adaptation and independent living
After an amputation, your home may be less accessible. Think of stairs, the bathroom, thresholds or the space needed to use aids. Not everyone needs the same adaptation. An expert assessment must match your capabilities and the actual home.
Sometimes limited measures are sufficient; sometimes a larger renovation or a move is considered. Necessity, usability, costs and future expectations all play a role in that assessment. A personal injury claim does not automatically give a right to every desired home improvement. However, reasonable accident-related additional costs must be seriously assessed.
Obtain quotations and make clear which elements are needed because of the accident. Involve any municipal or other facilities. Where possible, discuss major irreversible choices in advance, so that there is no dispute later about alternatives that were never explored.
Transport and participation in daily life
Mobility is not only about medical appointments. Work, shopping and social activities may also change because of limitations. Which transport solution is appropriate depends on your functioning and the options available. Any fitness to drive and adaptations must be assessed through the designated expert channels.
For the assessment of the loss, the extra costs compared with the situation without the accident are relevant. Think of adapted transport or necessary extra costs of a vehicle. A full purchase price is not automatically entirely accident-related loss if you would also have had transport without the accident.
Record usage, distances and costs. A structural solution also includes maintenance and replacement, insofar as these are sufficiently substantiated. Keep the relationship with other facilities visible, so that the same transport need is not included in several budgets.
Care, informal care and personal care
You may temporarily or permanently need help with washing, dressing, transfers or other activities. The need may change during rehabilitation. Describe the tasks separately, with frequency and duration. The number of hours a family member is present alone says nothing about how much care is actually provided.
Unpaid help from family may qualify for compensation under certain conditions. That is not automatically equal to the income a partner gives up. The type of care, its reasonable extent and the legal assessment must be investigated. Where intensive help is needed over a long period, the feasibility for family members also deserves attention.
Professional care, personal budgets and other facilities must be considered together. Draw up an overview of the care required, the available cover and the remaining need. This makes clear which loss still needs to be compensated and prevents double counting.
Work and loss of earning capacity
The effect on your work must be investigated in concrete terms. Which tasks can you still perform, which aids are possible and is other work realistic? A vocational expert can translate the medical limitations into the requirements of your occupation. The outcome differs from a general disability percentage.
For the financial loss, your situation with the accident is compared with the likely situation without the accident. For employees, salary, allowances and sufficiently concrete career developments may play a role. For the self-employed, business results, replacement and reasonable adjustments to the business are also relevant.
Also investigate possible pension loss. A lower earning capacity may affect pension accrual, but a premium waiver or other schemes may limit the loss. The specific pension scheme determines what must be calculated. Do not add a standard percentage to the loss of income without substantiation.
Compensation for pain and suffering after an amputation
Compensation for pain and suffering (smartengeld) concerns the non-pecuniary consequences, including pain, loss of independence and changes in your life. With an amputation, the nature and severity of the injury are important circumstances. Treatments, recovery time, permanent limitations and personal consequences are also taken into account.
An amount for the loss of a finger cannot simply be applied to the loss of an arm or leg. Even with the same amputation, the circumstances may differ. Case law can provide guidance, but it is not a price list. A careful assessment must explain why the comparison fits.
Smartengeld is not the budget from which you then have to fund all necessary care. Care costs, aids and loss of income are separate heads of pecuniary loss. So check whether an overall amount offered clearly distinguishes between those components.
Consequences for your partner and family
An amputation can change the entire household. Your partner may take over tasks and family activities may need to be adjusted. For the claim, it must be clear which loss belongs to you and which claims a family member may have in their own right. Not every emotional or practical burden automatically gives rise to separate compensation.
In the case of serious and permanent injury, bereavement and affection damages (affectieschade) may be explored under statutory conditions. This is a separate claim for a limited circle of close relatives and has a different legal basis from your smartengeld. The severity and permanence of the injury and the relationship must be assessed; an amputation does not necessarily lead to the same outcome in every situation.
Make the consequences for your family open to discussion without trying to translate everything into money. Sometimes practical support helps more than an additional description of loss. For the legal assessment, it remains necessary to distinguish between concrete costs, care and non-pecuniary claims.
Calculating future losses with clear assumptions
With long-term losses, costs are often estimated over several years. Assumptions about needs, duration, price developments and the time of payment then become important. Ask for a calculation in which you can see which facility or cost item has been included for which period.
A lump sum must be able to cover recurring expenditure within the assumptions made. This sometimes requires an actuarial assessment. It is not enough to multiply an initial annual amount by an arbitrary number of years without explanation. Changes in work, care and facilities may also be relevant.
Discuss uncertainties separately. Perhaps the final prosthesis has not yet been chosen or the home adaptation has not yet been investigated. Sometimes additional information is needed before a final settlement is responsible. Other uncertainties can possibly be dealt with through clear agreements or a reservation.
Fictitious example of a hand amputation at work
An employee loses a hand in an accident involving a machine. In this fictitious example, the employer accepts liability. The first priority is treatment and rehabilitation. At the same time, information about the machine, the instructions and the accident is preserved.
For the claim, aids, help at home and work options are then investigated. The former job involves a great deal of two-handed work. A vocational expert looks at adaptations and other positions, while a financial expert calculates the consequences. The employee is not regarded as fully unfit for work without investigation.
For a final settlement, maintenance of aids, future care and pension accrual are also assessed. The example shows why a serious personal injury case requires several areas of expertise and cannot be concluded with an amount of smartengeld alone.
Organising maintenance and replacement in a personal plan
An aid may be suitable on delivery, but then requires maintenance, adjustment and sometimes replacement. So draw up a practical overview of the facilities you use and who is responsible for servicing. Also state how you function when an aid is temporarily unavailable.
With a prosthesis, the intended uses may differ. Walking at home, travelling to work and a specific sporting activity do not necessarily make the same demands. Ask an expert to explain which facility is needed for which purpose and which alternatives are appropriate. The most expensive version is not automatically recoverable, but the cheapest solution is not automatically adequate either.
When obtaining cost estimates, ask which elements are included. Think of check-ups, parts that wear out, necessary adjustments and any temporary replacement during repairs. Only include costs that are sufficiently related to your specific need. A general list of every conceivable product does not make the assessment stronger.
Then record which party pays. A health insurer may reimburse a facility while certain reasonable additional costs are still in dispute. Keep those elements separate and keep decisions and refusals. This makes it possible to investigate which part belongs in the personal injury claim without double compensation.
In a final settlement, discuss how changes in your situation have been taken into account. Growth in a child, different work or changes to the home may affect usage. Not every future development is certain. That is precisely why the assumptions, uncertainties and any agreements on reassessment must be clearly described.
A personal facilities plan brings this information together. It shows you, your healthcare providers and your representative which choices are needed now and which decisions can only responsibly be taken later.
The legal basis for long-term losses
In cases of serious injury, the law allows the future to be assessed as well:
- Article 6:162 of the Dutch Civil Code (BW) or Article 7:658 BW the legal basis, depending on whether the accident happened on the road, at work or elsewhere. In a workplace accident, the employer bears the burden of proving that it complied with its duty of care.
- Article 6:96 BW compensation for pecuniary loss, including reasonable costs of establishing the loss, such as a vocational or occupational therapy assessment.
- Article 6:97 BW the court assesses the loss in the manner most consistent with its nature and may estimate it where exact calculation is not possible.
- Article 6:105 BW the key provision: loss that has not yet occurred can be assessed in advance after weighing up the good and bad prospects, as a lump sum or as periodic payments. This allows prosthesis replacements over thirty years to be included.
- Article 6:107 BW costs incurred by family members on your behalf that you could have claimed yourself, plus care they provide. See also the domestic help guideline.
- Article 6:106 BW smartengeld; for very serious and permanent injury, the amounts in case law fall into the highest category, but there is no fixed tariff.
The articles have been checked on wetten.overheid.nl. With long-term losses, the quality of the assumptions matters more than the calculation method: have them recorded explicitly and made verifiable.
Frequently asked questions about amputation and compensation
Can I claim the costs of future replacement?
Yes, if the need and the expected replacement are sufficiently substantiated. The period varies per aid and per user. Ask for an estimate covering maintenance, fitting and lifespan rather than a general fixed cycle.
Is the loss of a finger enough for a personal injury claim?
It can certainly be relevant, depending on liability and consequences. Fine motor skills and the practice of your occupation may be seriously affected. The extent of the injury alone does not predict the financial loss in your specific situation.
Do I have to apply for all facilities first?
The relationship between facilities and the claim must be coordinated. Which application is reasonable and who advances the costs differs from case to case. Do not let urgent needs slip out of view while organisations refer you to one another.
Can my partner also receive compensation?
Extra help or certain claims in their own right may be relevant under certain conditions. Affection damages are subject to specific statutory conditions. Not every burden on a partner is a separate head of loss. Have the different legal bases assessed separately.
When can the case be settled definitively?
When limitations, needs and the future are sufficiently clear, or uncertainties can be dealt with carefully. A medical assessment alone is often not enough; work, housing and care must also be taken into account.
How much smartengeld will I receive after an amputation?
There is no fixed amount for every amputation. The severity, permanent consequences and personal circumstances are decisive. Moreover, smartengeld is only one component alongside pecuniary loss such as income, aids and care.
Who pays for my prosthesis: the health insurer or the liable party?
Often both pay a part. Health insurance or the Wmo usually covers an adequate basic facility. If a more expensive, functionally more suitable prosthesis is needed for your work or daily life, the difference can be recovered from the liable party. Substantiate this with advice from your rehabilitation physician or orthotist-prosthetist.
How are replacement costs over thirty years calculated?
By recording the lifespan of the facility, the replacement frequency, the price and the maintenance, and discounting that series to a present-day amount. Discount rate, inflation and life expectancy are assumptions that have a major influence. Always ask for the starting points used, so that you can have them reviewed.
Can I opt for periodic payments instead of a lump sum?
Yes, Article 6:105 BW expressly mentions that possibility. In practice, parties usually opt for a lump sum with full and final settlement. Periodic payments or a reservation for specific future costs may be appropriate where the need could change significantly. Take the tax consequences of both options into account.
Putting your future needs first
Arslan Advocaten can discuss with you which experts and information are needed to map out your loss carefully. Bring information about treatment, rehabilitation, work and facilities. We also look at advance payments for needs that have already been substantiated and at clear agreements on costs.
Read more about personal injury or contact us for an assessment of your situation.
Related articles
- Spinal cord injury after an accident
- Informal care and personal care after an accident
- Personal injury after a workplace accident
- Loss of income and loss of earning capacity
- Domestic help guideline
- Full and final settlement: do not sign too quickly
- Smartengeld: what are you entitled to?
Sources and further information
- The Dutch judiciary on personal injury
- The Dutch Personal Injury Council (Letselschade Raad) on guidelines
