An elderly 74-year-old Maltese woman who was seriously injured in a traffic accident last December has been unable to leave her home on the second floor at will as a result of her injury, and she has not yet received any payments from the insurance company used by the driver who hit her.

Maria (a pseudonym given to protect her identity) was walking towards her house last December, when she, and another woman, was hit by a vehicle.

She has, as a result, suffered extensive injuries to her leg, and has been unable to leave her home at will ever since returning after her stint in hospital. She has been unable to leave at will as she lives on the first floor of her home, and cannot currently use the stairs leading down to her ground floor.

This newsroom met with Maria, who manages to move around in her apartmenr despite her injuries, but has to literally fall back onto a chair to get into her kitchen, due to a slight change in room level and her being unable to go up one step because of the injury. She is an independent woman, and looks to have been quite active prior to her injury.

Maria’s pension income is under €500, and she doesn’t have much saved, she said. She lives alone, and has no family locally.

She said that she doesn’t want to be a burden on anyone. Describing the accident, she said: “I was returning back home from the butcher, and another woman was walking on the pavement on the opposite side of the road. I was carrying my bag and had a carrier bag with me. I knew the woman on the other side of the road, and told her not to get off the pavement. At that moment, I was hit and scraped along the wall. I saw the other woman sitting on the pavement holding her head.”

“By this point other people came. My hands were shaking and I had blood coming down from my head. I remained conscious. The police came and I was yelling for one of my neighbours, who I know well, to come over.”

The ambulance then took her to hospital. Where she received some treatment for the injuries she suffered, mainly in her hand and leg.

This newsroom was told that the driver of the car was given a €250 fine and had her driving licence suspended for one week.

Just after her accident, she spent two months at Mater Dei Hospital and another two at the Karin Grech Rehabilitation Hospital, she said. She then wanted to go home, and did. “I wanted to go home, and didn’t realise how complicated it would be.”

Thus far, she has undergone two operations, but is unable to conduct another on her leg due to an infection. After a biopsy was taken, the doctors told her that her best option was to travel to the UK for an operation there. She told this newsroom that the Maltese doctors informed her that if the operation fails, they might need to amputate.

“I’m an active woman, and now find myself in this position...” she said as she became slightly worried.

She said that prior to having the leg operation, she needs to fight off an infection she currently has, which is being treated through antibiotics. In October, she will check whether her infection is gone.

The Housing Authority, her as well as a friend of hers explained, has agreed to provide the funds required to install a stair lift so that she will be able to head downstairs, as well as a swivel chair she requested, which would make life easier for her when getting into the kitchen and which she would be able to use to help her when bathing. They argue however, that she would rather not have to take money from the state for this. Her friends who represents her also said that they want to pay it back it back when the insurance payments are eventually made.

When in hospital, she was offered the meals on wheels service once she arrived home and support from social services.  When going home, she told the meals on wheels service that she didn’t require them, opting to cook for herself. Someone she knows helps her out with the grocery shopping.

She said that the insurance agency of the driver who had hit her with a car want to know her percentage disability before making any payments. “If I don’t even know what is going to happen with the operation for my leg, how can I give an answer for that?”

This newsroom asked the insurance agency to explain why no funds have been given to the accident victim, and if it is due to them requiring information, why a small amount cannot be given until the final amount is settled.

The agency would not speak about the specific case due to data protection regulations, however answered in general terms. “When a person suffers loss or damage as a result of a car accident, he or she will be entitled to compensation by law payable by the responsible person.  Since third party liability insurance is compulsory, it is often the insurance company of the responsible party that ends up paying such compensation.  Therefore the relationship between the injured party and the insurance company of the responsible party is not a contractual one, as is the case between the a policyholder and his/her insurance company which is determined by the policy wording, but one that is determined by tort law. Under Maltese law the injured party must prove that the other party acted negligently and that this directly resulted in loss or damage.  In addition, jurisprudence has laid down certain rules and formulas that are used to calculate the amount of compensation payable.”

“Technically the insurance company of the responsible party is only liable to pay compensation once a judgement in favour of the injured party and determining the amount of compensation is delivered by a court of law.  In spite of this, in the majority of cases, insurance companies prefer to settle such cases outside court, particularly if there is no doubt as to responsibility for the accident.  However for this to happen agreement on the amount of compensation has to be reached between the parties.  Insurers would normally seek to determine that the amount claimed is fully in line with the law and with jurisprudence.  This is why it is often the lawyers representing the injured party and the insurance company that will discuss, negotiate and agree this amount.”

“Maltese law does not cater for partial payments of compensation.  The injured party must quantify the full amount being claimed and it is only once this is accepted by the court in its judgement that payment become due.  In addition Maltese law defines that compensation is to be paid only for actual expenses incurred by the injured party, and for loss of future earnings that is directly arising from any permanent disability resulting from the incident.”

“Also, it is pertinent to point out that the injured party has an obligation to keep costs at a reasonable and acceptable level, and not to inflate such costs.  It is understandable than any amount claimed has to be substantiated by the appropriate documentation, such as receipts, pay slips, income tax returns and medical reports.  In many cases there may be differing expert opinion on, for instance the degree of disability incurred or the type medical treatment required, so it is very common that both parties appoint their own experts to draw up separate reports.  In most cases these reports will only differ slightly in their conclusions, but there are cases where the opinions are very divergent.  In such cases, unless agreement can be reached, the matter will have to be resolved in court, as then the court would appoint its own experts.”

“An insurance company negotiating settlement with a third party has a duty to follow these rules and procedures as otherwise it may prejudice the rights of its policyholder.  It also has an overriding duty that any payment made to third parties is according to the law and thus if it is paid in an out-of-court settlement, there must be reasonable evidence that the amount is what a court of law would have accepted as the compensation payable. We can assure you that in this case, as in all others we follow the above rules and procedures and are proud to say that in the large majority of cases agreement on a settlement is reached without the need to go to court.”

While Maria likes her independence, she does have issues with keeping her home clean due to her injury. She said that government will be probably be providing some sort of home help, and said that government takes part of her pension if she opts for home help. If she is not content with who they provide she would probably then have to look privately, she said. “Shouldn’t the insurance be responsible for paying for this?”

Asked whether she is worried, he said yes with regards to her leg, and while making due with what she has financially, she is concerned. “My mind is always on a possible amputation. I’m always worried.”

This newsroom has opted to keep the identities of all parties involved in this situation private for a number of reasons, including to protect the identity of the injured party, and to avoid prejudicing the ongoing situation.