Beyond rehabilitation: how cultural and religious practices can impact personal injury claims

The primary objective of personal injury compensation in the jurisdiction of England and Wales is rooted in the legal principle of Restitutio in integrum (Latin for "restoration to the original position"). Under this principle, the civil justice system aims to put the victim in the same position they would have been in "but for" the accident or negligence, insofar as reasonably possible.

Personal injury practitioners, aim to achieve this by providing financial compensation for; physical and psychological injuries, loss of earnings, and medical or rehabilitation costs. 

Bilal Hussain, Associate Solicitor in Serious Injury at Irwin Mitchell considers in order to return the client, insofar as reasonably possible, to their pre-accident position, a pre-requisite is that personal injury practitioners must first truly understand who their client was before their accident. 

We live in an ethnically rich and diverse society, where many of our clients have their own distinct cultural background, religious traditions and often language. These differences are present in each one of our clients and form part of their very own unique code of values. This begs the question as to whether, our legal services and client care should incorporate a practice of respect, tolerance and understanding of our client’s religious and cultural values. Knowing the law is one thing, (but this is most likely presumed or expected) but knowing your client’s core values, breeds confidence and trust. 

The client’s identity?

A client's identity is rarely defined by a single characteristic. Rather, it is shaped by a combination of factors including their religious beliefs, cultural background, ethnicity, language, family structure, personal values, community ties, lifestyle and lived experiences. These aspects of identity influence: how an individual lives their life, interacts with others and plans for the future. 

As solicitors, we are reminded by Rule 3.4 of the SRA Code of Conduct that we must consider and take account of our clients' attributes, needs and circumstances. Understanding how religious practices may influence a personal injury claim is therefore not simply a matter of cultural/religious awareness; it is incumbent upon all practitioners to ensure a claim is properly valued and that a client's long-term needs are fully met in accordance with those needs.

In personal injury litigation, understanding these factors is essential to ensuring that damages accurately reflect the client’s pre-injury life, ongoing needs and future aspirations. This article specifically focuses the religious beliefs of Muslim clients and how their religious beliefs and practices of Sharia law can impact their personal injury claim. 

As a starting point, it is important to acknowledge the pressure on solicitors to be seen to know everything. Sadly, we do not. This article aims to help provide helpful information which can help tailor your approach in personal injury claims to clients from different backgrounds/beliefs (in this article, Muslim clients). 

Muslims in the England & Wales 

Muslims represent one of the fastest-growing faith communities in England and Wales. According to the 2021 Census conducted by the Office of National Statistics (ONS) there were approximately 3.9 million Muslims in England and Wales. This represents 6.5% of the total population (up from 4.9%, 2.7 million, re 2011 Census). The Muslim population in England and Wales has continued to grow. 

For many Muslim clients, religious obligations, family structures and cultural practices form an important part of their daily lives. These factors can have a direct impact upon rehabilitation, care provision, accommodation requirements and the quantification of damages in personal injury claims. 

A practical guide to personal Injury claims for Muslim Clients 

In this section, specialist serious injury practitioner, Bilal Hussain shares his experience of representing Muslim client’s and the impact of their religious practices in personal injury claims. 

Avoiding Assumptions

The starting point should always be the individual client. Muslims are not a homogenous group. Cultural practices vary significantly depending upon ethnicity, nationality, family background, level of religious observance and personal beliefs. Assumptions should therefore be avoided. The most effective approach is to ask open questions and explore whether there are any religious or cultural considerations that should be taken into account when assessing the client’s needs and losses.

A Tailored approach – Expert Hand, Human Touch 

No two personal injury claims are ever the same, and the same can be said for client’s. There is no one size fits all. It is always good practice to meet your clients in person and obtain detailed instructions on their life before the accident. These meetings should take place within their homes, so you can observe the words unspoken, their home environment and the loved ones around your client. At times, it may be their choice of clothing (a headscarf), a prayer mat in the corner of the room or even a framed photograph of their religious pilgrimage to Mecca. Ask open questions about their religious beliefs and what is important to them, so that you may tailor their claim according to their needs. 

Quite often, matters that initially appear unusual within a Schedule of Loss may, upon closer examination, represent genuine and foreseeable consequences of an injury when viewed through the lens of a client's faith and lifestyle.

Rehabilitation, Faith and Quality of Life

For many Muslims, religious practice forms part of their daily routine and personal identity. This includes reading the Quran (in Arabic) and praying 5 times a day in the direction of “the Kaaba” (translated “the Cube” in Arabic), in Mecca. The prayer rituals include kneeling, squatting, bending, sitting and prostrating onto the ground using a prayer mat. Following serious orthopaedic injuries, the ability to continue participating in these religious practices may be significantly impacted. The inability to return to performing daily prayers can cause significant psychological distress. This should be addressed by specialist rehabilitation providers, as part of a client’s rehabilitation programme with specific goals to help the client return to their religious practices. 

In cases involving complex neurological injuries (including traumatic brain injury), Bilal shares his experience of claims which included specialist religious equipment, such as Quran audio devices and Quran pillows. These have helped client’s return to reading / listening to the Quran. Whilst these heads of loss may appear modest in value, they can play an important role in enabling participation in religious learning and maintaining a sense of normality within the family environment.

Similarly, many Muslim families who have children, may take it upon themselves to teach their children the Quran (in Arabic). Where clients are unable to return to these duties, a claim for private Quran tuition may form part of the claim to replace the services of the injured person. 

In the case of a paediatric brain injury or learning difficulties, there would be a need for additional support and consideration should be given as to whether specialist private tuition, adapted learning or one-to-one support may be required.

As with any other aspect of a claim, the key question remains one of evidence and causation. If an injury has created an additional need, this should be properly investigated, and the costs associated with meeting that need would need to be supportive by evidence, to form part of the claim.

Care Regimes and Cultural Considerations

Perhaps one of the most significant areas in which religious and cultural factors arise is care provision. Many Muslim clients hold strong preferences regarding personal care being delivered by individuals of the same gender. This can become particularly important where intimate care is required. Whilst same-gender care is not unique to Muslim clients, for some individuals it represents a deeply held religious obligation rather than a simple personal preference.

In practice, this can affect recruitment, availability and potentially the cost of care packages. Language and cultural compatibility may also become relevant. In a recently settled multimillion case, Bilal acted for a traumatic brain injured (TBI) client, who spoke a remote regional dialect of Pakistan (Pothwari) and required suitably skilled support workers who could communicate effectively whilst respecting cultural and religious requirements. Locating support workers who spoke the same language but also were experienced in working in TBI rehabilitation, proved to be very challenging particularly given the dearth in support workers available. 

In order to overcome this issue, a specialist multi-disciplinary team (MDT) were tasked to provide specific TBI education and training to a bespoke team of female pothwari speaking support workers. Another issue was the language barriers faced by the client and her treating therapists in the MDT. Whilst there were some therapists who were able to communicate (in part) with the client in the national language Urdu/Punjabi, some required independent translators. 

The costs of the above 2 examples were substantial and were included in the recovery of this multimillion claim. Where these requirements can be demonstrated as reasonable and necessary, they should be reflected within expert evidence and the overall care needs assessment.

Accommodation and Extended Family Living

Accommodation claims can be particularly complex when cultural and religious practices are considered. Whilst many accommodation claims proceed on conventional assumptions regarding future independent living, these assumptions may not accurately reflect the circumstances of some Muslim families.

Multi-generational living arrangements are common within many Muslim communities. Adult children may remain living with parents after marriage, and extended family support often plays a significant role in day-to-day life. It is not unusual for families to live in adjoining properties, annexes or larger homes designed to accommodate multi-generational living arrangements. In short the family unit is much larger than may be seen as “conventional”. 

In serious injury cases, this can directly influence the type and size of property required. Where a client's future care and support network is intrinsically linked to their wider family structure, those living arrangements should be properly considered by accommodation experts when assessing suitable long-term housing.

In a recent case, Bilal represented a polytrauma client now severely disabled, who had been the main carer of his spouse prior to his road traffic accident. Following the accident, he relied upon the wider extended family members to take on additional responsibilities, in the form of gratuitous care. Whilst some of these care needs were met by family members, they also required specialist trained support teams to offer individual care / support to both spouses. One as replacement services of the injured party to his spouseand the other directly supporting the injured party. The support needs of both, directly impacted and significantly increased the costs for long-term support and accommodation. 

As with all aspects of litigation, these issues are highly fact-sensitive and should be determined by the evidence rather than assumptions.

Religious Travel and Pilgrimage

The courts routinely recognise claims for holidays and travel where these are reasonably required to restore quality of life following serious injury. Religious travel should be approached no differently.

For many Muslims, pilgrimage to the Grand Mosque (the Kaaba) in Mecca, Saudi Arabia holds profound religious significance. “Hajj” is a mandatory multi-day pilgrimage, performed at a specific time in the year and is one of the five obligatory pillars in Islam). This generally is undertaken once in a lifetime by those who are physically and financially able. The minor pilgrimage known as “Umrah” is voluntary, takes only a few hours and may be performed at various times throughout the year.

Bilal has previously advanced claims relating to the additional costs associated with an Umrah pilgrimage where significant care and support requirements substantially increased the cost of travel. 

These cases require careful consideration of practical issues including:

• Accessibility: the Grand Mosque in Mecca has a capacity of 2.5-4million worshippers at one time
• Specialist equipment: including mobility aids and wheelchairs, which are rented from the Grand Mosque
• Support workers: Access to the Grand Mosque is restricted to Muslims only
• Medical travel arrangements: including upgraded flights for additional leg room and nearby hotels in cases of mobility issues. 

In Bilal’s recent case, a typical family trip to Umrah for his client pre-accident would average £2,000 x 4 persons = £8,000. Post-accident, the same Umrah package included 2 x support workers (1:1), suitable flight/accommodation and transfers was claimed at over £38,000. 

Similarly, holiday destination choices may differ from those commonly encountered. Factors such as access to halal food, appropriate facilities and cultural familiarity may make destinations in countries such as Turkey, Pakistan, Morocco or the Gulf states more suitable than some traditional European holiday destinations. These are often much more expensive than short-haul trips across Europe. 

Holiday claims here, require specific evidence of the client’s pre-injury holidays and witness statements to support future religious plans that may have disrupted or caused additional loss as a consequence of the accident. 

Ramadan and Ongoing Religious Obligations

Religious obligations can also give rise to additional considerations following a personal injury. Many Muslims fast during Ramadan. However, where illness or disability prevents fasting, Islamic teachings may require an alternative charitable payment known as Fidya.

In appropriate circumstances, consideration may be given to whether these payments represent a recoverable loss arising directly from the injury. Whilst such claims are likely to require careful supporting evidence, including religious and expert input where necessary, they demonstrate how an injury can have consequences extending beyond purely medical or financial considerations.

Personal injury practitioners should also be mindful of Ramadan when arranging conferences, witness statement appointments and rehabilitation meetings. Altered sleeping patterns and fasting (from sunrise to sunset) can affect concentration and energy levels. Simple adjustments when scheduling meetings may improve engagement and ensure clients can participate fully in their case. In preparation for trial, to ensure the client is able to give their best evidence, it would be good practice to avoid Muslim client’s giving evidence during the month of Ramadan. 

Financial Considerations and Sharia Compliance

Muslim clients may have concerns regarding the receipt of interest due to Islamic principles prohibiting riba (interest). 

Whilst this issue will not arise in every case, solicitors should be aware that some clients may not wish to hold interim payments in an interest-bearing account or recover interest on past losses. Practical solutions may include utilising non-interest-bearing accounts where available or obtaining appropriate financial advice regarding the management of damages.

You may also find it helpful to discuss Sharia-compliant financial arrangements with your clients. Muslim clients may wish to avoid the management and investment of their compensation funds, which do not align with their religious practices. These may include avoiding investment in: the gambling industry, alcohol and tobacco, weapons, prohibited foods (pork) or even conventional finance. In cases where client’s lack mental capacity, a collaborative approach with input from specialists in court of protection may be helpful. 

Muslims also have a strict charity obligation called Zakat. This requires eligible adults to donate exactly 2.5% of their accumulated wealth and savings to help the poor and vulnerable. Here, a conventional lump sum award versus periodical payments would need to be carefully considered, and it would be good practice to obtain expert evidence from a financial advisor. 

Open dialogue is essential. Rather than making assumptions, practitioners should explore any concerns early so that arrangements can be made which respect both the client's religious beliefs and their best financial interests.

Conclusion: A Holistic Approach to Serious Injury Litigation

Understanding religious and cultural needs is not about creating special treatment. Rather, it is about ensuring that compensation accurately reflects the life the client would have lived and the life they must now live following injury.

Serious injury practitioners should understand that rehabilitation and compensation extend far beyond medical treatment and financial calculations. Faith, family, culture and identity are often fundamental aspects of a person's life. If an injury affects those aspects, we should be prepared to recognise and properly evidence the consequences.

By taking the time to understand the clients' religious practices and cultural backgrounds, we not only improve the quality of our legal advice but also ensure that serious injury claims genuinely place the client at the centre of the litigation process. In doing so, we fulfil both our professional obligations and our broader responsibility to provide truly client-focused representation.