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If you are suffering from various diseases, which complicate your life and interfere to perform at least three routines of six (dressing, bathing, movement, toileting, eating, the ability to get out of bed and to sit in the chair yourself) as well as if you have urinary incontinence, memory impairment and susceptibility to Alzheimer’s, dementia (senile dementia), etc., you have the right to apply for obtaining money from the insurance company within your health insurance in the health insurance Fund.
Citizens of Israel, recognized by the Institute of national insurance («bituah Leumi») with disabilities, entitled to assistance and additional rightsthat people often do not even know. We are talking about amounts that can reach up to several thousand shekels per month.
For example, a person who suffered a stroke, heart attack or does it have some other cardiac problem, get metapelet (a nurse) from «bituah Leumi» several times a week. You can also assume that this patient is a member of any health insurance Fund («kupaty Holim»), through which he framed the collective insurance, including insurance for long-term care – «bituah side». Payment of premiums for this insurance are made through the health insurance Fund («kupaty Holim»). Since insurance companies often do not send insurance policies to customers, they don’t even know that their insurance policy also includes «bituah side».
Law firm «Meir Zohar and companions» specializiruetsya on the conduct of cases against insurance companies that deny payments to policyholders suffering from various diseases and forced to be dependent on outside help.
In the lawsuits, the law firm «Meir Zohar and partners» works with a number of medical experts and experienced professionals in the field of orthopedics, geriatrics, rehabilitation, neurology, family medicine, pain medicine, and others. Our lawyers have experience in reading the «fine print» in insurance policies for long-term care and many won lawsuits against insurance companies.
Consider the examples:
Meni (name changed), a relatively young male, 59, who has a «bouquet» of chronic diseases. He underwent a major surgery to replace the knee joint and resection of the stomach. In addition, he underwent surgery to implant a platinum plate in the lower spine.
Given all these problems, Meaney was recognized by the national insurance Institute 100% disabled and received help in implementing all tasks that he could not cope without assistance.
Before her illness, Meaney worked in the health insurance Fund «Clalit» had insurance «national insurance siudi» as an employee of the health insurance Fund. He turned to their own insurance company and asked for the payment of care benefits, which should be 8000 NIS. per month. The insurance company checked the requirements to Time and sent him for a medical check. As a result, the Time was refused and contacted our office so we helped him get from the insurance company laid him payments. We filed a lawsuit against the insurance company and submitted all the necessary medical opinion and verification. After several months of negotiations, agreement was reached with the insurance company that Time will receive insurance compensation in the amount of about NIS 400,000.
Roman (not his real name), polio, confined to a wheelchair. He hired a foreign worker (a nurse) for the care and constant help. Novel is insured under group insurance health insurance «Maccabi» insurance company «Clal»». In 2011, the novel appealed to the clinic «Maccabi» request from «Klal» payments for long-term care in the amount of about NIS 5000. in the month that it should have a period of 5 years. «Clal» conducted a special inspection of his health and appointed him to a payout is only 2.5 years instead of 5. After 2.5 years, during which time the novel has received monthly payments from the «Klal», they stopped the transfer of money, explaining that a doctor at his home was held for more functional check, his condition improved and he was no longer in need of constant care.
In connection with the termination of payment of, the novel appealed to the attorney Meir Zohar, which specializiruetsya on litigation insurance «national insurance siudi». On his behalf, a lawsuit was filed in the tel Aviv magistrate’s court to continue payments on the policy. This lawsuit is the lawyer of Meir Zohar filed against the insurance company «Clal». The company argued that the novel, polio, in 2009 was recognized as constantly in need of care, and when the disease can be improvements. Independent expert appointed by the court, concluded that the approval of the attorney Meiry Zohar is completely untrue, and there was no reason to continue the monthly payments for care. There can be no improvement in his condition. In light of this decision, the novel received from the insurance company «Clal» all the required payments in the total amount of 180,000 shekels, in accordance with the agreement, which has made the lawyer of Meir Zohar.
Based on these examples we can conclude that even if you received a refusal of payment from the insurance company by contacting a specialist for settlement of such conflicts, you can get all the money due to you.
If your life is such a case, we strongly recommend to verify the right to compensation in addition to providing «bituah Leumi» assistance. Our staff is ready to answer any question concerning «the national insurance side».
Office hours: Sunday-Thursday, from 8:30 to 18:30.
For the purpose of the first meeting for consultation call: 03-5622772
The website of «Meir Zohar and companions».
Meir Zohar was born in tel Aviv in 1994 he graduated from the law faculty of tel Aviv University and since 1995, began to practice law.
Law firm «Lawyer of Meir Zohar and partners» was founded in 1997 and is one of the oldest and most experienced in Israel. The main area of work is filing lawsuits against insurance companies in case of refusal of payments under policies of long-term care («Saudi»).
In 2001, in recognition of the magazine «a-Proclaim» («Lawyers»), the firm has won recognition and evaluation in the «List of the century» among the leading and reputable companies in the region demand compensation for damages.