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What are the important financial law hidden from the patients in healthcare organizations

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Unfortunately, one of the most common phenomena in Israel is the increasing number of adult patients people whose treatment is difficult and expensive, but it’s because they or their families do not know they have the right to Finance or participate in the cost of care, which includes medical insurance, the owners of which they are in their healthcare organizations – explains the lawyer of Meir Zohar.

Miriam, an elderly woman with heart disease for several years is in a state which needs constant care. Accidentally she learned that he has the right to assistance for supplementary health insurance in health insurance, and demanded that the insurance company gave me the opportunity to take advantage of its right to receive the money for the last three years. This term, which is to appeal to receive retroactive compensation.

The insurance company checked the elderly woman and found that she really is almost completely devoid of the ability to move. Nevertheless, Miriam was determined to be eligible to receive aid only from the date of inspection. Her appeal for money, which she put retroactively, as it hires a foreign nurse, and carries a heavy cost of caring for many years, with no success. What was it correctly done, so this is a request for legal representation, in which the medical records of an elderly woman was presented to the court. In these documents there was a reference on the functional status prepared nurse from the national insurance Institute, where it was found, that for many years an elderly woman is limited in daily functions and are constantly used care services.

Medical card Miriam was presented by our attorney’s office to the insurance company within the framework of a lawsuit filed on behalf of Miriam, and as a result the insurance company agreed to a quick plea agreement. Miriam received a retroactive lump-sum payment in the amount of 85,000 shekels, in addition to the monthly payments in the amount of 4 500 shekels, until then, until the end of the 5-year period provided under the insurance contract.

Like Miriam, Joseph, 88 years old, suffered two years ago when he fell at home, suffered a fracture to the right hip, and was in need of long-term care. He gets 22 hours a week metapelet from the national insurance Institute. Joseph didn’t even know that he has the right to monthly payments from the health insurance Fund through its insurance «national insurance siudi». With the help of our office of Joseph went directly to the insurance company and won the case that allowed him to get a monthly payment in the amount of 5 500 shekels in addition to the assistance of the National insurance Institute the national insurance Institute.

Such as Miriam and Yosef, in Israel there are many adults who don’t even know that they have health insurance long-term care insurance policy via health insurance Fund in which they are insured. Some of them pay monthly premiums since 1990-ies in the framework of the payment of an additional insurance. Themselves health insurance does not always take care to inform their insured about their rights, despite the fact that all of the information about «the national insurance side» is at their disposal. It is, ultimately, simple operation, you need to tricotril letter clearly set out the information to the insured or disabled, as is confirmed by their doctors.

Since older people do not have this information, they continue to pay insurance for long-term care, not knowing that they already have the right to insurance money on your insurance policy that can reach 4,500 shekels a month or more. Thus, many older people do not use their rights, on the one hand, continuing to pay for care at their own expense, and on the other side to pay the premiums for more relevant insurance policies.

Patients who know about their right, and ultimately decide to apply for health insurance and/or insurance company, can be in a situation that they simply refuse, after examination of the expert from the insurance company with a variety of excuses. Insurance companies have appeals committees, and they can even cause a person’s hearing, but often they’re only doing this to calm people down and give them a kind of «tranquilizer». In practice, this is usually not activesky or objective appeal Committee, and in fact the majority of the members of the Committee are members of the insurance company.

Unfortunately, «a good system» works perfectly, when it comes to the elderly, which is well known to the Department of social insurance the national insurance Institute, and whose situation is clearly updated in the squat, which is especially outrageous. A reasoned claim, supported by references to medical papers and the national insurance Institute, is the most effective measure against insurance companies. When they get sued, they usually rush to negotiate, and quickly give nearly all the provisions, or most of the insurance money.

However, all this fuss could be avoided if HMOs were required to submit a clear and detailed letter every year, elderly people have reached a certain age – for example, 70 or more – and to keep them informed in a language which is spoken by the insured, including all necessary details that the insurance covers, what rights they have, what monthly payments you can expect, etc., together with the relevant shapes and forms. How many difficulties and unnecessary trouble can be avoided for many people in need.

So if you have a close, which receives the clock care in Leumi, pay attention to the money he is entitled to receive in accordance with vyplyvali insurance contributions, amounting to tens of thousands of shekels.

From the foregoing it is obvious that in case you suffer from health problems and functional disorders, should check with their financial rights and use these rights most efficiently and correctly.

If your life is such case we recommend you contact us for help. 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

Our website: law-EN.co.il

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.

What are the important financial law hidden from the patients in healthcare organizations 14.01.2018

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