Claims for long-term nursing care and disability benefits (Bituach Siudi)

What is a long-term nursing care insurance (bituach siudi)?

Israeli residents own a long-term nursing care insurance provided by The National Insurance Institute of Israel (bituach siudi). However, since the bituach siudi benefit is not a considerable amount and does not always cover actual expenses people incur, insurance companies offer a private insurance plan which covers monthly nursing care expenses a sick or an elderly person needs. 

You may be entitled to benefits from The National Insurance Institute of Israel or an insurance company if you have physical impairment (according to the criteria of an ADL test) or in case of a serious cognitive impairment.

What is an ADL test? (Activities of Daily Living)?

The ADL test is designed to test the ability of a patient to perform daily physical activities. This is one of the possible ways of assessing if a patient is entitled to a long-term nursing care benefit. 

According to The ADL test the following physical daily actions of a patient are checked:

• Ability to lie down and get up – is a person able to do it without any assistance.
• Bathing – a person’s ability to use a bathtub without any assistance.
• Dressing – the ability to get dressed and undressed including underwear without any assistance.
• Eating/drinking – the ability to feed yourself or take medicine without any assistance.
• Mobility – the ability to move (if at all possible) about the home without any assistance.
• Continence/incontinence – a degree at which person is able to control his/her bladder and bowel functions and what degree of assistance the person needs in order to perform these functions.

Why are thousands of long-term nursing care claims (bituach siudi) rejected by insurance companies?

Every year a considerable percent of claims filed to insurance companies are rejected. The most frequent reason is due to  the insured person’s incomplete or inaccurate claim. The most frequent mistake people make is trying to file a long-term nursing care claim (bituach siudi) on their own, without the assistance of a lawyer who specializes in the area of a long-term nursing care insurance (bituach siudi).

Why does this tactic prove to be wrong? 

Insurance companies are not a generous advocate for all the insured who file the claims but rather  on the contrary. The problem is the ADL test criteria are not always unequivocal, thus insurance companies do not rule in favor of the insured. The lawyer who specializes in this area of bituach siudi must be an expert at interpreting the ADL test results in the patient’s favour. 

Our office has accumulated many years of experience in all areas of insurance and civil rights violation including a numerous number of claims on behalf of the clients who owned long-term nursing care insurance policies (bituach siudi).

We will check if you are entitled to benefits absolutely free of charge and will be happy to provide you with this service.