Insurance claims

Just think for a moment: What role do insurance companies play in your life (hevrot bituach) and how much time do you spend on them? It is probably difficult to disagree that nowadays insurance companies affect any aspects of a person’s life. It is unlikely that fingers of two hands are enough to count the number of insurance policies covering our life activity.

If we categorize them according to areas of life we will get the following picture:

• house and family: mortgage insurance, home and contents insurance for a house or apartment you live in and all its possessions, car insurance, health insurance, employment insurance, life insurance, school insurance, a long-term nursing care insurance for those who lost their capacity to function (bituach siudi in Hebrew); 
• work: pension insurance (bituach pensioni), personal insurance and a pension accumulation agreement with an employer by which you accumulate your pension and which is an alternative to a pension fund (bituach menahalim), Israel’s National Institute insurance (bituach leumi), medical insurance from contributory sickness fund, business insurance (bituach esek), professional liability insurance (malpractice insurance) (bituach achraiut mikcoit);
• overseas travel: life insurance, medical insurance, property loss insurance during overseas travel, flight cancellation or ticket insurance.

Have I forgotten anything?

An insurance policy is an agreement between the insured and the insurer, the insurance company. According to a policy, the insured person pays an insurance company a certain amount of money monthly or annually for the insurance against potential risks. It means that for the moment of signing a contract it is unknown if a certain situation according to which the insured person is entitled for a compensation will take place or not. 

You should though not forget that all insurance companies are above all commercial organizations, commercial organizations in all meanings of this word. They were initially founded for making a profit, thus will be doing everything possible applying schemes which are beneficial for them in order to reduce their expenses. 

Basically, it tells us that sometimes insurance companies legally interpret an insured event in such a way so the insured would not receive any compensation by their policies. They take an advantage of the ignorance and lack of understanding of the policies the insured buy (polisat bituach) as well as of the legislative regulations which regulate insurance issues and regulate them in such a way that benefits go not the insurance company but to the insured person.

If there is a need to appeal an insurance claim denial (dchiiat tviia) or (dhiiat drisha le hevrat bituach), the best decision here is to hire a lawyer who understands law and who can efficiently challenge a denied claim.  

It is very important to bear in mind that when an insurance company denies your claim, it is only the beginning of the process and in order to receive a due compensation, the insured person can choose among different options which way to proceed.  The main thing is to remember that you can receive a due compensation but only if you choose a smart approach and appropriate tools.