Claim Against an Insurance Company in Petah Tikva

What is a Claim Against an Insurance Company?

A claim against an insurance company is a legal proceeding in which a person or company sues an insurance company for compensation for damage or loss they have suffered, claiming that the insurance company is obligated to compensate them under the policy terms or by law. In Petach Tikva, as throughout Israel, such claims may be related to traffic accidents, workplace accidents, property damage, public liability, or an insurance company's refusal to pay the benefit to which it has committed.

For many years, our firm has represented claimants exclusively in tort matters, which means we specialize in protecting the rights of injured parties and obtaining the full compensation they deserve. When an insurance company refuses to pay or offers an amount that is too low, we are here to help you understand your options and take necessary legal action.

Why Do People Sue Insurance Companies?

Typically, a person sues an insurance company when there is a disagreement over the amount of compensation, when the insurance company refuses to pay at all, or when the respondent raises unjustified claims. The most common circumstances include:

• Insurance Denial: The insurance company claims that the claim is not covered under the policy terms or that there has been a breach of obligation by the insured.
• Unfair Damage Assessment: The insurance company offers a compensation amount that is significantly lower than the actual damage suffered by the claimant.
• Payment Delay: The insurance company delays payment without clear reason or requests additional documents that were not previously submitted.
• Breach of Insurance Contract: The insurance company breaches its obligations under the policy or under Israeli insurance law.
• Public Liability: Following damage caused by the negligence of a public or municipal body, and a claim against the insurance company of the responsible body.

How Does a Claim Against an Insurance Company Work in Petach Tikva?

The process of filing a claim against an insurance company involves several steps, each of which is essential to the success of the claim:

1. Document and Evidence Collection: Before filing a claim, all relevant documents must be collected — the insurance policy, previous claim letters, medical reports (if bodily injury is involved), photographs from the scene, testimonies, and any document that can prove the damage and causation.
2. We Send a Written Demand: Usually, before filing a claim in court, a formal demand letter is sent to the insurance company detailing the damage, the amount requested, and the legal reasons for the claim.
3. Negotiation: Often, the insurance company will respond to the letter with a counter-offer or a request for additional documents. This stage may lead to an out-of-court settlement.
4. Filing a Claim in Court: If no settlement is reached, a formal claim must be filed in district court (usually in the jurisdiction where the accident occurred or where the insurance company's office is located).
5. Discovery Procedures: Both parties are required to disclose to each other all relevant evidence, including internal documents of the insurance company.
6. Arbitration or Late-Stage Negotiations: Often, at this stage, new information comes to light that may lead to a settlement.
7. Trial and Judgment: If no settlement is reached, the case will be heard in court, and a judge will determine whether the insurance company is obligated to pay and in what amount.

What Types of Damages Can Be Covered in a Claim?

When a person sues an insurance company, they may claim various types of damages, depending on the circumstances of the case:

• Personal Injury Damages: Includes medical expenses, surgeries, physiotherapy, medications, and ongoing medical treatment. Additionally, claims can be made for pain and suffering, loss of earning capacity, and permanent disability.
• Property Damage: Damage to a vehicle, home, equipment, or other property that was damaged in an accident or incident.
• Financial Losses: Expenses incurred as a result of the damage, such as repair costs, temporary rental expenses, or maintenance costs.
• Emotional Damages: Under certain circumstances, claims can be made for emotional damages and psychological distress resulting from the accident.
• Interest and Legal Expenses: Following a delay in payment or insurance denial, claims can be made for interest on the amount for the period in which it was not paid, as well as legal expenses and attorney's fees.

What Are the Key Factors That Influence the Compensation Amount?

The compensation amount in a claim against an insurance company depends on many varied factors. In each individual case, circumstances must be examined carefully and professionally. The following factors generally influence the compensation amount:

• Extent of Damage: The breadth and depth of physical or financial damage directly influence the compensation amount.
• Degree of Fault: In traffic accidents, for example, if the injured party is found to be partially at fault for the accident, the compensation amount will be reduced accordingly.
• Age and Employment Status: The injured party's age and employment status affect the calculation of loss of earning capacity.
• Existence of National Insurance: The compensation amount can be reduced by the allowances the injured party received from national insurance.
• Policy Terms: Limitations, deductibles, and special conditions in the policy affect the compensation amount.
• Proof of Damage: The stronger the proof of damage (documents, medical evidence), the higher the compensation amount.

What is the Difference Between Insurance Denial and Undervaluation of Damages?

These two terms are often used as synonyms, but they involve different legal consequences. Insurance denial means that the insurance company refuses to pay the claim entirely, claiming that the damage is not covered under the policy, that there has been a breach of the insured's obligations, or that there is no causal link between the damage and the covered event in the policy. Such refusal may or may not be justified, and a lawsuit against the insurance company may result in a determination that the denial was arbitrary or unlawful.

In contrast, undervaluation of damages occurs when the insurance company agrees in principle to pay, but offers a sum significantly lower than the actual damage. In this case, the injured party may sue for the difference between the amount offered and the amount they believe they are entitled to.

In certain circumstances, an insurance denial that is unjust or in violation of the insurance company's duty of good faith may result in a penalty for arbitrary or wrongful conduct. This is one reason why for every case of insurance denial or unfair damage assessment, you should consult with a lawyer experienced in this field.

Do I Need a Lawyer to Sue an Insurance Company?

By law, you are not required to be represented by a lawyer to file a lawsuit in court, but in practice, it is strongly recommended. A lawsuit against an insurance company involves deep legal knowledge, understanding of insurance law, and familiarity with court procedures. Insurance companies employ experienced and skilled lawyers, and they will make every effort to prove that the claim does not warrant full or any compensation.

When you are represented by a lawyer experienced in insurance claims, you gain significant advantages: in-depth analysis of the policy, efficient evidence gathering, strong negotiation with the insurance company, and protection of your rights in court. Additionally, in some cases, the court may order the insurance company to pay your legal expenses, including attorney fees.

At our firm, Mandelbaum, Gor, Witzman-Gor and Co., we represent plaintiffs in tort cases only, which means we specialize in protecting the rights of injured parties. Our initial consultation is free of charge, and we invest time in understanding your case to ensure you receive the best representation.

How Long Does a Lawsuit Against an Insurance Company Take?

The duration of a lawsuit against an insurance company varies depending on the complexity of the case, the cooperation of the insurance company, and the court's schedule. Generally, a lawsuit that settles outside of court can be resolved within several months to one year. In contrast, a lawsuit that reaches court may take two years or more, depending on the court's workload and the number of hearings required.

During this period, strict legal deadlines must be met, documents must be filed on time, and hearings must be attended. This is why it is important to have a lawyer who manages the case efficiently and professionally.

What Are the Risks of Filing a Lawsuit?

Every legal lawsuit involves certain risks. When you sue an insurance company, there is a risk that the court will not grant you full justice, or will determine a compensation amount lower than you expected. Additionally, if you lose the lawsuit, the court may order you to pay part of the insurance company's legal expenses.

However, if you have an experienced lawyer who will help you assess the chances of success in the early stages, you can make an informed decision whether to proceed with the lawsuit or try to reach a settlement. At our initial consultation, we discuss the prospects of your case openly and sensitively.

Comparison Table: Typical Scenarios in Insurance Claims

Below is a table presenting typical scenarios in insurance claims and how they may affect the claim:

What Should You Do Immediately After an Accident or Damage?

The first steps you take immediately after an accident or damage can significantly affect a future claim. Here are essential recommendations:

1. Safety first: Ensure that you and others are safe. Call emergency services if there are injured persons.
2. Report to police: In case of a traffic accident, report to the police and obtain an accident report. In case of property damage due to theft or break-in, report to the police and obtain a certificate.
3. Document the scene: Take photographs of the accident scene, the damage, vehicles (if a traffic accident), and witnesses if present.
4. Collect Witness Information: If there are witnesses, collect their names, phone numbers, and addresses.
5. Report to the Insurance Company: Report the damage to the insurance company as soon as possible. Most policies require notification within a certain period (usually 30 days).
6. Preserve Documents: Keep all documents related to the accident — insurance card, policy, medical reports, invoices, and any other relevant documents.
7. Contact an Attorney: If there is substantial damage or insurance denial, contact an attorney experienced in insurance claims. In the first consultation meeting, you will receive clear guidance on the next steps.