Lawsuit Against an Insurance Company in Ramat Gan

What is a Claim Against an Insurance Company?

A claim against an insurance company is a legal proceeding in which an insured party (or an injured party entitled to compensation) sues an insurance company to pay compensation for damages suffered. Such damage may consist of personal injury (injury, illness, loss of earning capacity), property damage (damage to vehicles, apartments, or equipment), or other damages covered by the insurance policy.

In Israel, insurance claims are a common part of civil litigation. When an injured party sustains injuries from a motor vehicle accident or workplace accident, they may sue the insurance company of the party responsible for the damage, or their own insurance company (under national insurance or comprehensive insurance). The Mandelbaum, Gor, Witzman-Gor and Co. law firm represents claimants exclusively in personal injury and insurance claims, bringing years of experience in providing strong and professional legal representation in this matter.

When Do You Need to Sue an Insurance Company?

A claim against an insurance company becomes necessary in several common situations:

• Complete Insurance Denial: The insurance company refused to pay at all due to policy cancellation, non-payment of premiums, or claiming the damage is not covered under the policy terms.
• Partial Insurance Denial: The company agreed to pay an amount, but the amount is significantly lower than the actual damage or the appropriate legal compensation.
• Delayed Payment: The company delays payment without reasonable cause, even when it acknowledges the debt.
• Attempt to Evade Liability: The company claims the damage is not covered by the policy, but its claim is not based on legal provisions or policy terms.
• Non-Response to Claim: The insurance company does not respond to compensation requests or ignores the claim.

In all these situations, strong legal representation is essential to protect your rights and ensure you receive the compensation you are entitled to.

Common Types of Insurance Claims

Insurance claims can relate to various types of damages, each with different legal characteristics and admissibility. Below are the most common types:

Insurance Claims for Traffic Accidents

Traffic accidents can result in serious or minor bodily injuries, as well as property damage. In such a claim, the injured party can sue the insurance company of the driver responsible for the accident. Compensation may include medical expenses, lost income, pain and suffering, disability, and property damage. Generally, the injured party must prove that the driver was responsible for the accident and present evidence of the extent of damage (medical bills, medical reports, mechanical assessments).

Insurance Claims for Work Accidents

When an employee is injured in a work accident, he or she may sue both the employer (usually through the employer's insurance) and National Insurance. Such claims typically include medical expenses, wage compensation, disability benefits, and pain and suffering. Work accidents are protected by law, and there is often a fixed entitlement to certain compensation, but additional compensation is possible if the employer or a third party is proven to be liable for the damage.

Insurance Claims for Public Negligence

When a public entity (municipality, government ministry, public service company) causes damage due to negligence, the injured party can sue the public entity through its insurance. Examples include falling on a street due to poor drainage, injury from defective equipment in a park, or damage from construction work without proper warning. In such claims, negligence by the public entity must be proven.

Insurance Claims for Property Damage

When property (apartment, car, business equipment) is damaged due to an insured event (fire, theft, accident, flooding), the owner can claim from the insurance company for repair or replacement of the property. Compensation is usually calculated according to the market value of the property or cost of repair, less depreciation and reduction according to the policy terms.

Insurance Denial and Your Rights

Insurance denial is one of the most challenging situations an injured party or insured person can face. When an insurance company refuses to pay compensation, it claims that the damage is not covered under the policy, or that the insured has breached the policy conditions. However, under Israeli insurance law, there are strong protections for the insured:

Insured's Rights in Case of Insurance Denial

• Right to Request Justification: The insurance company must provide a written and clear explanation for the refusal. If the explanation is unclear or not based on policy conditions, it can be challenged.
• Right to Appeal: If you dispute the insurance denial, you can file an appeal with the insurance company itself (usually to an internal appeals committee), and then appeal to the court.
• Right to Legal Claim: You can file a lawsuit in court to enforce payment of compensation. In such a claim, the insurance company bears the burden of proving that the damage is not covered under the policy.
• Right to Compensation for Bad Faith: If the insurance company consistently or unjustly refuses to pay, and this is considered bad faith, the court may order the company to pay additional compensation (usually interest and legal fees).
• Protection Against Retroactive Policy Cancellation: An insurance company cannot cancel a policy retroactively based on a claim that the insured misled it upon policy signature, unless it proves that the misrepresentation was intentional or highly material.

How to Handle Insurance Denial

If an insurance company has refused to pay you, here are the steps you can take:

1. Request a Written Explanation: Send a letter to the insurance company requesting an explicit and clear explanation for the refusal. Keep a copy of your letter.
2. Review Your Policy Terms: Carefully read your policy terms and see whether your damage is actually covered or not. Often, insurance companies claim that damage is not covered when it actually is.
3. Gather Evidence: Collect all evidence supporting your claim: medical reports, photographs of the damage, witness statements, police reports, and so forth.
4. Send a Formal Claim: If the insurance company does not change its position, send a formal claim through an attorney. The claim should be documented, clear, and present the legal arguments on your behalf.
5. Consult with an Attorney: A specialized attorney can help you understand your rights, review the policy, and lead your claim with strength.

Mandelboim, Gor, Yitzhman-Gor & Co. specializes in insurance denial claims. We represent claimants only, which means we stand by your side without conflicts of interest. With over 18 years of experience, we know how to deal with insurance companies and obtain fair compensation.

Comparison Table: Types of Damages and Typical Compensation Ranges

Below is a table presenting various types of damages and typical compensation ranges. It is important to emphasize that every case is unique, and the amount of compensation depends on the specific circumstances of the case, the severity of the damage, the evidence presented, and the court's approach.

Important note: This table presents general ranges only, based on typical cases. Every case is examined individually, and the amount of compensation can vary significantly depending on the specific facts, the victim's age, occupation, injury consequences, and the court's approach. An experienced attorney can provide a more accurate assessment based on your specific situation.

Strong Legal Representation in Ramat Gan

Mandelbaum, Gor, Witzman-Gor & Co. specializes in insurance claims and personal injury claims in Ramat Gan and central Israel. We represent claimants exclusively, which means we stand on your side with no conflicts of interest with insurance companies or employers. With over 18 years of experience, we know how to deal with insurance companies, negotiate, and achieve fair compensation.

Our branch in Ramat Gan, located at 12 Ben Eliezer Aryeh Street, serves residents of Ramat Gan, Givatayim, Petah Tikva, Rosh HaAin, and other communities in central Israel. We believe in a personal and dedicated approach, and listening to the unique needs of each client. Every claim is a case unto itself, and every client deserves personal and meaningful representation.

We offer a free initial consultation meeting, where you can share the details of your case with us, and we will assess your rights and representation options. During the consultation, we will explain to you the claims process, the prospects, and the financial options of representation.