Life Insurance Claim in Petah Tikva

What is a Life Insurance Claim and When Will You Need One?

A life insurance claim is a legal action filed against an insurance company that has refused to pay life insurance benefits or has unreasonably delayed payment. When an insured person or their heirs file a claim, they demand that the insurance company fulfill its obligations under the policy and pay the amount due — plus legal fees, interest, and related expenses.

In Petach Tikva and throughout central Israel, life insurance claims arise in many circumstances: death of an insured person as a result of a traffic accident or workplace accident, total loss of earning capacity, serious health events (stroke, heart attack, diabetes), or even when the insurance company claims that the insured person concealed information when signing the policy. In these cases, the heirs or the insured person themselves need strong legal representation to secure their rights.

Mandelbaum, Gor, Witzman-Gor & Co. has represented claimants in life insurance claims since 2008. At our Petach Tikva office (8 Yigal Alon Street), we specialize in proving the insured person's entitlement, investigating insurance refusals, and refuting insurance company claims on behalf of our clients.

Life Insurance Refusal — What Is It and Why Does It Happen?

Insurance refusal occurs when an insurance company refuses to pay insurance benefits that the insured person or their heirs are entitled to receive. The refusal may be reasoned or arbitrary, and is typically based on one of the following claims:

• Concealment of information when signing the policy: The insurance company alleges that the insured person failed to disclose relevant information about their health condition, family medical history, smoking, or medication use. If the concealed information would have changed the insurance company's decision, it may refuse to pay.
• Non-compliance with policy conditions: The policy may contain special conditions (for example, periodic health examinations, notifications when the insured person's circumstances change). If the insured person failed to comply with these conditions, the insurance company may claim it is relieved of its payment obligation.
• An event not covered by the policy: Generally, life insurance policies do not cover death resulting from suicide within the first year of policy signing, or from certain events specifically listed as "exclusions" in the terms.
• Technical or bureaucratic arguments: The insurance company may claim that the claim was filed too late, that documents were not properly completed, or that the insured person is not the rightful beneficiary of the policy.

These issues arise frequently in life insurance claims and typically require deep legal examination of the policy, correspondence between the insured person and the insurance company, and the legal conditions applicable to insurance companies in Israel.

Life Insurance Claim Process — Key Stages

A life insurance claim typically proceeds through several stages, each of which is critical to the success of the claim:

Stage 1: Document Collection and Policy Review

At this stage, we request from the claimant all relevant documents: the policy itself, medical certificates, death certificates or loss of earning capacity, correspondence with the insurance company, notice of denial (if filed), and any other document related to the claim. We then examine the policy thoroughly to understand the insurance company's obligations, exclusions, and special conditions.

Stage 2: Notice to Insurance Company and Settlement Negotiation

Typically, we send a formal letter to the insurance company detailing our arguments and demanding payment within a specified period (usually 30 days). The letter includes a legal analysis of the policy and a response to every argument raised by the insurance company. In many cases, such a letter is sufficient to persuade the insurance company to agree to a settlement or partial payment.

Stage 3: Examination of Claims by Appeals Committee or National Insurance (if applicable)

If the claim is related to a work accident or traffic accident, it may be necessary to file a claim with National Insurance or with a medical committee to determine the degree of disability or loss of earning capacity. The committee's or National Insurance's decision may affect the amount the insurance company is required to pay.

Stage 4: Filing a Claim in Court

If no settlement is reached, we file a formal lawsuit in the district court (usually in the city where the claimant resides or where the insurance company has offices). The lawsuit includes a detailed description of the event, legal claims for breach of insurance contract, and calculation of damages (the amount due plus interest and costs).

Stage 5: Insurance Company's Response and Exchange of Pleadings

The insurance company responds to the lawsuit within a specified period and presents its defenses. Thereafter, a process of "exchange of pleadings" begins — each party responds to the other party's arguments, and typically written evidence (documents, medical expert opinions, etc.) is submitted.

Stage 6: Evidence and Court Hearing

At this stage, we submit oral evidence (witnesses, medical experts), cross-examination of the insurance company's witnesses, and oral arguments before the judge. In life insurance claims, medical expert opinions are often submitted to prove that the event or its consequences were as the claimant claims.

Stage 7: Judgment and Decision

After the hearing concludes, the judge issues a judgment determining whether the insurance company is liable to pay, in what amount, and which party will bear the court costs. This judgment may be subject to appeal if either party believes the judge erred in applying the law or assessing the evidence.

This process may last from months to years, depending on the complexity of the claim and the court's schedule. Mendelboum, Gor, Witzman-Gor and Partners handles all these stages for our clients, managing every legal, medical, and technical aspect of the claim.

Who Can File a Life Insurance Claim?

A life insurance claim can be filed by several parties, depending on the circumstances:

The Insured Person

If the insured is still alive and has suffered an event covered by the policy (for example, total loss of earning capacity or loss of a limb), they can file a claim against the insurance company demanding payment of the benefits due to them.

The Insured's Heirs

In the event of the insured's death, their heirs (family members, beneficiaries of the estate) can file a claim to demand the amount guaranteed by the life insurance policy. The amount owed is part of the deceased's estate and is typically distributed in accordance with the Law of Succession and a will (if one exists).

The Named Beneficiary in the Policy

Some life insurance policies name a specific "beneficiary" (such as a spouse, family member, or even a bank) who is designated in the policy as entitled to receive the amount upon a certain event. If the beneficiary has not received the amount, they can file a claim.

Guardian or Estate Administrator

In cases where the heir is a minor or a person lacking legal capacity, a guardian or estate administrator can file a claim on their behalf.

Mandelbaum, Gur, Witzman-Gur and Partners represents all these parties in life insurance claims in Petah Tikva and throughout the central region of Israel.

How Long Does It Take to File a Life Insurance Claim?

The duration of the process varies depending on the complexity of the claim, the insurance company's cooperation, and the court's schedule:

• Settlement Negotiation Phase: Typically, this stage takes 2–6 months. If the insurance company agrees to a settlement, the claim will be resolved quickly.
• Filing a Lawsuit in Court: From the time the claim is filed until a judgment is rendered, the process can take 1–3 years, depending on the court's docket and the complexity of the evidence.
• Appeal: If either party appeals the judgment, the process may take another year or more.

During this period, we protect the client's rights, ensure that statutory deadlines are not exceeded, and manage all correspondence with the insurance company and the court.

Costs and Common Legal Arguments in Life Insurance Claims

In life insurance claims, there are several recurring legal arguments that insurance companies use to avoid payment. We specialize in refuting these arguments:

"Concealment of Material Information"

This is one of the most common claims. The insurance company argues that the insured failed to disclose vital information when signing the policy, such as medical history, medications taken by the insured, or dangerous habits. We examine whether the information was truly "material," whether the insured was obligated to disclose it, and whether concealing it would have actually changed the insurance company's decision.

"Event Not Covered by the Policy"

Insurance companies often argue that the event causing death or disability is not covered by the policy. For example, if the policy does not cover suicide in the first year, or if it does not cover certain illnesses. We carefully review the policy language to understand whether the event is truly not covered, or whether the insurance company is interpreting the policy arbitrarily.

"Non-Compliance with Policy Conditions"

Insurance companies may claim that the insured failed to meet certain conditions of the policy, such as periodic health examinations or notification of changes in circumstances. We examine whether the conditions were reasonable, whether they were clearly stated, and whether non-compliance actually releases the insurance company from its payment obligation.

"Technical Arguments"

Sometimes insurance companies use technical arguments, such as "the claim was filed too late" or "the beneficiary is not the legally designated beneficiary of the policy." We examine the legal deadlines, the identity of beneficiaries, and any technical detail that may affect the claim.

In every case, we help our clients understand the insurance company's claims and build a strong legal argument proving they are entitled to payment.

Legal Costs in Life Insurance Claims

Legal costs in life insurance claims vary depending on the complexity of the claim, the duration of the proceedings, and the type of services required:

• Initial Consultation Fee: Your first consultation with the Mandelbaum, Gor & Yitzhman-Gor office is free of charge. During the meeting, we examine the policy, the circumstances, and the prospects of the claim.
• Representation Fees: If you choose to proceed with the claim, we work on a contingency fee agreement or hourly fees, depending on your preference and the complexity of the claim. We explain all options during the consultation meeting.
• Court Expenses: In a court claim, there are expenses such as court filing fees, costs of medical expert opinions, and documentation. Typically, if you win the claim, the insurance company pays most of these expenses.

We prefer that our clients understand the costs in advance and are not surprised later in the proceedings. During the initial consultation meeting, we will explain exactly how much this may cost and what your chances are.