Guide to National Insurance Claims — How to File Correctly

What is a National Insurance Claim and Who It Is Intended For

A national insurance claim is a legal procedure in which an injured person (or their heirs) submits a formal request to the National Insurance Institute for monetary compensation due to bodily injury, occupational disease, loss of earning capacity, or death resulting from an accident or illness covered by national insurance. National insurance covers a wide range of situations: traffic accidents, workplace accidents, occupational diseases, medical surgeries and their consequences. Any person who has been injured and requires medical treatment or has experienced a limitation in their earning capacity can file a claim.

National insurance is not a simple system. It includes several types of benefits (pension, lump-sum compensation, reimbursement of medical expenses) and complex rules that determine who is entitled and in what amount. Many injured persons are unaware of their full rights, and some even waive their rights due to lack of knowledge. This is why encouraging the filing of well-founded and professional claims is so important.

Why It Is Important to File a National Insurance Claim Correctly

Incorrect filing of a national insurance claim can lead to rejection, a lower result than deserved, or loss of substantial sums. National insurance requires accurate documents, clear medical evidence, and precise legal wording. Any error in filing—such as a missing document, inaccurate description of the disability, or failure to list all medical expenses—can affect the final amount you receive.

When you file a claim on your own, without legal representation, you may miss important details or encounter complex bureaucratic requirements. In contrast, when an experienced attorney handles a claim, they review every detail, collect all necessary documents, negotiate with the National Insurance Institute, and if necessary, file an appeal or lawsuit in court. This significantly increases the chances of receiving full compensation and a fair settlement.

Practical Steps for Filing a National Insurance Claim

Step 1: Collection of Initial Documents

Before filing your claim, you must collect all relevant documents. These include: medical documentation (physician reports, diagnoses, test results, medication prescriptions), health insurance or private insurance policies, employer documentation (if the accident occurred at work), accident reports from police or authorities, medical invoices, and documentation of additional expenses (transportation, physical therapy, medication). The more documents you collect at this stage, the stronger your claim will be.

Step 2: Submission of Initial Request to National Insurance

You must submit a formal request to the National Insurance Institute (or your local branch). The request must include: full name and ID number of the injured person, accurate description of the accident or illness, details of family physician or specialist, list of all attached documents, and signature. If you file on your own, it is important that you keep a copy of every document you send and request a receipt confirmation from the National Insurance Institute.

Step 3: Medical Examination and Determination of Disability Percentage

After receiving your request, the National Insurance Institute will send you for a medical examination by a physician on its behalf. This physician will determine your disability percentage (if any) and issue a medical report. The disability percentage is a crucial factor in determining the compensation amount. It is important that you prepare for this examination: bring all your medical documents, describe your symptoms and difficulties accurately, and explain how they affect your ability to work and function.

Step 4: Receipt of Initial Decision

After the examination, the National Insurance Institute will issue an initial decision. This decision will include: approval or denial of entitlement, disability percentage (if approved), proposed compensation amount, and type of benefit (monthly pension, lump-sum compensation, expense reimbursement). If you agree with the decision, the claim is concluded. If you disagree, you can file an appeal.

Step 5: Appeal (If Necessary)

If your claim was denied or if you believe the proposed amount is too low, you have the right to file an appeal to the National Insurance Appeals Committee. In an appeal, you can present additional evidence, bring witnesses (including physicians), and present legal arguments. This appeal is a more formal procedure and requires careful preparation and legal precision.

Step 6: Request for Legal Review or Court Appeal (If Necessary)

If the appeals committee denied your appeal or if you wish to challenge its decision, you can file a request for legal review in the Labor and National Insurance Court. At this stage, professional legal representation is essential, as the procedure requires a deep understanding of national insurance law and experience in presenting complex arguments before a judge.

Scenario Comparison and Typical Compensation Amounts

The compensation amount in a National Insurance claim depends on several factors: the degree of disability, the age of the injured party, income prior to the accident, the type of benefit (monthly allowance or lump sum payment), and the time elapsed since the accident. Below is a table presenting typical scenarios (the figures are general estimates only and each case is examined individually):

Important Note: This table is a general estimate only. Each case is examined separately by the National Insurance Institution and appeals committees. The amounts may be higher or lower depending on specific circumstances, previous income, age, and other factors. Professional legal advice is essential for an accurate determination of entitlement in your case.

Practical Tips for Filing a Strong Claim

• Keep every document: Every medical invoice, letter from a doctor, examination report, and record of expenses is part of your file. Organize all documents in a folder or digital file.
• Describe the disability and its impact precisely: When speaking with a doctor or submitting a form to the National Insurance Institution, be accurate in describing symptoms, pain, difficulty with movement, impact on sleep, ability to work, and daily life activities.
• Request supporting letters from doctors: If you have a family physician or specialist who knows your condition, ask them for a letter describing the disability, required treatment, and recovery prospects. Such a letter is essential in an appeal.
• Follow up on your claim: It is not enough to submit a request and wait. Contact the National Insurance Institution, check the status of your case, ensure they have received all documents, and respond promptly to any requests they make.
• Do not give up easily: If your claim is rejected the first time, it is not the end of the road. Appeal is your right, and in many cases you can achieve a better result on appeal.
• Consider professional legal representation: If your claim is complex (high disability, high expenses, initial rejection, or dispute) — seek legal advice. An attorney experienced in National Insurance law can significantly increase your chances of success.

Why Choose Mandelbaum, Gor, Vitsman-Gor & Co. Legal Representation for Your Claim

Mandelbaum, Gor, Vitsman-Gor & Co. is a boutique family law firm specializing in tort law (representing claimants only), real estate law, and civil-commercial law. Founded in 2008 by Attorney Keren Mandelbaum, we have since represented injured parties in complex claims, including National Insurance claims.

Our Experience: Over 18 years of experience representing claimants in tort law. We are familiar with all the complexities of National Insurance, the procedures of appeals committees, and the legal arguments that help achieve full compensation. Each case is handled with personal attention, without any "autopilot" approach.

Claimant Representation Only: We represent only injured parties (claimants), not insurance companies or employers. This means we are on your side, with no conflicts of interest.

Personal and Dedicated Approach: Every client is family to us. We dedicate time to understanding your situation, hearing your concerns, and guiding you every step of the way. We are not a "transactional firm" — we are a "relationship firm".

Free Initial Consultation: If you are unsure whether you have a claim or want to understand your rights, come in for a free initial consultation. We will listen to you, explain your rights, and give you clear advice.

Convenient Location: Our office is located in Ramat Gan, close to the train station and in a central area that is easy to access.