Nursing Care Claim in Petah Tikva — Complete Legal Explanation

What is a Nursing Care Claim?

A nursing care claim is a legal claim filed by an injured party or their family to receive compensation for nursing and care expenses incurred as a result of an accident (motor vehicle accident, work accident, public negligence, or other injury). Nursing care includes assistance with daily activities such as eating, hygiene, personal grooming, dressing, mobility within and outside the home, and medical management of health conditions. A nursing care benefit is the financial compensation to which the injured party is entitled for these expenses — whether they have been paid in the past or are expected to be paid in the future.

In Israel, nursing care claims are typically filed as part of a comprehensive tort claim, which aims to compensate the injured party for all damages incurred — bodily injuries, loss of income, and medical and nursing expenses. Israeli law requires the party liable for the damage (whether national insurance, private insurance, or a private individual) to compensate the injured party for all reasonable and foreseeable nursing care expenses.

Who is Entitled to a Nursing Care Claim?

Any injured party who has suffered bodily injury and as a result requires nursing care is entitled in principle to a nursing care claim. This includes:

• Motor vehicle accident victims — drivers, passengers, pedestrians, and cyclists injured in an accident.
• Work accident victims — employees injured in an accident at the workplace or while traveling to work.
• Public negligence victims — persons injured due to negligence by a public authority (municipality, ministry, public institution).
• Private injury victims — persons injured due to the action or inaction of a private individual or company.

If the injured party is a minor, their parents or guardian may file a claim on their behalf. If the injured party died as a result of the injury, a claim may be filed on behalf of their estate or on behalf of surviving family members (such as a spouse and children).

What is the Difference Between a Nursing Care Claim and Other Tort Claims?

A nursing care claim is part of a comprehensive tort claim, but it is distinguished from other damages. In a comprehensive tort claim, the injured party may seek compensation for:

• Bodily injuries — pain and suffering, impairment of physical functions, permanent health problems.
• Loss of income — loss of income the injured party could have earned if not injured.
• medical expenses — surgeries, medications, tests, rehabilitation, and various treatments.
• Nursing care expenses — cost of employing a caregiver, hygiene, cleaning, personal care, and any nursing services.
• Disability damages — if the injured party has lost permanent or partial work capacity.

A nursing care claim focuses on medical and nursing care costs alone, but it is typically the most significant component of a comprehensive claim when the injured party requires prolonged or permanent care.

How is a nursing care benefit calculated?

The calculation of nursing care benefits in Israel is based on several key factors, and the procedure varies depending on the stage at which the claim is filed:

1. Stage of the claim in national insurance or private insurance

When an injured party files a claim with the National Insurance Institute, they first receive a medical evaluation by a medical committee. The committee determines the degree of disability of the injured party (on a scale of 0–100%), and accordingly, the National Insurance Institute pays a fixed monthly benefit. The nursing care benefit under national insurance is calculated as a percentage of the average salary in Israel and depends on the degree of disability.

2. In a civil tort claim

In a civil claim (against the tortfeasor, private insurance, or a public authority), the calculation of the nursing care benefit is based on:

• Actual nursing care costs — if the injured party is already paying for nursing care services (caregiver, nursing home, care center), the claim will include these actual expenses.
• Expected nursing care costs — if the injured party is expected to require nursing care in the future, the court will calculate the expected nursing care expenses for each year of their life and discount them to present value (economic discount).
• accepted tables — typically, Israeli courts use accepted tables for calculating nursing care costs, based on statistical data of care costs in Israel.

3. Life expectancy and maintenance

If the injured party is expected to require nursing care for many years or for life, the court uses statistical life tables to calculate how many additional years the injured party is expected to live. The annual expenses are multiplied by life expectancy and then discounted to present value, because money received today is worth more than money received in the future.

4. What factors affect the amount of the benefit?

The amount of the nursing care benefit depends on several factors:

• The degree of disability of the injured party (the percentage of disability determined by the medical committee).
• The age of the injured party (the younger the injured party, the longer their life expectancy, and thus the greater the nursing care benefit).
• Prior health condition (if the injured party had prior health problems, they may affect life expectancy).
• Type of injury (brain or spinal cord damage typically requires more intensive care than limb injuries).
• Actual nursing care costs (if the injured party is already paying for care, this directly affects the benefit).

The Process of Filing a Nursing Care Claim — Main Stages

The process of filing a nursing care claim typically follows structured stages:

Stage 1: Initial Medical Assessment

Following the accident or injury, the injured party undergoes a medical examination. Under National Insurance, the injured party will undergo a medical assessment by a medical committee that will determine their disability percentage. Under private insurance, the insurance company may require its own medical examination.

Stage 2: Collection of Medical and Nursing Documentation

It is important to begin collecting relevant documentation early: medical reports, prescriptions, caregiver invoices, assessments by social workers, and any evidence of actual nursing expenses. This documentation will be critical to the claim.

Stage 3: Filing a Claim with National Insurance or Private Insurance

When the injured party is ready, they can file a formal claim with National Insurance or private insurance. The claim should contain supporting documents: a medical report, receipts for nursing expenses, and any other evidence of damages.

Stage 4: Negotiation with Insurance

After filing the claim, the insurance company may offer a settlement (a sum of money to conclude the claim). Typically, the insurance company's initial offer is lower than the actual compensation due. An attorney can conduct negotiations with the insurance company to obtain a higher amount.

Stage 5: Court (If No Settlement is Reached)

If no settlement is reached with the insurance company, the claim may proceed to court. At this stage, an attorney will present legal arguments, introduce medical evidence, and seek to obtain a favorable court judgment for the injured party.

What Are Typical Nursing Care Costs in Petah Tikva and Israel?

Nursing care costs vary depending on the type of nursing care, intensity level, and geographic location. Typically, nursing care costs in Israel range as follows:

• Part-time home nursing (a few hours per day) — typically in the range of 100–250 NIS per hour, depending on the caregiver's qualifications and care requirements.
• Full-time home nursing (24 hours per day) — typically in the range of 6,000–12,000 NIS per month, depending on care intensity.
• Institutional nursing (nursing home, hospital, care center) — typically in the range of 5,000–15,000 NIS per month, depending on the type of institution and level of care.
• Medical and therapeutic equipment (wheelchair, electric bed, respiratory cleaning devices) — typically in the range of 500–3,000 NIS per item, depending on the type of equipment.

It is important to note that these costs are updated regularly, and insurance companies may use different data. An experienced attorney knows how to calculate costs accurately and realistically based on current data.

Types of Care — What They Are and How They Affect the Benefit?

Care can take various forms, and each type may affect the care benefit differently:

Medical Care

Medical care includes direct treatments prescribed by a physician, such as replacement of medical devices, airway clearance, limb movement to prevent contractures (muscle contractions), and monitoring of medical parameters. This type of care typically requires a caregiver with medical training, and therefore its costs are higher.

Personal Care (ADL — Activities of Daily Living)

Personal care includes assistance with basic daily activities: dressing, undressing, eating, drinking, bathing, personal hygiene, and mobility within and outside the home. This type of care is typically provided by a caregiver without special medical training, but requires patience and accuracy.

Domestic Care (Housekeeping and Home Management)

Domestic care includes house cleaning, laundry, cooking, shopping, and household management. This type of care may be less intensive than personal care, but it is also necessary to maintain a reasonable quality of life.

Psychological and Social Care

For injured persons suffering from psychological or cognitive damage (brain injury, depression, anxiety), psychological care may be needed — assistance with emotional management, psychological support, and companionship. This type of care is more difficult to quantify, but is typically covered in a care claim.

Institutional Care

If the injured person requires such intensive care that it cannot be provided at home, they may need to be transferred to an institution (nursing home, hospital, care center). Institutional care is typically more expensive than home care, but it covers all expenses related to treatment.

Rights of Claimants in Care Lawsuits

An injured claimant in a care lawsuit has several important rights:

• Right to Full Compensation — The injured person is entitled to compensation for all reasonable and foreseeable care expenses, both present and future.
• Right to Choose the Type of Care — The injured person may choose whether to receive home care or institutional care, and essentially decide how they want to be treated (as long as it is medically reasonable).
• Right to Unbiased Medical Evaluation — The injured person is entitled to an unbiased medical evaluation, and may bring their own medical witnesses if they believe the insurance evaluation is biased.
• Right to Legal Representation — The injured person is entitled to be represented by an attorney, who will ensure that they receive the full compensation due to them.
• Right to Appeal — If the injured person disagrees with the insurance company's or court's decision, they may file an appeal to a higher court.
• Right to Confidentiality — All medical information of the injured person is protected by confidentiality, and the insurance company cannot disclose it without consent.

Why Choose an Experienced Attorney for Nursing Care Claims?

Nursing care claims are complex, requiring a deep understanding of the law, medical knowledge, and the ability to negotiate with insurance companies. An experienced attorney can assist in several critical ways:

1. Accurate Calculation of Benefits

An experienced attorney knows how to calculate nursing care benefits to the maximum, using accepted tables, statistical life expectancy data, and court precedent experience. Incorrect calculations can lead to significantly lower compensation — given nursing care costs over many years, a difference of just a few percentage points can amount to thousands of shekels.

2. Collection of Strong Evidence

An attorney knows which critical evidence to obtain: detailed medical reports, assessments from social workers, testimonies from caregivers, invoices for actual nursing care expenses, and medical expert opinions. This evidence forms the foundation of the claim, and obtaining it requires knowledge and expertise.

3. Strong Negotiation with Insurance

Insurance companies typically attempt to reduce nursing care benefits. An attorney knows how to counter insurance claims, present strong legal arguments, and negotiate from a position of strength. Generally, an experienced attorney can achieve a significantly higher amount than the insurance company's initial offer.

4. Representation in Court

If the claim reaches court, an experienced attorney can present strong legal arguments, bring relevant evidence, and achieve a favorable judgment for the injured party. Israeli courts respect experienced attorneys, and this impacts the outcome.

5. Advice on Additional Rights

An attorney knows what additional rights the injured party may have — such as tax exemptions, pensions for family members, subsidies from public institutions, or compensation for other damages (lost income, pain and suffering). An experienced attorney will ensure no rights are overlooked.