Pension Claim and Benefit Denial in Petach Tikva

What is Pension Benefit Denial and How Can You Fight It?

Denial of pension benefits or a reduction in a decision by the National Insurance authority or employer is one of the most difficult situations faced by work accident victims and road accident victims alike. When a person is injured in an accident, they expect the insurance system to support them when needed — but often, what is rightfully due to them is withheld due to an incorrect decision, a misunderstanding of their medical condition, or weak arguments by insurance institutions.

A pension claim is a legal process in which you, as an injured party or insured person, challenge a decision by the National Insurance Institute, a private insurance company, or a pension fund. The purpose of the claim is to restore your right to a monthly pension, a one-time financial compensation, or an increase in the amount you already receive. In Petah Tikva and its surroundings, Mendelboim, Gor, and Witsman-Gor Law Office has handled such claims for over 18 years, with extensive experience in National Insurance law and tort claims.

Why Do Insurance Institutions Close Their Doors?

National Insurance bodies and private insurance companies sometimes operate based on incorrect assumptions about the medical condition of the injured party. They may argue that the disability is not truly connected to the accident, or that the disability is insufficient to justify a pension. In some cases, these decisions are based on superficial medical examinations, an appraisal that did not take into account the full clinical findings, or an incorrect legal interpretation of the law. In such circumstances, you have a legal right to appeal or file a lawsuit in court.

Who Is Entitled to File a Pension Claim?

Any person injured in a work accident or a road accident, and suffers from permanent or temporary disability that affects their ability to work, is entitled to file a claim. Family members of a victim killed in an accident are also entitled, under certain conditions. Additionally, if you are insured by a pension fund or private insurance company, and you have a claim under the policy terms, this also gives rise to a legal right to file a claim.

• Work accident victims: Every employee injured at work is entitled to compensation from National Insurance and in certain cases also to an additional civil claim.
• Road accident victims: Drivers, passengers, and pedestrians injured in a road accident are entitled to file a claim under tort law and are also entitled to compensation from National Insurance if certain conditions are met.
• People with pre-existing disabilities: If a pre-existing disability has worsened or been aggravated as a result of an accident, there is a right to claim for the aggravation.
• Family members: Family members of a person killed in an accident may be entitled to a direct pension or a claim for economic loss.

The Claim Process: What is the First Stage?

When you decide to file a pension claim, the process begins with examining documents and medical evidence. The Mandelboim, Gur, Witzman-Gur office in Petah Tikva will begin the first stage by submitting a formal request (appeal or request for reconsideration) to the insurance company or medical committee. At this stage, we analyze all medical documentation, witness testimony, and medical reports, and construct a strong legal argument proving that the rejection decision was incorrect.

Main Process Stages:

1. Personal Legal Consultation: In the first meeting, we listen to your story, examine existing documents, and assess the strength of your claim. This is a vital part of developing the correct legal strategy.
2. Gathering Medical Evidence: We request complete medical reports, test results, and often commission an independent medical assessment to challenge the insurance company's original evaluation.
3. Submitting an Appeal Request: If an appeal has not yet been filed, we submit a formal request to the appeals committee of National Insurance or the relevant insurance company. This request includes a detailed legal argument and new medical evidence if necessary.
4. Appeal Procedure: If the appeal is rejected or does not progress, we may file a lawsuit in court. At this stage, the proceedings are conducted before a judge who reviews all evidence anew.
5. Negotiation and Settlement: At certain points in the process, there is an opportunity to settle the claim by agreement, saving time and money.

Role of the Medical Committee

A medical committee is the body that decides your disability percentage. This decision directly affects the amount of monthly allowance you are entitled to. When the committee decides that the disability percentage is too low, or when it rejects the claim entirely, this is usually because it did not fully understand the extent of your disability. In a legal claim, we can sharpen the medical argument, bring new assessments, and present clinical evidence that was not presented to the original committee.

Common Misconceptions

Insurance companies often assume that if an injured party can perform basic activities (such as walking or sitting), then he or she is not entitled to an allowance. This is a misconception. The law recognizes practical disability, meaning impairment of the ability to work in one's own job or similar work. Even if you can do things at home, you may be unable to return to your previous job or similar work, in which case you are entitled to compensation.

How Much Does a Pension Claim Cost and What Can You Expect?

A common question asked at the first meeting is: "How much does it cost?" and "What are my chances?" Mendelboim, Gor, and Vitzman-Gor law firm typically works on contingency fee agreements in tort claims, meaning you only pay us if you win your claim. This means you have no financial risk in filing the claim.

Our Payment Model

We believe that claimants should not have to pay legal costs upfront. Therefore, we accept cases on a contingency fee basis, where we receive a percentage of the compensation you receive at the end. This means you only pay if you win, and our fee is tailored to the size and complexity of your claim.

Typical Compensation Ranges

Compensation amounts in pension claims vary widely depending on many factors. If you are entitled to a monthly pension, the amount depends on your disability rate (percentage), your previous income, and your age. A monthly pension can range from several hundred shekels to several thousand, depending on the circumstances. Additionally, if your claim includes a one-time compensation for bodily injury or loss of earning capacity, the amount may be considerably higher.

• Monthly Pension: Varies based on disability percentage, previous income, and age. Typical range: hundreds of shekels to several thousand per month.
• One-Time Compensation: For bodily injury, pain and suffering, loss of income, or future medical expenses. Range: tens of thousands to hundreds of thousands of shekels depending on the severity of the disability.
• Legal Expenses: Typically covered from the compensation itself, under a contingency fee agreement.

How Long Will It Take?

A pension claim process can take anywhere from several months to several years, depending on the complexity of the case and the stage at which you begin. If you are at the first appeal stage, the process can be faster. If the claim reaches court, it may take longer. However, in some cases, early-stage negotiations can lead to a quick settlement.

Why Choose Mendelboim, Gor, Witzman-Gor Law Office in Petah Tikva?

Mendelboim, Gor, Witzman-Gor is a boutique family law office specializing in tort law since 2008. We represent plaintiffs exclusively, which means we do not represent insurance companies or employers. This means your interests are our only interests. We are not obligated to any external body, and we work with complete transparency with our clients.

In-Depth Legal Experience

Attorney Karen Mendelboim, the office founder, holds over 18 years of experience in tort law and national insurance claims. Over the years, we have handled hundreds of cases for accident victims and established relationships with medical experts, competing attorneys, and insurance bodies. This experience means we know how to navigate the system, how to build a strong argument, and how to achieve results in favor of plaintiffs.

Personal and Dedicated Approach

As a small family office, we offer a personal and friendly approach to every client. You are not just a case number — you are a person who has undergone trauma and needs legal and human support. We dedicate time to understanding your situation, listening to your concerns, and guiding you through every stage of the process.

Free Initial Consultation

We believe everyone is entitled to professional legal advice without initial cost. Therefore, your first meeting with us is free of charge. In this meeting, we will examine your situation, hear your story, and assess the strength of your claim. If we decide we have capacity to handle your case, we will offer you a clear agreement where you will know exactly what to expect.

Close to You in Petah Tikva

Our branch in Petah Tikva (Yoni Netanyahu 8) is conveniently located, close to public transportation and parking. We understand that it is sometimes difficult to travel, especially if you suffer from disability or pain. Therefore, we also offer virtual meetings and telephone consultations, so you can receive legal advice without having to travel.