Injury Compensation Claim in National Insurance in Petach Tikva

What Are Injury Compensation Benefits in National Insurance?

Injury compensation benefits in National Insurance are monetary payments made by the National Insurance Institute to an employee or self-employed person who has been injured in a work accident or a traffic accident on the way to or from work. This is compensation intended to cover bodily damages — namely, injury to health, loss of earning capacity, and diminished quality of life. Unlike a civil claim against the responsible party, National Insurance injury compensation is based on a predetermined statutory rights system and does not depend on proof of fault.

National Insurance pays injury compensation based on a percentage of disability determined by a medical committee. Each percentage of disability is linked to a defined monetary amount, thereby accounting for the severity of the injury. Additionally, a separate civil claim can be filed against the party responsible for the accident in order to receive compensation for damages not covered by National Insurance.

Who Is Entitled to Injury Compensation?

Eligibility for injury compensation benefits exists for employees injured in a work accident (i.e., an accident that occurred during working hours or in connection with work), as well as for employees injured in a traffic accident on the way to or from work. Self-employed individuals registered with National Insurance may also be entitled, under certain conditions. It is important to note that eligibility exists even if the injured party was partially responsible for the accident — National Insurance does not require proof of fault by the other party.

Process for Obtaining Injury Compensation Benefits from National Insurance

The process begins with submitting an application to National Insurance with relevant documents: medical certification of the injury, examination reports, a description of the accident circumstances, and any supporting documents. Following submission of the application, National Insurance refers the injured party for examination by a medical committee, which will determine the percentage of disability. Based on this percentage, the injury compensation is calculated. In cases where National Insurance rejects the application or assigns a lower disability percentage than expected, an appeal to an appeals committee can be filed, and thereafter an appeal to the District Court if necessary.

Types of Injury Compensation and Their Calculation

National Insurance calculates injury compensation based on several key components: the percentage of disability, the injured party's daily wage, and coefficients established by law. Each disability level has a monetary range that is updated periodically. Generally, injury compensation is higher when the disability percentage is higher, and also when the injured party's wage is higher.

Injury Compensation for Partial Disability

When the injured party suffers from partial disability (for example, 20% to 70%), National Insurance pays a lump sum calculated based on the percentage of disability and wage. This amount is intended to cover the damage resulting from the injury, including loss of earning capacity, pain, suffering, and diminished quality of life. Additionally, the injured party may receive a monthly stipend if the disability affects their ability to earn income.

Injury Compensation for Total Disability

In cases of total disability (100%), National Insurance pays a significantly higher amount, as well as a fixed monthly pension for life. This pension is intended to support the injured party throughout their lifetime, as total disability means the injured party cannot earn income at all.

Injury Compensation for Secondary Illnesses and Complications

Sometimes an initial injury causes complications or secondary illnesses that develop subsequently. In such cases, an additional application can be submitted to National Insurance to obtain additional injury compensation. It is important to document every illness or complication related to the original accident, as National Insurance requires a clear causal connection.

Differences Between National Insurance Injury Benefits and Civil Claims

It is important to understand that injury benefits in national insurance and civil claims are two different ways to receive compensation for bodily injury. National insurance pays according to a statutory schedule, regardless of proof of fault. Civil claims, by contrast, are based on proving the defendant's fault (negligence or intent) and establishing the causal link between the fault and the damages incurred.

Amounts and Ranges

National insurance injury benefits are limited to the statutory schedule. In a civil claim, however, you may claim higher amounts, based on the actual damages sustained (including loss of future income, pain, suffering, and diminished quality of life). Typically, civil claim awards are substantially higher than national insurance benefits.

Requirements for Filing

For national insurance injury benefits, you must prove that the accident occurred during work or on the way to work. For a civil claim, you must prove that the other party was at fault (negligent or intentional) and that this caused your damages. Both claims can proceed simultaneously and do not exclude each other.

What is the Average Amount for Injury Benefits?

National insurance injury benefit amounts vary based on the degree of disability, salary, and age of the injured party. Typically, for partial disability (20%–50%), benefit amounts range from tens of thousands of shekels. For higher disability (70%–100%), amounts can reach hundreds of thousands of shekels, plus a monthly pension. It is important to note that each case is unique, and accurate assessment is not possible without reviewing the specific documents of the injured party.

Importance of Legal Representation

In injury benefit claims, strong legal representation can significantly impact the outcome. An experienced attorney knows how to present medical evidence persuasively, how to overcome national insurance objections, and how to prepare compelling appeal arguments. Additionally, an attorney can help you combine an injury benefits claim with a civil claim to ensure you receive the full compensation you are entitled to.

Stages of a Claim in Petah Tikva — From Filing to Final Decision

The process of obtaining injury compensation through National Insurance is a process that can take months, and sometimes years. Below is a detailed description of the stages:

Stage 1: Filing an Application with the National Insurance Institute

The first step is to submit a formal application to the National Insurance Institute. This application must include an accurate description of the accident, medical confirmation of the injury, and all relevant documents (police report, eyewitness accounts, etc.). In Petah Tikva, you can submit an application at your local National Insurance office or through an attorney. We handle the preparation of the application and submit it on your behalf to ensure all details are correct and no important documents are missed.

Stage 2: Initial Review by the National Insurance Institute

After the application is submitted, the National Insurance Institute conducts an initial review to verify that the accident meets the criteria for injury compensation. This review includes document verification and, at times, contact with your employer's physician or treating physician for additional information. Typically, this stage lasts a few weeks.

Stage 3: Referral to Medical Committee

If the National Insurance Institute approves the application, the injured party is referred for examination by a medical committee. This committee consists of various physicians (typically a general practitioner, a specialist in the area of injury, and a radiologist), and they examine the injured party to determine the percentage of disability. The examination includes physical examination, review of medical documents, and sometimes additional tests. It is important that the injured party prepares carefully for this examination and brings all relevant medical documents.

Stage 4: Determination of Disability Percentage

After the examination, the medical committee decides on the disability percentage. This decision is based on a medical table established by law, as well as the discretion of the committee physicians. The disability percentage is the determining factor in calculating injury compensation.

Stage 5: Calculation of Injury Compensation

After the disability percentage is determined, the National Insurance Institute calculates the amount of injury compensation based on the statutory formula. This calculation takes into account the disability percentage, the injured party's daily wage, and coefficients set by law. The National Insurance Institute notifies the injured party of the calculated amount and typically pays the injury compensation within a few weeks.

Stage 6: Appeal to the Appeals Committee (if necessary)

If the injured party is not satisfied with the decision (rejection or lower disability percentage than expected), they may file an appeal with the National Insurance Institute's appeals committee. This appeal must be accompanied by strong legal and medical arguments, as well as additional evidence if available. The appeals committee reviews the appeal and decides whether to modify the original decision.

Stage 7: Court Appeal (if necessary)

If the injured party is not satisfied with the appeals committee's decision, they may file an appeal to the district court. This is a more formal legal stage that requires the submission of a statement of claim, legal arguments, and representation by an attorney. The court reviews the appeal and makes the final decision.

Why Choose Mandelbaum, Gur, Witzman-Gur & Co. in Petach Tikva?

Choosing an attorney specializing in personal injury claims is an important decision that can significantly impact the outcome. Mandelbaum, Gur, Witzman-Gur & Co. is a boutique family law firm specializing in tort law, particularly in representing claimants exclusively. Here's what sets us apart:

Deep Experience Since 2008

Our firm was founded in 2008 by Attorney Karen Mandelbaum, and since then we have handled personal injury claims, traffic accidents, workplace accidents, and public negligence cases. This experience of over 18 years enables us to understand all the nuances of National Insurance, medical committees, and courts. We know what works and what to avoid.

Claimant Representation Only

Unlike many firms that represent both employers and insurance companies, we represent claimants exclusively. This means our incentives are completely aligned with yours — we work to achieve the highest compensation for you, without conflicts of interest. We don't need to worry about maintaining good relationships with insurance companies or employers — we are 100% on your side.

Personal and Dedicated Approach

Because we are a boutique family firm, we know each client personally. You are not just a case number — you are a person injured in an accident who needs help. We dedicate time to understanding your situation, explaining your rights, and accompanying you at every step of the way.

Free Initial Consultation

We offer a free initial consultation so you can understand your situation, your rights, and your options. In this consultation, we examine your request and assess your prospects. There is no obligation — you can decide for yourself whether to work with us or not.

Office in Petach Tikva

8 Yoni Netanyahu Street, Petach Tikva. We are close to you, and it is easy for you to reach us. Additionally, we also have an office at 1 Donesh Street, Ramat Gan, to be convenient for all our clients in neighboring cities.