Guide to Third-Party Care and Medical Expenses

What are third-party care and medical expenses?

When a person is injured in a traffic accident, work accident, or as a result of public negligence, they are entitled to compensation for all damages incurred. Among the most important — yet sometimes overlooked — damages are third-party care and medical expenses. This guide explains in detail what these expenses are, how they are calculated, and why it is crucial that you claim every shekel spent on rehabilitation and treatment.

Third-party care is compensation for assistance received from other people (family, friends, and also professional workers) for performing daily activities that you could not perform yourself due to the injury. Medical expenses include any payment made for examinations, treatments, medications, rehabilitation, physiotherapy, psychological treatment, and any other medical expense related to the injury. In Israel, current case law requires the defendant (insurance, employer, public body) to reimburse all such expenses, provided that they are reasonable and directly related to the injury.

Why it is important not to ignore these expenses

Often, injured parties focus on compensation for pain and suffering, or loss of earning capacity, and forget to document and claim medical expenses and third-party care. This is a critical mistake. In many cases, these expenses amount to tens of thousands of shekels, and sometimes hundreds of thousands — especially in cases of serious injury requiring long-term treatment. Additionally, medical expenses not claimed in the original lawsuit may be difficult to recover in the future, especially if the defendant or insurance company has closed the file.

Our firm, Mendelbaum, Gor, and Vitzman-Gor Law Offices, has been representing tort claimants since 2008. In fifteen years of experience, we have seen many times how medical expenses and third-party care treatment made the difference between fair compensation and partial compensation. We handle every case carefully and meticulously, ensuring that not a single shekel of medical expense is forgotten.

Types of medical expenses that can be claimed

Medical expenses that can be claimed are broad and varied. They include not only expenses at hospitals or private doctors, but also expenses not paid directly from your pocket — such as treatment covered by the National Insurance or private health insurance, if they included costs not fully covered.

Examination and treatment expenses

Medical examinations of any kind related to the injury — blood tests, X-rays, MRI scans, CT scans, ultrasounds, eye exams, hearing tests — all of these are medical expenses that can be claimed. Treatments at hospitals, treatments with private specialists, surgeries, and any medical treatment related to the injury — all can be claimed.

Physiotherapy and rehabilitation

This is one of the most important chapters. Physiotherapy, movement therapy, functional rehabilitation — all of these are legitimate medical expenses. In cases of spinal cord, limb, head, or chest injuries, rehabilitative treatment can last months or years. Every hour of therapy, every session with a physiotherapist, every customized rehabilitation program — all require compensation. Generally, case law recognizes these expenses provided they were performed according to a doctor's recommendation or by a recognized medical team.

Medications and medical supports

Any medication prescribed by a doctor as a result of the injury — this is a medical expense. Any medical support (cast, bandage, back support, orthopedic brace) — medical expense. Any medical equipment purchased for treatment purposes (heating pad, muscle strengthening device, pain relief device) — this is any expense that can be claimed provided it is reasonable and related to the injury.

Psychological and psychiatric treatment

Physical injury often causes psychological trauma, depression, anxiety, or sleep disorders. Psychological or psychiatric treatment related to the injury — this is a legitimate medical expense. Generally, courts recognize psychological treatment provided it was performed by a qualified therapist and is directly related to the injury.

Auxiliary equipment and innovations

In cases of permanent disability, auxiliary equipment such as wheelchairs, crutches, hearing devices, corrective glasses (if damaged in the accident), prosthetics, and any other auxiliary equipment — all of these are medical expenses that can be claimed. Generally, courts recognize these expenses as long as they are reasonable and necessary for rehabilitation or improving the injured person's quality of life.

Third-Party Assistance — What It Is and How It Is Calculated?

Third-party assistance is compensation for help received from other people to perform actions that you could not perform yourself due to your injury. This can be assistance from a family member (mother, father, spouse, children), friends, or professional workers (home care aide, caregiver, personal assistant).

Examples of Third-Party Assistance

If you were injured in an accident and as a result could not leave your home, prepare meals, do laundry, shower, do shopping, or maintain your house — all assistance you received for these activities is third-party assistance. If you received assistance with transportation to medical appointments, rehabilitation exercises, or medication management — this is also third-party assistance. If you needed a personal assistant or caregiver for medical reasons — this is third-party assistance.

How Is Third-Party Assistance Calculated?

Third-party assistance is calculated in two main ways: The first method is actual calculation — if you paid for assistance (to a home care aide, caregiver, personal assistant), you can claim the amount you actually spent. The second method is hourly calculation — if assistance was provided by a family member or friend without payment, courts typically recognize compensation based on hours of assistance at minimum wage or average market wage for similar assistance. Courts generally recognize third-party assistance from family members at minimum wage or higher rates, depending on the circumstances and severity of the injury.

Essential Documentation for Third-Party Assistance

To claim third-party assistance, it is essential to document it in writing. If you paid for assistance — keep receipts, invoices, and bank transfers. If assistance was provided by a family member — document the hours using a diary or list, and obtain written confirmation from the care recipient or caregiver regarding the type of expense and its scope. In our cases, we have seen several times where injured parties lost the right to compensation for third-party assistance due to lack of documentation. This is a very costly mistake.

Future Third-Party Assistance

In some cases, particularly in cases of permanent or severe disability, courts also recognize compensation for future third-party assistance — meaning assistance that will be needed by the injured party in the coming years. This calculation is more complex, as it requires an assessment of life expectancy, degree of disability, and the amount of assistance needed. In some cases, courts recognize future third-party assistance as a lump sum payment, and in other cases as a monthly or annual payment over the years.

Comparison Table — Types of Medical Expenses and Their Treatment

Important Tip: Any expense not claimed in the original claim will be extremely difficult to recover in the future. Document everything, retain all receipts, and ensure your claim includes every medical expense and every hour of assistance provided.

What Courts Require to Recognize Medical Expenses and Third-Party Assistance

Israeli courts are strict regarding medical expenses and third-party assistance. They will not recognize every expense you claim, but only those that meet certain criteria. Here are the main criteria:

1. Direct Causal Connection to the Injury

The expense must be directly related to the injury. If you were injured in a traffic accident due to a broken femur, an expense for treatment of the femur is directly connected. However, if you claim for dental treatment unrelated to the accident — the court will not recognize it. This seems straightforward, but in practice, claims often include expenses that are not directly connected, which weakens the claim.

2. Reasonableness of the Expense

The expense must be reasonable. This means it does not have to be the cheapest treatment on the market, but it also cannot be luxurious or unnecessary. For example, if a certain treatment costs 500 shekels at a public hospital and 2,000 shekels at an upscale private clinic — courts will generally recognize the more reasonable amount (500 shekels) or an average between the two. This does not mean you must use the cheapest treatment available, but courts will examine the reasonableness.

3. Medical Recommendation or Approval

Generally, courts require that medical expenses be based on a physician's recommendation or approval. If you underwent treatment that was not based on a medical recommendation — it is very difficult for the court to recognize it. Therefore, it is essential that every treatment be based on a written medical recommendation.

4. Complete Documentation

You must prove that this expense actually occurred. Receipt, invoice, medical report, bank transfer — any document that proves this expense actually took place. Without documentation, it is very difficult to prove an expense in court.

5. Third-Party Assistance — Documentation of Hours or Payments

If you claim for third-party assistance, you must prove the hours (if unpaid assistance) or the payments (if paid assistance). Documentation such as a diary, list, or written confirmation from the patient or caregiver — all of these help. Without documentation, it is very difficult to prove hours of assistance.

Case Example — How Medical Expenses and Third-Party Care Made a Difference

To demonstrate how important medical expenses and third-party care are, let us look at a case example (names and some details have been changed to protect privacy):

The Case: A 45-year-old man was injured in a serious traffic accident. He suffered a spinal fracture and as a result he is now confined to a wheelchair. He underwent emergency surgery in a hospital, followed by months of intensive rehabilitation treatment.

Medical expenses we documented:

• Hospital hospitalization for three weeks: 50,000 shekels
• Surgery and medications during hospitalization period: 30,000 shekels
• Physiotherapy treatment in hospital and afterward: 45,000 shekels (45 sessions × 1,000 shekels)
• Medical equipment (wheelchair, home elevator, orthotic devices): 80,000 shekels
• Monthly medications for one year: 12,000 shekels
• Psychological treatment (due to trauma): 15,000 shekels
• Total medical expenses: 232,000 shekels

Third-party care we documented:

• Spouse assisted with housework, laundry, meal preparation, and transportation to treatments: 20 hours per week for one year (1,040 hours) × 35 shekels (minimum wage at the time): 36,400 shekels
• Daughter assisted with personal care and bathing: 10 hours per week for one year (520 hours) × 35 shekels: 18,200 shekels
• Paid home aide (because spouse worked): 8 hours per week for one year (416 hours) × 50 shekels: 20,800 shekels
• Total third-party care: 75,400 shekels

Total compensation for medical expenses and third-party care: 307,400 shekels

This is a very substantial amount, and without good documentation of these expenses, the injured party would have lost almost 300,000 shekels. The family did an excellent job documenting every expense, every receipt, and every hour of care. When we filed the claim, the insurance company included these expenses in the final settlement.