Nursing care insurance lawyer
Long-term care (siudi) insurance disputes: entitlement, the ADL tests insurers use, and appeals when a claim is underpaid or denied.
What these files turn on
Insurers apply functional tests (washing, dressing, eating, continence, mobility, and sometimes cognition). The gap between the medical record and the insurer’s scoring is often the case. The policy wording and the examination protocol both matter.
How we start
The policy, the denial or partial-approval letter, and the recent medical record. Then a decision whether to appeal inside the company, go to the regulator path, or sue. No promised amount at the first call.
Related: all practice areas · fees · why this office.
First consultation
A first call to review the claim and the path forward. No promised amount. The office is in Ramat Gan; we represent clients throughout Israel.
ADL, denials and how we work
Most private long-term care policies turn on Activities of Daily Living (ADL) — transferring, dressing, bathing, eating/drinking, continence and mobility — or on a cognitive / supervision track. A medical diagnosis alone rarely wins the file. Insurers often send an assessor; a short “good day” can produce a report that understates daily dependence.
- Read the policy wording (thresholds, waiting periods, exclusions) before arguing facts
- Prepare a short function diary and updated medical summary for the assessor visit
- Treat a denial or partial approval as a legal document — answer the reasons, do not only “send more papers”
- Keep National Insurance nursing benefits separate from the private policy track
Related: Hebrew nursing-care guide · denial guide · medical vs functional disability · first meeting · why choose us · Ariel Freiberg.