Harel paid the benefit - and regretted it: The 71-year-old demands 16,930 shekels
A 71-year-old insured person is suing the insurance company Harel, after it recognized him as a nursing care patient based on its own doctor's examination, but shortly thereafter canceled his eligibility following a covert investigation.
Can an insurance company cancel the eligibility of a nursing care insured person that was approved by its own doctor, based solely on footage from a private investigator? This issue is at the center of a lawsuit recently filed in the Magistrate's Court in Herzliya against the insurance company "Harel".
According to the lawsuit, filed by attorneys Raphael Almog and Ariel Gold, a 71-year-old resident of Rishon LeZion who is insured under a "Golden Care" policy, suffers from a severe deterioration in health including fibromyalgia, mobility difficulties, and other issues. After he contacted the company, Harel sent a specialist doctor on its behalf to his home, who determined unequivocally that he needs help with three daily activities (dressing, bathing, and transfers), and is therefore entitled to a monthly benefit of over 5,200 shekels. The company approved the claim for the period between October 2025 and August 2026.
However, less than two months after the approval and while he was already receiving the nursing care benefit, Harel announced unexpectedly the cancellation of his eligibility. According to the company, a covert investigation it conducted revealed that he is capable of performing the actions on his own.
The statement of claim argues that the rejection letter does not specify what was observed in the investigation, and how a few moments documented by a person lacking medical training contradict the professional assessment of a specialist. In addition, it is emphasized that insurance companies are prohibited from sending investigators without a well-founded suspicion of fraud.
"The case joins an ugly phenomenon in which the company disavows nursing care insured persons who are at the lowest point of their lives," the attorneys noted.
The plaintiff demands the withheld benefits totaling approximately 16,930 shekels, the continuation of the benefit payment, and the imposition of special interest on Harel for acting in bad faith. A statement of defense has not yet been filed.
