IDF veteran sues Harel insurance company over denial of nursing benefits
An 80-year-old IDF veteran, suffering from cancer and functional decline, is suing Harel for approximately 119,000 shekels. He claims his nursing claim was rejected without a home visit by a medical expert, relying instead on surveillance by a private investigator. Harel stated they will respond in court.
Is an insurance company allowed to reject a nursing claim from an IDF veteran suffering from cancer without sending a medical expert to his home to examine his condition? This serious allegation is at the center of a lawsuit recently filed in the Herzliya Magistrate's Court against the Harel company by attorneys Raphael Almog and Eden Levy from the Raphael Almog & Co. law firm.
According to the lawsuit, Y., about 80 years old, from Gush Dan, purchased a group nursing insurance policy years ago from Harel for members of the IDF Disabled Veterans Organization. The policy was intended to provide him with monthly benefits of 4,755 shekels and an exemption from premiums in the event of a qualifying nursing condition. In recent years, Y. has dealt with bladder cancer, multiple spinal and hip surgeries, herniated discs, and chronic pain.
In 2024, Y.'s condition deteriorated significantly following a bout of West Nile fever and encephalitis. His medical records document instability, memory loss, and a need for significant assistance with daily activities. While the National Insurance Institute recognized him as needing nursing care, Harel allegedly refused to send a medical expert to his home to verify his condition.
Instead, Harel sent a rejection letter, claiming that a covert investigator had tracked his movements and documented him "acting independently." Attorney Almog argues that insurance companies are prohibited from using private investigators to monitor insured individuals without clear evidence of fraud. "It is impossible to compare a professional medical assessment with point-in-time documentation by someone lacking medical knowledge," Almog stated.
Harel responded: "We are studying the statement of claim and will respond in the appropriate courts. Due to privacy and medical confidentiality obligations, we cannot comment on the details of this specific case."
The lawsuit asks the court to order Harel to pay 118,875 shekels in backdated benefits, continue future payments, and refund excess premiums. The attorneys also requested that the court impose special interest penalties on Harel due to their alleged bad-faith conduct.
