Class action lawsuit approved against HMOs: they provide benefits to large families
The Tel Aviv Labor Court has approved a class action lawsuit against the four HMOs, alleging improper preference for large families. The court determined that there is a reasonable chance the lawsuit will be decided in favor of the group members. The HMOs may be required to cancel the discounted family rate.
The Tel Aviv Labor Court has approved a class action lawsuit against the HMOs Maccabi, Leumit, Meuhedet, and Clalit, alleging that they provide an improper preference to large families by exempting them from payment starting from the fourth child. The court recommended that the HMOs re-examine the legality of the discounted family rate and the possibility of canceling it.
Four mothers filed the request, claiming that the HMOs are blatantly and persistently violating the principle of equality enshrined in the National Health Insurance Law by providing significant benefits for the fourth child and onwards. It is argued that this policy causes certain insured individuals to receive additional health services at the expense of other insured individuals, which constitutes improper discrimination.
In the lawsuit, it is claimed that according to Central Bureau of Statistics data for 2020, the fertility rate of ultra-Orthodox women stands at 6.64 children per woman compared to 1.96 for secular women, so the benefit disproportionately favors the ultra-Orthodox public. It is also argued that the number of children does not constitute a relevant criterion for examining economic status and that the law prohibits considering economic factors.
The HMOs argued that the benefit was approved by the Ministry of Health and therefore the petition should be against it. The Ministry of Health refrained from taking a position but clarified that it intends to establish a team to conduct dedicated staff work. This is for the purpose of examining, on a forward-looking basis only, the exemption benefit starting from the fourth child.
The HMOs' activities were in accordance with the regulator's guidelines and approval
The court determined that the Ministry of Health's position "struggles to reconcile the 'permit' established in a 2005 document, according to which 'there is no obstacle to setting a rate for a family', with the explicit provisions of the National Health Insurance Law that require the collection of insurance premiums from every insured person according to their age." It was determined that in circumstances where the Ministry of Health struggles to stand behind a rule it established, "the plaintiffs succeeded in proving, apparently, that they have a cause of action that has a reasonable chance of being decided in favor of the group members."
The court approved the management of the lawsuit, but noted that it would be difficult to award compensation for the past since the HMOs' activities were in accordance with the regulator's guidelines and approval. However, since operative remedies looking to the future were also requested - one of which is that the HMOs cancel the discounted family rate - and since the Ministry of Health is no longer behind the permit for the benefit, there is justification for continuing the proceedings.
The class action lawsuit was filed by Gal Berkovitz Pizanti, Tamar Katz, Shira Bergman, and Maayan Weiner Shelman through attorneys Hagai Kalai and Lior Sokol.
