Israeli Insurer Halts Elder Care Payouts, Citing Patient's 'Improvement'
Translated & summarized from Walla by baba
An 83-year-old Israeli man had his nursing care benefits stopped by Harel insurance after nearly two years of payments, as the company claimed his condition had improved. The man and his lawyers dispute this, filing a lawsuit arguing his health has not changed and seeking reinstatement of payments.
The story in 5 lines · by baba
- Harel insurance stopped nursing care payments to an 83-year-old man.
- The company cited an 'improvement' in his condition.
- The man had received benefits for nearly two years.
- He and his lawyers are suing Harel, disputing the claim of improvement.
- The lawsuit seeks reinstatement of benefits and reimbursement.
An 83-year-old man in northern Israel, identified only as 'Sh', has had his monthly nursing care benefit of 3,200 shekels ($850) stopped by the Harel insurance company, which claims his condition has improved. Sh, a resident of a kibbutz, experienced a significant health decline in 2024, suffering from severe orthopedic issues, widespread pain, diabetes, dizziness, weakness, instability, and incontinence, alongside a history of prostate cancer. He required assistance with basic daily activities such as dressing and bathing.
Following a National Insurance assessment in February 2024 that confirmed his need for help, Sh was approved for nursing care benefits by Harel, which administers a group policy for Clalit Health Services members. Harel's own assessment by a registered nurse also determined he was in need of significant daily assistance, and the company paid him the benefit for nearly two years, renewing his eligibility after a second assessment.
However, in April 2026, a subsequent assessment by Harel concluded that Sh's condition had improved to the point where he only needed help with dressing and bathing, thus no longer meeting the criteria for nursing care. Consequently, Harel ceased payments.
Sh and his lawyers have filed a lawsuit against Harel in the Magistrate's Court in Herzliya, arguing that his medical and functional condition has not substantially improved and that the insurance company's decision is unreasonable and contradicts its previous findings. They contend that his need for daily assistance remains, and the chances of significant recovery are negligible. The lawsuit seeks the reinstatement of his benefits, ongoing payments as long as his condition persists, reimbursement of premiums paid during the period he claims he was exempt, and legal costs.
Harel stated in response that it is reviewing the lawsuit and will respond in court. The company added that as the administrator of the nursing care policy for Clalit Health Services, it operates professionally and responsibly according to applicable rules, but due to privacy and medical confidentiality, it cannot comment on specific cases.