Israeli Economy Committee Probes Allegations of Unethical Practices by Long-Term Care Insurers
The Knesset's Economy Committee held a heated discussion on Monday regarding concerns over improper investigative methods used by insurance companies against long-term care policyholders. The session, led by MK Moshe Pasal in the absence of the committee chair, revealed complex challenges faced by elderly insured individuals in exercising their rights, while insurers cited a sharp rise in claims necessitating thorough scrutiny.
During the debate, serious accusations emerged that private investigators hired by insurance firms impersonate delivery personnel, essential service providers, or medical staff to coerce policyholders into actions detrimental to their claims. MK Pasal stressed the committee's intent to understand the criteria for initiating investigations, their scope, and the regulator's role in ensuring compliance with legal standards. "Long-term care insurance confronts people at their most vulnerable moment," Pasal said, emphasizing the need to prevent investigations without reasonable grounds.
Tatiana Mazersky, an MK with experience assisting health and long-term care beneficiaries, highlighted cases where elderly insured individuals struggled to claim their rights, calling for oversight that respects citizens and prevents harmful practices. Israel Maimon, CEO of the Insurance Companies Association, presented data showing a dramatic increase in long-term care claims from 8,200 in 2012 to approximately 20,000 in 2023. He explained that investigations are triggered by "red flags," such as discrepancies between the insured's reported functional status and other collected information.
MK Pasal noted that the term "reasonable grounds" remains vague and suggested legislative clarification might be necessary. Dor Fisher, representing the Capital Market, Insurance and Savings Authority, confirmed that insurers must act fairly and are prohibited from impersonating public officials or sabotaging claimants during investigations. Since 2023, about 600 complaints related to long-term care insurance have been handled by the authority, which has tightened restrictions on investigative practices.
Mali Granot, legal head of the Aviv Association aiding seniors, criticized the lack of representation for many claimants and the use of manipulative investigative tactics. Conversely, Asaf Weitzman, head of the Private Investigators Association, stated no complaints have been filed against investigators. Lawyers representing policyholders reported recurring incidents of impersonation and submitted complaints to the regulator. Gilad Ramati from the Bar Association clarified that the dispute centers on the legality of investigation methods, not their existence.
A poignant testimony was given by Miriam Ohana about her husband, a Parkinson's patient, who was summoned to a clinic, photographed by an investigator, and subsequently had his long-term care payments stopped. Pasal called this a serious and touching case but emphasized the committee's focus on systemic issues. He concluded by acknowledging insurers’ claims that they do not receive success fees from investigations but warned that the lack of clear rules is troubling. Pasal urged the regulator and insurers to provide detailed data on ongoing investigations at the next meeting and stressed the importance of ensuring that prohibitions on impersonation are effectively enforced. "We will not relent on this issue," he affirmed.
