Insurance Claims: Rights of a Breast Cancer Patient

By: Attorney Michael Lev

Case Overview

A breast cancer patient filed an insurance claim after her insurer denied her disability benefit, arguing she no longer met the policy’s definition of total disability. The court sided with the claimant, ruling that her supportive-care condition qualified under the policy terms and awarding her 134,549 NIS in compensation.

Key Legal Principles

• Good faith obligation: Insurers must act in good faith when evaluating claims and may not rely on narrow policy interpretations to deny legitimate claims.
• Policy wording: Ambiguous policy language is construed against the insurer (contra proferentem rule).
• Supportive care condition: A patient receiving ongoing supportive treatment for cancer is considered to be in a state of disability entitling her to benefits.
• Medical evidence: The court relied on independent medical opinions over the insurer’s internal assessments.

What This Ruling Means for Insured Patients

This verdict confirms that insurance companies cannot arbitrarily terminate disability payments when a patient is still receiving active cancer treatment or supportive care. If your insurer has denied or reduced your benefits, you may have a strong legal claim.

Steps to Take if Your Claim Was Denied

1. Request the full written reasons for the denial from your insurer
2. Gather all medical records, treatment summaries, and oncologist letters
3. Obtain an independent medical opinion from a specialist
4. Document all out-of-pocket expenses and lost income
5. Consult a lawyer specializing in insurance disputes before the limitation period expires

Frequently Asked Questions

If your insurer has denied your claim, the Lev-Taieb insurance claims team is ready to help. Call 03-609-0958 or contact us online.

Further reading: Insurance Claims | National Insurance | Case Results

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