An appeal filed by an ultra-Orthodox widower, father of 10 children, through lawyers David Pyle and Yossi Cohen against the Phoenix company, was recently accepted - after years of legal struggle.
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The affair began in 2015, when the deceased, a mother of 10 children, was diagnosed with aggressive cancer, and passed away just a day after her diagnosis.
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The deceased had joined the Phoenix Pension Fund about two and a half months earlier, as part of her work as a teacher at the Torah Education Association. However, despite her acceptance into the fund, the Phoenix Company refused to recognize her widowed husband and their ten orphaned children as eligible for a survivor's pension.
In the rejection letter, the Phoenix company agreed that the deceased was not diagnosed and did not know about the existence of her illness when she joined the pension fund, but according to the Phoenix, the deceased was already suffering from the symptoms of the disease at the time of her joining.
According to Attorneys Pyle and Cohen, according to the Pension Fund regulations, symptoms from which an insured suffers before joining the Pension Fund are not sufficient to disqualify him from receiving benefits. For such disqualification, it is necessary to prove that the disease from which the insured died was the one that was present in his body before joining.
Attorneys Pyle and Cohen filed several appeals against the Phoenix's decision to leave the widowed father and his ten orphaned children without benefits - but these were rejected.
The lawyers appealed to the National Labor Court, claiming that the deceased died due to damage caused during the colonoscopy and not from the cancer she suffered from.
The National Court ruled that the examination of the medical questions should be returned to a new committee.
To the latest appeal they filed, Attorneys Pyle and Cohen attached a medical opinion from Dr. David Edelman, an oncology expert from the Doctors' Forum, who determined that the sepsis from which the deceased suffered, and which caused her death, was caused by a perforation of the intestine from which she suffered.
According to Dr. Edelman, it cannot be determined unequivocally whether the intestinal perforation was caused by the surgery she underwent due to the cancer she suffered from, or by the colonoscopy she underwent.
The expert also determined that such a perforation could have also occurred as a result of the preparation for the colonoscopy. In fact, Dr. Edelman determined that, upon examination of the circumstances, it can be learned with a very high probability that the deceased died due to the intestinal perforation she suffered from and not the cancer.
According to attorneys Pyle and Cohen, the question at hand is whether the cause of death is the same illness that lay dormant before joining the Phoenix pension fund.
According to them, the regulations speak of the death of an active insured person due to a previous illness. Attorneys Pyle and Cohen emphasize the word 'due to' - if there is a previous illness, no matter what its condition, but the cause of death is not directly from the previous illness, then Phoenix's claim is invalid.
At the hearing, the Medical Appeals Committee accepted the arguments of Attorneys Pyle and Cohen, and determined that it is not at all certain that cancer was what caused the deceased's death, and therefore the claim that the disease was present in the deceased's body before she joined the pension fund loses its importance.
Because of this, the committee determined that the family's claim should be accepted and the widowed father recognized as entitled to monthly benefits for the rest of his life, while five of his minor children (while the other children have become adults over the years), who remain orphans, are entitled to a monthly benefit from the pension fund - until they reach the age of 21.
According to Attorneys Pyle and Cohen, as a result of the appeals committee's decision, the total compensation that the Phoenix will pay to family members over the years amounts to millions of shekels.
