Filing a Complaint Against Your Health Fund (Kupat Cholim)

Step-by-Step Instructions

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   In brief

   If your kupat cholim refused a treatment your doctor referred you to, denied coverage you believe you're entitled to, or you've experienced a serious service failure, you have two clear paths to escalate:

   1. Internal complaint to the kupah's own public-complaints office.
   2. If unresolved: external complaint to the Public Complaints Commissioner for the National Health Insurance Law at the Ministry of Health.

   For suspected medical negligence or patient-safety incidents, there's a separate complaint track at the Ministry of Health's professional supervision unit (see Medical negligence and patient safety below).

   There is no fee for filing any of these complaints.

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   Step 1 — Internal complaint to your kupah

   Start here. Every health fund has a Public Complaints Office (Lishkat Tlunot HaTzibur) that is legally required to handle member complaints and respond within a defined time.

   How to file:

   • Online through your kupah's website or app (search for "Tlunot HaTzibur" or "Public Complaints").
   • By post to the kupah's complaints office address.
   • In person at any branch.

   What to include:

   • Your identifying details (Teudat Zehut number, membership number).
   • A clear description of what happened — dates, names of doctors/clerks if known, what you were told.
   • What you're asking for — a Form 17, reimbursement, a treatment authorisation, a procedural change.
   • Copies of relevant documents — referral letters, refusal letters, receipts.

   Response timing: the kupah is required to respond — typically within 30 days for routine complaints, sometimes longer for complex cases.

   Tip: keep your complaint written and dated. Phone complaints are useful but harder to escalate later — always follow up in writing.

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   Step 2 — Public Complaints Commissioner (Ministry of Health)

   If the kupah's response is unsatisfactory or they fail to respond, escalate to the Public Complaints Commissioner for the National Health Insurance Law (Netzivat Kvilot HaTzibur LeChok Bituach Bri'ut Mamlachti) at the Ministry of Health.

   The Commissioner has the power to:

   • Investigate the kupah's conduct and request documents from them.
   • Order the fund to provide treatment or services they wrongly refused.
   • Issue a binding decision on your case.
   • Recommend systemic corrections when a complaint reveals broader problems.

   How to file:

   • Online through the Ministry of Health's complaint form portal.
   • By post or fax to the Commissioner's office in Jerusalem.
   • By phone for guidance: *5400 (Kol HaBriut).

   Important: the Commissioner will usually expect to see that you first complained to the kupah and either got an unsatisfactory response or no response within 30 days. Attach copies of your kupah complaint and any reply when filing.

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   What to include in your complaint

   Whether internal or external, a strong complaint includes:

   1. Identifying details — Teudat Zehut, member ID, contact info.
   2. Chronological summary — dates, the appointment or interaction, what was requested, what was refused or what went wrong.
   3. Names of anyone involved on the kupah side (doctor, clerk, customer-service rep) if known.
   4. The harm or impact — delayed treatment, out-of-pocket cost, lost referral, etc.
   5. The specific remedy you want — a Form 17, reimbursement of NIS X, an apology, policy clarification.
   6. Supporting documents:
      • Medical referrals (hafnaya)
      • The kupah's written refusal (if any)
      • Receipts for any treatment you paid for privately
      • Correspondence with the kupah

   Tip: keep your tone factual and chronological. Emotional language doesn't strengthen a complaint and can distract reviewers from the substance.

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   Medical negligence and patient safety

   For complaints about medical negligence, professional misconduct, or patient-safety incidents (not service failures), the relevant track is the Ministry of Health's professional-supervision unit, not the National Health Insurance Commissioner.

   Examples:

   • A medical professional behaved improperly during treatment.
   • A treatment was carried out below the accepted standard of care.
   • A patient-safety incident occurred (medication error, surgical complication, misdiagnosis with consequences).

   How to file:

   • Online at the Ministry of Health's complaint portal.
   • Phone: *5400 for guidance on which track applies.

   For legal claims for compensation (medical malpractice lawsuits), you'll need a lawyer specialising in medical negligence — the Ministry's process handles professional discipline and patient-safety reporting, not compensation.

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   Useful resources

   Phone helplines:

   • Kol HaBriut (Ministry of Health): *5400 — patient rights and complaints guidance
   • Bituach Leumi: *6050
   • Yad Mechavenet (Bituach Leumi rights assistance): *2496
   • Sha'il (Citizens' Advice Service): 118

   Patient-rights organisations that can help you draft and submit complaints:

   • The Clinic for Law and Health — Patient Rights (Tel Aviv University)
   • The Israeli Association for Patient Rights
   • Physicians for Human Rights — Israel
   • Dolev Foundation for Medical Justice — assistance with medical-negligence claims

   Complaint procedures and the Commissioner's authority are set by the National Health Insurance Law and the Ministry of Health's procedures. Time limits and specific complaint forms can change — verify on the Ministry's website before filing.

   Kol HaBriut — Ministry of Health complaints portalThe Clinic for Law and Health — Tel Aviv UniversityPhysicians for Human Rights — Israel
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   Related guides

   Other guides in the Kupat Cholim (Health Fund) — member rights series:

   • Registering with a Health Fund (Kupat Cholim)
   • Form 17 (Hitchayvut) — Health Fund Commitment Form
   • Switching Between Health Funds (Changing Your Kupat Cholim)