To the rescue!

G. of Tel Aviv went for a drive with his two children. When they arrived at their destination, one of the kids accidentally got locked in the car. Under stress, G. did what every red-blooded parent would do: He dialed 102 from his cellphone.

Within moments the fire engine was there, but the fireman couldn't manage to pick the lock and had to break the car window using a rock. (Which G. could have done perfectly well himself.) G. thanked the nice firemen for their help, the alacrity of their response and nifty rock-work, and moved on.

A week later he got a bill for NIS 185. That's when G. understood why, at the time, the firemen had asked for his details. "It never occurred to me that rescuing a child would cost money," he says. "I'd have tried to break into the car myself, or break the window myself." He rather wonders why the nice firemen didn't mention the cost at the time.

From the perspective of the service provider, action taken to rescue life or property isn't a choice, it's an absolute. They are called, they come. But the service is not free, even in cases of life or death rescue operations by the fire department or Magen David Adom ambulance service.

Last year, the fire department handled about 87,000 calls, of which 55% involved rescue that had nothing to do with combustion. These included cases of car accidents, rescues from stuck elevators, kids in trees and so on. Only 45% of cases involved putting out fire.

The rules governing the fire department state that every event of a fireman or fire truck being summoned involves the issue of an invoice, which will be served to the person summoning the assistance. The definition of "service recipient" is the property owner or occupant, or the person being rescued, or person responsible for the person being saved (parent, guardian). If the apartment you rent caught fire and you called the fire department, your landlord would be billed.

Itemized charges for saving your life

Naturally, mistakes happen. Such is life. When the landlord can't be conveniently tracked down, the person who called the rescuers may find the bill in his mailbox. In that case get in touch with the fire department to clear it up.

If you don't have fire insurance, the service charge will be itemized. It may include the truck's journey based on kilometers, use of the fire hose (not by the centimeter, at least), use of a pump, a ladder, electrical equipment, extinguishing chemicals or powders, each charged separately. The bill can come to hundreds of shekels and the worse the fire and more equipment used to contain it, the more you will pay. It isn't arbitrary, though, it's all based on a price list.

At least with the ambulance service, your chances of getting the money back are good. In 2007, Magen David Adom evacuated 1,255 people a day, or, roughly one a minute. Ambulances and intensive-care vehicles ("Natan" - nayadot tipul nimrat) handled in total half a million cases last year, including 350,000 sick people, 58,500 people injured in car accidents, 2,200 people injured at work, 6,500 women in labor and 72,500 "trauma" victims, suffering from everything from electric shock to stabbing to drowning to botched suicide.

Magen David Adom's policy is to charge for the journey to hospital, plus any medical care that may be administered en route. The journey by ambulance is billed as a function of mileage, double the distance between your home and the ambulance's point of origin (first it came to you, then took you for treatment). The minimum amount is NIS 301.

Summoning an intensive-care vehicle (Natan) will cost double that of a regular ambulance: NIS 603 at least, but the mileage isn't a factor.

If you pay on the spot, you get a discount of some tens of shekels, compared with the bill if you sign an IOU and pay within 30 days.

Road accidents are the exception, in that there is a blanket charge of NIS 584 for the ambulance irrespective of distance. Women in labor pay regular rates, up but if the distance from her point of origin to hospital is more than 41 kilometers, she only pays for the first 20 and the rest is handled by the National Insurance Institute.

The upside is that people get their money back from their healthcare service provider (kupat holim), as long as they took a regular Magen David Adon ambulance and were hospitalized. If the patient is evacuated by an intensive-care vehicle or if hospitalization was deemed unnecessary, a full refund is unlikely, though 50% is possible.

The full refund is also there for people who lost consciousness and somebody else called for help, even if the call was answered by an intensive-care vehicle. Terror victims are also spared any payment at all, as are people evacuated by ambulance ordered by a clinic. Also, if the patient dies en route to medical care, the grieving family is spared the added anguish of getting a bill in the mail.

As for road accident victims, seek a refund not from the healthcare service provider but from the car insurance company of the driver who hit you and/or your own (or of the person driving - you get the picture.)

As things stand, first you pay, then later you can get money back. However, Magen David Adom is working with Knesset member Sofa Landver, chairwoman of the Public Petitions Committee, to amend the law and move the burden from the patient to the National Insurance Institute, which would then offset the amounts it pays from the sums of money it gives to the healthcare providers.

Meanwhile, Magen David Adom counsels people to check their refund options with their kupat holim. But steps you may be taking to clarify your rights doesn't mean you can delay paying the bill, the service begs to note.