Bank Negara mulls ‘no look back’ policy for medical insurance claims, Parliament told

 

KUALA LUMPUR: Bank Negara is considering introducing a "no look back" policy that would prevent insurers and takaful operators (ITO) from rejecting claims over medical conditions that policyholders unintentionally failed to disclose when taking up coverage, the Dewan Rakyat was told.

Deputy Finance Minister Liew Chin Tong said this was part of measures being considered to strengthen protection for policyholders.

Liew said policyholders with qualms about medical insurance claims should contact their ITO firstly.

“If they are still unsatisfied, they can access the BNM Link site to lodge a dispute complaint and later raise this to the Financial Markets Ombudsman Service at no charge,” he said during Question Time on Monday (July 6).

He said ITO industry data for 2025 also showed they had maintained an average claims payout exceeding 90%.

“Collectively, insurance industry players consistently approve more than million claims each year,” he said.

On Medical and Health Insurance/Takaful (MHIT) products, Liew said ITOs  must adhere to policy documents by Bank Negara.

This includes that ITOs cannot just cancel a policy or takaful certificate or refuse to renew insurance coverage just because the policyholder had made a claim or was diagnosed with an ailment after obtaining coverage.

“Here, ITOs are also responsible for reviewing and managing claims fairly according to the terms of the contract, which includes ensuring the claims are within the medical coverage scope,” he said.

Among other measures taken to resolve issues related to MHIT claim disputes is going through the Healthcare Partners Protocol & Solutions Committee (HPPSC).

The committee is spearheaded by the government alongside stakeholders including the medical industry, ITOs and Bank Negara.

The deputy minister was responding to Tan Kok Wai (PH-Cheras) who asked the Finance Ministry to state government measures to strengthen insurance regulations to protect policyholders, critical illness and cancer patients from arbitrary policy cancellations, retrospective claim rejections and unclear disclosure requirements.

This was alongside enhancing accountability, transparency and fair dispute resolution mechanisms to guarantee protection and continuity of medical treatment.

In response, Liew said insurance policies are not usually cancelled by ITOs but due to policyholders no longer making payments or the detection of fraud.

“However, if there are still such issues, they can discuss with their respective ITO, lodge a dispute complaint with Bank Negara and later reach out to the Financial Markets Service Ombudsman.

“If there are situations where the issue is still not resolved despite not going through these channels, Yang Berhormat can bring the matter to the Finance Ministry,” he said. - Star