The Finance Ministry today said all premiums paid for the MySalam insurance scheme for the B40 community will be returned to a trust fund if they are not utilised for claims.
As such, the ministry said there is no profit element in the MySalam scheme managed by Great Eastern Takaful Bhd, and no reason for the company to deny claims.
"All premiums paid by the government, if unutilised in claims from the beneficiaries, will be reimbursed back to the MySalam Trust Fund," it said in a statement today.
The Finance Ministry was responding to an open letter by PSM chairperson Dr D Jeyakumar, who questioned why the payout to date this year was only RM3 million, when Great Eastern received some RM400 million for critical illness coverage of 3.8 million people in the B40 group.
"The performance of MySalam over the past six months shows that the largest beneficiary is Great Eastern itself, which received a payment of RM400 million for insurance cover for the B40 population for 2019, but will likely only pay out RM3 million or so to the Malaysian public for 2019," he said.
Jeyakumar (photo) said this in an open letter to Prime Minister Dr Mahathir Mohamad in raising the plight of a lorry driver with stage four cancer.
The patient, he said, was denied a claim of RM8,000 after he was diagnosed in a private hospital and is now in heavy debt.
Addressing the case, the ministry said the insurance provider was prepared to assist the lorry driver in getting his claim approved.
"The claims process for MySalam is relatively straightforward and simple.
"Any patient who is diagnosed in the government, university or military hospital in Malaysia with any of the 36 critical illnesses can submit his or her medical report to MySalam to qualify for the RM8,000 cash benefit.
"The recent case of a 48-year-old lorry driver with stage four cancer of the colon had his critical illness claim denied because he did not submit his medical report from a government hospital doctor.
"Great Eastern is ready to assist in the appeal process for the RM8,000 critical illness benefit," it said in the statement.
The ministry said all information on the qualifying parameters are available on the MySalam website.
According to the site, those who are diagnosed with a critical illness at a private hospital can still qualify for the RM8,000 claim if they subsequently seek treatment at a government hospital, but with additional documentation.
"The patient is still eligible for critical illness benefits provided the 'Critical Illness - Doctor's Statement form is completed by the attending doctor or specialist from a government hospital," said the website.
The ministry said roadshows are being conducted to create awareness about the MySalam scheme.
The scheme is an RM2 billion seed fund provided by Great Eastern to provide insurance coverage to the B40 community, as an alternative to the requirement for the company to divest 30 percent of its equity to local stakeholders.
The RM2 billion is placed in a government-controlled Trust Fund which is then used as premiums to Finance the MySalam scheme provided by Great Eastern.
While similar to regular insurance where premium is contributed in exchange for coverage, it differs in that excess premium not used for claims will be refunded to the trust fund. - Mkini
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