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New rules require min RM500 co-pay for medical insurance to cut costs, curb unnecessary claims | Scoop
Insurance and takaful operators will be required to offer at least one medical reimbursement product which will include a minimum co-payment amount effective September 1, 2024. – Scoop pic, June 22, 2024
News

New rules require min RM500 co-pay for medical insurance to cut costs, curb unnecessary claims

BNM’s policy document stipulates operators to offer at least one product with minimum co-payment amount alongside existing products, effective Sept 1

Main Author Image
Arjun Mohanakrishnan
Updated
8:00 PM MYT

 

KUALA LUMPUR – To maintain affordable contribution rates for their consumers and reduce unnecessary claims, insurance and takaful operators will now be required to offer at least one medical reimbursement product – which will include a minimum co-payment amount. 

According to the Malaysian Takaful Association (MTA), this move is in line with aspirations to ensure the sustainability of the nation’s healthcare system laid out in Bank Negara Malaysia’s (BNM) Policy Document on Medical and Health Insurance to balance cost-sharing between consumers and takaful operators. 

“Under BNM’s policy document, insurers and takaful operators will have at least one product with a minimum co-payment option requiring consumers to bear a small portion of their medical expenses. 

“Specifically, this involves either a co-takaful of 5% of total claimable expenses per policy certificate year and/or an RM500 deductible per policy certificate year. 

“There will also be a range of other co-payment amounts offered as options for consumers to consider,” MTA chief executive Mohd Radzuan Mohamed told Scoop in a statement. 

28122023-Central-Bank-of-Malaysia-Bank-Negara-Malaysia-BNM-ABDUL-RAZAK-LATIF-002
On February 29, 2024, Bank Negara issued a policy document stipulating that insurance and takaful operators will not be allowed to design new medical insurance or takaful products without the minimum co-payment feature. – Abdul Razak Latif/Scoop file pic, June 22, 2024

Negating concerns that the move intends to burden consumers, MTA explained that the measure ensures the maintenance of affordable contribution rates, which guarantees medical takaful and insurance products remain accessible. 

In addition to curbing unnecessary medical claims, which could increase contributions for users, MTA says the decision would encourage consumers to be mindful when utilising their benefits. 

“As part of our ongoing efforts to promote sustainable healthcare usage, this initiative of co-sharing would be an effective method of maintaining cost-effectiveness and would cause consumers to be mindful of their healthcare choices and expenditures. 

“Certificate holders are encouraged to prioritise preventive care and make more informed decisions about their medical treatments. 

“By focusing on prevention and maintaining a healthy lifestyle, certificate holders can reduce the likelihood of requiring extensive medical treatments in the future,” Radzuan added. 

On February 29, 2024, BNM issued a “Policy Document on Medical and Health Insurance/Takaful Business” that applies to all licensed insurers and takaful operators offering medical and health insurance products. 

The document, available online, stipulates that the requirement for insurance and takaful operators to offer at least one product with a minimum co-payment alongside existing products will come into effect on September 1, 2024, unless otherwise specified by BNM. 

According to the document, insurance and takaful operators will not be allowed to design new medical insurance or takaful products without the minimum co-payment feature. – June 22, 2024 

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