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Insurance companies deny 'cuts' from policyholders' medical cost

KUALA LUMPUR: Insurance companies and takaful operators have confirmed that they have not requested for “cuts” from hospitals for the medical expenses incurred by their policyholders.

The Life Insurance Association of Malaysia (LIAM), General Insurance Association of Malaysia and Malaysian Takaful Association (MTA) said in a joint statement they viewed such unfounded allegations made by the hospitals with serious concerns.

“Insurance companies and takaful operators through LIAM, PIAM and MTA had worked closely with the hospitals and third party administrators to ensure that the cost of healthcare is maintained at an affordable level.

“In recent years, premium rate increases have been driven by high inflation in healthcare costs, which averaged 12 per cent per annum during the period of 2010 to 2014,” they said.

They said the premium rate is projected to increase at a rate of 15 per cent each year due to demands for better healthcare services from a more affluent segment of the population, aging population and a higher prevalence of chronic and lifestyle diseases, among others.

They said currently, the fees charged by doctors in private hospitals for consultation and performance of procedures are regulated under the Thirteenth Schedule of the Private Healthcare Facilities and Services Regulations.

However, they said other components of the hospital charges such as fees for hospital stay, laboratory investigations, nursing care, use of equipment and operation room and drugs are not regulated.

In view of this, there is a wide range of costs differences among private hospitals, they said.

They said in order to manage the rising healthcare costs, there are a number of measures that insurance companies and takaful operators would like to be implemented, such as for the government to regulate and make public the recommended retail price of pharmaceutical products, medical devices and medicines.

They said whilst doctors’ fees are regulated, currently there is no regulation to curtail the increase in the prices of drugs.

Besides that, the associations also call for the government to mandate that all hospitals publish the fees for the cost of treatments.

“This is to provide a choice to policyholders to select the hospital in which he/she would like to be treated and to be aware of the amount that their insurers and takaful operators are able to reimburse,” they said.

They said insurance companies and takaful operators will continue to work with the Ministry of Health, Bank Negara Malaysia and healthcare providers to ensure that medical treatments are charged at fair prices and treatments recommended are clinically required.

“Insurance companies and takaful operators will continue to use best efforts to maintain health insurance premiums at a fair and affordable level with the cooperation of all stakeholders for the benefit of all consumers,” they said.

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