KUALA LUMPUR: Human Resources Minister Steven Sim has directed the Social Security Organisation (Socso) to overhaul its claims system amid an ongoing anti-corruption investigation into fraudulent claims.
He said that since June, Socso had ceased accepting claims from a hospital flagged for suspicious submissions, following an internal investigation into a cartel involved in these activities.
The cartel's fraudulent claims, primarily involving permanent disability cases, have cost Socso over RM2 million since a few years ago.
"Following our internal investigation, Socso proactively reported the matter to the Malaysian Anti-Corruption Commission (MACC) and has been fully cooperating with them since July 2, under Ops Tunjang, to dismantle the cartel.
"The Human Resources Ministry will not compromise and is determined to fight such cartel activities to the fullest extent, as social protection benefits should be directed to contributors and their rightful dependents who genuinely deserve and need them.
"I have instructed Socso to reform the claims process to prevent such incidents from happening again," he said during a special press conference at Menara Perkeso today.
Joining him were Socso CEO Datuk Seri Dr Mohammed Azman Aziz Mohammed and Sim's political secretary, Dr Kelvin Yii.
Earlier today, 33 individuals, including three senior doctors and a woman, were remanded for their alleged involvement in a cartel accused of falsifying Socso disability claims.
Magistrate Nadratun Naim Mohd Saidi ordered the doctors to be remanded for two days, while the woman was remanded for one day.
Sim said that the internal investigation was conducted by Socso's Anti-Fraud, Ethics, and Integrity Unit and that they will continue to collaborate with MACC and the Health Ministry under Ops Tunjang.
He said that new standard operating procedures for the claims system would be announced soon.
"The ministry, including Socso, continuously reviews and improves its procedures. When gaps are identified, we take immediate action to address them. This issue with the doctors highlights a serious integrity breach, and Socso is committed to resolving the entire process comprehensively," he added.
While Socso has suspended claims from the hospital under investigation, contributors can still submit claims through referrals from other hospitals.
"We take all claims seriously to avoid victimising any party. While we will not compromise on our service to eligible contributors, we must also close any gaps that could allow cartels and syndicates to commit fraud," Sim said.
Yesterday, MACC Chief Commissioner Tan Sri Azam Baki confirmed that three senior doctors in Penang were among the 32 individuals arrested in a major swoop for their alleged involvement in the Socso claims cartel. The doctors included two from government hospitals and one from a private hospital.