January-February . 2024 | The HEALTH

Several factors are causing a noticeable increase in insurance premiums . They include :

• Global medical trends : The 2023 Global Medical Trends Survey by Willis Towers Watson underscored the global nature of the challenge , projecting a high average healthcare benefit cost trend of 10 per cent . Malaysia ’ s projection rose from 12.9 per cent in 2022 to 13.8 per cent in 2023 , making it the highest in Asia .

• Post-pandemic impact : The aftermath of the Covid-19 pandemic has seen a resurgence in medical consultations as policyholders seek or resume treatments previously disrupted by the outbreak . This uptick in medical claims during 2022 and 2023 has further contributed to the premium adjustment .

• Unregulated costs : A significant portion of claimable costs is attributed to hospital supplies and services which are not regulated . These costs are increasing rapidly , surpassing the growth rate of other hospitalisation expenses .

• Medical advancements : The industry ’ s commitment to providing the latest and most effective medical treatments is reflected in investments in new technologies , diagnostic equipment , and advanced medications . The costs associated with these advancements contribute to the overall escalation of healthcare expenses .

• Non-communicable diseases ( NCDs ): The prevalence of NCDs , including diabetes , high cholesterol and obesity , has increased demand for longterm medical care , necessitating hospitalisation and intervention .

• Growing population of senior citizens : The demographic shift towards a larger population of senior citizens has resulted in higher occurrences of sickness and diseases , driving up the demand for medical care and subsequent insurance claims .

Fabrice Benard

how to minimise their medical expenses by living a healthy lifestyle , taking regular screenings and vaccinations , visiting our panel providers for the best treatment and price , and understanding the necessity of the recommended treatments to avoid being overcharged .

“ Our goal is to always balance affordability with thorough coverage to stay sustainable and meet our customers ’ changing needs .”

By leveraging data analysis , market trends , and insights into customer preferences , Generali strives to stay informed and adaptable .

“ We also work on preventive healthcare , finding ways to keep our costs down , and developing better and more innovative products . Doing this allows us to offer more valuable protection to customers , building trust over time .”

“ We also look at historical claims data on areas where costs can be optimised and work with digital and virtual healthcare partners to promote preventive care and wellness programmes to incentivise healthy lifestyles ,” said Benard .

LIAM , said O ’ Dell , encourages policyholders to engage actively with their medical policies . This involves understanding the necessity of medical procedures , exploring alternative treatments , insisting on itemised bills , and questioning unreasonable billing practices . These initiatives empower policyholders to make informed decisions and manage their healthcare costs effectively .

The HEALTH also reached out to several insurance companies for comments .

AmMetLife Insurance Berhad and Great Eastern Life Assurance ( Malaysia ) Bhd declined to comment . Meanwhile , Prudential Assurance Malaysia Bhd , AIA Bhd , Hong Leong Assurance Berhad , Tokio Marine Life Insurance Malaysia Bhd , and Manulife Insurance Berhad did not respond .

AFFORDABLE AND QUALITY CARE

Association of Private Hospitals Malaysia ( APHM ) President Datuk Dr Kuljit Singh provides insights into private hospitals ’ strategies to manage the effects of escalating premiums .

“ Ongoing proactive engagement with the Ministry of Health ( MoH ), the Association of Private Hospitals Malaysia ( APHM ), the Malaysian Medical Association ( MMA ), consumer groups and other relevant organisations is crucial for ensuring the sustainability of the private medical insurance industry .”

– Mark O ’ Dell

LIFE Insurance Association of Malaysia ( LIAM ) CEO Mark O ’ Dell underscored the industry ’ s active collaboration with regulatory bodies like Bank Negara Malaysia ( BNM ) and stakeholder engagement .

“ Ongoing proactive engagement with the Ministry of Health ( MoH ), the Association of Private Hospitals Malaysia ( APHM ), the Malaysian Medical Association ( MMA ), consumer groups and other relevant organisations is crucial for ensuring the sustainability of the private medical insurance industry .”

He advocates for a collective effort involving the government , regulators , private hospitals , and consumers to address the issues of medical cost and premium inflation . Understanding the necessity of every medical procedure and opting for cost-sharing measures can promote responsible medical and health insurance usage , reducing the pressure on premium increases .

He also highlighted the need for increased transparency among private hospitals . Currently , consumers have limited or no information before choosing a hospital . Greater transparency can empower consumers

Mark O ’ Dell to make informed decisions about their healthcare providers and contribute to cost-conscious healthcare choices .

APHM President Datuk Dr Kuljit Singh proposed a strong public-private partnership involving the government , insurers , and private hospitals to create a sustainable healthcare financing structure .

Acknowledging the survival needs of each stakeholder , he suggested allowing those who can afford it to continue paying premiums for premium care while also implementing collaborative efforts to provide affordable options for those in need .

Federation of Malaysian Consumers Associations ( FOMCA ) President Datuk Dr Marimuthu Nadason proposed that BNM and MoH establish a regulatory mechanism for private hospital prices .

“ Also , BNM should mandate the insurance companies to disclose the variables used in determining a premium and how insurance premiums are calculated .

“ For any renewal notice to existing customers , the insurance companies must show a comparison between the previous year ’ s premium and the current premium and include an explanation of how the new premium is calculated .”

By understanding these factors , consumers can make informed decisions , and insurance companies can be held accountable for justifying any premium increases .

BNM declined to comment on whether its approval is required for repricing , leaving a critical regulatory perspective unaddressed in the ongoing dialogue on the sustainability of health insurance protection in Malaysia .