Coverage of Compulsory Medical Insurance Policies for Domestic Helpers

1 Mr Patrick Tay Teck Guan asked the Minister for Manpower whether the Ministry will consider introducing some policy enhancements to help employers cope with unexpected and huge medical bills when their domestic helpers are diagnosed with mental and critical illnesses that fall outside the coverage of the compulsory insurance.

2 Dr Tan Wu Meng asked the Minister for Manpower (a) whether insurers provide data to the Ministry regarding the claims made on the compulsory medical insurance policies of domestic helpers; (b) if so, what proportion of medical bills reached or exceeded the claims limit in the past three years; and (c) what measures are available to assist employers when domestic helpers are diagnosed with unexpected serious illnesses.

Mr Speaker: You can take Question Nos 1 and 2 together.

The Minister of State for Manpower (Mr Sam Tan Chin Siong) (for the Minister for Manpower): Sir, employers of foreign domestic workers (FDWs) buy medical insurance for their FDWs directly with insurers. Insurers are not required to provide individual claims data directly to MOM.

MOM regularly tracks hospital bills from public hospitals to ensure that our employers have adequate coverage for their FDWs. Based on the records of public hospitals, the current compulsory minimum coverage of $15,000 was sufficient to meet 97% of all inpatient and day surgery bills for FDWs in the last three years. For the minority of employers who face genuine difficulties in paying their FDWs' medical bills, they can seek help through the medical social workers at the relevant healthcare institutions. Medical social workers will assess each case individually and provide assistance based on their needs.

MOM regularly consults relevant stakeholders, such as insurers, employers and employment agencies, and reviews the minimum insurance coverage to ensure adequate protection at affordable premiums for our FDW employers. We are mindful that mandating higher insurance coverage will raise premium costs for all employers. Notwithstanding, our current policy already allows employers who are concerned about the risk of higher medical bills to have the option of taking up insurance plans with higher coverage.

Mr Patrick Tay Teck Guan (West Coast): Sir, I thank the Minister of State for the reply. I just want to ask two supplementary questions.

Firstly, will MOM be reviewing the insurance coverage, as 3% of employers, which is about 6,000 to 7,000 people, still face huge medical bills beyond the current coverage of $15,000? And there is little or no help for those FDWs who get inflicted with critical illnesses, chronic conditions, mental conditions and other conditions requiring long-term or critical intensive care. And, sometimes, the bills balloon to the hundreds of thousands.

The second question is: how will MOM ensure that FDWs employed by employers are free of major medical conditions, such as mental illnesses, including depression and those physically undetectable at point of hiring?

Mr Sam Tan Chin Siong: Sir, I thank the Member for the two very important supplementary questions. First, about the medical insurance coverage for the 3% of FDW employers, I would like to clarify that it is not 6,000 to 7,000 employers who are facing difficulties in paying very huge bills. In the last three years, according to our statistics, there are 1,900 cases of FDWs who have chalked up bills. Across the last three years, a total of 170 actually had incurred more than $15,000 of medical bills. On average, it is about 55 cases a year.

For these cases, they can seek assistance from the Medical Social Workers to defray part of the medical costs, if they genuinely have difficulties in meeting the medical bill payments.

Can I ask the Member to repeat his second question, please?

Mr Patrick Tay Teck Guan: How does MOM ensure FDWs are free from medical conditions?

Mr Sam Tan Chin Siong: Thank you. For all first-time FDWs coming to Singapore, they are required to undergo a full medical examination at our healthcare institutions in Singapore. So, it is a time where our doctors in Singapore will examine these FDWs to pick up any symptoms. Mental illnesses are not covered but some major illnesses, such as heart conditions and all that. This is so as to reduce the risks of FDW employers employing an FDW who may have potential major illnesses.

Dr Tan Wu Meng (Jurong): I thank the Minister of State for his answer. I have met Clementi residents who are elderly and who, therefore, are not in a position to shoulder the cost of healthcare for their domestic helper, if the domestic helper has a serious illness exceeding the insurance cover.

I have received feedback that some FDW agencies do not provide enough information about insurance plans with enhanced cover at the point of hiring. Would the Ministry consider encouraging FDW agents to provide better information to prospective employers?

Secondly, what avenues are there to expedite claims for FDW insurance in the event that the insurer is taking a long time to process the claim?

Mr Sam Tan Chin Siong: Let me answer the second question first. For FDW employers who have difficulty in claiming the insurance coverage for the medical bills incurred by the FDWs, if the delay is excessive, the employers of the FDW can always approach MOM for assistance.

As for the Member's first question of FDW employment agencies providing adequate information to employers on medical coverage, we have been working closely with employment agencies to highlight to them the need to explain to them the various medical insurance coverage for the FDWs where the employers can make a decision. So, given the feedback by the Member, we will continue to engage our employment agencies to require them to more proactively disseminate the information to FDW employers, particularly the first-time employers who may not be familiar with their medical insurance.

On the other hand, MOM also provides information through our newsletters to FDW employers to provide information on medical insurance coverage. On MOM's website, such information is made available. For those who are more Internet-savvy, they can seek out all these information from the MOM website. In particular, for the Member's elderly residents who may have medical insurance issues for their FDWs, if the Member so wishes, he can let me have the information so that MOM will look into it.

Mr Lim Biow Chuan (Mountbatten): Mr Speaker, Sir, I, too, have a resident staying in a private estate, not poor by any means, stuck with the same situation where his domestic helper incurred a bill of more than $15,000 for a critical illness. He can afford to pay; it is just very difficult for me to explain to him that he has to pay that large sum of money for a domestic helper who is not related to him. In situations like these, what does MOM advise?

Mr Sam Tan Chin Siong: I thank the Member for the very useful question. As it is now, although the mandatory, compulsory medical insurance for FDW is capped at $15,000, employers actually are at liberty to buy insurance that has a higher coverage. So, we will continue to encourage our employment agencies to disseminate this information to employers that, for peace of mind, if they worry about the risk of higher medical costs in future, they have the option of buying higher insurance coverage. But for those who are genuinely having difficulties to pay the higher medical fees incurred by the FDWs, they are encouraged to seek assistance from the Medical Social Worker (MSW) at the hospitals.

From our statistics, very few employers are genuinely facing financial difficulties, like for the case that the Member mentioned. I think, on average, there are three to four cases of FDW employers having to face medical claims of above $50,000. So, the number is fairly small. In the case of the Member's resident, he has the financial means to pay, so, he does not need assistance from the hospitals. But for those who genuinely have difficulties, they are always encouraged to approach the MSW for assistance.