Insurance Coverage for Individuals with Mental Health Conditions

20 Dr Tan Wu Meng asked the Minister for Health (a) how many Singaporeans under the age of 35 are living with or have been diagnosed with bipolar disorder within the last three years; and (b) what avenues of appeal and assistance are available to young Singaporeans who encounter stigma from insurers or are declined insurance coverage due to their mental health condition, including bipolar disorder.

21 Ms He Ting Ru asked the Minister for Health (a) what avenues are available to patients who are unable to obtain medical insurance coverage as a result of their mental health condition; (b) whether the Ministry is considering a regulatory approach to address this concern; and (c) if so, what are the measures being considered.

The Senior Minister of State for Communications and Information and Health (Dr Janil Puthucheary) (for the Minister for Health): Mr Speaker, may I have your permission to answer Question Nos 20 and 21 on today’s Order Paper?

Mr Speaker: Go ahead.

Dr Janil Puthucheary: Thank you, Sir. My response will also cover the matters raised in the written Question No 24 by Dr Tan Wu Meng in today's Order Paper.

Sir, according to the Singapore Mental Health Survey 2016, 2.8% of Singapore residents aged 18 to 34 years had bipolar disorder. The proportion with active symptoms was lower, at 2.1%.

Members raised concerns about individuals being denied health insurance coverage due to their mental health conditions. This is a valid concern and should be considered within the larger context of our S+3M healthcare safety net system.

All Singaporeans are eligible for healthcare subsidies of up to 80% in public healthcare institutions. All Singaporeans and Permanent Residents are also covered under MediShield Life (MSHL), regardless of pre-existing conditions, including mental health conditions. MSHL is sized to cover nine in 10 bills in the subsidised wards of public healthcare institutions.

Beyond subsidies and MSHL, individuals can also buy private Integrated Shield Plans (IPs) and other insurance plans. In making underwriting decisions, insurers are fully expected by the Ministry of Health (MOH) and the Monetary Authority of Singapore (MAS) to deal fairly with their customers. For example, insurers should not indiscriminately reject an application solely on the basis of declared personal information, such as occupation, income, disability or medical condition, including mental health conditions.

Insurers should carry out an objective assessment of every application, based on reliable information or data relevant to the risks being insured. Where an application is rejected or approved with higher premiums or additional conditions, insurers should properly explain to the customer the basis for the underwriting decision. MAS will take action against insurers whose practices are in breach of MAS’ regulations or guidance.

Individuals who have concerns over their insurer’s underwriting decision can make an appeal through their insurer’s feedback channel or through MAS.

Mr Speaker: Dr Tan. Please keep your supplementary question short. We want to allow Ms He to also ask her supplementary question.

Dr Tan Wu Meng (Jurong): Thank you, Mr Speaker. I thank the Minister for his answer. Can I ask the Minister if he would consider one suggestion? Would MOH look into setting up a website portal so that members of the public can provide authenticated experiences of their dealings with insurance companies, including when the company is unreasonable in refusing to provide insurance coverage, such as in the case of the person, a member of the public, Tan Hui In, who, in The Straits Times Forum in July, mentioned how their daughter had bipolar disorder but got turned away by two large insurance companies? Mr Speaker, can I ask the Minister to consider this because such a platform will help the public see better which firms are kind or which firms might be considered "one kind"?

Dr Janil Puthucheary: Sir, I thank Dr Tan for his suggestions. Firstly, a website or a social media page portal does not need MOH to set it up. These are experiences that the public can, indeed, share. But I think the larger point is, perhaps, should we take into account complaints or concerns expressed by members of the public and how they have been dealt with by their insurance companies and use that in some way to inform the public. But it is a good suggestion. I will take it back to my colleagues in MOH and we will study to see how this can be used to improve conditions for all the insured.

Mr Speaker: Ms He Ting Ru.

Ms He Ting Ru (Sengkang): Thank you, Mr Speaker. I thank the Senior Minister of State for his reply earlier. I have two supplementary questions.

First, I noticed that the Senior Minister of State quoted data from the 2016 Mental Health Survey that was conducted. I am wondering whether a more up-to-date survey is in the works, given that with increased awareness and after COVID-19, we could actually see a difference in the number of individuals who are diagnosed with mental health conditions and illnesses.

Second, does the Ministry consider these issues about ostensible denial of insurance coverage? Does the Minister consider this to be a problem or is the Ministry working with MAS at the moment to study whether this is an issue and how many individuals this might actually be affecting and whether or not further remedial action needs to be taken to make sure that insurers are not discriminating against these individuals?

Dr Janil Puthucheary: Sir, I thank Ms He for the questions. The short answer to both questions is yes. There will be further surveys and studies conducted and released, and MOH and MAS do continue to work together to see how we can appropriately regulate and guide the insurance industry to be able to provide these products in order to appropriately protect the public.

3.00 pm

Mr Speaker: Order. End of Question Time. Business Motions. Leader of the House.

[Pursuant to Standing Order No 22(3), provided that Members had not asked for questions standing in their names to be postponed to a later Sitting day or withdrawn, written answers to questions not reached by the end of Question Time are reproduced in the Appendix.]