by ALIFAH ZAINUDDIN / pic credit: www.mysalam.com.my

PREMIUMS paid for the National Health Protection Scheme (mySalam), which provides insurance coverage to the lower-income group, that are not used for claims will be reimbursed back to the mySalam trust fund.

Finance Minister Lim Guan Eng in a statement yesterday said the move is in line with the project’s principle as a low-income health protection scheme had no element of profit.

The scheme is managed by takaful operator Great Eastern Takaful Bhd.

Lim was responding to an open letter by Parti Sosialis Malaysia chairman Dr Jeyakumar Devaraj, who claimed that the greatest beneficiary under the scheme is not B40 group, but Great Eastern Life Assurance (M) Bhd.

Citing federal data, Dr Jeyakumar said the company had paid out only RM3 million, with issuance as of July 22, at RM1 million — comprising 108 approved claims for critical illnesses worth RM864,000 and 941 approved claims for hospitalisation at RM50 per day for a maximum of 14 days.

Dr Jeyakumar, in an open letter to Prime Minister Tun Dr Mahathir Mohamad last week, called for a review on the scheme, while raising the plight of a lorry driver with stage four cancer who was denied a claim of RM8,000 after he was diagnosed in a private hospital and is now in heavy debt.

Responding to the claim, Lim said the case was denied because the 48-year-old failed to obtain his medical report from a government hospital doctor.

“The claims process is relatively straightforward and simple. Any patient who is diagnosed in government, university or military hospitals in Malaysia with any of the 36 critical illnesses can submit his or her medical report to mySalam to qualify for the RM8,000 cash benefit,” Lim said, adding that information on the qualifying parameters are available on the mySalam website.

According to the site, those who are diagnosed with a critical illness at a private hospital can still qualify for the RM8,000 claim, if they subsequently seek treatment at a government hospital, but with additional documentation.

“The patient is still eligible for critical illness benefits provided the Critical Illness — Doctor’s Statement form is completed by the attending doctor or specialist from a government hospital,” said the website.

Lim said Great Eastern was prepared to assist the lorry driver in getting his claim approved.

The scheme is a RM2 billion seed fund equipped by Great Eastern to provide insurance coverage to the lowerincome group, in exchange for a permanent exemption from a government requirement that 30% of its stake must be owned by local entities.