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Relief for employers of foreign workers with high medical bills

Foreign manpower Employment practices
  • The Straits Times (20 April 2019): Insurance coverage for maids too low: Agents, NGOs
  • The Straits Times (24 April 2019): Have simple system that gives maids proper healthcare cover
  • The Straits Times (29 April 2019): Responsibility lies with employer if maid’s insurance cover is inadequate

Relief for employers of foreign workers with high medical bills
-The Straits Times, 3 May 2019

  1. We refer to recent discussions on insurance coverage for foreign domestic workers. (Letter: “Responsibility lies with employer if maid’s insurance cover is inadequate”, 29 Apr 2019; Letter: “Have simple system that gives maids proper healthcare cover”, 24 Apr 2019; and Report: “Insurance coverage for maids too low: Agents, NGOs”, 12 Apr 2019).
  2. Employers are responsible for the upkeep of their foreign work permit holders including medical treatments.  It is a more reasonable approach than to externalise such costs and impose them on taxpayers in general.
  3. To help employers manage medical costs for their foreign work permit holders, they are required to purchase medical insurance plans with a minimum coverage of $15,000 per year. Employers who wish to be better protected against large medical bills can opt for insurance plans with higher coverage.   These plans are readily available in the market today for employers to decide if the additional premiums are acceptable.
  4. In the past three years, 96 per cent of FDW medical bills were below $15,000. This means that the vast majority of FDW employers can claim the full medical cost incurred from insurers. Where necessary in the remaining cases, employers can approach the healthcare institutions for assistance. In the case of Mr Saw, the hospital had approached him to offer relief but he had yet to respond.
  5. The Ministry of Manpower reviews our policies regularly to ensure adequate medical insurance coverage for work permit holders. In 2010, the mandatory insurance coverage for work permit holders was raised from $5,000 to $15,000 to keep up with larger bill sizes. 
  6. We will need to balance the assurance of increased insurance coverage with keeping premiums affordable for employers. While providing relief to employers in genuine need, we must also be mindful to prevent over-consumption of services in our public healthcare system.

Chew Ee Tien (Ms)
Director, Foreign Manpower Unit
Workplace Policy and Strategy Division

Have simple system that gives maids proper healthcare cover
-The Straits Times, 24 April 2019

  1. There are three considerations worth highlighting when it comes to insurance coverage for foreign domestic workers (Insurance coverage for maids too low: Agents, NGOs, April 20).
  2. First, the unpredictable nature of catastrophic illness or injury means that no matter what the insured amount is, there will always be some workers and their employers who will suffer tremendous financial hardship. Employers are mainly everyday Singaporeans who do not have the financial buffer to absorb the fees for catastrophic health events sustained by their domestic workers.
  3. The Ministry of Manpower reports that 96 per cent of claims are covered by the existing schemes, but this means that 4 per cent of families are at risk of financial hardship through no fault of their own.
  4. Second, having more insurance options, while useful, is not a real solution. What is needed, instead, might be a structural backstop which covers employers' obligations once expenses exceed a pre-identified amount, say, $5,000 or even $10,000. This could be funded by a proportion of premiums, or even by the Government and non-governmental organisations.
  5. Indonesian domestic helper Ani Sumarni and her employer, Mr Saw, were fortunate that crowdfunding platform GiveAsia managed to help raise $49,200, which will help greatly in paying off the hospital bill, which stood at $60,300 as of last week.But we cannot depend on the vagaries of crowdfunding to protect Singaporeans from financial ruin.
  6. Finally, private healthcare fees are high in Singapore. Foreign domestic workers are not eligible for subsidised healthcare, and these women are of modest means.
  7. Let us establish a simple system to enable them to work here with peace of mind for themselves and the quarter of a million Singapore families that employ them.

Responsibility lies with employer if maid’s insurance cover is inadequate
-The Straits Times, 29 April 2019

  1. The medical issues involving Indonesian domestic helper Ani Sumarni and her employer, Mr Saw, are sad and highlight the problems that occur when medical bills exceed the insurance coverage arranged (Insurance coverage for maids too low: Agents, NGOs, April 20).
  2. HealthServe's letter proposed several potential solutions to such problems, and I agree that unless insurance companies provide unlimited medical expenses coverage, which they are unlikely to do, there will always be some cases that fall outside of the minimum insurance cover mandated by the Ministry of Manpower (MOM), which is $15,000 per year.
  3. MOM's assertion that insurance coverage is adequate in 96 per cent of cases provides reasonable assurance, if not a certainty, in assessing the likelihood of a maid being covered by a medical insurance policy.
  4. The issue of medical claims was discussed in Parliament last year, and one suggestion was that employment agencies should be more proactive in highlighting this issue to prospective employers. This could include offering insurance plans with higher coverage limits, which are readily available in Singapore.
  5. However, some employers may decline this option, perhaps seeing it as a means to increase sales commission rather than an effort to raise awareness and provide greater protection for their maids.More public education on the risks and improvements in how these policies are presented and sold in employment agencies may alleviate this misconception.
  6. As HealthServe states, crowdfunding is not the solution to the problem, and the suggestion that the Government fund a scheme misses the point that governments do not fund schemes, taxpayers do. Hence, any funding would need to consider whether it represents an appropriate use of taxpayer funds, bearing in mind the risk is one that should rest with the employer.
  7. A similar argument could apply to non-governmental agencies that might consider paying for uninsured medical expenses. Funding by using a proportion of premiums is also problematic, as insurance companies would have to levy this on all policyholders as an added charge to create a separate pool specifically for medical expenses above any uninsured amount.
  8. It is, therefore, preferable to let individuals decide their level of insurance cover and associated risk. If the cover purchased falls below the amount needed, the employers should accept responsibility for the shortfall.