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Singapore: Associations call for greater clarity to combat rising claims costs

By AAN team | 31 Mar 2021

On 29 March 2021, the Singapore Medical Association (SMA) released a position statement on issues surrounding Integrated Shield Plans (IPs). It said that IP insurers need to hold themselves accountable for certain IP riders resulting in higher and more frequent claims.

“This is because these riders were introduced by IP insurers, and with knowledge of the consequences of such riders which have been well known in the industry for a long time,” it said.

SMA also made it clear that it is unable to support the way in which the Life Insurance Association Singapore (LIA) and many of its members had implemented the recommendations found in the Health Insurance Task Force (HITF) report, including: Highly exclusive panels where many IP insurers only have about 21% of private specialists on each panel; and opacity in the selection criteria for doctors to be included as preferred providers in panels.

It added that more information-sharing and a better understanding of insurance products would be beneficial to all parties involved and urged the Ministry of Health (MOH) and the Monetary Authority of Singapore (MAS) to publish more data on individual IP insurers to educate stakeholders and the public who are considering buying an IP.

LIA responds

In a prompt response, LIA agreed that greater transparency is required to ensure the continued accessibility of quality healthcare in Singapore.

“On this end, we recently concluded an update of the LIA Singapore guidelines on panel management. This includes guidance that IP insurers should explain the criteria for selection of panel doctors and is publicly available on the LIA Singapore website,” it said.

It urged SMA to respond promptly and positively to its repeated call s for transparency, having already requested for clinical quality measures and guidelines to prevent over-treatment on numerous occasions.

LIA also pointed out how expanding panels to include all private specialists may result in the need for further premium increases.

“SMA is strongly advocating for panels to be expanded to include all private specialists in Singapore, and for all panel doctors to be compensated up to the upper bounds of the MOH fee benchmark range. This needs to be carefully considered as trade-offs are involved,” it said.

“The upper bound of the MOH Fee Benchmark range for a procedure can be up to five times of the lower bound. As such, proceeding per SMA’s suggestion without calibration may lead to substantial cost increases and further premium increases for policyholders.

“Striking this balance is critical, and we invite SMA for a discussion on how this can be done in a way that will not disproportionately burden policyholders with higher premiums.”

Meanwhile, AIA Singapore said in a statement that it intends to continue growing its healthcare panel to become one of the largest specialist panels in the IP market.

“Even with our own panel in place, we continue to see value in engaging and having active discussions with the broader healthcare provider ecosystem, including non-panel doctors, public hospitals, private hospitals and day surgery centres to explore how we can work together to better manage healthcare costs. A successful example of this is in making pre-authorisation available for all non-panel doctors too,” it said.