PETALING JAYA, Oct 1 — Medical and legal experts have proposed streamlining the processing of medical disability claims and compensation payments to ensure patients get the necessary support and assistance in the shortest time possible.
They said these were now typically contested in court by the insurance companies, which could afford to hire and retain lawyers to dispute such claims.
“It is often a lengthy legal process involving court appearances and expert witness opinions.
“There are patients who have waited for as long as 12 years for a simple settlement,” said Malaysian Healthy Ageing Society (MHAS) advisor Professor Nathan Vytialingam.
He said in many cases, the long wait for financial settlement often left the patients with difficulty moving on with their lives, particularly in cases where the claimant is also the sole breadwinner of the family.
Giving the example of a claimant aged 20, he said the person would be in his mid-30s before his claim would be paid out, severely restricting his and his family’s prospects.
“This is why we have come together to organise this seminar to look at how we can propose to enforcement agencies on how to help the patient, get the process going as fast as possible to get back to the community with quality life,” he added.
MHAS president Dr Shahrul Bahyah Kamaruzzaman also said the medical claims system was dysfunctional due to complexity and lack of collaboration.
“There are so many moving parts but there are no moving parts working together to try to get a solution — they are working in silos.
“Can you imagine, the young ones they have some kind of social support, but when you’re aged and disabled as well this happens to you that becomes much more of a challenge to you.
“It needs to be multi-disciplined, getting all the various stakeholders, getting them together to speak on how to move forward but together,” she said.
Lawyer and MHAS advisor K. Siladass pointed out that awards for claimants were now reaching vast sums, which could pose its own problems.
“If the award is not going to person (claimant) it is a windfall for somebody (else).
“So, those days the courts are very zealous to ensure that the recipient is in a good position to ensure the benefits of the award. The idea is not to compensation a perfect compensation the idea is to make the person live a comfortable life, as they were if not for the accident.
“Now it is seen as great profit making, sad to say that, accidents have become a kind of a profit-making exercise,” he said.
University Malaya Medical Centre (UMMC) consultant neurosurgeon Dr Viknes Waran added that medical costs would only increase as technology and science advances.
“So, in my area, we recognise that you might have a minor head injury but you could psychological impact and those have not really been recognised here, though more and more have been picked up.
“As that goes up, on the other hand, we have road traffic issues where implementation of rules and regulation is very laxed as we can clearly see in the way the Grab riders drive, three people on the motorcycle, and we are seeing more and more people without helmets,” he said indicating that these road traffic issues have been noticeable in the last 10 to 15 years.
“On the other hand, we also have to remember that the majority of ppl involved in road accidents are at their most productive part of their lives — you pull a guy out of the system, usually it would be a guy, either one child will have to stop from going to school or wife has to stop from work.
“In the old days, you have 10 children, one of them will be dedicated to look after the parents, now it’s no more, that don’t’ exist, so the whole system crashes,” Dr Viknes added.
A senior consultant for hand and micro surgery from Singapore, Dr Vaikunthan Rajaratnam said any compensation given must be to help restore a claimant’s quality of life and not for financial profit.
“That’s where this seminar is for that purpose to see how we can best address this and one component is to provide assessment so that it is fair and accurate,” he said.
Dr Vaikunthan said there are laws and regulations that could be used to regulate and prevent claims for profit.
Siladass, who agreed with Dr Vaikunthan said there is also a need for government intervention.
“What is needed, is thorough study and the government must come in. Without the government’s support nothing works and the enforcement agencies, they must come.
“If they come in, we can all sit down and say look, these are the problems we are facing,” he said.
Dr Shahrul said the seminar today will end with the MHAS organising committee drafting a consensus statement to include viable recommendations to the government towards improving the handling of medical disability cases in the country.
