insurers and takaful operators (ITOs) Archives

22 January 2026

Malaysia

Galen Centre Moots Partial Government Subsidies For Short-Term Private Health Insurance

The Galen Centre proposes partial government subsidies for seniors/ unemployed to buy short-term health insurance for a 3-year period on a co-pay basis. Two other analysts, Dr Rafick Khan and Chua Hong Teck, urge transparency mandates for ITOs, hospitals.

22 December 2025

Malaysia

BNM Tells Insurers To Settle Medical Claims Promptly, Prohibits Applying Unknown Exclusions

BNM says ITOs cannot "unreasonably" delay or deny medical insurance claims, or enforce unknown exclusions. But no timelines were set for claims processing. The central bank also isn't mandating medical check-ups before buying health insurance policies.

1 December 2025

Malaysia

Send Legal Letters To Insurers Over Denials, Oncologist Tells Patients

Dr Ibrahim Wahid advises patients to send insurers legal letters to challenge medical claims denials; this is enough to scare them. Even if it goes to court, he says oncologists are unlikely to defend the insurance industry as doctors will defend patients.

28 November 2025

Malaysia

A TPA’s Medical Trend: Average RM9,300 Hospitalisation, RM131 GP Visit

PMCare, a TPA, reported average cost per visit/admission in 2024 at RM9,289 for hospitalisation, RM526 for specialists, and RM131 for GPs. Medical cost inflation under 1% for hospitalisation in 2024. Average GP cost: RM134 (RM100 meds + RM34 consultation).

27 November 2025

Malaysia

PMCare Wants Act To Regulate TPAs Under MOH

PMCare calls for a standalone Act to regulate TPAs and MCOs that should set out an operational framework, including payment terms for panel providers and definitions of "clinical interference". PMCare wants TPA regulation to be under MOH's jurisdiction.

25 November 2025

Malaysia

Stop Using Previous MOH Letters To Justify Denials, Ministry Tells Insurers, MCOs

MOH's medical practice division orders ITOs and MCOs/TPAs to halt their practice of using previous MOH letters as general policy to justify denials of health insurance claims, saying those opinions were limited and specific to the individual case referred.

17 November 2025

Malaysia

Grievance Mechanism Committee To Resolve Health Insurance Claims ‘Pain Points’

At its first meeting on Nov 10, the Grievance Mechanism Committee – comprising MMA, APHM, LIAM, PIAM and MTA – decided to prioritise health insurance claims protocols that will be co-developed by specialists and payers to resolve common claims pain points.

10 November 2025

Malaysia

Bank Negara Wants Explanation From ITOs, TPAs On Clinical Interference

Bank Negara is seeking explanations from ITOs and TPAs on their alleged interference with doctors’ clinical decisions, including GL denial, delay, revocation; denying diagnostic tests; questioning a procedure or admission; or dictating treatment modality.

6 November 2025

Malaysia

MOF: Insurers And TPAs ‘Have No Power’ To Decide Patient Care

Deputy Finance Minister Lim Hui Ying says insurers and TPAs have “no power” to decide patient care and only assess claims. She said treatment decisions are the “exclusive responsibility” of doctors despite complaints of insurer interference in clinical decisions.

31 October 2025

Letter

Malaysian Health Care Needs Urgent Reform — Dr Goh Heong Keong

Nephrologist Dr Goh Heong Keong laments inertia in health care cost regulation. Insurance companies and TPAs exert immense pressure on doctors for substantial discounts, affecting doctors' ability to maintain their practice and deliver comprehensive care.

Tag: insurers and takaful operators (ITOs)

Galen Centre Moots Partial Government Subsidies For Short-Term Private Health Insurance

BNM Tells Insurers To Settle Medical Claims Promptly, Prohibits Applying Unknown Exclusions

Send Legal Letters To Insurers Over Denials, Oncologist Tells Patients

A TPA’s Medical Trend: Average RM9,300 Hospitalisation, RM131 GP Visit

PMCare Wants Act To Regulate TPAs Under MOH

Stop Using Previous MOH Letters To Justify Denials, Ministry Tells Insurers, MCOs

Grievance Mechanism Committee To Resolve Health Insurance Claims ‘Pain Points’

Bank Negara Wants Explanation From ITOs, TPAs On Clinical Interference

MOF: Insurers And TPAs ‘Have No Power’ To Decide Patient Care

Malaysian Health Care Needs Urgent Reform — Dr Goh Heong Keong

Ampang Hospital’s IT System Down For 33 Hours In First Huge Outage

Report: Treasury Wants RM3b Cut To Health Ministry’s 2026 Budget

Too Many Agencies Involved In Doctor Workforce Pipeline: Health DG

Take Action Against Retail Blood Testing In Pharmacies — FPMPAM

Don’t Blame MOH Alone For Health Workforce Shortages — MMA