How Unnecessary Takaful Claims Have Distorted Market Prices

Updated 26 Sep 2016 – By Loanstreet


Contrary to what many think, increasing Takaful contributions are not just due to increasing medical costs. In fact, one ‘culprit’ that plays a significant role in pushing up Takaful contributions is the prevalence of dubious and borderline fraudulent Takaful claims. Bear in mind, that dubious claims are not just unethical – if found to be actually fraudulent, they are considered illegal! Additionally, what most participants do not know is that whether or not a dubious claim goes through, market premium prices are affected. Read on to find out just how the market, and your Takaful contributions, are being affected by runaway claims.

Payouts Increase, Takaful Contribution Increase

 

This one is pretty logical –Takaful operators work on a risk pool management system, balancing out probabilities of claims and their costs with Takaful contributions. Naturally, as payouts increase and the pool of Takaful contributions are depleted more quickly over time, higher Takaful contributions are charged to offset the outflow. Serious fraudulent cases aside, many claimants tend to overstate the amount of losses or even misrepresent certain facts to ensure they receive payments.

Some may argue that economic factors such as medical inflation, mortality rates, private hospital fees and the new GST system play a much larger part in the increase of Takaful contributions. However, it has been found that in 2013, the motor insurance and Takaful segment alone reported an estimated RM760 million loss by insurers and Takaful operators due to insurance and Takaful fraud.[1] Actuaries would most certainly take this into account, along with probabilities of such incidence rates in the future, and offset their potential losses with higher premiums.

Red Tape and Delays

Another considerable setback dubious claims create for insurers and Takaful operators is the measures that have to be put in place to prevent them. This affects other policyholders and Takaful participants in two ways – for one, with the implementation of such procedures, more manpower is required, increasing the operating costs of the companies, which are ultimately passed down to the consumer in the form of higher Takaful contributions. Secondly, more procedures to verify the authenticity of a claim, along with investigations into suspicious claims translate into more red tape and, subsequently, longer delays for genuine claimants to receive their due payments.

A Cooperative Effort

Increasing Takaful contributions due to excessive and dubious claims is not a problem isolated to Malaysia; some countries report insurance fraud as high as 30% to 40% of total claims! Be that as it may, consumers, health providers and businesses alike need to collectively work towards better market conditions. For participants such as yourself, dismiss the mindset that they would lose out to wealthy Takaful Operators if you do not abuse the system. In fact, according to the industry’s statistics from Malaysian Takaful Association (MTA) and Persatuan Insurans Am Malaysia (PIAM), the claim ratio for motor Takaful and insurance in 2015 stood at 67.0% and 71.3% respectively, which means that the Takaful industry paid out 67 sen in claims for every RM1 contribution collected while the Insurance industry paid out 71.3 sen in claims for every RM1 premium received. ; and this does not include operating costs which include management and commission expenses!

Having said that, you should know your rights as a participant, and how to take full advantage of your coverage – legally, of course!

For more information on what Takaful can do for you, please visit http://www.malaysiantakaful.com.my.

[1] Source from BNM’s Deputy Governor's Keynote Address at the Insurance Information & Ratemaking Forum of Asia 2015 (IIRFA)

Continue reading...

Suggested Articles

The complete guide to everything about ILPs - Part 1

The complete guide to everything about ILPs - Part 1

EIS in Malaysia: What do I need to know?

EIS in Malaysia: What do I need to know?

AKPK expands its services in bid to help potential bankrupts

AKPK expands its services in bid to help potential bankrupts