Over 90pc insurance claims approved yearly, Parliament told amid policyholder concerns

KUALA LUMPUR, July 6 — Insurance and takaful operators (ITOs) maintained an average claim approval rate of 90 per cent in 2025, Deputy Finance Minister Liew Chin Tong told the Dewan Rakyat today amid concerns over rejected claims.

Liew said during Question Time that an average of more than one million claims is approved each year, even as he acknowledged policyholders’ concerns.

“Industry data as of 2025 also shows that the ITO industry maintained an average claim approval rate of over 90 per cent. Collectively, industry players consistently approve more than one million claims every year,” the deputy minister replied to a question from Cheras MP Tan Kok Wai (DAP).

“If policyholders have a complaint, they can contact the ITO first. If the policyholder is still dissatisfied, they can contact BNMLINK and submit the dispute to the Financial Market Ombudsman Service (FMOS) free of charge.”

Tan had asked what the government has done to strengthen protection for health insurance policyholders, especially those with critical illnesses such as cancer.

Liew said all medical and health insurance and takaful (MHIT) products must comply with the regulations set out in the MHIT Business Policy Document issued by Bank Negara Malaysia, adding that ITOs cannot arbitrarily cancel a policy or takaful certificate unilaterally.

“ITOs also cannot terminate or refuse to renew coverage solely because the policyholder has made a claim or experienced health issues after securing the coverage,” the deputy minister added.

Under BNM’s MHIT policy document, ITOs are responsible for reviewing and managing claims fairly in accordance with contractual terms, including ensuring claims fall within the scope of coverage and are medically necessary.

Liew said the review is conducted based on standard treatment protocols that comply with clinical practice guidelines, including those issued by the Ministry of Health.

For most hospitals, this step is carried out before treatment is administered. He said this ensures policyholders do not have to bear unapproved costs retrospectively.