Sim says gaps in social protection see over 80% of accident claims rejected


KUALA LUMPUR: Gaps in the social protection system have led to more than 80% of accident claims being rejected, says Steven Sim.

The Human Resources Minister said 26,865 accident claims, including fatal cases, were rejected between 2018 and Aug 31 of this year.

He said the Social Security Organisation statistics showed the claims were rejected under the Employees’ Social Security Act 1969 as non‑occupational accidents.

“Of the total, 87.21% of cases as of August this year were rejected,” said Sim on Thursday (Oct 9).

“Meanwhile, 85.74% of cases in 2024 were rejected as the accidents were not categorised as occupational,” he added.

He added that when a case is determined to be non‑occupational, the insured person and dependents are not eligible for benefits under the Act.

Sim was replying to Datuk Mohd Isam Mohd Isa (BN ‑Tampin) on plans for 24‑hour social security protection for all workers.

This includes shift workers, part‑time employees and gig workers.

Sim, who is also the Bukit Mertajam MP, said rejected claims can strain the public healthcare system.

“The recent National Audit Report showed outstanding medical bills reached RM360mil as of December 31, 2024,” he added.

He said the ministry plans to introduce the non‑occupational accident scheme, or SKBBK, administered by Perkeso.

He said the scheme will sit under the Lindung Pekerja framework, a rebranding of protection under the Act.

Once implemented, eligible workers will receive 24‑hour protection during their employment period.

The scheme will cover accidents outside working hours that are not directly job related.

Under the scheme, Perkeso will bear medical expenses for contributors involved in non‑occupational accidents.

“The ministry is confident this will ease workers’ financial burdens and reduce outstanding hospital bills,” he added.

This was highlighted in the National Audit Report.

 

 

 

 

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