MOH: The late Mr K received more payouts than total amount of premiums he paid

Since Workers’ Party MP Sylvia Lim raised in Parliament about the case of Mr K who was denied ElderShield payouts before he passed away in May 2017, many netizens have reacted angrily towards the government’s ElderShield scheme as well as its replacement in 2020 – the mandatory CareShield Life scheme.

To qualify for getting payouts, one must be “severely disabled”, unable to perform at least 3 out of 6 Activities of Daily Living (ADLs): (i) showering/bathing; (ii) dressing; (iii) feeding; (iv) toileting; (v) transferring from chair to bed or vice versa; and (vi) walking or moving on level surface.

Some have viewed the schemes with suspicion, calling them scams.

In any case, MOH has quickly responded to online buzz about the case mentioned by MP Sylvia Lim and posted a response on its Facebook page yesterday (17 Jul).

MOH said that Mr K joined the ElderShield scheme in 2002. He first submitted ElderShield claims in Sep 2014 and started receiving his payouts in the same month. However, after Sep 2016, he stopped receiving further payouts.

This was because when he did his periodic reassessment in Sep 2016, MOH said that the doctor who assessed him decided that Mr K did not meet the criteria anymore to justify getting the ElderShield payouts.

Following an appeal by Ms Lim in Mar 2017, the insurer did another assessment and re-started the payouts for Mr K in Apr 2017.

“Unfortunately, Mr K passed away in May 2017,” MOH said.

But MOH also said that Mr K received from the insurer more than the total amount of premiums he had paid, “The total amount of payouts he received from the insurer from Sep 2014 to Sep 2016 was $7,500, higher than the total of amount of premiums he paid (~$3,100).”

MOH added that it is checking with the insurer and doctor to find out the reasons for the Sep 2016 assessment to discontinue Mr K’s payouts.

“If there were lapses on the part of the insurer or doctor, we will not hesitate to take action against them,” MOH said.

ElderShield has benefited more than 15,000 policyholders since the scheme started in 2002, MOH said.

“The cash payouts helped to reduce their long-term care costs. As the ElderShield policyholders get older, we can expect more to become severely disabled and total claims will increase in future,” it added.

According to an ST report, there were some 1.3 million ElderShield policyholders at the end of last year and they have contributed $3.3 billion in premiums. Only about $133 million has been paid out in claims.