Migrant labour rights non-profit organisation Transient Workers Workers Count Too (TWC2) has shared two incidents on its website on how employers have tried their ways to avoid paying their S Pass holders’ medical bills after they were hospitalised for health problems.
Detailing the events on its website, TWC2 first shared about the predicament experienced by a Filipino man named Danny who was working in sales for a company in the tech industry.
Mr Danny joined this company only recently but he had worked in Singapore for about 10 years. His boss is based in India, while the HR department is outsourced.
In March this year, the Filipino man suffered a stroke. He was only in his 40s, but he has a history of hypertension.
Due to this, Mr Danny had to stay in Tan Tock Seng Hospital for two weeks, before moving to a step-down care facility for another four weeks. His hospital’s bill accumulated to S$34,000 after he was discharged.
At first, his employer issued a Letter of Guarantee (LOC) for S$10,000 to the hospital to cover his costs, but soon after that, the insurance company discovered that Mr Danny has a history of hypertension, and the insurer told the employer that their policy didn’t cover this case. As such, the employer then withdrew the LOC, resulting in Mr Danny being asked to fork up his own money to pay the outstanding medical bill.
“When he spoke with his HR department, they told him that it was his responsibility to settle the hospital’s bill, and not the company’s, because of his pre-existing condition. However, when Danny applied for the job, no one asked him about pre-existing conditions. Also, he passed the medical exam that was required before he was issued with the S-Pass,” TWC2 recounted.
Upon being presented with this case, TWC2 noted that their first advice to Mr Danny was to “inform him that the discussion about pre-existing conditions was beside the point” and that the issue here is the “statutory obligation of the employer to cover his medical bills, which his employer was attempting to deny”.
According to the subsidiary regulations under the Employment of Foreign Manpower Act, the employer is responsible for and must bear the costs of the foreign employee’s medical treatment in Singapore.
Except as the Controller specifies otherwise in writing, the employer is responsible for and must bear the costs of the foreign employee’s medical treatment in Singapore, except that and subject to paragraphs 2A and 2B, the foreign employee may be made to bear part of any medical costs in excess of the minimum mandatory coverage…(it then goes on to detail when cost sharing may apply).
— Employment of Foreign Manpower (Work Passes) Regulations, Fifth Schedule, Part I, paragraph 2
“Nowhere in these regulations is there any provision for exclusion of medical costs due to pre-existing conditions. Nor did Danny’s contract of employment contain any mention of cost-sharing,” said TWC2.
“It is entirely possible for the policy to include reservations and exclusions, but such clauses will not affect the statutory responsibility of the employer to cover an S-Pass holder’s medical costs stated in (1) above. If there are such exclusions in the insurance policy, they simply mean that the employer’s liability in those circumstances will be uninsured. The liability remains nonetheless,” it added.
Additionally, the law also states that employers must take out insurance cover for at least S$15,000.
TWC2 also pointed out that they made sure Mr Danny understood his rights, and this allowed him to engage more strongly with the hospital and his employer.
“The complication on the employer’s side was that its HR functions had been outsourced to an HR service provider, and Danny was thus having to deal with an outside contractor. Danny’s direct supervisor was sympathetic to his case but had no influence over the outside contractor.
“It later emerged that this HR service provider had not even informed the India-based boss that there was this case going on, or so they said. The HR provider took its own decision to deny responsibility for Danny’s medical bills,” it explained.
To get more assistance, both Mr Danny and TWC2 reached out to the Ministry of Manpower (MOM) explaining his predicament.
However, according to TWC2, MOM’s reply to Danny was “useless” as they were “boilerplate email enumerating a foreign worker’s entitlements”, which did not deal with any specifics that the foreign worker raised, and was even sent by a “Do-not-reply email address”.
Thankfully, the issue eventually reached to Mr Danny’s boss in India, and Mr Danny submitted his resignation letter after the problem was solved.
“It was obvious that the law was clear and so a decision was made at the highest levels to reverse the HR service provider’s insistence that Danny pay his own bills,” TWC2 remarked.
Case 2 – Burmese worker Lin
TWC2 also shared another incident involving a Burmese worker named Lim who needed medical care and her employer tried disregarding the rules in providing financial assistance for her.
This story was highlighted to TWC2 by a doctor from Tan Tock Seng Hospital on 4 June 2021 as Ms Lin needed surgery for a salivary gland tumour.
It all started sometime in 2018 when the Burmese national experienced pain on her left cheek but did not seek any treatment as it was difficult for her to leave the shop she was working at unattended.
However, when her pain intensified and she developed an ulcer in January this year, she asked her employer to take her to the hospital.
“Our records however indicate that she was taken to a polyclinic. We’re still not clear what diagnosis was reached at this point in time.
“Nonetheless, her employer began making the point that treatment in Singapore would be very costly and she should go back to Myanmar where it would be more affordable for her. There didn’t seem to be any discussion about the employer’s obligaton to provide and pay for medical care. Lin was left to believe that this was not the employer’s responsibility,” TWC2 explained.
As her pain was getting unbearable, Ms Lin decided to return to Myanmar and tendered her resignation letter in late February this year, and her S-Pass was cancelled on 2 March.
Unfortunately, she couldn’t go back to her home country due to COVID-19 lockdowns.
After her condition became progressively worse by June, she was conveyed to Tan Tock Seng Hospital, and a CT scan on 2 June indicated that a surgery was necessary.
Her doctor said that it would cost around S$10,000 and told her not to worry as her employer should be able to use her insurance to pay for the operation.
Ms Lin was shocked because this was the first time she heard about insurance and was not even sure if her employer had bought insurance cover.
She then confronted her former boss who admitted that there had been insurance in place. This made Ms Lin feel upset and cheated as her former employer’s suggestion to resign and return to Myanmar was so “self-serving and unfair”.
Responding to this, TWC2 noted that it then came up with a number of action plans which include getting the doctor to write a memo indicating the surgery is necessary for Ms Lin, asking MOM for an extension of stay, and informing the Ministry of the employer’s action of trying to dodge her obligation of covering Ms Lin’s medical cost, as well as to underwrite the surgery cost if the employer decides not to pay.
TWC2 added that MOM stepped in and called Ms Lin for an interview a day before her scheduled surgery.
However, MOM asked mostly about her salary in the interview.
“It turned out that her employer had declared a monthly salary of $2,500 to MOM when they applied for an S-Pass for her. On questioning, she disclosed to the MOM officer that she was only paid $1,680 a month. She explained that she had raised this matter with the boss initially when she joined but the boss said a portion had to be set aside to cover the monthly foreign worker levy, plus other costs. This is a deceitful explanation. The levy and related costs should not be deducted from a worker’s salary,” said TWC2.
“The officer then told her that he would initiate a salary claim for her. Salary claims tend to take months to resolve, which would be a way to buy time for her to remain in Singapore for treatment,” it added.
Ms Lin then proceeded with her surgery and it was a success. In a twist of events, her former boss came to visit Ms Lin at the hospital to give her three cheques totalling to about S$9700.
The Burmese national said that her boss was crying profusely and stated that she didn’t want any problems with the authorities, adding that the cheques were from her own pocket as she could no longer claim against the insurance policy.
TWC2 then said that Ms Lin must have felt sorry for her former employer and agreed to sign a letter saying she wouldn’t make a salary claim nor claim for medical bills after 2 July 2021.
“The reason for the employer’s suddden change of heart became clear when MOM called Lin. It was MOM who instructed the boss to settle all outstanding bills. There was also some assurance that Lin’s pass would be extended for as long as the doctor deemed necessary until she was fit to fly.
“Perhaps — but we’re only speculating here — MOM held the threat of action against the boss for salary offences as a way to make the employer pay Lin’s medical bills,” it added.
At the end, Ms Lin got a green light from her doctor to fly back home, and she left to Myanmar on 26 July.
