Insurers responsible for 94% of workplace injury claim payouts: MOM
Investigations ongoing for alleged fraud flagged by Sumo Salad’s late owner, Jane Lee
[SINGAPORE] Nearly all workplace injury claims are handled by insurers rather than employers directly, with insurers covering 94 per cent of payouts, said the Ministry of Manpower (MOM) on Friday (Aug 1).
The remaining 6 per cent of claims are paid directly by employers exempted from purchasing insurance under the Work Injury Compensation Act (Wica), such as the public sector. These employers may still provide voluntary insurance coverage.
Each year, less than 3 per cent of Wica claims face objections. Employers, workers or insurers may challenge claims they believe are inadmissible; dispute permanent disability assessments; or contest compensation amounts.
MOM released these figures two weeks after Jane Lee, the late owner of local food and beverage chain Sumo Salad, alleged that an employee had made fraudulent workplace injury claims.
Each year, about 28,500 workplace injury compensation claims are filed under Wica, split evenly between local and foreign workers. Of these, 26,800 claims are eventually paid out.
The median processing time for a Wica claim is six months, with 96 per cent of claims resolved within a year of filing.
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Over the past five years, MOM has prosecuted two employers a year for failing to meet their Wica obligations. An average of two workers a year over the same period have been prosecuted for fraudulent claims.
Investigations ongoing
In the case involving Lee, the employer was covered by a valid insurance policy, said MOM.
Lee had alleged that the former employee orchestrated a fraudulent compensation claim by faking a fall two days before her contract ended, with help from the worker’s husband and possibly a law firm. Lee died a day later.
MOM said the incident involving the employee took place on Jun 6, and the employer subsequently filed a work injury incident report to MOM.
Specific to this claim, the insurer fully compensated the employer on Jun 26 and 27 for medical bills and medical leave wage losses incurred up to Jun 27, and notified the employer.
As investigations are ongoing, the claims process is not settled, said MOM.
A ministry spokesperson added that there is no evidence of syndicate activity related to this case.
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