Revised laws on work injury a boon for workers, but some questions remain

This letter was sent to TODAY and was published on 22 September 2019.

The Humanitarian Organisation for Migration Economics (Home) welcomes the important steps forward under the revised Work Injury Compensation Act (Wica). Nonetheless, some changes also raise new questions.

Under the revised Wica, insurers will process claims by default. Conflicts of interest could arise, given the insurers’ business interests and duty to process claims. 

While the Ministry of Manpower (MOM) will set guidelines and licensing standards, what safeguards will MOM implement to proactively monitor and ensure that insurers will process claims respecting the workers’ full rights and entitlements?

Processing claims is seldom a straightforward application of formulae. Factors that affect the compensation payable still need to be determined. For example, even if a workplace injury is admitted, which incapacitated body parts should the compensation account for? 

Workers may not know to request from doctors clear evidence that subsequent complications arose from the workplace injury. This problem is exacerbated in cases where a worker’s access to medical treatment is delayed by errant employers.

For a worker who has been persistently underpaid, his compensation may not be calculated according to his rightful salary. In Home’s experience, insurers are content to rely on employers’ salary records, and workers do not realise they have the right to start a salary case to rectify this.

Low-wage labourers, who are most reliant on Wica, are especially vulnerable. Insurers have no incentive to ensure that workers are fully aware of their rights or guide them on protecting their interests through the process. 

Medical treatment is often delayed because of employers' refusal to pay. The revised Wica now allows hospitals to recover payment from employers directly. Where the employer is insolvent, insurers may also be ordered to pay hospitals directly. This is progress.

A much-needed development is direct billing between hospitals and insurers. Currently, employers must pay hospitals first, before insurers reimburse them.  

The main barrier to treatment is hospitals’ lack of assurance of payment from tardy or errant employers. 

With compulsory insurance, why do such barriers remain? Hospitals should simply have an account with the insurer to draw on, at the worker’s authorisation. This reduces delays in treatment and stress for injured workers.

Workers should have the right to choose their hospital. MOM policy requires workers to receive treatment and assessment at the employer-appointed institution, unless inadequacy of care is proved.  

There are, however, doctors who prioritise the employer’s interests over their patient’s. 

Injured workers are seldom in a position to question doctors. Most workers simply want to recover well, with the help of doctors they can trust.    

Allowing employers to decide where workers are treated and assessed is a paternalistic anachronism. 

Furthermore, leaving payment in employers’ hands creates unnecessary friction that hinders workers’ access to treatment.  

Looking ahead, Home urges further progress to the Wica regime by minimising the employer’s role and prerogatives in the provision of medical treatment.