38,000 rejected claims expose gap in workers' safety net

KUALA LUMPUR: Over the past decade, more than 38,000 workers injured in accidents suffered a second blow when the Social Security Organisation (Perkeso) rejected their claims, classifying the incidents as non-employment related.

Deputy Human Resources Minister Datuk Khairul Firdaus Akbar Khan said the figure, recorded between 2015 and 2025, exposed a significant gap in social protection for workers injured outside working hours, particularly those without private insurance or takaful coverage.

The gap persisted in more recent years, with 12,306 claims rejected by Perkeso between 2023 and October last year because the injuries were classified as non-employment-related.

He said the figures highlighted the need for a broader safety net that protected workers beyond the workplace.

"Such a high number of cases required immediate intervention to ensure workers in Malaysia remained protected, not only during working hours but also outside working hours," he told the New Straits Times.

Khairul Firdaus said the issue was particularly pressing for B40 and some M40 workers, many of whom could not afford the monthly premiums for private insurance or takaful after prioritising basic household expenses.

Citing Bank Negara Malaysia data, he said personal insurance or takaful ownership among B40 workers remained low, at between four and 30 per cent, compared with 88 per cent among higher-income urban workers.

He said the introduction of the Lindung 24 Jam scheme on June 1 aimed to close the gap by extending social protection to non-employment accidents.

Under the scheme, workers contribute 0.75 per cent of their monthly wages. A worker earning RM1,500, for example, contributes about RM11.25 a month.

Khairul Firdaus said the low contribution could provide crucial support to workers who suffered serious injuries or disabilities from accidents outside working hours.

"When B40 or M40 workers suffer serious injuries or disabilities due to accidents outside working hours, they can lose their source of income and become exposed to financial risks that can severely affect their lives.

"Lindung 24 Jam helps close this gap by providing protection around the clock, including income replacement and benefits for dependents."

The scheme has already recorded a sharp increase in claims since its introduction.

Between June 1 and July 31, a total of 2,751 claims were submitted, averaging 45 a day.

Perkeso approved RM3.45 million in benefits for 2,508 recipients in July alone, bringing the total benefits paid during the first two months to RM4.69 million.

More than 90 per cent of claims were approved and processed within five days, Khairul Firdaus said.

The largest share of benefits went towards rehabilitation equipment and implants, amounting to RM3.69 million cumulatively, followed by more than RM909,800 in Temporary Disablement Benefits to replace income during medical leave.

Additionally, long-term benefits for dependants exceeded RM2 million.

Khairul Firdaus said more than half of Lindung 24 Jam beneficiaries after the first two months were lower-income workers earning below RM3,500 on average, while the remainder were from the M40 group.

He said most beneficiaries were workers involved in everyday accidents outside working hours.

The figures, he said, showed that accidents outside working hours were not isolated incidents but a recurring financial risk for workers and their families.

Khairul Firdaus added that Lindung 24 Jam should not be viewed as a substitute for private insurance, but as a complementary layer of protection.

He said private medical cards were generally designed to cover hospital treatment, while Perkeso protection provided income replacement and longer-term support in cases of permanent disability or death.

Among the benefits available under Lindung 24 Jam are Temporary Disablement Benefit, Permanent Disablement Benefit, Dependants' Benefit, Constant Attendance Allowance of RM500 a month, funeral benefits and rehabilitation services through Perkeso facilities.

"Private insurance and Perkeso protection do not overlap. Instead, they complement each other," Khairul Firdaus said.

He added that the scheme was ultimately based on the principle of social solidarity, where contributions help spread financial risks across the workforce.