Malaysian regulator Bank Negara Malaysia (BNM) and the ministry of health (MOH) will soon meet the country's medical community to discuss the government's proposed base medical and health insurance/takaful (MHIT) product.
According to media reports this meeting would be virtual and the session will be co-chaired by BNM technical adviser Jessica Chew Cheng Lian and Dr Yap Wei Aun, CEO of the Health Transformation Office at the MOH.
This meeting would be a follow-up of the first engagement session held on 21 May 2025 that provided an overview of the Reset strategy and initiatives and included discussions on the practices of medical and health insurers and private hospitals to manage escalating claims costs.
According to a national survey by CodeBlue among more than 850 specialists practising in private hospitals, 99% perceived interference from insurers and takaful operators or third-party administrators with their clinical decision-making. The findings were published in a 200-page report in October 2025.
In its initial response to the CodeBlue survey report, Bank Negara said that insurers and takaful operators (ITOs) and third-party-operators have no authority to “direct” patient care and that ITOs assess medical claims based on “accepted treatment protocols” and “clinical practice guidelines”. Claims must be honoured if treatments are established to be “medically necessary”.
The insurance and takaful industry in a joint response to CodeBlue survey report has said that the
CodeBlue’s anonymous survey highlights areas where the insurance and healthcare sectors can collaborate further to enhance service delivery and efficiency for policyholders/certificate holders.
The joint statement said the industry’s priority is to ensure that all medical claims are managed fairly, transparently, and efficiently. Insurers and takaful operators are responsible for paying all eligible claims while safeguarding the collective medical claims pool to maintain sustainable premium/contribution rates for consumers.
The joint statement said the insurance and takaful industry will continue to engage constructively with all stakeholders through an “all-of-nation” approach to strengthen Malaysia’s private healthcare ecosystem.
It said the industry will continue to explore ways to support the nation’s healthcare system as well as According to media reports and CodeBlue the joint statement by the Life Insurance Association of Malaysia, the General Insurance Association of Malaysia, and the Malaysian Takaful Association (MTA), however, completely omitted mention of clinicians’ allegations of payer “interference” with the practice of medicine.