KUALA LUMPUR: Mohd Ridhuan Zaini, 46, was left reeling after paying RM4,800 out of his own pocket for surgery following a motorcycle accident that left him with a fractured shoulder.
The driver, who has more than 20 years of experience, declined to work on a Saturday in December last year due of a family commitment. Later that day, he skidded and fell while riding his motorcycle, leaving him injured and unable to work for more than a month.
Without personal medical insurance, Ridhuan had to rely on his company's medical coverage, as he was not eligible for Social Security Organisation (Perkeso) protection because the accident occurred outside working hours.
"I thought the Lindung 24 Jam scheme had already taken effect by then, but it had not.
"When I checked with my company, I was told that the coverage was only for accidents during working hours, so I had to rely on my company's medical coverage to get treatment," he told the New Straits Times.
Ridhuan initially sought treatment at a university hospital but was told he would have to wait a week for surgery. Unable to endure the pain, he later opted to go to a private hospital.
Although his company provided medical coverage, it wasn't enough for the treatment.
His recovery was further complicated by the loss of overtime while he was on medical leave, leaving him with only his basic salary. He also struggled to afford follow-up treatment, with each appointment costing more than RM200.
"Because of the cost, I only went for one follow-up. At the time, I was only receiving my basic salary, which was significantly lower without overtime payments.
"When I saw the medical bill and realised I had to pay RM4,800, I wanted to run away," he said.
OFF-HOUR PROTECTION
Ridhuan said the introduction of Perkeso's Non-Employment Injury Scheme, also known as Lindung 24 Jam, would provide workers with protection against accidents outside working hours.
"I wish it had been introduced sooner. It would have provided a social safety net for people who have jobs like me."
Introduced on June 1, the scheme extends social protection to eligible workers who suffer non-work-related accidents, regardless of when or where they occur.
[[nid:1558560]]
Perkeso group chief executive officer Datuk Seri Dr Mohammed Azman Aziz Mohammed said 8.5 million workers, or 87.6 per cent of those eligible, remained enrolled in the scheme, reflecting the importance workers placed on protection beyond working hours.
He said workers spent 33 per cent of their time each year working, including commuting to and from work, leaving the remaining 67 per cent, or about 244 days, outside the scope of conventional employment-related protection.
He added that the scheme received 6,330 claims in its first three months, from June 1 to Aug 31, averaging 69 claims a day.
A total of RM9.97 million in benefits was paid during the period, covering temporary and permanent disablement, medical expenses, funeral benefits, dependants' benefits, rehabilitation equipment and implants.
However, Azman said 52 per cent of workers earning below RM3,500 had opted out of the scheme.
He expressed concern that many workers in this income group did not have private insurance, leaving them vulnerable to financial hardship.
'IT WAS A GREAT HELP TO US'
For 32-year-old housewife Syahirah, the scheme provided financial support when her husband suffered an anterior cruciate ligament injury while playing football on a Sunday.
She said her husband received RM540 under the scheme and that the claims process was straightforward, requiring only a copy of the claimant's identity card, a bank account statement and the original medical certificate (MC).
"As my husband's medical leave (MC) was issued in stages, Perkeso processed each claim separately after the respective MC period ended.
"We submitted the first claim on July 7, and the payment was credited into his bank account on July 13. The process was very fast."
The payment helped ease the family's financial burden during her husband's recovery.
Although he had a private medical card, it did not cover income lost while he was on medical leave.
"Alhamdulillah, Lindung 24 Jam has been a great help to us. I advised my husband not to opt out of it because it provides protection that our medical insurance does not," Syahirah said.
Another claimant, who identified herself only as Mimi, received RM180 as temporary disablement benefit after injuring her left leg when she fell into an uncovered drain while picking up her child after work on June 26.
She submitted her claim on July 6 and received the payment on July 22.
"The claims process was simple. I submitted my application through the Lindung24 portal by filling in the required information and uploading the necessary documents," said Mimi.
"Perkeso then contacted my employer for verification before the payment was credited."
The experience made her realise the importance of protection against accidents outside working hours.
"Only after experiencing the accident myself did I realise how important it is to have protection for accidents that happen outside working hours," she said.
Another claimant, who requested anonymity, received RM304 after being placed on 17 days of medical leave following an accident.
She submitted her claim on July 6 and received the payment on July 24.
While describing the application process as straightforward, she called for greater transparency in how compensation was calculated.
"It would be helpful if claimants could receive an email or a statement explaining how the compensation amount is calculated," she said.
'IT GIVES ME PEACE OF MIND'
For younger workers who cannot afford private medical insurance, Lindung 24 Jam offers an additional layer of protection against unexpected accidents.
Private company protege Syaf, 26, said the lack of a medical card made the scheme an important safety net, particularly as she commuted about 6km between her rented home and office.
"One unexpected accident could quickly become a financial burden.
"The medical benefit was the main factor. At the moment, I cannot afford a medical card, so this scheme gives me some peace of mind knowing I have protection if I am involved in an accident outside working hours.
"At least I can receive treatment or make a claim for eligible medical expenses."
Syaf said the monthly contribution was more affordable than private medical insurance plans she had considered, many of which cost more than RM80 a month.
For 25-year-old company secretary executive Danish, the decision to remain covered was largely driven by his daily commute.
He travels about 70km by motorcycle to work each day and said financial commitments had prevented him from taking out private medical insurance.
"My main consideration was my daily commute. Since I ride a motorcycle almost every day, the risk of an accident is always there.
"I do not have a medical card because of financial constraints. My current commitments do not allow me to get one, so I think it is better to be protected under Lindung 24 Jam.
"Perkeso is an affordable option for people like me because the monthly deduction is much lower, with the maximum contribution capped at RM45 a month."
The scheme is being implemented in three contribution phases, starting at 0.75 per cent of monthly wages and fully borne by employees, subject to a wage ceiling of RM6,000.
© New Straits Times Press (M) Bhd