Why Some Foreign Workers Remain Underserved Despite PERKESO Coverage

Barnama

19-07-2025

T
wo foreign workers were injured on the job in Malaysia but their stories couldn't have been more different.
One — Jebaraj Kumar (not his real name) from India — died alone, with his hospital bills unpaid. His body remained in the morgue for nearly two months and was only flown back to India in a closed casket after the outstanding bills were settled.
The other — Sri Handayani or Riyanie, a 49-year-old maid from Indonesia — was hit by a car while heading to the grocery store. She was treated and discharged within hours, received a month of physiotherapy, and has since returned to work.
The incidents happened about a year apart.
The Malaysian government-backed insurance scheme for workers, the Social Security Organisation (PERKESO), paid for both medical bills. All workers, foreign and local, are required by law to be enrolled in PERKESO, which not only pays for medical bills for injuries and illnesses sustained at work, but also disability and death benefits.
But Jebaraj did not receive any help from PERKESO until almost two months after his death, while Riyanie received assistance almost immediately.
Their stories expose the stark difference in outcome on a system that arguably relies too much on employers and luck for workers with little support system here.
'For migrants, it is essential to be covered by (PERKESO) as migrants work in 3D (dirty, dangerous, difficult) sectors where injuries can happen anytime,' said Sumitha Shaanthinni Kishna, founder and director of the migrant labour rights group Our Journey. 'PERKESO has a very strong system when it works as intended.'
Sumitha Shaanthinni Kishna.
WITHOUT PERKESO
The case of Jebaraj illustrates what could happen to a worker if the unthinkable happened without PERKESO's assistance.
On March 6, 2024, the 48-year old man from Tamil Nadu, India was working in the kitchen of a restaurant in Bangsar, when a gas tank exploded. He sustained severe burns on 80 per cent of his body and was the only one injured, according to news reports on the incident. He was brought to Kuala Lumpur Hospital (HKL) for treatment.
No one had notified his family. His 25-year-old daughter, who asked to be identified only as Suba, told Bernama via an interpreter that they only knew something was wrong when her father failed to call them at 6.30 pm as scheduled.
She called her father's employer, who informed her that Jebaraj had been injured at work and was in the hospital.
'He told me my father was ok, he was awake and talking,' she said via Google Meet. 'We didn't fly to see him because we thought he was going to be ok.'
She said in reality, her father was in a coma. She and her mother asked to talk to Jebaraj, or see photos of him recovering in the hospital, but the employer said HKL did not allow any phones on its premises.
Things got worse from there. Jebaraj passed away on June 2, 2024. But Suba and her mother would not be able to bury him until almost two months later. She claimed that Jebaraj's employer tried to persuade the family to bury him in Malaysia, citing the extensive paperwork involved in repatriating the body.
She then asked her father's friend to check on her father's case and found out that the body had not been released because of unpaid hospital bills.
Suba does not know whether her father's employer reported the case to PERKESO, as required by law. In any case, it appears PERKESO was not involved in Rebaraj's case until Sumitha—whose NGO is representing Suba and her mother—petitioned the organisation to cover the hospital bill and provide the entitlements owed to them.
When contacted, Jebaraj's employers said he had PERKESO coverage at the time of the incident but did not explain why the hospital bills were left unpaid.
PERKESO confirmed to Bernama via WhatsApp that Jebaraj was covered.
'PERKESO has investigated this case and confirmed that the case is covered under the Employment Injury Scheme (Act 4) and eligible to receive benefits from PERKESO,' the group said.
Suba confirmed her mother has begun receiving dependent's benefits through the scheme.
Malaysia made PERKESO coverage mandatory for foreign workers in 2019, and expanded its Invalidity Scheme to foreign workers in July 2024 to provide disability pension, funeral and death benefits, as well as survivors' benefits. Failure to comply could result in a RM10,000 fine or two-years' imprisonment or both.
PERKESO has covered Malaysian workers' since 1971 via the Employees' Social Security Act 1969 (Act 4), Self-Employment Social Security Act 2017 (Act 789) and Employment Insurance System Act 2017 (Act 800).
WITH PERKESO
Riyanie vividly recalls the terrifying moment the car struck her—her body and purse flying into the air.
Just moments earlier, she had been waiting for the light to turn green so she could cross. Now, she lay sprawled in the middle of the road in Puchong like a rag doll, blood covering her face and body, the contents of her purse scattered around her.
'I could tell it was bad because there was so much blood. My hand was covered in blood,' said the Indonesian domestic worker to Bernama.
Pedestrians and the remorseful driver helped her contact her employer and took her to the nearest clinic and then to Putrajaya Hospital. Her employer met her there, stayed by her side during the X-rays, helped her through treatment for a scalp gash, and arranged her physiotherapy sessions. She also assisted Ryanie fill out the necessary forms.
Not once during that time did she worry about accessing medical care, including the physical rehabilitation for muscle damage on her right side.
'I received physiotherapy from PERKESO too—they covered everything,' she said, adding that her employer had enrolled her in the programme as required by law, and also provided coverage under the Indonesian government's workers' insurance scheme.
The accident took place on May 6 this year. Today, Riyanie is fully healed, healthy and moving without any aches or pains. She described the entire process as smooth and mostly hassle-free. All she had to do was provide her PERKESO number to the hospital staff, and if she didn't have it, her employer would do it for her.
For Riyanie, the system worked as intended.
DIFFERENCES IN RESPONSE
Both are foreign workers who met with an accident at work. Both have PERKESO coverage. Yet, the paths diverged sharply.
Experts said the difference came down to how helpful the employers are. For foreign workers, who are often alone and lack a support network here, this reliance on the employer is compounded. Malaysian workers who are recent transplants may be in a similar situation.
Bar Council Migrants and Refugees Committee Co-Chair Datuk Seri Ramachelvam told Bernama the onus was mostly on employers contacting PERKESO when accidents happen.
'There's also nothing barring an employee from reporting, but employees are less likely to report it in the sense of the lack of knowledge,' he told Bernama via Zoom.
Media reports of serious or deadly incidents are not enough to trigger PERKESO action either as there is no way to know who the workers involved were or whether they were contributors to PERKESO.
Under Malaysian law, not all workers are covered. Workers who earn more than RM6,000 are not required to have PERKESO coverage, a ceiling increase from RM 4,000 to RM5,000 on Sept 1, 2022, and another to RM6,000 on Oct 1, 2024.
National Association of Human Resources Malaysia (PUSMA) president Zarina Ismail said the way PERKESO is set up, employers have an outsized role in looking after their employees.
'As employers, that is their responsibility. Whether it's a big or small company, once we hire workers—whether foreign or local—it is our duty to ensure their welfare,' she said.
Nevertheless, labour experts said most employers are compliant and provide PERKESO and other coverage for their workers as required by law.
FILLING IN GAPS
That employers should be responsible for their employees' well-being is a given. But a system that hinges on them to activate benefits leaves too much room for failure.
Labour experts say to prevent cases such as Jebaraj's, there needs to be changes at the systemic and administrative level. All said better communication between governmental agencies would help plug the gap in reporting and service.
Attorney Michael Cheah, who deals with labour issues among others at AmerBON Advocates, blamed government agencies' tendency to work in siloes.
'The system is built in such a way that everyone operates in siloes so there's no integration between the agencies,' he said.
Datuk Seri M. Ramachelvam (2023) COPYRIGHT RESERVED
Ramachelvam agreed. He said having a standard operating procedure (SOP) in place where one department receiving a report triggers action from another agency would prevent cases from slipping through the cracks.
For instance, the law mandates reporting of industrial accidents to the Department of Occupational Safety and Health (DOSH). Should any worker die or be injured, DOSH can take note and inform PERKESO.
'I don't see why, when an accident is reported to the department (DOSH), there should (not) be an SOP for it to notify PERKESO as well—so that PERKESO can follow up,' he said.
That future may not be long way off. Even now, the government is in the process of digitalisation and possibly digitally linking their services between agencies, as part of the five-year digitalisation plan, overseen by Jabatan Digital Negara (JDN).
In the meantime, Riyanie—who still cares for her employer's elderly mother—considers herself fortunate to be working for a family that follows the rules. A mother of three grown children, she feels assured they will be taken care of should anything happen to her while she's away from home.
'I'm not worried because I have insurance,' she said, smiling.
For Suba, her father's passing, alone and unconscious in a strange land, is still a source of pain. She last saw him in 2019 when he was in India for a vacation.
'He was supposed to come back last year to arrange my marriage,' she said. Instead, the next time Jebaraj was back on Indian soil, it was in a closed casket, buried hurriedly at 2 am without a priest attending the burial.
'I'm still heartbroken that I couldn't talk to him before he died.'