But for insurers, this generosity hurts. Executive director of the Life Insurance Association, Singapore (LIA Singapore), Mr Chan Wai Kit, said that in specific years, despite rising premiums, the industry has seen single-digit profit margins in health insurance portfolios and some IP insurers are even incurring losses. 

LIA Singapore is the not-for-profit industry body representing life insurance companies in Singapore. 

Of the seven Integrated Shield Plan insurers, four – Income Insurance, Singlife, HSBC Life and Raffles Health Insurance – posted underwriting losses in 2024, as rising claims outpaced premium growth.

Across the six major IP insurers, net claims rose between 9 per cent and nearly 28 per cent in 2024, far exceeding medical inflation of about 10 to 11 per cent. 

“It cannot remain a loss-making proposition indefinitely, because that’s just not economically viable,” said Mr Chan. 

Mr Chan said insurance design must evolve to stay sustainable, with IP insurers balancing premiums, benefits and customer needs.

“It isn’t as simple as saying, if you make a loss, just increase premiums by a certain percentage. Insurance doesn’t work that way. It’s a commitment to customers, protecting them over the years and decades to come.”

Chief customer officer at Income Insurance, Mr Dhiren Amin, said insurers are “careful and calibrated” about making changes to IPs, as they have to maintain a delicate balance to maintain claims sustainability, cost discipline and alignment with national healthcare priorities. 

Additionally, insurers also face the challenge of having to keep up with medical innovations, which tend to be expensive.  

Prudential Singapore’s chief health officer, Dr Sidharth Kachroo said the number and size of claims that the company has seen have increased steadily, with claim volumes rising by more than 15 per cent in 2024 from the year before. 

“Medical inflation is a complex issue,” said Dr Kachroo. “Advancement of medical technology and manpower costs contribute to increasing healthcare delivery costs, leading to increases in insurance costs and corresponding premiums.” 

For doctors, the pressures are equally complex. Dr Peter Chow, the chief executive officer of IHH Healthcare Singapore, said doctors must balance patient expectations with medical necessity in an increasingly competitive environment. 

IHH Healthcare Singapore operates four private hospitals in Singapore: Gleneagles Hospital, Mount Elizabeth Hospital (Orchard), Mount Elizabeth Novena Hospital, and Parkway East Hospital.

And the solution is not as easy as capping prices on certain items, Dr Chow said, adding that if such a move were made, some doctors might make up the difference by ordering more scans or prescribing extra medication, as patients often lack the knowledge to question these decisions.

“Doctors have to earn a living, hospitals need to be sustainable, insurers need to keep going – it’s not necessarily a conflict, but everyone must play their part responsibly.”