Part of a comprehensive analysis of the MediShield Life Scheme Act 2015
All Parts in This Series
Offences Relating to False or Incorrect Health Declarations under the MediShield Life Scheme Act 2015
The MediShield Life Scheme Act 2015 establishes a comprehensive legal framework to ensure the integrity and proper administration of the MediShield Life Scheme. Central to this framework are the provisions addressing offences related to false or incorrect health declarations, means declarations, and claim applications. These provisions serve to deter fraudulent conduct, empower investigations, and impose penalties to uphold the Scheme’s objectives.
Section 19: Offences Involving False or Misleading Declarations and Information
Section 19(1) criminalises the act of making false or misleading health declarations, means declarations, or claim applications under the Scheme. It also covers omissions that render such declarations misleading, and the provision of false or misleading information knowing its falsity or misleading nature. The provision states:
"19.—(1) A person commits an offence if the person — (a) makes a health declaration, means declaration or claim application under the Scheme which is false or misleading in a material particular, knowing that the declaration or application is false or misleading in a material particular; (b) omits any matter or thing without which the health declaration, means declaration or claim application (as the case may be) is misleading in a material particular, knowing that the omission makes the declaration or application misleading; or (c) provides any information to any person which is false or misleading in a material particular, knowing that — (i) the information provided is false or misleading in a material particular; and (ii) the information provided may — (A) be included in a health declaration, means declaration or claim application made under the Scheme; (B) affect the amount of any benefit or claim to be paid under the Scheme or whether any such benefit or claim is payable; or (C) affect the amount of any grant, subsidy or benefit to be paid or given under a relevant public scheme or whether any such grant, subsidy or benefit is payable or may be given." — Section 19, MediShield Life Scheme Act 2015
Purpose: This provision exists to safeguard the Scheme from fraudulent claims and misrepresentations that could lead to improper payments or subsidies. By criminalising both acts and omissions that materially mislead, the law ensures comprehensive coverage against deceitful conduct.
Section 19(4): Definition of “Relevant Amount” and Its Significance
Section 19(4) defines the “relevant amount” as the financial impact resulting from the offence, including undercharged premiums, overpaid benefits or claims, or wrongly given grants or subsidies. The exact wording is:
"In this section, “relevant amount” means — (a) the amount by which any premium has been undercharged as a result of the offence, or that would have been so undercharged if the false or misleading declaration, application or information (as the case may be) had been accepted as correct; (b) the amount of any benefit or claim under the Scheme that has been overpaid as a result of the offence, or that would have been so overpaid if the false or misleading declaration, application or information (as the case may be) had been accepted as correct; or (c) the amount of any grant, subsidy or benefit under a relevant public scheme that has been wrongly given as a result of the offence, or that would have been so wrongly given if the false or misleading information had been accepted as correct." — Section 19(4), MediShield Life Scheme Act 2015
Verify Section 19 in source document →
Purpose: This definition is crucial for quantifying penalties and ensuring they are proportionate to the financial harm caused by the offence. It aligns the penalty framework with the actual or potential monetary impact on the Scheme.
Section 19(2) and (3): Penalties for Offences under Section 19(1)
The Act prescribes graduated penalties depending on the nature and intent of the offence. Section 19(2) imposes penalties based on the relevant amount, while Section 19(3) addresses offences committed with the intention to cause financial loss or gain. The provisions state:
"(2) A person shall be liable on conviction of an offence under subsection (1) — (a) in any case where the person is an individual, to a penalty equal to the relevant amount; or (b) in any other case, to a penalty equal to 5 times the relevant amount. (3) A person who commits an offence under subsection (1), with the intention of causing any premium to be undercharged, any benefit or claim to be overpaid under the Scheme or a higher amount of any grant, subsidy or benefit to be given under a relevant public scheme, shall be guilty of an offence under this subsection and shall be liable on conviction of the offence under this subsection — (a) in any case where the person is an individual — (i) to a fine not exceeding $5,000 or to imprisonment for a term not exceeding 12 months or to both; and (ii) in addition, to a penalty equal to 2 times the relevant amount; or (b) in any other case — (i) to a fine not exceeding $10,000; and (ii) in addition, to a penalty equal to 4 times the relevant amount." — Section 19(2) and (3), MediShield Life Scheme Act 2015
Verify Section 19 in source document →
Purpose: These penalty provisions serve as a deterrent against fraudulent behaviour by imposing financial and custodial consequences. The heavier penalties for offences committed with intent reflect the increased culpability and potential harm to the Scheme.
Section 20: Appointment of Investigators
Section 20 empowers the Minister and the chief executive officer of the MediShield Life Board to appoint investigators to probe offences under the Act:
"20.—(1) The Minister may, in writing, appoint any public officer to investigate any offence under this Act. (2) The chief executive officer of the Board may, in writing, appoint any officer of the Board to investigate any offence under this Act." — Section 20, MediShield Life Scheme Act 2015
Purpose: This provision ensures that authorised and competent personnel are empowered to conduct investigations, facilitating effective enforcement of the Act.
Section 21: Powers of Investigators
Section 21 grants investigators extensive powers to obtain information, require attendance, inspect documents, and retain copies relevant to suspected offences. It also imposes penalties for refusal or failure to comply:
"21.—(1) An investigator who has a reasonable suspicion that any person has committed an offence under this Act may — (a) by written notice require any person to attend at such reasonable time and at such place as may be specified by the investigator to answer any question or to provide a signed statement in writing concerning the suspected offence; (b) require any person — (i) to furnish any information within the person’s knowledge; or (ii) to produce for inspection any document or record in the person’s possession, that the investigator believes on reasonable grounds to be connected with the suspected offence; and (c) retain the original copy of any document or record that the investigator believes on reasonable grounds to be connected with the suspected offence, or make or cause to be made, without payment, copies of or extracts from that document or record." — Section 21(1), MediShield Life Scheme Act 2015
"(4) Any person who, when required by an investigator to furnish under subsection (1)(b) any information or produce any document or record, refuses or fails, without reasonable excuse, to furnish the information or to produce the document or record within the time allowed by the investigator shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $10,000 or to imprisonment for a term not exceeding 6 months or to both." — Section 21(4), MediShield Life Scheme Act 2015
Verify Section 21 in source document →
Purpose: These powers are essential for thorough investigations, enabling investigators to gather evidence and verify compliance. The penalties for non-compliance ensure cooperation and prevent obstruction.
Section 22: Offence of Obstructing Investigators
Section 22 criminalises any act that obstructs, hinders, or impedes an investigator in the performance of their duties:
"22. Any person who, without reasonable excuse, obstructs, hinders or impedes any investigator in the performance or execution of a duty or anything which the investigator is authorised, empowered or required to do under this Act shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $20,000 or to imprisonment for a term not exceeding 12 months or to both." — Section 22, MediShield Life Scheme Act 2015
Verify Section 22 in source document →
Purpose: This provision protects the integrity of investigations by penalising interference, thereby ensuring that investigators can perform their functions effectively and without obstruction.
Section 23: Offences by Bodies Corporate, Partnerships, and Unincorporated Associations
Section 23 addresses liability where offences are committed by entities such as companies or partnerships. It holds officers or members liable if the offence was committed with their consent, connivance, or neglect:
"23.—(1) Where an offence under this Act committed by a body corporate is proved — (a) to have been committed with the consent or connivance of an officer; or (b) to be attributable to any neglect on the officer’s part, the officer as well as the body corporate shall be guilty of the offence and shall be liable to be proceeded against and punished accordingly." — Section 23(1), MediShield Life Scheme Act 2015
Section 23(5) further defines key terms:
"In this section — “body corporate” includes a limited liability partnership as defined in section 2(1) of the Limited Liability Partnerships Act 2005; “officer” — (a) in relation to a body corporate, means any director, partner, member of the board of management, chief executive, manager, secretary or other similar officer of the body corporate and includes any person purporting to act in any such capacity; or (b) in relation to an unincorporated association (other than a partnership), means the president, the secretary, or any member of the committee of the unincorporated association, or any person holding a position analogous to that of president, secretary or member of such a committee and includes any person purporting to act in any such capacity; “partner” includes a person purporting to act as a partner." — Section 23(5), MediShield Life Scheme Act 2015
Purpose: This provision ensures accountability at the organisational level, preventing entities from evading liability by attributing offences solely to individuals. It promotes responsible governance and oversight within organisations.
Section 24: Compounding of Offences
Section 24 allows authorised officers to compound certain offences by collecting a sum of money, thereby stopping further legal proceedings:
"24.—(1) A public officer authorised by the Minister, or an officer of the Board authorised by the chief executive officer of the Board, may compound any offence under this Act that is prescribed as a compoundable offence by collecting from a person reasonably suspected of having committed the offence a sum not exceeding the lower of the following: (a) one half of the amount of the maximum fine that is prescribed for the offence; (b) $1,000. (2) On payment of the sum of money, no further proceedings are to be taken against that person in respect of the offence." — Section 24, MediShield Life Scheme Act 2015
Purpose: This mechanism provides an efficient alternative to prosecution for minor offences, reducing the burden on the courts and allowing for swift resolution while still enforcing compliance.
Section 25: Conduct of Prosecutions
Section 25 stipulates that prosecutions under the Act may be conducted by authorised public officers or Board officers with the Public Prosecutor’s authorisation:
"25. Proceedings in respect of any offence under this Act may, with the authorisation of the Public Prosecutor, be conducted — (a) by any public officer appointed by the Minister to conduct such proceedings; or (b) by any officer of the Board appointed by the chief executive officer of the Board to conduct such proceedings." — Section 25, MediShield Life Scheme Act 2015
Verify Section 25 in source document →
Purpose: This provision ensures that prosecutions are carried out by competent authorities, maintaining the integrity and consistency of enforcement actions under the Act.
Cross-References to Other Legislation
The Act explicitly incorporates definitions from other statutes to maintain consistency and clarity. For example, the definition of “body corporate” includes limited liability partnerships as defined in the Limited Liability Partnerships Act 2005:
"“body corporate” includes a limited liability partnership as defined in section 2(1) of the Limited Liability Partnerships Act 2005;" — Section 23(5), MediShield Life Scheme Act 2015
Verify Section 23 in source document →
Purpose: This cross-reference ensures that entities recognised under other legislation are appropriately captured within the scope of the MediShield Life Scheme Act, preventing loopholes and ensuring comprehensive coverage.
Conclusion
The provisions under Sections 19 to 25 of the MediShield Life Scheme Act 2015 form a robust legal framework to deter, investigate, and penalise fraudulent conduct related to health declarations and claims under the Scheme. By defining offences clearly, empowering investigations, imposing graduated penalties, and ensuring organisational accountability, the Act protects the Scheme’s financial integrity and public trust. The inclusion of compounding mechanisms and clear prosecutorial authority further enhances the effectiveness and efficiency of enforcement.
Sections Covered in This Analysis
- Section 19 – Offences relating to false or misleading declarations and information
- Section 20 – Appointment of investigators
- Section 21 – Powers of investigators
- Section 22 – Obstruction of investigators
- Section 23 – Offences by bodies corporate, partnerships, and unincorporated associations
- Section 24 – Compounding of offences
- Section 25 – Conduct of prosecutions
Source Documents
For the authoritative text, consult SSO.