Bangladesh’s migrant workers have insurance. But it does not cover their medical bills

Rafiq Ahmed has a fever and has been unwell for some time, suffering from several illnesses. But in Saudi Arabia, where he works without legal documentation, a visit to the doctor is an expense he cannot afford.

“I am not seeking treatment because medical care is expensive here,” he told Daily Waadaa over whatsapp.

Rafiq, whose name has been partly changed to protect his identity, did not enter Saudi Arabia illegally. He travelled through Bangladesh's formal migration system, with the paperwork required to take up employment abroad.

Somewhere along the way, he lost his legal status. He is now among the estimated hundreds of thousands of Bangladeshis working irregularly in Saudi Arabia, exposed to a labour market in which losing a work permit can also mean losing access to essential services.

His immediate concern is medical treatment. But a recent factory fire in Riyadh that killed 16 Bangladeshis has left him contemplating another possibility: If he dies in Saudi Arabia, who will bring his body home?

It is a question that exposes a gap in Bangladesh's migrant welfare system.

The country has a mandatory insurance scheme for workers going abroad. It promises compensation for death, disability and certain cases of early return. But it is not health insurance. It does not pay for ordinary medical consultations or treatment for illnesses like Rafiq's.

And for workers who become undocumented after leaving Bangladesh legally, access to even the limited protections available can become uncertain.

The workers who disappear from the system

Saudi Arabia is one of the largest destinations for Bangladeshi migrant workers, part of a labour migration system that has sustained millions of households and supplied Bangladesh with billions of dollars in remittances.

The arrangement is straightforward in principle. Workers obtain clearance from the Bureau of Manpower, Employment and Training (BMET), pay the required fees and travel abroad to jobs arranged through employers or recruitment agencies.

But the system can begin to unravel after arrival.

Some workers discover that the jobs they were promised do not exist. Others find that their employers have failed to issue or renew work permits. Still others change employers without completing the legal procedures required in Saudi Arabia.

A worker who left Bangladesh with valid documents can therefore become undocumented without ever having intended to migrate irregularly.

A recent study estimated that between 200,000 and 300,000 Bangladeshis were working irregularly in Saudi Arabia. The figure is not an official government count, but it suggests the scale of a population that can fall outside formal employment protections.

A 2022 submission to the United Nations by the Ovibashi Karmi Unnayan Program (OKUP), a migrant rights organisation, documented complaints involving nearly 3,500 Bangladeshis stranded in Saudi Arabia without work permits or jobs.

Some borrowed money to find new employers and regularise their status. Others remained undocumented.

Shakirul Islam, OKUP's founding chairperson, told Waadaa the problem often begins with failures in recruitment and employment arrangements rather than deliberate violations by workers.

“A worker does not become undocumented when he leaves Bangladesh. He becomes undocumented after reaching the destination country,” he said.

An OKUP study involving approximately 1,084 migrant workers found that 43% had not received work permits after reaching their destinations, according to Shakirul.

Some eventually secured permits after spending substantial sums. Many others remained without legal status.

For Shakirul, it matters because Bangladesh's migration authorities had already approved the workers' departure.

“This is where the gap lies. The government needs to acknowledge that, whether because of flaws in the recruitment process or unethical recruitment practices, our workers are becoming undocumented after reaching their destination countries,” he told Waadaa.

He argued that BMET, which grants migration clearance, could not simply relinquish responsibility when workers subsequently lose their status.

“If a Bangladeshi worker becomes undocumented after going abroad, he or she should still have the right to receive services,” he said.

That includes access to benefits funded by contributions the workers made before leaving Bangladesh.

“Since they have paid the welfare fee to the Wage Earners' Welfare Board, they should be entitled to its benefits. This includes bringing their bodies back home after death and compensation for their families,” Shakirul said.

Bangladesh's mandatory migrant-worker insurance was introduced in 2019 and expanded in 2023.

Under the current arrangement, workers pay a one-time premium of 1,000 taka for five years of coverage.

The policy provides 10 lakh taka to the family of a worker who dies and up to 2 lakh taka for permanent or partial disability, including the loss of limbs or other body parts. Workers who lose their jobs or return home within six months under qualifying circumstances can receive 50,000 taka.

“If a worker loses a hand, finger or leg, we provide up to 2 lakh taka for the disability,” said Md Asaduzzaman, director general of the Wage Earners' Welfare Board. “In case of death, the family receives 10 lakh taka.”

But medical treatment is excluded.

“Medical insurance is a separate matter. It is not currently within our coverage,” Asaduzzaman told Waadaa. “Our insurance coverage is limited to these three categories.”

This distinction is consequential.

A worker who loses a limb may qualify for compensation. A worker suffering from an illness that requires expensive treatment may receive nothing from the scheme, even if the condition prevents him from working.

Employer-provided medical insurance can offer additional protection to workers in regular employment, depending on the destination country's rules and the terms of coverage. But when employment or immigration status becomes irregular, access to that protection may be disrupted.

Many like Rafiq have paid the price of migration, travelled thousands of miles for work and now find themselves unable to afford treatment for a fever.

The risks become more complicated when a worker dies.

When 16 Bangladeshis were killed in the Riyadh factory fire, the Wage Earners' Welfare Board began checking whether they had paid the mandatory premium and qualified for insurance compensation, Asaduzzaman said during an interview in early August.

The board also finances the repatriation of the bodies of registered migrant workers through its welfare resources, separate from the insurance policy.

But registration, documentation and communication between agencies can determine how quickly families receive assistance.

For Sheikh Jalil, an elderly father from Faridpur, these administrative questions have become a prolonged ordeal. His son, Sheikh Mostafa, had worked in Sharjah in the United Arab Emirates for about seven years before he died.

Jalil said he was initially informed that arrangements were being made to return his son's body to Bangladesh. He supplied identification documents and his telephone number.

Then the information became contradictory.

A colleague of Mostafa told the family that the body was no longer at the morgue. When Jalil contacted officials in Dhaka, he said he was told that the information was incorrect.

Months later, he still did not know whether his son's body remained in the UAE or had already been buried.

“One person says the body has been buried, another says it has not. I cannot reconcile these two pieces of information,” he told Waadaa.

He has been left trying to establish not only when his son will return, but whether a return is still possible.

“I just want my son's body back. I want to see him one last time,” he said.

Insurance exists. Getting paid is another matter.

Even when migrant workers qualify for compensation, receiving it can be a lengthy process.

Marina Sultana, research director at the Refugee and Migratory Movements Research Unit (RMMRU), said some workers in formal employment have insurance provided by employers, including protection against workplace accidents and death.

But the existence of coverage does not guarantee timely payment.

“The major problem with this insurance coverage is that, in many cases, there is no option to receive it instantly or quickly,” she told Waadaa.

The delays are substantial.

According to data reported by Bonik Barta, insurance claims worth approximately 69.73 crore taka involving 2,100 migrant workers and their families remained overdue as of June.

The claims included compensation for deceased workers, workers with disabilities and those who had returned home.

The newspaper also reported that the overall claim settlement rate through April stood at 56.11%.

The figures suggest that the problem extends beyond gaps in the policy itself. Even benefits formally promised to workers and their families are not consistently reaching them on time.

The Wage Earners' Welfare Board and state-owned Jiban Bima Corporation have attributed the delays to coordination and data-management problems.

Asaduzzaman told Bonik Barta that the two agencies were working to resolve the difficulties. But the timing of insurance payments can be as important as the amount.

A family that has lost its principal earner may need money immediately for food, rent, outstanding migration loans and children's education. Compensation arriving months later cannot necessarily prevent the debts and disruptions that accumulate in the meantime.

Marina said Bangladesh needed to strengthen BMET, the Welfare Board and the welfare wings of its diplomatic missions so that workers and their families could obtain insurance payments and legal assistance more efficiently.

“The policy exists, but how many workers are actually receiving the coverage? Are those who receive it getting it properly? How long does it take?” she said.

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