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Lawmakers yesterday demanded that the Sh53 billion medical cover for teachers be terminated for offering poor services.

The MPs who sit in the education committee regretted that the cover provided by Minet Insurance Brokers was not helping teachers because they were being required to pay from their own pocket following the capping of their cover at Sh1,500.

In a meeting with Minet officials, led by Chief Executive Officer Sammy Muthui, the MPs narrated harrowing stories of how teachers had been left to die after being denied medical services while in other cases they had been forced to remain in hospital longer without being discharged due failure by the insurance company to clear bills.

The committee members led by the Chairperson and Tinderet MP Julius Melly claimed that on a daily basis, they receive complaints from teachers claiming to have been turned away by hospitals whenever they produce the Minet card.

“We want to stand you down to allow you to go back and come back to us on December 5 when you are adequately prepared. During this meeting please come and tell us why we should not terminate this contract at all because it is clear teachers are on their own,” Melly said, adding, “Why are you subjecting teachers to this harrowing process. Many of the hospitals are turning them away. This is very sad.”

The committee further regretted that the cover is indeed bad for teachers as they are forced to co-pay Sh 100 per outpatient visits.

They alleged that out of the Sh100 that they co-pay the insurance, the service provider ends up pocketing Sh300 million from approximately 3million visits that teachers make to the hospitals yearly.
Added Melly, “You have come here and told us that you suspended this Sh100 that teachers are required to pay but this is not the case on the ground things are different.”

And MPs Contributing to the matter, MPs Peter Orero (Kibra), Nabii Nabwera (Lugari), Anne Muratha (Kiambu County Woman Representative), Clive Ombane (Kitutu Masaba) and Timothy Toroitich (Marakwet West) said there is need to save teachers from further suffering by terminating the said cover.

Orero narrated how despite being a teacher, he and his family suffered in the hands of the cover and thus said there is need to terminate it to allow the Teachers Service Commission (TSC) to source for another provider.

Service provider

“I am the immediate teacher who suffered because of this cover. My family also refused to be included as beneficiaries because of what they saw me going through. Mr CEO please provide a list of where we can get a service provider for this cover because it seems that teachers are not human.” He added: “I think we should terminate this contract as MPs because you (Minet) are doing a disservice to our teachers,” said the Kibra MP, a former classroom teacher.”

Nabwera told the committee members how one teacher last week was denied laboratory services after the doctor informed him that he had only a limit of Sh1,500 out of which 500 was for consultation and the rest for medication. “I want the CEO to come here and convince me why this cover should continue being in existence. We need to terminate it.”

Muratha sought to know where the facilities listed by the insurance broker are available as none of them is known to teachers.

She said: “What hospitals are these in Kiambu County, if I as the MP cannot trace them, then what about our teachers? Mr CEO please tell us which criteria you used to settle on these service providers.”
Marakwet West MP Timothy Toroitich demanded that the insurer be made to account for the Sh100 co-pay paid by teachers when they visit hospitals.

Suffering teachers

Said Toroitich: “Teachers are suffering, we should be told where Sh300 million a year from co-pay go to and how much has this been over the years,” Toroitich said.

CEO Muthui, although admitting that there were delays in rendering services, he said this was due to the strict measures they have put in place to comb through documents provided by the insurance company whenever a teacher is admitted in hospital.

He claimed that this was occasioned by the fact that the insurance firm had detected fraud cases while in other instances there were cases of impersonation as well as instances where there was billing of non-treated patients.

He also explained that lack of full disclosure by doctors whenever they send pre-authorisation forms to them, delays in the submission of documents from radiology department has also been the reason behind the delays.

He said, “Yes indeed there are delays sometimes but this is because of various reasons. But this delay has only affected five per cent of the teachers.”

On the Sh100 that teachers’ co-pay he said this was abolished from July 1.