The Teachers Service Commission said 12 teachers’ requests to stop signing health insurance contracts since the new contract came into force on December 1, 2022 have been rejected.
The contract with Minet Kenya Insurance Brokers Limited to provide health insurance to more than 341,000 teachers employed by TSC and thousands of others to be employed will continue from December 1, 2022, according to documents filed in court by Human Resources Director Julius Olayo. . Resource management and development at TSC.
It cost Sh53.3 billion with a value of Sh27 billion.
About 359 health facilities across the country have provided medical services under contract.
Dr. Olayo argued that the petitioners should seek correction from the Procurement Board. “The prayer to set aside the execution of the contract between TSC and Minet and declare the procurement proceedings null and void is not only incidental but within the jurisdiction of the court,” he said.
Dr. Olayo said TSC will send $14.9 billion to Mineta in its first year. In the second tranche, $17.9 billion will be wired to insurers. The last batch of Sh20.6 billion will be handed over to Minet.
Sh53.3 billion cover
Responding to the request, Dr Olayo explained, “Sh53.3 billion for 341,847 teachers and their dependents to cover outpatient, hospitalization, dental, optical, funeral expenses, air and road evacuation, international travel and referral and victim services. teachers on quality of service which is provided by
However, the commission work experience since 2019 is not included in the plan.
Dr Olayo and Bliss Health Care Limited, Medical Managers Ltd, Old Mutual General Insurance Ltd, Britam General Insurance, CIC General Insurance, Star Discover Insurance Limited, TSC and other consortium members. Pioneer Assurance Company Ltd and Star Discover Life Insurance Ltd.
The TSC said it could not fully support the scheme by paying the premiums set out in the Insurance Act due to the budget allocation for medical insurance from the National Assembly.
Therefore, the allocated funds are directed towards providing basic medical services, rather than buying smart cards with potential financial costs.
“The main purpose of the smart card is to make it easier to identify the members,” said Dr Olayo.
The teachers complained that they were asked to send text messages to Minet to verify their identities before receiving treatment. They asked the court to compel Minet to supply the smart card.
The plaintiffs say they are forced to finance their treatment, but Minete is paid billions of dollars to provide services.
To avoid abuse of the health scheme, TSC negotiated a Sh100 co-pay for outpatient visits. TSC says health services have improved under the new contract.
Through its CEO, Edwin Kegode, Minet has opposed the cancellation of the multi-billion dollar health insurance contract.
Kegode said that Minet had difficulties in checking and identifying patients through messages sent.
Greatly prejudiced
“More than a million people are covered under this scheme and there may have been some complications in the previous contract,” Kegode said.
Minet’s lawyer, Wilson Mwihuri, objected to the 12 teachers being represented by more than one lawyer, saying chaos and confusion would ensue.
“If the petitioners are represented by several counsels, the problem will suffer a lot because the claim can lead to chaos and confusion,” said Mwihuri.
He argued that this was an academic exercise because the New Deal was flawed.
However, Justice Matanga gave the teachers 10 days from December 15, 2022 to present evidence in response to the issues raised by TSC and Minet. The court adjourned the hearing to January 17, 2023.
The 12 teachers who filed the petition were suspended and fired by the Kenya National Union of Teachers for suing their employer.
The union is not involved in the litigation.