Minet Health Insurer Sued by Teachers Over Poor Services
Minet Health Insurer Sued by Teachers Over Poor Services. Details of the multibillion-shilling teachers’ health insurance coverage have come to light in response to the filing of a lawsuit by some educators who contend that the treatments are of subpar quality and that they do not receive value for their money.
The teachers are now seeking that Minet Kenya Insurance Brokers Limited be forced to make sure that the major service provider provides excellent services commensurate with the Sh51,400,000,000 given to it.
Teachers claim that the Teachers Service Commission (TSC) awarded Sh60 million to a “ghost” company for actuarial services without conducting a competitive tendering process.
The master capitator, Bliss Health Care Services, received Sh51.4 billion of the total Sh53 billion contract value between Minet and TSC.
The teachers, lead by Mathai Boniface Ndirangu, provided Justice Bernard Odongo Manani Matanga with a tabulation of the three-year contract between TSC and Minet outlining how the Sh51 billion will be used by Bliss.
The petitioners name TSC and Minet Kenya as respondents.
Bliss has set aside Sh32 billion for outpatient treatment, Sh13.6 billion for inpatient care, Sh2.07 billion for maternity care, Sh1.3 billion for dental care, Sh2.2 million for ophthalmology care, and Sh179 million for evacuation services under the terms of the three-year contract.
Minet has opposed to the petition, claiming that there is no employer-employee relationship between the business and the teachers that would allow the company to sue the teachers in the employment court.
The teachers contend that since Minet and their employer, TSC, entered into a contract, the teachers have the authority to bring charges against Minet.
They’ve let Justice Matanga know that the Constitutional Court, which deals with rights problems, has properly sent the case to him.
So there is no reason why teachers should be turned away or required to top-up by a medical administrator hired by Bliss, the petitioners claim.
Teachers receive unlimited in-patient and out-patient coverage, although they must pay a Sh100 co-pay before accessing treatments.
The court has been informed that TSC pays a business they believe to be dishonest Sh20 million annually for actuarial services.
Teachers would spend Sh3 billion of the contractual Sh53 billion on a system to identify them when they receive treatment at Bliss hospitals, they add, and the Sh60 million allotted for the services might be used to issue job and medical cards to them.
Employee badges are absent for teachers. In order to ensure that they are not turned away from hospitals, the irate teachers assert that Minet employed Medical Administrators (K) Limited (MAKL).
Mr. Mathai asserts that he was recently denied medical care at Guru Nanak Hospital on the grounds that his identity had not been verified, nevertheless. Furthermore, it has been disclosed to the court that MAKL and Bliss are “one and the same in terms of ownership, yet they are paid separately.”
The inclusion of Star Discover Insurance Limited and Star Discover Life Insurance as bidders for the Sh53 billion offer when they were under six months old and without the essential competence to compete on public contracts has also been charged by teachers as a violation of Article 277 (1) by TSC.