Boniface Mwangi shows part of his injuries at a past demo. AAR Insurance had declined settling his medical claims
Cofek delegation will Wednesday 4 pm, meet with the top management of the Insurance Regulatory Authority (IRA) over a myriad issues which have combined to fuel a public uproar over the manner insurance firms have been conducting themselves.
Matters came to a head last week when AAR Insurance, like many others, declined at the eleventh hour to cover costs for medication of activist Boniface Mwangi. A public uproar forced the firm to eat a humble pie and settle the claims in full.
Before then, AAR insurance hired social media influencers to hit back at Mr Mwangi who enjoys over a million followers on Twitter and even Facebook.
AAR argued that Mr Mwangi's condition was "pre-existing" and couldn't therefore be covered. The Cofek team is keen to discuss with IRA about how well the measurement of "pre-existing" is realistic given that the newly covered consumers who take up covers only start being served after the third month.
The term pre-existing has been abused and has been used to defraud many insured people. Cancer, for instance, takes time to manifest itself in detectable form. To turn around and avoid taking responsibilities for such conditions unknown to the consumer is not only unlawful but a fraud on the Kenyan people.
It for the reason that Cofek wants to candidly discuss with IRA on how it can rein in on rogue and notorious insurance firms fleecing the public and major state corporations without remaining true to their basic responsibilities.
Cofek will further be keen to see mechanisms of accountability in the industry, fearing as we do, that the industry risks serious setbacks if it continues to punish their clientele.
On communication, insurance firms only communicate too late through hospitals giving patients almost no good time to arrange alternative financing options.
Cofek wants to equally have the IRA strategy on Information, Education and Communication reviewed. There is need for standardization and tailor-made consumer education across all Counties.
National Hospital Insurance Fund (NHIF) has failed to stop wastage which renders it incapable of competing graft-ridden insurance firms from the private sector. Well managed, NHIF presents the only and sure opportunity to arrest the collusion witnessed between private hospital doctors and insurance firms.
Cofek team will equally be keen to address the questionable billing by insurance firms, especially on outpatient cover, which often depletes the covers within a a few visits to hospitals.
The Cofek delegation will be led by Secretary General Mr Stephen Mutoro and will include among others Cofek lawyer, Ms Martha Karua.