Over 1,000 Kenya Medical Research Institute (Kemri) employees and their 4,000 dependents are unable to get medical cover over Ksh43 million owed to Madison Insurance.
The stalemate has ensued for over four months now, with the employees and their dependents being forced to pay for their medical bills and demand refund from the employer.
Kemri inked a Ksh158 million medical insurance deal with Madison in 2020, despite having only budgeted for Ksh115 million.
The deal was a shocker to the employees, since they were used to National Health Insurance Fund (NHIF) cover which they say is better than the one being offered by Madison.
The Sunday Nation reports that Union of Kenya Civil Servants, said they were never consulted and that they had never complained about NHIF.
“We were getting comprehensive medical cover and even our families were getting treatment in the best hospitals in the country and even abroad only for the management to wake up one morning and stop the cover,” said a union official who sought anonymity.
The union tried to petition to Health CS Mutahi Kagwe to intervene before the contract was awarded to Madison, but the CS kept mum.
“We wish to appeal to you to intervene to ensure that Kemri does not contract a private insurer to offer medical services. Kindly note that the government through the Ministry of State for Public Service and Gender has signed a contract with NHIF to offer comprehensive cover to civil servants,” said the union in a letter dated August 24, 2020.
The tender attracted at least 18 bidders, with the evaluation committee consisting of the head of finance, head of procurement and corporation secretary, awarding Madison despite being one of the most expensive insurers, providing less.
The cover was however suspended on March 1, 2021, with employees being directed to seek treatment privately and seek for reimbursement.
“The management is in consultation with the insurer to resolve the issue. In the meantime, staff who need medical attention are advised to visit a facility of their choice for treatment at their own cost and subsequently claim reimbursement for the medical cost incurred. The claim should be accompanied by a copy of diagnosis, prescription and receipts submitted through the nearest Kemri Centre,” the management said.
According to Kemri director-general Samuel Kariuki NHIF’s cover ended in October 2019, but did not bid for this tender, which was advertised in the newspaper.
“The law does not require the management to seek for permission to advertise any services provided to the institute and this was also the case for this particular tender. It should be noted that management did not withdraw from NHIF but their contract lapsed and Kemri was under no obligation to renew NHIF but to follow the Public Procurement Process of sourcing for the services,” said Kariuki.