EACC Unearths Ksh40Million Medical Insurance Scam

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EACC Unearths Ksh40Million Medical Insurance Scam

A photo of the EACC headquarters, at Integrity House in Nairobi.

The Ethics and Anti-Corruption Commission(EACC) has arrested the Human Resource Manager of the Kenya Maritime Authority (KMA) over medical insurance fraud.

According to EACC, the HRM was arrested over allegations of corruption involving a Ksh40,539,760 tender for the provision of staff medical cover.

The HR officer was arrested in an operation that also targeted two insurance brokers believed to have participated in the insurance hoax.

The culprit is said to have worked in cahoots with the Head of Supply Chain Management in the same company to fraudulently award the medical insurance tender to an illegal insurance agency.

An insurance police form

Spectacles placed on top of an insurance claiming form.
Photo
IRA

“The HRM who serves as the Assistant Director in charge of HRM at KMA is accused of colluding with his counterpart Head of Supply Chain Management at KMA to fraudulently award the medical insurance tender to an insurance agency outside the law,” the report by the commission revealed.

Investigations on the company began on September 30, 2024, after the court received a complaint that the company officials had corruptly and irregularly awarded the tender.

After the complaint, the court ordered EACC to investigate the matter.

Following the court orders, EACC investigated the matter and yielded valuable evidentiary material that it says will support the ongoing investigation.

The EACC has established that some staff are taking advantage of medical insurance to scam companies and employees, forcing the commission to tighten the loopholes.

“The Commission has intensified focus on the procurement of staff medical insurance in public institutions, which some officials use as conduits for embezzlement of public funds through bid rigging and kickbacks,” the commission revealed.

A survey by the Association of Kenya Insurance conducted in 2013 revealed that fraud and abuse are widespread and very costly to Kenya’s healthcare system.

The premium in medical business has been increasing but the business continues to make losses, a situation attributed to medical insurance fraud.

Police placing a suspect in handcuffs during an arrest

Police placing a suspect in handcuffs during an arrest
Photo
NPS

Source: kENYANS.CO.KE

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