The Insurance Regulation Authority (IRA) has announced after deliberations with Kenyan insurance firms that they have agreed to cover coronavirus patients barely a day after they had announced that they would not.
In a statement released on their social media pages on Friday, March 13, the IRA moved to allay the fear that policyholders would not be covered after the World Health Organization (WHO) declared Coronavirus a pandemic.
“Following engagement with the insurance companies, Commissioner of Insurance Godfrey Kiptum would like to assure the public that the insurers will continue to provide their services to policyholders affected or infected with the virus.
Earlier in the day, many insurance firms in the country were not sure of what stand to take since the international medical policy indicates that pandemics are not covered since the costs are unsustainable to the insurance firms.
A health practitioner in protective gear at Coronavirus treatment and isolation facility in Mbagathi District Hospital, Nairobi on Friday, March 6, 2020.
A spot check at three major insurance firms across the country informed kenyagist.com on Friday, March 13, that many companies in the country were holding an ambiguous stand even as the first case of coronavirus was reported in Kenya.
“Generally, that is a standard that pandemics are not covered under medical policies, but for this insurance, we will issue a formal communication to our clients on the organization’s stand, but at the moment we’re yet to decide the exact step we’ll take,” a senior manager in one of the firms stated.
Tongaren Member of Parliament Eseli Simiyu, a medical doctor who also sits in the National Assembly Committee on Health, told this reporter that the stand by insurance firms was within the law only if the firms had indicated in their agreements that they wouldn’t cover such eventualities.
For NHIF, however, he was not exactly sure of the stand, but explained that since it was a government organ, there was a chance that it would cover such eventualities.
“NHIF is not an insurance firm. It is a not-for-profit so I believe that it will cover if such an event occurs, but for the insurance companies, they can only escape covering if they included it in the contract. But if it was not there in the policy that you signed, they cannot include it later.
“If they did not include it there, then they are well within the law not to cover it. Insurance firms are what people joke that they give you an umbrella when the sun is shining and withdraw it when it starts raining,” Eseli stated.
NHIF CEO Nicodemus Odongo told kenyagist.com on Thursday, March 3, that while he had not been initially aware of the sentiments by the private insurers, the NHIF would continue operating on its existing structures and parameters.
National Hospital Insurance Fund (NHIF) acting Chief Executive Officer Nicodemus Odongo speaking before the National Assembly Public Investments Committee on October 15, 2019.
“We cover people depending on the benefit structure that we have. We cover the ailments that are treatable in hospitals. It is in the hospitals where our members go and get treated and then they send us the bills and we pay.
“We are not a private insurance and I do not know their stand and for whatever reason, so I can only speak for the NHIF, that we cover all members for ailments when they are treated in hospitals contracted by NHIF,” he stated.
Odongo’s sentiments were echoed by Likuyani MP Enoch Wamalwa, a medical doctor who also sits in the National Assembly Committee for Finance and National Planning who also indicated that he was not aware of the move by private insurers.
“NHIF will continue covering those diseases. I have not heard them say anywhere they have said that they will not cover people with Coronavirus. That is the body under which a majority of Kenyans are covered as compared to private insurance,” he stated.