MCAs cry foul over assembly's Sh25 million health insurance scheme

Members of County Assembly (MCAs) and other members of staff are up in arms over the assembly’s health insurance scheme which they say are unable to access.

The County Assembly Service Board (CASB) which is chaired by the speaker Stephen Ndicho signed the contract with Trident Insurance Company Limited last year paving the way for the health insurance scheme.

CASB in September last year entered in to a contract with the insurance company to provide medical cover for the MCAs at a cost of Sh25.4 million.

The health insurance scheme cover is for the assembly’s 92 ward representatives (60 elected and 32 nominated) and other members of the staff.

The MCAs and other members of the staff are unhappy that despite such colossal of amount money being paid, they are unable to access treatment in hospitals using the medical scheme.

In correspondences between a section of MCAs and CASB seen by the Standard, members are unhappy with the health insurance scheme contracted to Trident Insurance Company Limited.

In one of the complaint letter written by Nominated MCA Yvonne Wanjiku Waweru and seen by the Standard, the ward rep indicates she has been having difficulties in accessing medical services in many hospitals despite having the medical card.

“As a beneficiary of the County assembly of Kiambu medical scheme contracted to Trident Insurance Company Limited (Member no KCA/21512/1), I have been having several difficulties in accessing medical services in many hospitals (including consultants) listed by the said company as the services providers under the scheme,” reads part of the letter.

The MCA in the letter alleged that the medical card was being rejected by many hospitals and doctors therefore forcing her to pay for services using her own funds despite being covered under the scheme and the card being suspended for use in several hospitals.

“The problems have been recurrent since October 2017 and has been a big hindrance to my right to access health care, if and when needed and within reasonable timeframes without any delays,’ reads the letter.

The letter also indicates the insurer in a meeting with the MCAs held in Naivasha in January 2018, assured members that the problem had been solved and assured them that payments which they had made to hospitals due the inconveniences would be settled in full within seven days.

Despite the promise by the insurer, the Ward rep however claims in the letter that she has never received any reimbursement for money she had paid to hospitals in several visits made from October 2017 to February 2018.

Several MCA who spoke to the Standard also claimed on visiting various hospitals, they were being informed that the medical cards have been suspended due to administrative issues.

The assembly through Waithaka & Associates Advocates on March 9, 2017 wrote to the insurance company seeking explanation over the rejection of the smart cards by health care providers.

“Take notice that we have been instructed to demand that you immediately issue an unqualified apology to our client for the embarrassment of the Members of Kiambu County Assembly and the staff for the rejection of the smart cards by health care providers,” reads part of the letter.

In the letter, the assembly also wants the insurance company to set out in writing the reasons for the rejection of the smart cards and well as the reasons for their inability to comply the contract.

In addition, the assembly also wants the company to confirm in writing whether hitches in provision of the medical cover have now been resolved and whether it has the capacity to continue providing the insurance services as per the contract for the remaining contract period.

When contacted for a comment, the company said it was not aware of the complaints by the county assembly.