Insurers pull plug on hospital as billing row boils over

All private health insurers have suspended services with Nairobi Women’s Hospital in the wake of allegations of cost inflation at the facility.

The Association of Kenya Insurers (AKI) said yesterday the indefinite suspension would remain as a “thorough review” on quality and costs of the hospital’s services is conducted.

“All medical insurers have from February 5, 2020 suspended Nairobi Women’s Hospital from their list of accredited service providers. This follows recent accusations made in the media against the institution,” said AKI in a statement.

The regulator said the suspension would not affect insured customers already admitted to the hospital. “Billing and settlement of expenses incurred by these customers will not be affected,” said AKI.

The move followed a meeting between AKI and the Chief Executives of the insurance companies on Monday where it was “noted that there are several administrative issues concerning the hospital which disadvantage insured customers.” “This is contrary to the interest of medical insurers which is to ensure that customers get the best services at competitive rates,” said AKI.

“The medical environment has many players, including doctors, pharmacists, laboratories, imaging services, among others. For medical insurance to make sense, each of these players has to give the best service at the most reasonable rates. This is, however, far from the reality on the ground.” By yesterday, at least seven insurance companies had withdrawn their services. They include Jubilee, Britam, UAP, AAR, APA, CIC and GA Insurance. The insurers, however, did not specify the length of the suspension.

“Due to some administrative concerns, we wish to notify you that services at the Nairobi Women’s Hospital will be suspended effective February 5. As we work towards the concerns, you may continue to access services from any of our accredited providers,” said CIC in a notice to its clients signed by General Manager Medical Division Kang’e McDonald.

The hospital on Monday said it was conducting an internal review on the allegations along with an independent one by the Kenya Medical Practitioners and Dentist Council.