Hardly a day after Nairobi Hospital had dropped Jubilee Insurance from its list of cover providers following outstanding claims dating back to 2018, the insurer has come out accusing the hospital for inflating patients’ bills.
In a letter to Jubilee Insurance Group CEO Julius Kipng’etich, the Nairobi Hospital said the listed firm was yet to pay Sh 357million accumulated over a three-year period.
Reacting to being dropped by hospital from its list of cover providers, Jubilee in a statement said the dispute arose from failure of the hospital to justify certain client bills.
“This is as a result of a dispute arising from the failure by the hospital to provide justification for some bills adding up to about KES 80million, compared to an approximate business of KES 1billion per year,” read part of the statement.
The insurer has pointed an accusing finger at Nairobi Hospital for declining to help solve the situation by providing relevant documentation to enable the Jubilee to settle the outstanding claims. “We have been keen to resolve this impasse with the hospital who unfortunately have not been forthcoming with the information required to reach an amicable closure.”
The health insurer has said that it was incumbent on them to ensure that no doctored claims are paid and the integrity of the company is upheld at all times.
“As a trusted insurance company, it is our paramount responsibility to ensure that client resources are safeguarded and utilised appropriately and that our customers receive value for their money. We further wish to state that transparency in billing is vital to ensure that all Clients’ funds entrusted to us are aptly and prudently utilized. Towards this, we remain vigilant and accountable to our esteemed clients.”
Hospitals have in the recent past been accused of falsifying claims and inflating the costs of drugs prescribed by doctors, a move that has rendered many medical cover providers to register losses.
In February this year, Nairobi Women’s Hospital was accused of among other, inflating client bills, admitting and detaining patients unnecessarily just to hit financial targets. This led to several health insurers suspending their services with the hospital on February 5th, 2020.