Senators have raised an alarm that, despite being covered
under the NYS insurance scheme, the affected families continue to languish
without compensation.
“I seek a statement from the Health Committee on a matter of
national concern regarding the delay by the defunct National Hospital Insurance
Fund scheme and its successor, the Social Health Authority, to settle claims
under the NYS insurance scheme,” Bungoma Senator David Wafula said.
The scheme, initially managed by NHIF, was taken over by SHA
after the health reforms.
However, Wafula said several NYS personnel and their
families remain unpaid, with claims amounting to Sh7.07 billion.
“Several personnel of NYS and their families have borne
untold suffering due to the failure by the defunct NHIF scheme and its
successor, SHA, to pay their claims amounting to Sh7.07 billion,” he said.
Wafula raised the matter on the floor of the House, where he
petitioned the Health Committee to probe the issue.
He said the arrears have accrued under Civil Servants and
National Youth Service enhanced group life, last experience, work injury
benefits and group personnel accident insurance scheme in the last four years.
According to the lawmaker, the National Treasury recently disbursed
Sh1.48 billion to SHA to facilitate part settlement of the claims.
However, SHA is yet to release these funds, worsening the situation
for beneficiaries.
In the probe, the committee is seeking to establish the steps
the Social Health Authority is taking to facilitate the prompt settlement of
the outstanding payments.
The claims include 1,004 deaths amounting to Sh4.21 billion;
1,026 funeral claims amounting to Sh207.3 million and 1,267 injury claims
amounting to Sh2,64 billion relating to NYS personnel.
“The committee should explain the inordinate delay by the
Social Health Authority to release the Sh1.48 billion disbursed by the National
Treasury for part settlement of the claims, including the timelines for the
same,” Wafula said.
Further, the panel will enquire whether SHA will factor
accrued interest when settling the outstanding claims and if so, provide
details on the applicable interest.
The authority will provide timelines for the full settlement
of all outstanding claims under the scheme.
The government has rolled out its first comprehensive
insurance cover for civil servants and the National Youth Service.
“The launch of the enhanced insurance cover with the
inclusion of Work Injury Benefits and Group Accident Cover will not only have a
profound impact on the well-being of civil servants and their families, enhance
public service motivation and productivity, but also boost the general growth
of our insurance industry,” the then Treasury CS Ukur Yatani said.
Under the new scheme, civil servants and employees of the
National Youth Service were entitled to a comprehensive insurance cover with a
total annual premium of Sh6.07billion per year.
INSTANT ANALYSIS
Following elaborate consultative meetings with relevant
stakeholders including the Public Service ministry among others, it was agreed
that in addition to enhancing the existing Group Personal Accident (GPA) cover
and Work Injury Benefits Act (WIBA) cover, the provisions be extended to
include a comprehensive Group Life cover to cater for all causes of death
including death arising from critical illnesses such as COVID-19. The
provisions were extended to all civil servants and employees of the National
Youth Service.
