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NHIF on the spot over dead officers’ payout

Monday, June 7th, 2021 00:00 | By
National Hospital Insurance Fund headquarters in Upper Hill, Nairobi. Photo/File

The National Hospital Insurance Fund (NHIF) is on the spot for failing to compensate families of 300 deceased police officers and prison warders.

And as families of the deceased officers continue languishing in poverty, the health insurer is unable to account for Sh1.7 billion that had been set aside for Group Life Insurance cover for the National Police Service (NPS) and Kenya Prisons Service.

Data from NPS and KPS indicates at least 300 officers have died since inception of the cover and their dependents are yet to be compensated.

With the 2020/21 financial year coming to a close, the families, through Inspector General of Police Hillary Mutyambai have written a protest letter to NHIF and the ministries of Health and Treasury over the money. The contract is expected to lapse at the end of July.

The stand-off has roped in the Directorate of Criminal Investigations (DCI) that is now mulling summoning the NHIF management, with a view to opening investigations into the disappearance of the funds.

Though DCI boss George Kinoti declined to comment on the issue, sources in his office said NHIF bosses could be summoned to record statements as early as this week.

Seeks intervention

“Please note that NHIF has not compensated any of the deceased officers who have passed on in the line of duty, thereby causing serious suffering to beneficiaries,” a letter from Mutyambai to NHIF dated June 4, states.

The police boss further complains that efforts by NPS and KPS to meeting the NHIF management over the issue had been futile with the latter taking them round in circles.

Consequently, Mutyambai’s office has sought intervention of the Principal Secretary in the Interior Ministry over the matter.

Revelations about disappearance of Sh1.7 billion meant for the officers’ Group Life Insurance cover comes days after a parliamentary committee summoned the NHIF management to explain why it had not refunded Sh200 million meant for police insurance to the ministry as required by law.

The Public Accounts Committee (PAC) of the National Assembly wants NHIF chief executive Peter Kamunyo, to explain why the refund has taken long.

The delay was flagged by Auditor-General Nancy Gathungu in her report on accounts of the Interior ministry for the 2018/19 financial year.

Interior Principal Secretary Karanja Kibicho, while appearing before the committee last month over the ministry’s audit queries, said efforts to have the money recovered from NHIF had hit a brick wall.

The Sh200 million is in addition to Sh4.79 billion for a comprehensive medical insurance cover awarded to NHIF on September 26, 2017, to cushion members of the National Police Service who might exhaust their limits.

The insurance cover was for a two-year period – from October 1, 2017, to September 30, 2019.

Last week, while appearing before PAC, Kamunyo could not explain the whereabouts of the funds nor provide the breakdown of how it was expended if indeed some officers exceeded their cover limits.

Kamunyo, who was turned away by the committee to get the required information together with proof of payments, had claimed that the money had been spent and that there was a balance of Sh5 million.

And on the latest report on the Sh 1.7 billion, questions have emerged over the manner in which the contract was awarded and expedited for implementation without following due process.

“The officers were neither consulted nor involved in the entire process other than being required to rubber-stamp the tender,” a senior officer privy to the process told People Daily.

NHIF was first drawn into the Group Life Insurance cover for the officers some times last year when Interior Cabinet Secretary Fred Matiang’i chided Pioneer Insurance Company, that then offered the services, for poor performance.

Speaking during a memorial service for fallen police officers at the National Police Service Training College in December, Matiang’i said the move was  part of the President’s desire to accord genuine recognition and appreciation to the honourable services and selfless sacrifices of police officers.

The CS then announced that the government had decided to hand over the scheme to NHIF as part of a government–to-government arrangement.

Firm instructions

Further, the CS said they were under firm instructions from the President to establish a modern facility at Police headquarters before the end of January 2021.

The facility was to look at aspects of welfare including payment of gratuity and pension benefits to police officers, even when they exit through natural attrition. But all these are said to have remained mere verbal pronouncements.

Soon after Matiang’i’s derision of Pioneer, the tender was hurried through without being advertised and even being subjected to the Insurance Regulatory Authority (IRA) as is required by law.

“NHIF was brought on board through single sourcing and exempted from being subjected to IRA scrutiny through a special gazette notice,” a senior officer said.

Officers complain that whereas Pioneer used to compensate deceased officers and their dependents by calculating one’s salary for five years, NHIF reduced the amount by paying for only one year.

Despite using shortcuts to get awarded the tender, the government enhanced the premium paid to NHIF from that previously given to Pioneer.

And while complaints against Pioneer were that compensations were delayed by about one month, NHIF has not paid a cent since the contact came into conception in January. 

“In the beginning the scheme was shrouded with many challenges. The telephone numbers given were not functional, forcing the affected families to travel from far flung areas to NHIF offices seeking money that was not forthcoming,” said another officer.

Yesterday, NHIF boss Kamunyo was non-committal when asked when the national insurer was likely to settle the matter.

“There are some little hiccups surrounding the scheme that we are sorting within the government. It is not such a big matter as you people would like it to appear,” Kamunyo stated when contacted.

But even as NHIF downplayed the issue, officers claim families of their colleagues who have died in the line of duty have now been forced to fund raise to meet their daily needs as the national health insurer sits on their claims.

“Many families have had their children drop out of schools due to lack of fees. Many have been kicked of their houses for failing to pay rent while hundreds of others are living in misery due to this NHIF monster,” said another officer.

The officers are also complaining over the NHIF medical scheme, which they claim that whereas in the contract it is said to be limitless for outpatients, the officers are only limited to Sh1,500 per visit.

And officers with chronic ailments are only limited to supply of drugs for only three months, subjecting them to suffering for the rest of the nine months of the year.

NHIF has also identified a few health facilities in Nairobi where officers infected with Covid-19 can be treated, leaving out the majority that serve outside.

“And this information has not been given to officers before hand. They only learnt of it when they have been admitted that NHIF disowns the facilities,” said another officer.

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