Medical claims raise payout by Sh1bn

Association of Kenya Insurers executive director Tom Gichuhi and board member Catherine Igathe during the release of a report on August 30. PHOTO | SALATON NJAU | NMG

What you need to know:

  • Insurance Regulatory Authority (IRA) industry release for Q2 2018 shows that claims amounted to Sh29.20 billion up from Sh28.62 billion reported during the same period in 2017.
  • Medical insurance, motor private and motor commercial were the largest contributors to the claims incurred with each accounting for 33.6 per cent, 24.8 per cent and 24.4 per cent respectively.
  • In medical insurance, a recent Ethics and Anti-Corruption Commission (EACC) revealed that there is widespread variation in what different hospitals charge for the same medical procedures.
  • The EACC report showed patients using insurance cards are charged up to 50 times more than those paying in cash for the same procedure at the same health facility.

Claims in the medical, motor private and motor commercial segments of general insurance rose nearly Sh1 billion to raise overall claims insurers incurred 2.03 per cent during the second quarter.

Insurance Regulatory Authority (IRA) industry release for Q2 2018 shows that claims amounted to Sh29.20 billion up from Sh28.62 billion reported during the same period in 2017.

Medical insurance, motor private and motor commercial were the largest contributors to the claims incurred with each accounting for 33.6 per cent, 24.8 per cent and 24.4 per cent respectively.

“The corresponding loss ratio was of 65.3 per cent during this period compared with 63.5 per cent recorded in the previous year,” the IRA report shows.

Losses in the motor private and motor commercial classes of business have been attributed to rampant fraud by motor vehicle owners and their associates including agents and garage owners.

In medical insurance, a recent Ethics and Anti-Corruption Commission (EACC) revealed that there is widespread variation in what different hospitals charge for the same medical procedures.

The EACC report showed patients using insurance cards are charged up to 50 times more than those paying in cash for the same procedure at the same health facility.

The report also shows paid claims rose 12.64 per cent to Sh27.71 billion from Sh24.60 billion recorded during a similar period in 2017.

The medical, motor private and motor commercial classes had the highest amounts of paid claims at 35.3 per cent, 23.4 per cent and 22.5 per cent respectively of the total industry under general insurance business.

Further, premiums underwritten increased by 3.06 per cent to Sh112.38 billion from Sh109.04 billion recorded during a similar period in 2017.

This was attributed to a 4.5 per cent growth in general business and 0.7 per cent rise in life business.

The increase in general business was mainly contributed to by medical and motor private insurance classes of business which increased by Sh1.24 billion and Sh824.39 million respectively.

Top six insurers in market share were Jubilee (9.3 per cent), APA (7.7 per cent), CIC General (7.6 per cent), UAP (7.0 per cent), Britam (6.3 per cent), and AAR (5.3 per cent). Others occupied the remaining 56.9 per cent.