A group of teachers has dragged their employer and a health insurer to court for allegedly denying them access to quality medical services and now want the signing of a new medical insurance scheme halted.
The simmering row over the largest medical insurance cover in the country ended up in court after several teachers were allegedly denied services following new directions to hospitals under the scheme.
The 12 teachers from public schools within Nairobi County on Friday last week obtained orders by Employment and Labour Relations Court (ELRC) judge Nzioki wa Makau to serve the Teachers Service Commission (TSC) and Minet Kenya Insurance Brokers Limited with the suit application. He also ordered an inter-parties hearing for Thursday this week.
The teachers are challenging the decision by the TSC to award a three-year medical insurance tender worth Sh35 billion to Minet Kenya Insurance Brokers Limited. They alleged that the tender was awarded before their opinions were sought, either through their trade union, Kenya National Union of Teachers (Knut), or direct communication to them through their mobile phones.
They have, therefore, sought an order from the ELRC to stop the implementation of a contract signed on November 1, 2022 between the TSC and Minet (formerly Aon Kenya Insurance Brokers) on grounds teachers are not getting quality medical services. The medical scheme has more than 346,000 teachers and over 800,000 beneficiaries.
As a consequence, Justice wa Makau certified the suit urgent and directed the teachers’ lawyer, Pauline Kiteng’e, to serve TSC and Minet with the pleadings. He declined to grant any interim orders “as to do so would jeopardise the health of teachers countrywide”.
The teachers claim they have encountered problems with new directives by Minet as teachers with broken or without functional mobile phones to receive a One-Time-Pin (OTP) are being denied treatment at hospitals contracted by the insurer.
In the lawsuit filed at the High Court in Milimani Nairobi, the 12 teachers, including union leaders, claim that the use of mobile phone messages to authenticate their personal identification instead of medical cards, has deprived them of the right to access the highest attainable standards of health.
They say the identification method has in extension threatened their lives and those of their dependants because even in emergency medical cases, hospitals insist on use of the SMS. As a result, they have resorted to cash payments although the money for the medical insurance cover is deducted from their salaries monthly.
“The petitioners’ right to emergency treatment and to highest attainable standards of health has been infringed by Minet’s directive to hospitals listed in its medical cover not to treat them and thousands of other teachers or their dependants without a functional phone. The directive has seen the petitioners denied treatment even in emergency cases,” says Ms Kiteng’e in court papers.
In an affidavit by Mr Mathai Boniface Ndirangu on behalf of the petitioners, it is alleged that leaders of teachers unions have received numerous complaints concerning challenges, humiliation and frustrations when seeking medical services under the scheme.
He claims that in some recent incidences, eight teachers had at different times been denied medical services after their phones went off before they received the OTP message. Mr Ndirangu says two other teachers complained that they had been denied medical services because their phones had cracked screens which made it difficult to read the OTP messages.
He says that three other teachers were not treated because their phones were unresponsive, hence could not receive the OTP message while four others were unable to receive the message because their phones lost network coverage.
Mr Ndirangu says that two teachers complained that they were blocked because they had lost their phone on their way to the hospital and three others presented police abstracts to show that they had just lost their phones.
“Different facilities demand different amounts in cash ranging between Sh50 to Sh2,000 from us or our dependants to be attended to yet the medical cover is comprehensive and if we did not have, we were not attended to,” says Mr Ndirangu.
The petitioners claim that TSC should have involved them before renewing its contract with the insurance company.
“Before the award of the said contract is done, the TSC is obligated under the law to consult with the teachers either through their representatives at the Kenya National Union of Teachers (Knut) who in turn consult us or through a circular and views taken into consideration before it issues the letter of award,” says Mr Ndirangu.
The suit is pending hearing directions at the ELRC.