13 March 2014

Kenya: CIC Insurance Moves to Cut Medical Fraud

CIC which yesterday announced a near flat pretax profit of Sh1.67 billion in 2013 from Sh1.65 recorded in 2012 said its claims for the year grew by 30 per cent driven largely by medical and private motor insurance payouts.

Its medical division made a loss of Sh293 million having taken up 26 per cent of the total claims paid out. Managing director Nelson Kuria said yesterday this class took "the lions share" of the claims last year followed by private motor and employee group life.

He said the company hopes to "significantly reduce" losses made by its medical business by appointing Dr. Edward Rukwaro to head the health insurance division.

"It takes a medical doctor to rein in on the others...sometimes they write their reports in their 'greek' terms that we as insurers are not aware of and end up inflating bills and taking patients through unnecessary procedures that add no value to the health of a patient but end up increasing the cost incurred," Kuria said yesterday after the company's investor briefing.

"Medical is a business that is notorious in this market. All players providing this cover face a challenge but by end of the year we expect to see a major turnaround in our medical business," added Kuria.

Rukwaro a University of Nairobi medical degree holder who also has a postgraduate diploma in life and healthcare insurance is not new to the industry having previously worked in management roles at AAR and Madison. He has also taught insurance and management at Strathmore University school of management.


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