What you need to know:
Allegations of fraud. The reinstated health service providers had been terminated last week over allegations of fraud.
Jubilee Insurance at the weekend took a U-turn and reinstated seven of the 23 medical insurance service providers whose services it had terminated last Tuesday.
The decision was communicated in emails to some of its clients pending further engagement with other affected medical insurance service providers.
In a notice issued to staff at one of Jubilee’s clients, a copy of which Daily Monitor has seen, the company told staff that: “We wish to advise you that Jubilee [our health service provider] has reinstated services at the undernoted health service providers,” one of the emails reads in part, naming some of the facilities as UMC Victoria Hospital, AAR Healthcare Clinics, Kampala Hospital, Kampala International Medical Centre, Marie Stopes, Bugolobi Medical Centre and Kampala Doctors Medical Centre.
The staff were also informed that Jubilee was still engaging the other services providers, whose services had been terminated with the hope that some will be considered and reinstated.
“They [Jubilee] are continuing to engage the rest of those facilities affected and shall keep updating from time to time in the course of the next few days [weeks],” the email reads.
Contacted for a comment, Mr Deepak Pandey, the Jubilee chief executive officer, told Daily Monitor at the weekend he was not in a position to comment because he was out of the country.
Mr Paul Kavuma, the Uganda Insurers Association chief executive officer, also declined to comment on the matter.
It was not immediately clear whether other insurance firms, which had also terminated services of some of the facilities, had reinstated them.
Medical insurance firms last week had terminated the services of about 30 health insurance providers following an investigation in which Uganda Insurers Association had claimed that some facilities had been involved in fraud.
The investigation, according to people familiar with the matter, had found that some medical insurance service providers were billing insurers over and above the service offered while others were billing for services not dispensed, conniving with patients to inflate bills and offering services to uncovered patients.
Uganda Insurers Association has not provided any indication whether it will prosecute facilities found to be involved in fraud.
Fraud in insurance
Insurance Regulatory Authority last year created an anti- insurance fraud unit in charge of investigating fraud in the sector.
A total of 102 cases were reported across all segments during 2018, with 34 involving forgery and issuing of fake policies, 32 motor related, 12 were third-party claims and 24 cases in respect to non-remittance of cash premiums by insurance agents.
Fifty eight cases were investigated and concluded while 20 are pending. Five are yet to be disposed of in court while 12 are before the Director of Public prosecution’s office for perusal. Seven are pending arrest of known and unknown accused subjects.
The unit in 2018 registered cases worth close to Shs3b which increased to Shs4.9b between January and September 2019 of which Shs64m came from the medical insurance class.