TSC, Minet Sued Over Teachers’ Poor Medical Services.
A group of teachers has filed a lawsuit against their employer and a health insurer, claiming they are keeping them from getting good medical care.
They now seek to halt the implementation of a new medical insurance plan.
Several teachers were allegedly denied services due to the scheme’s new directives to hospitals, which brought the simmering dispute over the nation’s largest medical insurance plan to court.
Judge Nzioki wa Makau of the Employment and Labour Relations Court (ELRC) granted the teachers’ request to serve the Teachers Service Commission (TSC) and Minet Kenya Insurance Brokers Limited with the suit application on Friday of last week. He also scheduled an inter-party hearing for this week’s Thursday.
The teachers contest the TSC’s decision to award Minet Kenya Insurance Brokers Limited a three-year Sh35 billion medical insurance contract.
They claimed that the contract was awarded before their input was solicited, either through their trade union, the Kenya National Union of Teachers (Knut) or through direct mobile phone contact.
So, they have asked the ELRC to stop a contract between the TSC and Minet (formerly Aon Kenya Insurance Brokers) from going into effect on November 1, 2022, because teachers are not getting good medical care.
The medical plan has over 346 thousand teachers and over 800 thousand beneficiaries.
As a result, Justice wa Makau deemed the case urgent and ordered Pauline Kiteng’e, the attorney for the teachers, to serve TSC and Minet with the pleadings. He refused to issue any interim orders “because doing so would endanger the health of teachers across the nation.”
The teachers claim they have encountered issues with Minet’s new directives.
Those without a functional mobile phone to receive a One-Time-Pin (OTP) are denied treatment at insurer-contracted hospitals.
In a lawsuit filed at the High Court in Milimani, Nairobi, twelve teachers, including union leaders, assert that using mobile phone messages to authenticate their personal identification rather than medical cards has deprived them of the right to the highest achievable health standards.
They claim that the identification method has threatened their lives and dependents’ lives because hospitals insist on using the SMS even in emergency medical situations.
As a result, they have resorted to cash payments, although their monthly salaries are deducted for medical insurance coverage.
“The petitioners’ right to emergency treatment and the highest achievable health standards has been violated by Minet’s directive to hospitals listed in its medical coverage not to treat them and thousands of other teachers or their dependents without a working phone. The directive has resulted in the petitioners being denied treatment, even in emergency situations, according to court documents filed by Ms. Kiteng’e.
In an affidavit filed on behalf of the petitioners by Mr. Mathai Boniface Ndirangu, it is alleged that leaders of teachers’ unions have received numerous complaints regarding difficulties, humiliation, and frustrations in obtaining medical services under the scheme.
In some recent cases, he claims that eight teachers were denied medical services because their phones went off before they received the OTP message.
Mr. Ndirangu states that two other teachers complained that they were denied medical services because the cracked screens of their mobile devices made it difficult to read the OTP messages.
According to him, three additional teachers were not treated because their phones were unresponsive and, therefore, unable to receive the OTP message.
In contrast, four others could not receive the message because their phones lost network coverage.
Mr. Ndirangu reports that two teachers complained that they were prevented from entering the hospital because they had lost their phones on the way there.
In contrast, three others presented police reports proving that they had recently lost their phones.
Mr. Ndirangu explains, “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.
The petitioners assert that TSC should have consulted them before renewing its contract with the insurer.
“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 lawsuit is pending ELRC hearing directions.