The Auditor-General has raised queries over the Sh8.1 billion premium covered by the National Health Insurance Fund to the National Police Service.
The report probes how the cover was adjusted from Sh2.3 billion to Sh8.1 billion for the financial year 2018/19 and 2019/20.
The A-G Nancy Gathungu indicated that the accounts of the Interior ministry raised eyebrows following an initial one-year contract where the insurer had offered to give a comprehensive group life cover and group personal accident cover for 131,816 principal members and dependents at a cost of 2.3 billion for the period between January and December 2021.
Contrary to the minutes of the meeting, NHIF is said to have quoted Sh8.3 billion as the cost for the cover.
“Negotiation minutes agreed that the two parties agreed to a total premium of Sh2.3 billion; however, there was no agreed schedule of the adjustment made to the rates,” says the reports.
The scrutiny of the procurement documents revealed that the Police service used a direct procurement arrangement instead of following the legal procurement method adopted.
The report further questioned why the fund was yet to settle a Sh67 million claim for funeral expense covering 374 claims for principal members and family.
“Reviews of the claims for the last (funeral) expenses covered under the comprehensive group life made in 2021 revealed that 374 claims of the principal members, spouses and children totaling Sh67 million were submitted to NHIF for settlement and had not been settled by December 31, 2021” says the report.
The insurer, however, failed to substantiate its delay in paying the claim despite provision by the contract under Clause 5 which notes that NHIF should pay the next of kin an amount specified for funeral expenses upon receiving a written notification of death.
Other documents that must be provided by the next of Kin include a duly completed form and a copy of the burial permit.