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City hospital sues insurance broker in Sh170m row

February 25th, 2019 2 min read

Nairobi West Hospital has slapped insurance broker Minet Kenya with a lawsuit for failure to settle Sh170 million medical bills of teachers and members of national police service treated at the facility.

The insurance firm denies the bill, arguing that it has settled all outstanding claims and is asking the health facility to produce evidence.

The hospital entered into a one-year deal with Minet in October 2016 for provision of medical services to members of the Teachers Service Commission (TSC) and the National Police Service which was extended for one year after expiry of the previous contract.

CONTRACTUAL OBLIGATION

The hospital says it has fulfilled its contractual obligation as per the agreement entered into between the parties and wants the court to order the insurer to settle the bill.

“It is unjust for the defendant to decline to pay for the medical services rendered. The refusal to pay for medical services rendered is detrimental to the plaintiff’s business,” says Nairobi West hospital in the documents filed in court.

At the heart of the dispute is a directive by Minet asking Nairobi West Hospital to send details of the patients within seven days of treatment.

The hospital says it declined the directive to share patients’ information every seven days due to a technical hitch stemming from Minet’s software that made it impractical.

Nairobi West Hospital further claims that Minet approved all the services prior to the patients being attended to and therefore was fully aware of the outstanding bill.

But Minet denies the claim, arguing that the requirement to share the weekly data was part of a contract signed between the parties when it was renewed and therefore the hospital breached the agreement.

DENIES LIABILITY

The insurance firm denies any liability arguing that it was not in control of the software that the hospital claims led to failure to it submitting weekly data.

The firm claims that the software was under control of Bliss GVS Healthcare Limited and that any further demand of payment should be settled by it.

Minet says it will seek to enjoin Bliss GVS Healthcare Limited to the proceedings.

The outstanding amount dates back to between March and August 2018.

According to the hospital, the firm settled Sh53 million during that period but rejected Sh170 million worth of claims.