MPs move to fix weaknesses in medical insurance system

Lawmakers on Tuesday brought to light a critical hitch in the insurance sector which, when solved, will save accident victims and health insurance providers like Mutuelle de Santé and Military Medical Insurance (MMI) from unnecessary problems.The insurance providers usually act fast to save lives by providing health support to accident victims but the insurers later refuse to make refunds.Medical insurers like MMI or Mutuelle de Santé do not cover accidents but are often compelled to act when human life is at risk.Christine Mukarubuga, a member of the Lower Chamber of Parliament’s standing committee on national unity, rights and fight against Genocide, noted that during the committee’s visit to Kibagabaga hospital, a Mutuelle de Santé official told them how they are burdened by motor accident insurers when seeking for refunds.Mukarubuga told the session how the official informed MPs that when people get involved in motor accidents, the community health insurance scheme covers their bills yet they are supposed to be covered by the pertinent insurance companies which provide for motor accident insurance.Françoise Mukayisenga, the vice president of the committee, backed Mukarubuga, noting that even when health insurance providers like Mutuelle de Santé later request for compensation from the likes of SORAS, they are frustrated by long procedures and end up spending more than they are owed.“You find that in the procedures of requesting for compensation, they pay even much more money than what they are reclaiming,” Mukayisenga said.Acknowledging the concern and noting that it has been subject of long discussions, Dr Wellars Uwilingiyimana, a SORAS official, labored to explain issues but the lawmakers as well as MMI and Rwanda Social Security Board (RSSB) officials did not entirely agree with him.Uwilingiyimana noted that it was agreed that health insurance providers be the first to provide medical treatment to accident victims and later seek compensation from motor accident risk insurance providers. But he admitted that the agreed terms between agencies like SORAS and individuals are really not clear on specific details, a scenario that often creates difficulty.Capt. Narcisse Nsengiyumva, a representative of MMI, shed more light on the dilemma. He noted: “this is a big problem because we receive many patients due to work related accidents.”“You take charge and provide medical assistance because you want to save life. The hospital that provides medical care will not receive a patient before you pay. A citizen is hit by a car and goes to hospital and we cover for the medical bills. But then you realize that the body that acted in goodwill is later penalized, and even if it is compensated, it is not compensated on time.”Alexis Ruliza, an RSSB official, summed it up noting that the refunding problem is caused by the numerous burdening or discouraging documents which automobile accident risk insurers demand from accident victims. This is aggravated by instances where people involved in hit and run accidents cannot identify vehicles involved.At one point, Capt. Nsengiyumva, highlighted a court battle they are involved in with SORAS after they were not refunded for over Rwf 10 million used to provide assistance to a motor accident victim at King Faisal hospital.“But now, because an insurance agency wants to protect its own interests, they say that in the police file, there is sharing of responsibility. They are using that to claim that the medical bill must be split into two,” Capt. Nsengiyumva said.“But let’s even assume that there was negligence and the victim had a role in it. How then should those who helped provide medical assistance for the victim be penalized for saving life?” he wondered.The MPs finally agreed and inserted a clause in article 21 of the health insurance bill which makes it mandatory for health insurance providers to be refunded by insurance agencies full amounts and without delays or any hindrances.Meanwhile, during the beginning of the debate on the same bill, early this month, the committee insisted that apart from a beneficiary’s spouse and children, parents must also be beneficiaries in the health insurance schemes.Consultations are continuing but the lawmakers earlier resolved that Article 9 of the bill states that beneficiaries of a person insured for a public health insurance scheme are: a legally married spouse; a child recognised by civil law; a handicapped dependent not able to earn an income, and a parent.

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MPs move to fix weaknesses in medical insurance system