wazua Fri, Nov 15, 2024
Welcome Guest Search | Active Topics | Log In | Register

3 Pages<123
Britam Linda Jamii with Safaricom (Health Insurance)
Taurrus
#41 Posted : Sunday, October 04, 2015 9:41:14 PM
Rank: Member


Joined: 8/25/2015
Posts: 839
Location: Kite
Linda Jamii hits dead end

Linda Jamii
www.standardmedia.co.ke/...inda-jamii-hits-dead-end
nakujua
#42 Posted : Monday, October 05, 2015 7:24:20 AM
Rank: Elder


Joined: 12/17/2009
Posts: 3,583
Location: Kenya
our 'eating' mentality will never allow such products to thrive - the doctor is looking to steal from the insurer, the insurer is only thinking of fleecing the client, the patient is looking at how to eat as much into their policy as possible, the doctor and the patient collude, the insurance employee and doctors collude.
Administrators who want to fleece developers, managers who think failure to automate processes is a money saving strong point ...
Its a mess
washiku
#43 Posted : Monday, October 05, 2015 9:19:36 AM
Rank: Chief


Joined: 5/9/2007
Posts: 13,095
Taurrus
#44 Posted : Monday, October 05, 2015 9:58:26 PM
Rank: Member


Joined: 8/25/2015
Posts: 839
Location: Kite
nakujua wrote:
our 'eating' mentality will never allow such products to thrive - the doctor is looking to steal from the insurer, the insurer is only thinking of fleecing the client, the patient is looking at how to eat as much into their policy as possible, the doctor and the patient collude, the insurance employee and doctors collude.
Administrators who want to fleece developers, managers who think failure to automate processes is a money saving strong point ...
Its a mess

well said
Bykhovets
#45 Posted : Monday, October 05, 2015 10:46:14 PM
Rank: Member


Joined: 5/17/2014
Posts: 231
jguru wrote:

It is not a good cover at all. For anyone.


jguru wrote:

All the major hospitals (MP Shah, Aga Khan, Nairobi, Mater etc) are excluded from the list of hospitals you can get treatment from.

http://lindajamii.co.ke/providers/

I'm hesitant to recommend this plan.


jguru wrote:

If you are a member of NHIF, you get better comprehensive in-patient treatment at any of those listed hospitals on that list (and many more), with no limits, at a far cheaper premium (Kes 1920 per year voluntary or Kes 3840 salaried).

What's the point of having LindaJamii and being admitted at Kabarnet District Hospital in the general wards?


It was said, over and over again, that it was a terrible health plan.

Whoever listened, listened. Whoever didn't, sorry.


"Occasionally I drop a tea cup to shatter on the floor. On purpose. I am not satisfied when it does not gather itself up again. Someday perhaps that cup will come together."
Gathige
#46 Posted : Tuesday, October 06, 2015 2:06:24 AM
Rank: Elder


Joined: 3/29/2011
Posts: 2,242
Medical insurance is a very risky business. Rarely do the underwriters make any any money due to one word... Fraud. All the parties in the chain are mostly out to freeze the other and the end game is normally disastrous. It requires trust to run a medical insurance product profitably and professionally.
"Things that matter most must never be at the mercy of things that matter least." Goethe
muganda
#47 Posted : Tuesday, October 06, 2015 10:15:24 AM
Rank: Elder


Joined: 9/15/2006
Posts: 3,905
Maybe this is just another case of poor execution by Safaricom and cohorts; another ugly sister as per the CEO, considering it was re-launched 3 times https://www.linkedin.com/pulse/s...-one-talks-bob-collymore
Taurrus
#48 Posted : Wednesday, October 07, 2015 5:55:08 PM
Rank: Member


Joined: 8/25/2015
Posts: 839
Location: Kite
Gathige wrote:
Medical insurance is a very risky business. Rarely do the underwriters make any any money due to one word... Fraud. All the parties in the chain are mostly out to freeze the other and the end game is normally disastrous. It requires trust to run a medical insurance product profitably and professionally.

could this be our general nature,dishonesty? serikari saidia wired!
Gathige
#49 Posted : Wednesday, October 07, 2015 7:11:00 PM
Rank: Elder


Joined: 3/29/2011
Posts: 2,242
muganda wrote:
Maybe this is just another case of poor execution by Safaricom and cohorts; another ugly sister as per the CEO, considering it was re-launched 3 times https://www.linkedin.com/pulse/s...-one-talks-bob-collymore


@Muganda, i guess the issue was costing and fraud. Medical costs in KE are very high and with low premiums for such products, even to break-even is a challenge. Second is the thievery culture where all and sundry from Docs to the door man at the facility all want a piece of the cherry.
"Things that matter most must never be at the mercy of things that matter least." Goethe
Prime
#50 Posted : Wednesday, March 23, 2016 10:37:54 AM
Rank: Member


Joined: 2/27/2011
Posts: 518
Allow me to give my view of this program from the perspective of a service provider.
1. Majority of the patients enrolled in this scheme (Scam) are majorly those with chronic illnesses. i.e. diabetes, Hypertension etc. These conditions require long term permanent treatment, whose cost goes far beyond the amounts paid. The model of the scheme was not sustainable.

2. initially, the service providers, me included were treated as partners in the program. We provided the service and drugs and made the claim from them. everything went smoothly until we started having issues of flimsy reasons not to pay the providers. There then came a cap on the amount a patient would spend per visit. Unofficially it was pegged at 2,300 and we had to get authorization to surpass the figure.

3. We opted out of the program as the unpaid claims were escalating. We attempted to rectify the reason to why the claims had not been paid. That is where the circus started. Refusal to pay despite e-mail follow ups. Till today, the payments remain unpaid.

4. I cannot even risk taking any other product by britam. The stress of getting paid is beyond words. The recruitment into their programs is always sugar coated until the payment issue comes up. CANNOT touch these guys with a 10 foot pole. Fellow partakers of these health program - linda Jamii... heed to wise counsel. You have been told.
Mseto binti
#51 Posted : Wednesday, March 23, 2016 3:31:36 PM
Rank: Member


Joined: 3/9/2012
Posts: 144
Brick wall Brick wall Brick wall Brick wall

Who will give us another option...ilikuwa inasaidia watu kama sisi....

anyone with info as to why Agha Khan is asking those under company medical cover to write their ID numbers on the receipts before you are served?...whats going on here?...
I found meaningful work🤓
Mseto binti
#52 Posted : Wednesday, March 23, 2016 3:33:30 PM
Rank: Member


Joined: 3/9/2012
Posts: 144
Brick wall Brick wall Brick wall Brick wall

Who will give us another option...ilikuwa inasaidia watu kama sisi....

anyone with info as to why Agha Khan is asking those under company medical cover to write their ID numbers on the receipts before you are served?...whats going on here?...
I found meaningful work🤓
Users browsing this topic
Guest (2)
3 Pages<123
Forum Jump  
You cannot post new topics in this forum.
You cannot reply to topics in this forum.
You cannot delete your posts in this forum.
You cannot edit your posts in this forum.
You cannot create polls in this forum.
You cannot vote in polls in this forum.

Copyright © 2024 Wazua.co.ke. All Rights Reserved.