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EXCLUSIVE: A Patient’s Disheartening Experience with Jubilee Insurance

On April 19, website like this Paul Wanyoto, viagra sale a city lawyer, was in a jovial mood as he prepared to hang out with friends at a stag party.

He would later settle for about four to six shots of Double Black mixed with a Coca Cola at Mask Lounge, a nightclub in Bukoto, Kampala.

“A few hours later, I develop a tummy ache and then got into nausea and diarrhea on Thursday Night into Friday,” recalled Wanyoto, who nearly lost his precious life.

“I managed it with Flagyl and ignored it as I was part of the organising committee for a friend’s wedding on Saturday,” he added.

“So I hard-lined with flagyl and Imodium through the wedding.”

On Sunday (April 22), Wanyoto consulted Dr Stone Luggya, a friend who practices medicine at Mulago and Nakasero Hospital.

The doctor advised Wanyoto to “drink a lot and have as much food” to see if there would be any reaction.

“I did and a few moments later, I vomited blood. …lots of clotted blood and collapsed,” recalled Wanyoto.

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He was then rushed to Nakasero, a high-end medical facility and admitted under emergency.

Wanyoto’s colleagues realised he had held medical cover under Jubilee Insurance and called a one Ashey and a one Gerald who told them Jubilee would not meet his bills at Nakasero and should go to Norvik Hospital or some other named medical facilities they preferred.

“They blatantly assured my contacts as I was unwell that I should have never gone to Nakasero if I was to benefit from my policy,” said Wanyoto.

Luckily, his sister Lydia Wanyoto had come to see him at Hospital where she took over the bills and made sure deposits were made to ensure his admission.

Legal action

But Jubilee’s refusal to help their insurance patient has triggered a lawsuit.

Gerard, a senior official whom Wanyoto’s friends spoke to, received a phone call from ChimpReports on Friday morning.

He responded: “I am busy.”

Asked to present Jubilee Insurance’s side of the story in regard to Wanyoto’s complaint, Gerard switched off his phone.

This development could as well blow the lid off the agony insurance patients endure during emergency moments.

According to the documents obtained by ChimpReports, Wanyoto took out a one-year Medical Insurance Policy with Jubilee Insurance effective May 9, 2016.

In the suit, Wanyoto’s lawyers said he “encountered a medical emergency (upper GI Bleeding)” which was covered under the policy and was admitted for four days at Nakasero Hospital.

The lawyers further stated that the insurance policy makes “no reference to a list of hospitals to which our client or any policy holder has to attend in order to benefit from the policy.”

Analysis

The policy defines a hospital as an “institution which is legally licensed as a medical hospital under the laws of that country in which it is located and which must be under the constant supervision of a registered and qualified physician medical practitioner.”

Legal experts say the best practice is an insured person notifying the insurer who then contacts the hospital to confirm that they attend to you and then bill them.

The insurers’ role is to pick bills and not to choose hospitals, experts tell this investigative website.

“If the Insurance Regulatory Authority can’t regulate them, we shall regulate them through court process,” said Wanyoto.

Ugandans in general do not take health care seriously and those who take out these policies are under corporate companies so they can’t enforce their rights as they see the insurance from their employer as a favor.

Many of the Insurance patients derive their insurance cover by virtue of their employment.

And quite often the employers in conjunction with the Insurance companies behind the backs of these employees cut deals as to where these employees should go for medical services.

Our investigations show that some turn around and pick kick backs.

This means that the employee does not have a direct Insurance Policy with the Insurance Company but the employer.

“So your boss turns up and gives you a medical card and also hands you a list of hospitals to attend. You take that as the gospel truth. You don’t look at the Policy,” said an insurance expert who preferred anonymity so as to speak freely.

“You can’t even question why you can’t go to a certain hospital.”

Letter

However, for Wanyoto’s case, it’s Private Individual Policy whereby he doesn’t have to seek permission from anyone to interrogate its execution.

 

Insurance usage in Africa is relatively low not due to cost or affordability but trust or the lack thereof as evidenced by the general attitude towards insurance.

According to Uganda Insurers Association (UIA) reports, Uganda’s penetration stands at less than 1 percent.

Interestingly, Wanyoto said he had already written to Jubilee Insurance to renew his policy.

Asked why he wanted to stick to an insurance company he accuses of not being up to the mark, Wanyoto responded: “I want to compel them to do the right thing. Where we go wrong as a society is to run away from playing our part because we are angry.”

He added: “I want to put them on the right course, renew new my policy and then have them respect the Policy. If I just run away, they will have achieved in cheating me, angering me and having me run away without me having a chance at compelling them to do the right thing not just for me but the public.”

Have you had any challenges with Uganda’s insurance companies? Please send us your concerns on a secure WhatsApp number: +256774719830 or Email: info@chimpreports.com

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