HARARE – The Insurance and Pension`s Commission of Zimbabwe (IPEC) says it is in the process of organising a consultative forum with key stake holders in the health care insurance industry to map the way forward for the industry after the latter was recently awarded jurisdiction to regulate the sector.
The sector, which was previously regulated under The Ministry of Health and Child care services was struggling as after thousands of policy holders have been struggling to get medical services on fully paid up schemes due to the high prevalence of corporate governance malpractices including corruption, misappropriation of funds and revenue leakages.
IPEC public relations officer Lloyd Gumbo said during a telephone interview that the regulator is currently engaged in talks with various players in the industry to organise for a platform through which they can iron all outstanding issues which will proffer a way forward.
“We are going to have a consultative meeting this month with medical aid societies and we also want the Ministry of health to be present at the forum so that we can discuss the way forward.
“IPEC will also be advising them on how they intend to regulate the industry, stake holders will also be expected to bring any issues of attention that they have,” said Mr Gumbo.
The insurance regulator was last month awarded regulation by Finance and Economic Development Minister Mthuli Ncube after a lengthy regulation dispute with the Ministry of Health and Child Care.
Minister Ncube is on record saying, Medical aid schemes and legal aid societies will in future be regulated by Insurance and Pensions Commission to ensure the public is covered for medical treatment and hospitalisation promised.
The lack of prudential supervision and regulation, Minister Ncube said, has the potential to compromise service delivery and protection of consumers of financial services provided by these institutions.
A case in point is that of Cimas and Corporate24 where the former argued that its customers should pay cash upfront when getting treatment at the medical facility. By law, subscribers holding valid medical aid cards are not supposed to pay cash as it defeats the whole purpose of medical aid insurance.
However, Cimas (which is the second biggest player after PSMAS) says Corporate24 has been submitting fraudulent claim forms. The Ministry of Health and Child Care, at that time as current regulator, had failed to resolve the dispute
Often parties consider the ministry to be an unfair arbiter and experts say by virtue of its centrality to both individual and collective health of its subscribers, disputes in the medical insurance business have to be solved timeously through a regulator.