Only 9pc of population has health insurance

ONLY 9 percent of Zimbabweans are currently covered by health insurance as general uptake of insurance in the country remains low, according to data from industry experts.

The data shows that only 1,3 million out of Zimbabwe’s estimated population of 14 million have health insurance and medical aid cover.

Insurance remains concentrated in the formal sector, another reason for the low uptake, after many companies scaled down operations in the past decade while others shut down.

Experts in the industry say, the situation presented an opportunity for the sector to come up with more attractive products to tap into a vast market especially the small to medium enterprise (SME) sector, where insurance uptake remains low or is almost non-existent. Cimas chief executive officer Vuli Ndlovu said the sector was marred by the high informality of the economy while liquidity constraints had also a knock on effect on this industry.

He also cited leakages caused by unscrupulous practices as posing a threat to the sector, amid the proliferation of false claims, excessive charges and impersonation among other factors.

In 2016 alone, 157 cases of fraud were investigated and a total of almost $2 million was recovered. Within the Southern Africa region, the prevalence of fraudulent practices in the medical insurance is estimated at 30 to 40 percent of the industry’s value.

“Cimas claims alone would mean about $32 million worth of claims paid annually were fraudulent, errors, waste, leakages and abuse.

“If Cimas accounts for about 20 percent of the medically insured (public service taking about 60 percent), then the medical fraud damage in Zimbabwe is just about a $160 million drain countrywide,” said Vuli.

The fraud is not only perpetrated by beneficiaries, but also by also services providers who submit claims for services that have not been rendered, misrepresenting dates, tariff times, incorrect reporting of diagnosis as well as over utilisation of services.

On the other hand common schemes by staff include soliciting for kickbacks resulting in fraudulent claims being processed while scheme members submit false hospital admission in collusion with doctors.

The leakages in health insurance industry are not unique to Zimbabwe, but are a practice prevalent across the world.

“It is unlikely healthcare fraud or leakages will ever go away. It is also a global challenge,” said Mr Vuli.