Insurance practitioners dilate on PMI

Practitioners in the various Private Medical Insurance schemes (PMIs) within the insurance industry took a day in the Insurance Awareness Week (IAW) that commenced in earnest on Monday 21 March, to look at the Evolution of Medical Insurance in The Gambia, with special focus on its prospects and constraints.

Organised by the Insurance Association of The Gambia (IAG), the weeklong sensitization campaign further increased the general public’s understanding of insurance and insurance policies in order to lay the foundation for building a trusting relationship between insurance providers and the public.

As part of the IAW, the IAG decided to have a lecture on the topic: Evolution of Medical Insurance in The Gambia, Prospects and Constraints, to provide a forum to discuss issues of mutual concern for the stakeholders of Medical Insurance for a better management of the scheme. Papers on the topic were presented by three major stakeholders of the scheme, who included an insurer, a service provider, and a sponsoring (insured) institution. These were Momodou Joof, Managing Director of Takaful Insurance Company, Dr Adama Sallah, CEO of Lamtoro Clinic, and Muhammed Jeng of the Gambia Revenue Authority. Their papers touched on various pertinent aspects of medical insurance and the PMI schemes.

“This year’s theme: ‘The Evolution of Medical Insurance in The Gambia: Prospects and Constraints’ is yet another demonstration by the IAG to create an environment for fruitful dialogue among all participants in the various Private Medical Insurance schemes (PMIs) within the insurance industry,” said IAG president Dawda Sarge, in his keynote address on the occasion held at the Laico Atlantic Hotel in Banjul.

“But then who are these participants?” he asks rhetorically. “Naturally, we cannot overlook the insurance companies who provide the various medical expense insurance covers. Secondly, the approved care-givers (hospitals, clinics, doctors, etc) are also very instrumental in the delivery process.

“Another very important participant is the so-called sponsoring institutions (who do so on behalf of their employees), who together with the various family groups and/or individuals are collectively defined as the beneficiaries of the PMI schemes.

“By the way, and lest I forget, our esteemed insurance brokers have, in recent times, been playing a very important and useful intermediation role in this sector as well.”

The forum provided insurance practitioners and other participants at the lecture a unique opportunity to discuss, in a forthright and very professional manner, some of the challenges inhibiting the successful operation of Private Medical Insurance schemes in The Gambia.

“It shouldn’t only stop at that but also work towards a framework for building a solid foundation for meaningful partnerships and cooperation,” Mr Sarge, who is also the managing director of Prime Insurance Company, said.

The IAG’s president’s forerunning speech to the lecture also states: “It is useful to note that the cardinal objective of all PMIs in The Gambia is to support national health development objectives through the use of best and useful practices that maximises the efficient and effective use of resources.

“As you may know, we now live in a world of interdependence hence the need for all PMI stakeholders to complement one another rather than compete; deliver services as expected rather than duplicate them; and finally show more equity, transparency and accountability in their transactions with one another. Besides, all development oriented partnerships should and - I dare say - must operate on the premise and principle of a shared responsibility.  We cannot have successful PMI schemes when insurers fail to provide good value medical expense insurance covers (by making the necessary reimbursements to the doctors or sponsoring organisations on time); or doctors and clinics charging exorbitant medical bills or encouraging practices that are inimical to the insurance delivery process; or the sponsoring organisations abdicating their responsibilities towards the scheme.

“The Chairman of Munich Re Management Board, Dr Nick Von Bomhard, once said: ‘Insurance companies should always avoid a situation wherein the insuring institution pays the loss upfront as a premium and gets the money back as a claim’. I believe this statement resonates well with the PMI provider institutions.”

The auspicious forum that attracted significant questions and relatable comments from seasoned insurance practitioners and erudite public commentators was moderated by the managing director of Capital Express Assurance Company, Kunle Adegboye.

Other events

The IAG, as part of its insurance awareness week, on Tuesday officially inaugurated the National Students Insurance Club (NaSIC) at a ‘historic’ ceremony held at St. Joseph’s Senior Secondary School in Banjul.

It also held its annual general meeting (AGM) on Thursday at the Laico Atlantic Hotel in Banjul, where salient issues on the IAG and members of the association were discussed. This was followed by other events on Friday and a dinner on Saturday at the Baobab Hotel in Kerr Serign.