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The work injury insurance Cover for Teachers: Latest TSC News

The Teachers Service Commission, TSC, is set to provide Work Injury Insurance to all teachers in Primary and Secondary Schools; employed by the Commission. The over 321 teachers now have a reason to smile as the Commission has advertized for tender bids to firms who would provide insurance against workplace related injuries. This will be good news more so to teachers handling Practical based subjects (science) who are highly susceptible to injuries and diseases; arising from the chemicals and equipment that they handle

Duration of Cover

According to the tender papers released by the Commission, the successful insurer will provide insurance services for three years; From January 1, 2020 to January 1, 2023. “The Administration Service will run for the twelve (12) months effective 1st January, 2020. The service/contract may be renewed for the next two years’ subject to satisfactory performance,” read the tender papers; in part.

Deadline for Submission of Tenders

Interested tenders are expected to make their bids not later than Wednesday 20th November 2019 at 9.00 am

What the Insurer will do

 Assess all work injury benefits claims lodged at the Commission, show due diligence and advice appropriately.
 Ascertain the legibility of individual claims.
 Investigate WIBA claims.
 Refer claimant for re-assesment to a panel of doctors appointed by the administrator where the assessment does not meet the criteria set as per the WIBA Act 2007.
 Coordinate with Medical Service providers and Administrator while investigating and authenticating treatment related to injury for the claimants.
 Advice the funds custodian (TSC) on amounts payable for compensation as a result of bodily injury and occupational illness.

Benefits Payable

Teachers will now get the following benefits:

1) On Fatal Accident: WIBA (Work Injury Benefit Act) During the period of cover, existing TSC Teachers and any additional teacher joining TSC will be covered. Benefits to be provided as per the provisions of the WIBA Act (2007).
2) On bodily injury: As provided for in the Act on occupational diseases.
3) On Occupation Illness: As provided in the Act.

Beneficiary Nomination:

Each member of TSC will nominate one or more Beneficiaries as recipients in the event of death. These, generally called the next of kin, will get compensation amount from TSC as may be determined.

What is expected of the Medical Cover Administrator

The following requirements must be complied with by the successful administrator: –
 Must have a countrywide panel of health care service providers/facilities spread countrywide up-to and including every County and Subcounty for assessment of WIBA claims.
 Detailed Methodology/operational plan on how to administer the scheme Nationwide.
 Evidence of experience in administration of Work Injury Benefits (WIBA) including recommendation from five (5) major clients in the last three years.
 Evidence of an ICT system that provides timely, accurate and efficient information on the administration of the scheme.
 Elaborate on the capacity for fraud detection, prevention and mitigation.
 Provide claims management model and process.
 Benefit coordination capabilities.
 Demonstrate capability in managing employer schemes with population of over 500,000 employees.
 Provide evidence of firm’s capability by way of Technical Expertise of key personnel who hold qualifications of Loss Assessment, insurance Valuation and Adjustment.

How The Work Injury Benefits Act, WIBA, Works In Kenya

The Work Injury Benefits Act (WIBA) is an Act of Parliament In Kenya to provide for compensation to employees for work related injuries and diseases contracted in the course of their employment and for connected purposes

What is an “accident”- means an accident arising out of and in the course and scope of an employee’s employment and resulting in personal injury;

Obligations Of Employer

Every employer must obtain and maintain an insurance policy, with an insurer approved by the Minister in respect of any liability that the employer may incur under this Act to any of its employees.

According to the Act, the following are covered:

Occupational Diseases; Any ailment as a result of workplace related conditions like Science teachers who are exposed to hazardous reagents;
Compensation for temporary or partial disablement;
Compensation for permanent disablement;
Medical Aid/ First Aid in case of accidents;
Compensation in case of death.