Fraud Management Strategies and Performance of Medical Insurance Providers in Nairobi City County – Kenya

dc.contributor.authorKinyuru, Maina Antony
dc.contributor.authorNjuguna, Njeri
dc.date.accessioned2024-02-13T08:22:29Z
dc.date.available2024-02-13T08:22:29Z
dc.date.issued2024-01
dc.descriptionArticleen_US
dc.description.abstractGlobally, medical insurance is pivotal in financing healthcare, significantly impacting the performance of healthcare systems. However, the effectiveness of this contribution is hindered by the pervasive issue of medical insurance fraud, which poses a serious challenge to cost-effective healthcare systems worldwide. Over recent years, medical insurance providers operating in Kenya have consistently reported dismal performance. An alarming 70 percent of medical insurance providers have sustained underwriting losses for a continuous period of more than five years. This chronic underperformance is primarily attributed to the persistent fraudulent activities plaguing these companies. The primary objective of this study was to evaluate the effects of fraud management strategies on the performance of medical insurance providers in Nairobi City County, Kenya. To achieve this, the study's specific objectives delved into investigating the influence of fraud prevention on medical insurance providers in Nairobi City County, Kenya. The study adopted a mixed research approach of both qualitative and quantitative research methods and employed a descriptive and explanatory research design, which is cross-sectional in nature. The target population consisted of 2891 employees from the 27 listed medical insurance providers operating across Nairobi City County in Kenya. The study's findings revealed a positive and significant influence of fraud prevention strategies on the performance of medical insurance providers. The study found that MIPs should strengthen internal controls and review existing processes to recognize vulnerabilities. This would mean implementing additional checks and balances to prevent similar fraud schemes in the future.en_US
dc.identifier.citationKinyuru, M. A., & Njuguna, N. INTERNATIONAL JOURNALS OF ACADEMICS & RESEARCH.en_US
dc.identifier.uriDOI: 10.32898/ibmj.01/6.2article12
dc.identifier.urihttps://ir-library.ku.ac.ke/handle/123456789/27630
dc.language.isoenen_US
dc.publisherIJARKEen_US
dc.subjectFraud Managementen_US
dc.subjectMedical Insuranceen_US
dc.subjectInsuranceen_US
dc.subjectKenyaen_US
dc.titleFraud Management Strategies and Performance of Medical Insurance Providers in Nairobi City County – Kenyaen_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Fraud Management Strategies and Performance....pdf
Size:
794.71 KB
Format:
Adobe Portable Document Format
Description:
Full text Article
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description: