According to the Association of Kenya Insurers, there are 29 registered insurance companies that provide medical
insurance cover, serving 4M clients, which represents a penetration rate of 9.4%.
In 2015, medical the medical premiums collected were 16B, while 12B were paid out as claims. 4.2M of the amount
claimed, representing 35%, were fraudulent claims. The fraud was attributed to forgery by service providers and/or
collusion between the service providers and the clients. To address these challenges, OptiSmart Solutions has
developed The SmartInsurance Product.
The SmartInsurance Solution
SmartInsurance Solution is an integrated web and mobile platform that facilitates the management of medical
insurance claims between the Insurance provider, medical service provider and the policy holder.
How it Works
1. The client initiates a claim via SmartInsurance mobile application
2. SmartInsurance Platform verifies claim details and relays results real-time to the Service Providers, via SMS or Web
3. Transaction statements are availed to the Insurance Provider, Service Provider and Client in real-time