Bahamas First probes issues affecting Cayman First

“CFI failed to comply with regulatory reporting deadlines with respect to claims processing, payment and client invoicing.”

(CMR) Bahamas First told shareholders it assigned its non-executive directors to probe woes at its subsidiary Cayman First, which faced threats of being barred from writing new life and health insurance policies due to a backlog in making payments.

Last year, several complaints were made to the Cayman Islands Monetary Authority (CIMA) by vendors in the Cayman Islands complaining of non-payment of claims for several months. Some were reportedly owed millions.

Earlier this year, the Health Insurance Commission (HIC)  revealed that it was monitoring the situation at Cayman First after finding there was a shortage of personnel and that there were problems with a newly introduced claims filing system which impacted clients being able to access the insurer. The new system also impacted registered healthcare providers being able to file claims directly, thus impacting their ability to receive payment for their “clean claims” in a timely manner.

In a notice to shareholders, Bahamas First disclosed that its Board had appointed a committee of its non-executive directors to investigate the matter.

Bahamas First told shareholders that  “As a result of problems with the implementation of the new processing system, Cayman First failed to comply with regulatory reporting deadlines with respect to claims processing, payment and client invoicing. These problems, which have proved both difficult and, as a result, slow to resolve, are ongoing.”

“They have led to the Cayman Health Insurance Commission (CHIC) indicating to Cayman First on March 30, 2023, that what occurred breached the conditions of its Approved Insurer Certificate for health insurance business issued by the CHIC, that it was considering enforcement action and may be minded to make regulatory orders which would prevent new health insurance for Cayman residents being underwritten by [Cayman First],” Bahamas First stated, according to The Tribune.

Bahamas First and  Cayman First, in response to the March 30 notice from the HIC, provided a plan to resolve the issues, hired an international consultant, and added extra staff with the hopes of addressing the issue within three months.

In its notice to stakeholders, Bahamas First stressed that “Cayman First has no problem in meeting claims in full, but the problem encountered has been in processing claims. The Boards of Bahamas First and Cayman First are concerned as to the time taken and the difficulties encountered by management to resolve the situation with life and health.”

“The Board has also resolved to use external consultants to advise them on the origin and handling of the problems both from a technical and wider perspective and further to advise on appropriate steps to ensure that life and health systems are robust and resilient as well as those of Bahamas First,” the notice to stakeholders added.