Why You Risk Missing Out on NHIF Insurance

  • More than half of Kenyans listed as members of the National Hospital Insurance Fund (NHIF) have stopped remitting their monthly payments.

    According to the fund’s Chief Executive Officer Peter Kamunyo, 5.7 million accounts have been declared dormant after their rightful holders failed to continue funding them.

    Mr. Kamunyo argued that the action by the members will plunge the statutory insurer into a major crisis.

    National Hospital Insurance Fund CEO Peter Kamunyo Gathege attends a past meeting.
    National Hospital Insurance Fund CEO Peter Kamunyo Gathege attends a past meeting.
    Daily Nation

    The CEO further noted that the majority of the members who have abandoned their payments have previously benefited from the insurer’s services.

    He further argued that the majority who have remained active have history of chronic illnesses, and the insurance is a relief for them.

    “The ones who stay are those on chronic treatment such as dialysis. They pay Ksh6,000 for the family and get up to Ksh935,000 every year,” he stated.

    Kamunyo termed as unfortunate the reluctances by members to remit their monthly deductions saying this will lead to an adverse selection and cripple the insurer’s ability to settle claims.

    Adverse selection refers to a situation whereby an insurance company extends their coverage to an applicant whose actual risk is higher than the risk known by the company. 

    Kamunyo affirmed that the problem of adverse selection would be solved through the new proposed changes which seeks to have every Kenyan remit payment to NHIF as part of the government’s bid to attain the Universal Health Care plan. 

    The number of beneficiaries enlisted by the NHIF has been on the rise with the insurer attributing this to increased inpatient and outpatient benefits that allow members to access expensive medical services such as dialysis, chemotherapy, radio therapy and theatre services.

    A photo showing National the Hospital Insurance Fund (NHIF) headquarters in Nairobi.
    National Hospital Insurance Fund (NHIF) headquarters in Nairobi.