AAR Insurance has urged the insurance industry to redesign health insurance products to provide better protection for people living with chronic illnesses, warning that many Kenyans continue to face devastating medical bills despite having insurance cover.
Speaking during a media session in Nairobi, AAR Insurance Chief Executive Officer Justine Kosgei said the country's growing burden of chronic diseases requires insurers to rethink traditional medical cover and develop products that respond to the realities facing patients.
His remarks come as Kenyans are estimated to spend Sh150 billion annually out of pocket on healthcare, a trend that continues to expose families to financial hardship, particularly those managing long-term illnesses such as cancer, diabetes, hypertension and kidney disease.
Kosgei said many policyholders only realize the limitations of their medical cover after they are diagnosed with chronic illnesses, when treatment becomes prolonged and costly.
“Healthcare needs are changing, and the insurance industry must evolve with them. We need products that provide meaningful protection for people living with chronic illnesses while making insurance easier for customers to understand and access,” Kosgei said.
He noted that AAR is investing in technology, including artificial intelligence (AI), to simplify how customers interact with insurance products and make informed decisions before purchasing cover.
According to Kosgei, the new AI-powered tools will allow customers to ask questions about insurance policies in everyday language, helping them understand what is covered, compare products within their budget and identify exclusions without having to interpret complex insurance terminology.
“Today, purchasing insurance can be a complicated process that often requires customers to rely heavily on intermediaries. We want to simplify that experience by allowing customers to interact with insurance in their natural language while the complexity remains in the background,” he said.
The AI platform, he added, will also support customers during the onboarding process by recommending products based on their healthcare needs and financial ability, making it easier to choose appropriate medical cover.
During the discussion, participants raised concerns over the growing number of insured Kenyans who exhaust their medical limits once diagnosed with chronic illnesses, forcing them to pay substantial amounts from their own pockets.
A question on why patients who faithfully pay insurance premiums continue to encounter benefit caps that leave them financially exposed when they require long-term treatment emerged.
Responding to the concerns, Kosgei acknowledged that the industry must continue innovating to ensure insurance products remain relevant as Kenya experiences a shift from infectious diseases to non-communicable diseases.
He said expanding financial protection for chronic disease patients would not only improve access to treatment but also help reduce catastrophic healthcare spending, which continues to push many households into poverty.
Kosgei called on insurers, policymakers and other healthcare stakeholders to work together in developing sustainable insurance solutions that strengthen financial risk protection and support the country's universal health coverage agenda.
“The future of health insurance lies in innovation, customer-centered products and ensuring that people can access the care they need without suffering financial hardship,” he said.
