Court declares NHIF pending claims verification committee illegal

Court rules that Health Cabinet Secretary Aden Duale has no powers under the Constitution to empanel an Ad Hoc committee. [File, Standard]

The High Court in Eldoret has declared the establishment of the National Health Insurance Fund (NHIF) pending medical claims verification committee illegal.

High Court Judge Reuben Nyakundi, in a judgment delivered on Monday, said the establishment of the committee through gazette notice dated March 28, 2025, was in contravention of Article 31 of the Constitution of Kenya 2010 as read with the Social Health Authority Act.

The court ruled that Health Cabinet Secretary Aden Duale has no powers under the Constitution or the National Government and Coordination Act to empanel an Ad Hoc committee and specifically the NHIF pending medical claims verification committee, through gazette notice.

The court further said the establishment of the committee lacked a statutory basis.

"That a declaration be and is hereby issued that the establishment of the National Health Insurance Fund (NHIF) Pending Medical Claims Verification Committee through Gazette notice has no constitutional or statutory basis and is therefore unconstitutional in its entirety," read the court's judgment in part.

The court issued the orders following a suit filed by Nakuru Surgeon Dr Magare Gikenyi, activist Eliud Matindi, Dishon Mogire, and Abuga Nyakundi.

The four had named the NHIF pending medical claims verification committee, Duale, PS Medical Services, and 21 others as respondents in the case.

Gikenyi, Matindi, Mogire, and Nyakundi claimed that the establishment of the committee was a roadside declaration without any legal and constitutional basis. The committee, they said, was to carry out the functions of the Auditor General, hence contravening the law.

"Handpicking people who are not employees of NHIF and or SHA (Its predecessor) nor public servants nor staff of the auditor general to look into sensitive and confidential medical records of patients in the name of claim verification and exposing private data and patients' disease conditions is against Article 31 of the Constitution," read the suit in part.