Nairobi, Kenya – Eight leading insurance companies have suspended services at Nairobi Hospital following its decision to raise medical fees by 61%, a move insurers describe as unsustainable. The withdrawals, effective next week, threaten to disrupt healthcare access for thousands of insured patients.
Table of Contents
Insurers Withdrawing Coverage
The affected insurers include:
- Madison Insurance
- First Assurance
- Minet
- Old Mutual
- Britam
- AAR
- CIC
- Pakis Insurance
In statements, multiple insurers cited the sharp cost increase as incompatible with affordable healthcare provision. Madison Insurance called the hike “not sustainable,” while CIC Group confirmed it would terminate services starting next Tuesday.
Hospital’s Position and Impact
Nairobi Hospital, one of Kenya’s largest private healthcare providers, has not publicly justified the fee adjustment. The increase affects all branches, including its main facility on Argwings Kodhek Road and satellite centers in Galleria Mall, Warwick Centre, and Rosslyn Riviera.
The suspensions leave insured patients with two options: pay out-of-pocket or seek treatment at alternative facilities. Industry analysts warn the dispute could set a precedent for other hospitals considering similar price hikes.
Broader Healthcare Sector Crackdown
The insurance crisis coincides with a government clampdown on fraudulent medical claims. Health Cabinet Secretary Aden Duale recently suspended 40 hospitals from the Social Health Authority (SHA) program over alleged fraud, including:
- Falsified patient records
- Outpatient cases billed as inpatient admissions
- Duplicate claims across facilities
Duale warned that suspended hospitals face financial penalties and will remain barred from SHA until investigations conclude. The most serious cases involve facilities in Nairobi and Homa Bay counties.
What Comes Next?
- Patient Adjustments – Insured individuals must verify coverage alternatives.
- Potential Negotiations – Pressure mounts on Nairobi Hospital to revise its pricing.
- Regulatory Scrutiny – The SHA fraud probe may expand to other institutions.
The dual developments underscore growing tensions between cost containment and quality care in Kenya’s evolving healthcare landscape.
Sources: Insurer communications, Ministry of Health briefings, industry sources
