The High Court in Eldoret has nullified the establishment of the National Health Insurance Fund (NHIF) Pending Medical Claims Verification Committee, ruling that it was created without legal authority and in violation of the Constitution.
The decision follows a petition filed by four individuals, including Nakuru-based surgeon Dr. Benjamin Gikenyi, challenging the legality of the committee appointed to audit unpaid NHIF medical claims.
In his judgment, Justice R. Nyakundi found that the body, created under Gazette Notice No. 4069 Vol. CXXVII No. 64 of March 28, 2025, contravened Article 31 of the Constitution and the Social Health Authority Act, neither of which provides for such a committee.
“There was no legal basis for the establishment of the committee. The transitional provisions of the Social Health Insurance Act do not provide for the formation of any committees to establish the liabilities of the NHIF,” Justice Nyakundi stated.
The court ruled that Health Cabinet Secretary Aden Duale acted outside his constitutional and statutory mandate in empanelling the ad hoc body, noting that the decision bypassed established oversight institutions such as the Directorate of Internal Audit and the Office of the Auditor-General.
Declaring the committee “a void decision, invalid from inception, and without legal effect,” Justice Nyakundi emphasised that while the CS may have acted in good faith, the move was incompatible with the law.
The contested committee had been tasked with reviewing pending bills owed to hospitals by the now-defunct NHIF, which was replaced by the Social Health Insurance Fund (SHIF) in October 2024.
Written By Rodney Mbua
