The High Court in Eldoret has nullified the formation of the National Health Insurance Fund (NHIF) Pending Medical Claims Verification Committee, ruling that it lacked any legal basis and was established in contravention of the Constitution.
The decision, delivered by Justice R. Nyakundi, follows a petition filed by four individuals, including Nakuru-based surgeon Dr. Benjamin Gikenyi, who challenged the legality of the committee. The contested body was constituted through Gazette Notice No. 4069 Vol. CXXVII No. 64 of March 28, 2025, to audit pending NHIF claims.
Justice Nyakundi held that the committee’s creation violated Article 31 of the Constitution, read together with the Social Health Authority Act, noting that neither the Constitution nor the Act provided for the formation of such a body.
“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,” the judge stated.
The court further ruled that the Health Cabinet Secretary had no authority under either the Constitution or the National Government Coordination Act to appoint such an ad hoc committee. Justice Nyakundi said the move bypassed constitutionally mandated oversight bodies such as the Directorate of Internal Audit and the Office of the Auditor-General, which are responsible for safeguarding public funds.
While acknowledging that the Cabinet Secretary may have acted in good faith, the court found the process to be outside the scope of the law and contrary to the principles of constitutional governance.
Consequently, an order of certiorari was issued, quashing the establishment of the committee and declaring it “a void decision, invalid from its inception, and from the standpoint of the Constitution, without legal effect.”
In March, Health Cabinet Secretary Aden Duale had appointed the committee to review pending bills owed to hospitals by the defunct NHIF, which ceased operations in October 2024 and was replaced by the Social Health Insurance Fund (SHIF).
The ruling is likely to have significant implications for the verification of NHIF’s pending claims, with the process now expected to revert to legally recognized oversight institutions.
