The High Court in Eldoret has declared the National Health Insurance Fund (NHIF) Pending Medical Claims Verification Committee unconstitutional, dealing a blow to the Health Ministry’s attempt to audit billions in unpaid hospital bills.
In a judgment delivered by Justice R. Nyakundi, the court found that the committee established through Gazette Notice No. 4069 Vol. CXXVII No. 64 of 28th March 2025 had no constitutional or statutory foundation, violating Article 31 of the Constitution and the Social Health Authority Act.
The ruling followed a petition by four litigants, among them Nakuru-based surgeon Dr. Benjamin Gikenyi, who argued that the Health Cabinet Secretary had no authority to create such a body. Justice Nyakundi agreed, stating that neither the transitional provisions of the Social Health Insurance Act nor the National Government Coordination Act empowered the CS to appoint an ad hoc verification committee.
“There was no legal basis for the establishment of the committee… This was a void decision, invalid from its inception, and from the standpoint of the Constitution, it has no legal effect,” the judgment read in part.
The court issued an order of certiorari quashing the committee’s formation, noting that the decision bypassed established oversight mechanisms such as the Directorate of Internal Audit and the Office of the Auditor-General.
While acknowledging that the CS may have acted in good faith to safeguard public funds, Justice Nyakundi said the move blurred constitutional lines and undermined transparency and accountability.
The disputed committee was appointed in March 2025 by Health CS Aden Duale to verify pending bills owed to hospitals by the now-defunct NHIF, which was replaced by the Social Health Insurance Fund (SHIF) in October 2024.
The ruling effectively means that any verification of NHIF’s pending claims will have to be handled by constitutionally recognised government audit bodies, not specially appointed committees.
