Nairobi Hospital Breaks Silence After 8 Major Insurers Suspend Services

The Nairobi Hospital has addressed public concerns following the withdrawal of eight major insurers over a 61% tariff hike.

In a statement dated August 9, 2025, CEO Felix Osano said consultative meetings are underway with insurance leaders to resolve the matter.

A forum with all affected insurers is scheduled for August 11 to find a solution to safeguard patient care.

“We have invited representatives of all affected insurers to a consultative forum scheduled for Monday, 11th August 2025, with the aim of reaching a mutually agreeable solution that safeguards patient care,” read part of the Nairobi Hospital statement.

The hospital defended the tariff adjustments as necessary to maintain high healthcare standards, insisting the rates remain competitive.

It urged the public to remain assured of its commitment to accessible, sustainable, and quality healthcare through dialogue and cooperation with stakeholders.

Nairobi Hospital in a crisis

Nairobi Hospital is facing a major setback after eight leading insurance companies suspended their services, citing a sharp rise in treatment costs.

The insurers, including Madison Insurance, First Assurance, Minet, Old Mutual, Britam, AAR, CIC, and Pakis Insurance, announced the move following the hospital’s decision to increase service charges by up to 61%.

In a statement, Madison General Insurance said the scale of the price hike was ‘not sustainable’.

Insurers withdraw, citing reasons

“While we respect the hospital’s dedication to delivering excellent care, the magnitude of these increases is, in our assessment, not sustainable,” read part of the Madison General Insurance statement.

CIC Group, in a staff notice, confirmed that it would withdraw services from next Tuesday.

Most companies plan to implement the suspension next week, a decision expected to significantly impact patients relying on insurance coverage for treatment at the facility.

Reports indicate that the hospital leadership implemented the price adjustments recently, sparking pushbacks from insurers who argue that the increase is excessive and will impact affordability for clients.

Nairobi Hospital founder and branches

The Nairobi Hospital has grown to become one of the leading providers of healthcare services in the East African region.

Sir Evelyn Baring, the then Governor of Kenya Colony, laid the Hospital’s foundation stone on the morning of October 20, 1952.

The Nairobi Hospital operates several branches across Kenya to provide accessible healthcare services.

The Main Hospital is located along Argwings Kodhek Road in Nairobi and serves as the central facility.

Additional branches include the Galleria Mall Branch on Lang’ata Road, the Warwick Centre Branch in Gigiri along UN Avenue, and the Capital Centre Branch on Mombasa Road.

Other locations include the Rosslyn Riviera Branch on Limuru Road, the Southfield Mall Branch in Embakasi along Airport North Road, and the Kiambu Mall Branch on Kiambu Road.

Duale suspends hospitals involved in SHA’s fraudulent activities

This comes after the Health Cabinet Secretary, Aden Duale, on August 8, suspended 40 hospitals from the Social Health Authority programme for engaging in fraudulent practices.

Speaking during a news briefing on Friday, Duale said that the Ministry will publish the names of the suspended hospitals in a Gazette Notice after they are investigated by the DCI.

According to the CS, the suspension will not be lifted until the 40 hospitals comply with all SHA regulations.

Also Read: Meet the Kenyans Behind the Ownership of Nairobi Hospital

“We have suspended 40 health facilities found to be defrauding SHA. These suspensions take effect immediately. During the investigation period, these facilities will not receive any benefits from SHA,” the CS announced.

Duale has explained that during the period of investigations, the hospitals are not entitled to receive any benefits from the SHA.

“Furthermore, we will be surcharging them to recover any money already paid to them based on any fraudulent claims,’ Duale further continued.

Fraudulent activities within insurance
Health Cabinet Secretary Aden Duale has raised concerns over fraudulent activities within the Social Health Authority (SHA) system, warning that such actions are punishable under the law.

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He cited a case in Bungoma where a health facility submitted a falsified medical report for a patient who had already been recorded in another facility.

Duale also noted a worrying trend of facilities, both public and private, converting outpatient cases into inpatient ones in a bid to inflate claims. This practice, he said, is particularly rampant in Nairobi and Homa Bay counties.

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