A ruling by the High Court, on Tuesday, spelt good news for National Health Insurance Fund (NHIF) members seeking to make changes to their cover or register a spouse as a beneficiary.
NHIF had issued a directive on February 22, 2018, that members seeking to make any changes regarding spouses to their cover were mandated to produce a marriage certificate or an affidavit commissioned by a magistrate.
This caught many of the funds’ members by surprise, especially the thousands of couples who had been living together as husband and wife but without marriage certificates.
However, the recent court ruling by Judge John Mativo stated the national fund had no power to dictate which affidavit to allow, meaning that one from an advocate should also be acceptable.
“The respondents have no legal mandate to prescribe which documents an advocate once appointed under the Act can commission,” he stated in his ruling.
“The decision lacks a legal basis, it offends the law, it defies logic, the decision is grossly unreasonable,” he added.
In their defence, the national fund explained that they had discovered a large number of beneficiaries were actually just dating or people not related to the health fund member in any way.
“The process of identification is necessary to avoid fraud or extending benefits to unqualified persons, resulting in loss of public funds,” NHIF argued.
Nonetheless, the year-long battle between advocates and the national fund was settled, with the court ruling that affidavits from lawyers would be sufficient proof that an individual is either a wife or husband to the registered member.
Justice Mativo went on to assert that NHIF’s move to disqualify affidavits commissioned by advocates prior to consulting with all stakeholders was unfair as it affected the majority of Kenyans.
Registered NHIF members were required to produce the contentious magistrate-commissioned affidavit when changing the name of one’s spouse or adding an individual as a spouse.