NHIF moves to curb fraudulent claims

The National Hospital Insurance Fund (NHIF) could be losing millions of shillings in fraudulent claims by contributors.
This comes after a woman was busted in Isinya, Kajiado County trying to use the card to cater for a non-dependant.

Sandra Wangila who works with a flower farm in Isinya allegedly tried to cater for her sister, Diana Wangila’s medical costs using her card contravening the legally gazetted dependants clause by NHIF.

She was arraigned in a Kajiado court allegedly for aiding in impersonation for health insurance.

According to the national health insurer’s Kajiado Branch Manager, Jeniffer Muriuki, the accused tried to use card to cover a non-dependent which is illegal.

“Dependants refer to one’s spouse and children and cannot be extended to other family members,” said Muriuki.
The 17-year-old girl was admitted to a hospital in Isinya last week before the discovery was made on Friday by the hospital which promptly informed the NHIF office who swung into action.

Muriuki says that it is illegal to use the card on non-dependents and it is a criminal offence.

She warns, “The public should be warned that anybody who impersonates another in order to benefit, does so fraudulently and will face criminal charges.”
Muriuki says that such cases may have been going on undetected but health facilities are now being sensitised to ensure that only beneficiaries are catered for as stipulated by the law.
NHIF CEO, Geoffrey Mwangi says that such cases are not common due to increased surveillance which has deterred unscrupulous health facilities.
“It is usually a collusion but we started cracking down on health facilities but now we are taking it to individual levels in order to weed out this problem once and for all,” says Mwangi.
He further says that the NHIF Act provides for a fine of Sh50,000 and a jail term of upto six months while the Penal Code provides for prison term of three years.

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