NAIROBI, Kenya, Apr 24 — The government will disburse Sh116 million to settle pending insurance claims under the defunct EduAfya medical scheme by May 8, following delays linked to the transition from the National Health Insurance Fund (NHIF) to the Social Health Authority (SHA).
In a response to the Senate plenary, the Ministry of Health said the delays in compensating beneficiaries were caused by system transitions and the need to audit inherited liabilities after the lapse of the EduAfya scheme at the end of 2023.
“The delay in compensation was occasioned by the operational transition from the defunct National Health Insurance Fund (NHIF) to the Social Health Authority (SHA) and the subsequent lapsing of the EduAfya Medical Scheme on 31 December 2023,” the ministry said.
“The Social Health Authority has finalized its settlement plan and prioritized the clearance of these specific beneficiary claims.”
The ministry noted that all liabilities under the scheme had to undergo verification and auditing before being transferred to the new authority under the Social Health Insurance Fund (SHIF) framework.
According to the response, the pending claims fall under the “Group Life and Last Expense” category, with total outstanding obligations amounting to Sh116 million.
The issue had been raised in the Senate following delays in compensating families of deceased students who were beneficiaries of the scheme, including cases involving students from Naivasha Girls Secondary School and Kibera Secondary School.
The government acknowledged receipt of the claims and attributed the backlog to “necessary system checks and verification” processes tied to the transition.
With the settlement plan now in place, the Ministry said SHA will disburse the full amount to clear all pending claims, bringing closure to affected families.
