The Social Health Authority (SHA) has been fingered by the Senate for failing to settle Sh8.14 billion in unpaid insurance benefit claims to the families of public servants who died or got injured while in the line. 

Bungoma Senator Wakoli Wafula has petitioned the Senate to investigate SHA’s failure to settle the State funded benefit claims accrued under civil servants, National Youth Service (NYS) and teachers enhanced insurance schemes for three financial years- 2020/21, 2022/23 and 2023/24. 

This came as National Treasury Principal Secretary Dr Chris Kiptoo, in a letter to SHA CEO Dr Mercy Mwangangi, confirmed the delays, attributing them to exchequer “challenges” at the National Treasury. 

Documents before parliament show that thousands of public servants “are suffering in silence” as billions of shillings meant for their insurance benefits remain unpaid. 

The claims have accrued under Group Life, Last Expense, Work Injury Benefit Act (Wiba) and the Group Personal Accident (GPA) schemes. 

The nonpayment of claims, according to Mr Wafula, exposes a deep crisis in the government’s human resources management, a “serious” challenge to motivate and retain the best workforce. 

“Several personnel and their families have borne untold suffering due to the failure by the defunct National Health Insurance Fund and its successor, SHA, to pay their claims, which have accrued over the years,” Mr Wafula says in the statement to the Health committee of the Senate. 

One of the cases involved a senior government dentist, who died while treating patients during the Covid-19 pandemic, is still owed Sh29.9 million in benefits, five years after the death occurred and reported. 

The delays in settling the claims means that every day of delay means a family goes hungry, a widow sells land to pay school fees and another injured worker is left without medical care. 

A member of the Senate Health Committee, who did not want to go on record for fear of being victimized and “targeted”, said that public servants keep the government systems running. 

“If the government cannot honor its basic obligations, what does that say about its commitment to the welfare of the people? Let’s call it for what it is. We can no longer sugarcoat as things go south,” the Senator said. 

In his July 1, 2025 letter to Dr Mwangangi, Dr Kiptoo confirmed the delays. 

The PS went on to acknowledge that “an outstanding premium of Sh8.14 for the three financial years has negatively impacted timely claims processing, directly affecting thousands of families awaiting compensation.” 

“Recognizing the urgency of the matter, the National Treasury has already remitted Sh1.6 billion as a sign of goodwill and commitment to resolving the issue,” assured Dr Kiptoo adding; “we are actively pursuing exchequer funding to clear Sh3.93 billion in legacy claims that were reported before the contract for the matter in question started on April 15, 2021.”

Despite the National Treasury releasing the Sh1.6 billion to facilitate partial settlement, SHA is yet to disburse the funds to the affected families. 

The unsettled claims affect over 7,200 families with teachers at over 4,000 deaths accounting for the largest followed by civil servants with at least 3,200 death cases. 

The Senate investigations will be undertaken by the Health Committee which is chaired by Uasin Gishu Senator Jackson Mandago. 

In its report to the Senate, Mr Wafula specifically wants the Mandago-led committee to establish what SHA is doing to facilitate the “prompt” settlement of the outstanding 1,004 death claims amounting to Sh4.218 billion. 

The others include 1026 funeral claims amounting to Sh207.3 million and 1,267 injury claims amounting to Sh2.645 billion for the government officers. 

“The committee should establish the reasons for the inordinate delay by the SHA to release the Sh1.6 billion disbursed by the National Treasury for partial settlement of the claims including the timelines for the same,” says Mr Wafula. 

The Bungoma Senator further wants to know whether SHA will factor accrued interest when settling the outstanding claims and if so, provide details on the applicable interest and the projected timelines for the full settlement of all the outstanding claims under the scheme. 

But Dr Kiptoo has since given an assurance that “we are confident that with your continued support, we can work together to expedite settlements, restore confidence in the program and demonstrate to our public servants and their families that their wellbeing remains a top priority.” 

The PS letter to the SHA CEO was to assure her of the government’s commitments after she became frustrated over the lack of exchequer releases to pay the insurance service providers for the schemes, who were on her case. 

The impact of the government’s failure to pay the premium amounts on public services is that private hospitals are cancelling services to civil servants over unpaid premiums, the Group Life, GPA and Wiba that expired in 2024 have not been renewed. 

This puts SHA at the center of a growing storm, blamed for inaction while public servants sink deeper into hardship, a major contributor to the rising political heat. 

On May 29, 2025, local insurance service providers- Britam Life Assurance Company (Kenya) Limited and Jubilee Allianz General Insurance (Kenya) Limited separately wrote to SHA CEO, without a response, seeking the government’s release of the premium amounts. 

The two insurance companies that co-insured the benefits, with copies of their letters to National Treasury, warned that delays in releasing the premium amounts are crippling their ability to pay valid claims and that they are straining their financial stability. 

However, Dr Kiptoo reaffirmed the government’s commitment to ensuring the successful execution of the scheme. 

The government through the National Treasury and the State Department for Public Service, partnered with the defunct NHIF to provide “vital” insurance cover- Group Life, Last Expense, enhanced Wiba and Group Personal Accident “for our” civil servants and NYS. 

The scheme covered the financial years 2020/21, 2022/23 and 2023/24. 

The initiative reflects “our shared commitment to safeguarding the wellbeing of public servants and their families.” 

In line with regulatory guidance from the Insurance Regulatory Authority (IRA) and the Public Procurement Regulatory Authority (PPRA), NHIF engaged “reputable reinsurance partners to strengthen the programs’ resilience and reach.”