Madison Insurance declines to lift suspension of Nairobi Hospital despite halting of price hikes
Insurer says that despite engaging in open and constructive discussions, they were unable to reach terms that safeguard its members' best interests at time
Madison General Insurance Kenya has declined to lift the suspension of The Nairobi Hospital from its network despite its decision to freeze the recent increase of its tariffs following talks with senior representatives of insurance companies on Monday.
In a statement, Managing Director Samuel Chege said that despite engaging in what he called “open and constructive discussions” to agree on a fair, sustainable pricing model that balances quality and affordability, they were unable to reach terms that safeguard its members’ best interests at time.
“Your health and wellbeing remain at the centre of everything we do. We are committed to ensuring that you continue to enjoy access to quality healthcare at costs that are fair, transparent, and sustainable. Recently, The Nairobi Hospital announced a significant upward revision of its service charges. While we respect the hospital’s dedication to delivering excellent care, the magnitude of these increases is, in our assessment, not sustainable and could result in much higher healthcare costs for our members in the long term,” the statement said.
“To protect the value of your cover, we engaged The Nairobi Hospital in open and constructive discussions to agree on a fair, sustainable pricing model that balances quality and affordability. Despite genuine efforts on both sides, we were unfortunately unable to reach terms that safeguard our members’ best interests at this time,” Chege added.
He said that a result, effective Wednesday, 13th August 2025, The Nairobi Hospital will be temporarily suspended from its network, and its services will not be covered directly.
However, Chege said that Madison’s customers’ cover remains active, with access to over 1,200 accredited facilities nationwide.
“We remain committed to pursuing further discussions with The Nairobi Hospital in the hope of reaching a fair and sustainable agreement that will allow us to reinstate access for our members. We sincerely appreciate your trust and understanding as we take these necessary steps to protect both the quality of your care and the long-term sustainability of your medical benefits,” he added.
On Monday, The Nairobi Hospital announced it had agreed to suspend implementation of the recent price review following a meeting with key insurance providers, most of whom had cut links with the facility in protest.
“Following a productive strategic meeting held today with key insurance providers, The Nairobi Hospital has agreed to suspend the implementation of its recently announced price review, effective immediately,” the Chief Executive Officer Felix Osano said in a statement.
“This decision, made in good faith, responds to requests from our valued insurance partners to allow for further consultation and collaborative dialogue.”
The statement said the meeting was attended by senior representatives of leading medical insurance providers, including Madison Insurance, First Assurance, Minet, Old Mutual, Britam, AAR, CIC and Pacis Insurance, which had last week announced they will not provide services for patients at the prime but beleaguered facility beginning Monday.
This was after discussions on a more sustainable, volume-based model failed to bear fruits.
Representatives of Heritage, Kenindia, Kenya Alliance and Fidelity also attended Monday’s crisis talks.
During the discussions, Osano said concerns over the proposed pricing structure, ensuring alignment with the hospital’s shared commitment to patient-centred care were addressed.
Initially, while calling for the meeting, the hospital had insisted that the tariff adjustments are necessary to maintain the high standards of healthcare its patients deserve.
“Independent comparisons indicate that our revised rates remain competitive and fair when measured against peer institutions offering equivalent levels of care and expertise,” it had said.
The hospital, which is owned by the Kenya Hospital Association (KHA), had last month announced an increase in the cost of services by as much as 61 per cent on key services such as scans, ultrasounds, and bed charges.
While it is considered the East African region’s most advanced hospital, it has been reeling in leadership wrangles and financial mismanagement allegations, affecting both its operations and reputation.
It is also reported to be indebted to the tune of over Sh3 billion.
