Nearly four years have passed since Business Talk’s original four-part series that dissected the Kenyan health insurance industry through rigorous perspectives on famous trust scales.
The series garnered extensive responses from insurance customers and insurance companies alike. Now in 2025, Business Talk in the Business Daily embarks on a fresh look at Kenya’s health insurance sector in a new multi-week series.
Back in 2021, policy holders raised such worrying issues such as tardiness in claims settling, formidably unfriendly forms, and brusque refusals of cover which disenchanted citizens.
Regulators burdened some operators with new capital conditions all with anecdotal testimony of broken promises echoing across the sector.
Now, have things improved over time or do concerns remain about health coverage among our population? Sadly, health insurance and subsequent renewals exist as textbook cases of how businesses should not engage their customers.
If there was a competition inviting university students from across the nation to a luxury resort in Kilifi and participants were given the task of designing customer experiences most likely to drive away future business and decrease renewals, then likely most of what such a hackathon would develop laughably may describe what many health insurers are already doing. Do health insurers simply not want business?
Remember, to win and hold customers, firms must instill feelings that uplift customer perceptions using Roger Mayer, James Davis, and David Schoorman’s famous trust scales involving ability, benevolence, and integrity.
Insurers must show consumers that they hold the ability to fully provide insurance coverage and payout claims when needed. Insurers need to display that they care about their customers’ wellbeing through demonstrations of benevolence.
Additionally, firms need to establish their integrity not just by not stealing but also being honest and upfront in their clear documentations, understandable disclosures, and advertisements.
Unfortunately, many Kenyan consumers still feel that insurers fail them and do not adequately demonstrate the insurers’ trustworthiness. Insurance penetration rates still fluctuate dismally in Kenya between 2.3 percent and 3 percent. KPMG claims that Kenya’s insurance penetration subsides as the third worst in all of Africa.
In the past four years, a disturbing trend of not providing customers with tangible proof of their insurance cover post-purchase appears to be getting worse. Consumers must often beg for their policy documents.
Insurance brokers who get rewarded on the sale rather than on customer satisfaction with their post-sale service have little incentive besides future renewals to deliver final coverage documents.
Then even worse, various insurers do not offer physical insurance cards instead giving digital virtual copies or requiring downloaded mobile apps to prove coverage.
Given the vast rumours of fake brokers selling false coverage, one would think that insurers would trip over themselves to reassure customers of the validity of their coverage and ways through even simple technology like a verification of policy numbers section on their websites.
Some insurers do deserve gold stars for great transparency on their websites. AAR and Old Mutual, as examples, transparently provide their health insurance offerings and their pricing per plan.
While some other insurers simply give a definition of what health insurance means and give a phone number or button to press to reach an agent to get a quote. Such awful lack of openness should be illegal.
A consumer should be able at minimum to receive pre-sale information on insurer websites of transparent pricing, coverage, exclusions, full policy terms not just partial highlights, and provider panels.
Why does our Insurance Regulatory Authority (IRA) not require and enforce complete transparency for the market? Foreign regulators, like in the United States, require it and even provide an independent way for consumers to rate their insurers and those ratings are visible on the government’s own website.
If relying on brokers to provide the pre-sale content, one never knows if the forms or provider panels are even up-to-date. Sadly, Kenyans are still pushed to go through brokers rather than buy directly from the insurers for our health insurance sales.
Next, many Kenyan consumers are frustrated with the health insurance renewal process for many insurers. Many insurers provide no email, text, or call to the customer reminding them of their renewal.
Then if a consumer remembers even a day late, their coverage collapses, and they have to start all over again with new waiting times for coverage.
Some who do provide reminders only give the reminders seven days in advance but in the text of the reminder state that renewals must be completed fourteen days before their cover expires.
This prompts one to wonder if insurers even read their own emails that they send out! Some of these insurers have probably never given a survey or conducted any customer interviews or focus groups to actually hear how their idiotic processes are viewed by consumers.
But instead, they would rather go on television and complain that Kenyan consumers seem not sophisticated enough to understand the importance of insurance when in reality insurers should be looking in the mirror and pointing the finger at themselves.
Then renewal notices when sought out by consumers or in some situations proactively sent in advance by the insurer contain lots of codes. One must use Google and ChatGPT to understand some of what is being spewed.
Renewals should provide clearly what is being renewed, how much is coverage, what is being covered, what are the exclusions, any changes since last renewal, how much of the fee is an increase due to inflation versus loading due to high usage, and new policy terms and conditions.
No Kenyan health insurance consumer when questioned for this article received all of these from their insurer for their last renewal.
Then some of the biggest insurers have just been caught, in preparing this article, for overcharging consumers in the renewals with fees erroneously placed in loading columns or other charges with questionable codes that in some cases do not exist.
Consumers must not blindly pay their health insurance renewals but instead challenge any new costs and get the reason in writing from the insurer themselves, not from the broker.
Join Business Talk next week as we delve into solutions for health insurers.
Have a management or leadership issue, question, or challenge? Reach out to Dr. Scott through @ScottProfessor on Twitter or on email [email protected]
