Simon Mukabane Okwomi v National Health Insurance Fund
Complaint upheld; enforcement notice issued. ODPC, 11 December 2023.
The facts
The complainant alleged the National Health Insurance Fund wrongly added people unknown and unrelated to him as beneficiaries under his NHIF card and removed his wife as his lawful beneficiary. The respondent said the added dependants had been removed, but did not demonstrate that the complainant's card details were corrected. He said his wife could not use the cover and he paid her medical bill out of pocket, but did not quantify the amount, and the Office declined compensation because specific damages must be pleaded and justified.
Orders and outcome
The respondent was found liable for violating the complainant's rights and failing to fulfil its obligations, and an enforcement notice was issued against it, including for the undemonstrated correction of the card details. Dated December 2023.
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