INSURANCE LAW CAT

1. Evaluate the legal framework of healthcare insurance under the National Health Insurance
Act as amended and consider how it meets the objectives of universal healthcare in Kenya.

The National Health Insurance Act of Kenya was passed in 1998 and amended in 2018 to create a legal
framework for healthcare insurance in Kenya. The main objective of the Act is to provide universal
healthcare coverage to all Kenyans by making healthcare services accessible and affordable. 1

The Act establishes the National Health Insurance Fund (NHIF) which is mandated to provide medical
insurance to all Kenyans. The NHIF is funded by contributions from employers, employees, and self-
employed individuals. The Act also mandates all employers to contribute to the NHIF on behalf of their
employees.

The NHIF is responsible for providing healthcare services to its members through accredited healthcare
providers. The Act sets out guidelines for the accreditation of healthcare providers and the minimum
standards of care that must be met by providers to be accredited.

The Act also provides for the establishment of a National Health Insurance Council which is responsible
for the regulation and supervision of the NHIF. The Council is responsible for ensuring that the NHIF
operates by the law and that it provides quality healthcare services to its members.

In addition, the Act sets out measures to prevent fraud and abuse in the healthcare insurance system. It
provides penalties for individuals or healthcare providers who engage in fraudulent activities such as
submitting false claims or providing substandard care.

Overall, the legal framework of healthcare insurance under the National Health Insurance Act in Kenya
as amended provides a comprehensive framework for the provision of healthcare insurance services in
Kenya. It aims to meet the objectives of universal healthcare in Kenya by making healthcare services
accessible and affordable to all Kenyans. However, there are still challenges in the implementation of
the Act, such as inadequate funding and a shortage of healthcare providers, which need to be addressed
to achieve the goal of universal healthcare coverage in Kenya.

2. CITING APPROPRIATE ILLUSTRATIONS, DISCUSS THE OBJECTIVES, DESIGN ELEMENTS, AND MERITS
OF A NO-FAULT INSURANCE SYSTEM IN CONTRAST TO THE COMMON LAW FAULT-BASED SYSTEM OF
INSURANCE APPLICABLE IN KENYA

No-fault insurance is a type of insurance system where drivers involved in a car accident are
compensated regardless of who was at fault for the accident. In contrast, a common law fault-based
insurance system requires that the party at fault for the accident be identified and held responsible for
any damages or injuries caused.

Objectives of a No-fault Insurance System:

To simplify the process of claiming compensation by eliminating the need for lengthy legal battles to
determine fault and liability for damages.

To provide faster and more efficient compensation for victims of car accidents.

1
“National Hospital Insurance Fund Act.Pdf.”
To reduce the costs associated with legal fees and administrative costs, which can drive up insurance
premiums.

To ensure that accident victims receive adequate compensation for their injuries and losses, regardless
of who was at fault.

Design Elements of a No-fault Insurance System:

Mandatory insurance coverage: All drivers are required to carry a minimum level of insurance coverage
that provides compensation in the event of an accident, regardless of fault.

Personal Injury Protection (PIP): PIP coverage provides compensation for medical expenses, lost wages,
and other expenses incurred as a result of an accident.

Limits on lawsuits: In a no-fault system, the ability to sue for damages is limited to cases where the
injuries or damages exceed a certain threshold.

Comparative fault: If multiple parties are found to be at fault for an accident, compensation is divided
according to the degree of fault assigned to each party.

Merits of a No-fault Insurance System:

Faster compensation: Because fault is not a factor in determining compensation, victims of car accidents
can receive compensation more quickly and efficiently.

Lower costs: No-fault insurance systems can reduce the costs associated with legal fees and
administrative costs, which can drive up insurance premiums.

Less litigation: By eliminating the need to determine fault and liability, no-fault systems can reduce the
number of lawsuits filed over car accidents.

Fair compensation: No-fault insurance systems ensure that accident victims receive compensation for
their injuries and losses, regardless of who was at fault.

Better for low-income individuals: No-fault insurance systems can provide better protection for low-
income individuals who may not be able to afford costly legal battles in the event of an accident.

However, there are also some potential drawbacks to a no-fault system, including reduced
accountability for drivers and potential increases in insurance premiums. Ultimately, the choice between
a no-fault or fault-based insurance system will depend on the priorities and values of each country or
state.

3. HAVING REGARD TO THE FINANCIAL MARKET CONDUCT BILL 2018, EXAMINE THE REFORMS THE
FINANCIAL MARKET COUNCIL BILL,2018 SOUGHT TO INTRODUCE ON THE CONDUCT OF BUSINESS OF
FINANCIAL CONGLOMERATES AND FINANCIAL CONSUMER PROTECTION

The Financial Market Council Bill, 2018 aimed to introduce reforms on the conduct of the business of
financial conglomerates and financial consumer protection. The key provisions of the bill include:

Regulation of financial conglomerates: The bill proposed to regulate financial conglomerates by

establishing a single regulatory body to oversee their operations. This would ensure that financial
conglomerates are subject to consistent regulation and supervision, regardless of the type of financial
services they offer.

Consumer protection: The bill sought to enhance consumer protection by establishing clear and concise
disclosure requirements for financial products and services. This would help consumers make informed
decisions about their financial products and services.

Complaints handling: The bill proposed to establish an independent complaints-handling body to deal
with complaints from consumers about financial products and services. This would provide consumers
with a more accessible and effective mechanism for resolving disputes with financial service providers.

Enforcement powers: The bill sought to enhance the enforcement powers of regulatory bodies to
ensure that financial service providers comply with their regulatory obligations. This would help to deter
misconduct by financial service providers and promote a culture of compliance within the financial
sector.

Overall, the Financial Market Council Bill, 2018 aimed to introduce important reforms to improve the
conduct of the business of financial conglomerates and strengthen financial consumer protection. If
enacted, the bill would provide greater regulatory clarity and consistency for financial service providers,
while enhancing consumer confidence in the financial sector. 2

2
“Draft-Financial-Markets-Conduct-Bill-2018.Pdf.”