National Hospital Insurance Act (Cap 255)

Cap. 255 National Hospital Insurance [Rev. 1977

(Repealed by Act 9 of 1998)

CHAPTER 255

THE NATIONAL HOSPITAL INSURANCE ACT

ARRANGEMENT OF SECTIONS

PART I – PRELIMINARY

Section

1 Short title 2 Interpretation.

PART II-THE NATIONAL HOSPITAL INSURANCE FUND

3 Interpretation of Part.

The Fund

4 National Hospital Insurance Fund.

Contributions

5 Liability to and Payment of Standard and Special Contributions. 6 Payment of Standard Contributions by Employers. 7 Persons to Be Treated as Employers. 8 Cards and Evidence of Payment of Contributions. 9 Penalty for Late Payment of Standard Contributions.

Benefits

10 Benefits. 11 Register and Receipts. 12 Stamps. 13 to 18 Repealed19 Offences Relating to Benefits. 20 Regulations Regarding Contributions. 21 Regulations Regarding Benefits. 22 Modification of Act in Special Cases. 23 General Provisions as to Regulations. 24 Consideration of Regulations Toy Advisory Council.

PART V-NATIONAL HOSPITAL INSURANCE ADVISORY COUNCILwww.kenyalaw.org


25 National Hospital Insurance Advisory Council.

PART VI-FINANCE, ADMINISTRATION AND LEGAL PROCEEDINGS

Finance

26 Investment of Fund. 27 Expenses of Administering Fund. 28 Application to Fund of Cap. 412.

Administration 29 Hospitals for the Purposes of Act. 30 Determination of Claims and Questions 31 Officers of Fund. 32 Inspectors. 33 Exemption from stamp duty.

Legal Proceedings 34 General Provisions as to Offences. 35 Proceedings to Recover Sums Due to Fund. 36 Recovery of Compensation or Damages.37 Evidence.

PART VII-REPEALS AND TRANSITIONAL PPP38 to 40 - Spent41 Disposal of European Hospital Treatment Relief Fund. 42 Disposal of Kenya Hospital Fund. 43 Savings and Regulations. 43A Disposal of Voluntary Fund, Etc. 44 Power of Minister to Exempt.

SCHEDULE

The National Hospital Insurance (Standard Contributions) (use of Franking Machine in Lieu of Stamps) Regulations

The National Hospital Insurance (Claims and Benefits) Regulations

The National Hospital Insurance (Foreign Claims and Benefits) Regulations

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Rev. 1977] National Hospital Insurance Cap No. 255

The National Hospital Insurance (Voluntary Contributions) Regulations

CHAPTER 255

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NATIONAL HOSPITAL INSURANCE ACT

Commencement Date: 1966-07-12

An Act of Parliament to establish a National Hospital Insurance Fund and a National Hospital (Voluntary) Insurance Fund; to provide for contributions to and the payment of benefits out of those Funds; and for matters connected therewith and incidental thereto

PART I-PRELIMINARY

Short title 1. This Act may be cited as the National Hospital Insurance Act.

Interpretation.4 of 1972,s.2.10 of 1958.

2. In this Act, except where the context otherwise requires –

"this Act" includes any regulations made thereunder;

"Advisory Council" means the National Hospital Insurance Advisory Council constituted under section 25 of this Act;

"benefit" means a benefit payable under this Act;

"card" means a National Hospital Insurance Card issued under section 8 of this Act;

"Commissioner" means the Commissioner of Income Tax appointed under the Income Tax (Management) Act;

"contribution" means a contribution to the Fund;

"contributor" means a contributor to the Fund;

"financial year" means the period of twelve months commencing on 1st July in any year,

"the Fund" means the National Hospital Insurance Fund established under section 4, of this Act;

"the Income Tax (Management) Act" means the East African Income Tax (Management) Act, 1958, of the High Commission;

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"the Minister" means the Minister for the time being responsible for health;

"Organization" means the East African Common Services Organization;

"prescribed" means prescribed by regulations;

"regulations" means regulations made by the Minister under this Act;

"stamp" means a National Hospital Insurance stamp sold under section 12 of this Act.

PART II-THE NATIONAL HOSPITAL INSURANCE FUND

Interpretation of Part.4 of 1972, s.3.

3. In this Part -

"employer" includes the Government and the Organization;

"register" means the register of contributors to the Fund referred to in section 11 of this Act;

"special contribution" means the special contribution payable under section 5 of this Act;

"standard contribution" means the standard contribution payable under section 5 or 5A of this Act.

The Fund

National Hospital Insurance Fund.4. There shall be established, under the control and

management of the Minister, a fund called the National Hospital Insurance Fund, into which shall be paid all contributions and other payments required by this Act to be paid into the Fund, and all donations and bequests made to the Fund, and out of which shall be paid all benefits and other payments required by this Act to be paid out of the Fund.

Contributions

Liability to and payment of standard and special contributions.

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5. (1) Subject to this Part, in the financial year commencing on 1st July, 1966, and in each succeeding financial year, every person who has or will have attained the age of eighteen years before the end of that year shall be liable as a contributor, subject to his having the income specified in this section, to pay the standard contribution for each month of that year and the special contribution for that year:

Provided that no standard contribution shall be payable for the month of July 1966

(2) The standard contribution shall only be payable by a person in respect of income in respect of which that person becomes liable to income tax in Kenya, or in respect of which he would have become liable if that income had been greater in amount.Provided that where the income of a person paying the standard contribution is derived solely from employment, the standard contribution shall be paid only from his wages or salary.

(3) The standard contribution for a month shall be paid on or before the first day of that month and shall be payable by every person liable as a contributor under this section whose total income –

(a) in the month immediately preceding that month was not less than one thousand shillings; or

(b) in the three months immediately preceding that month was not less than three thousand shillings; or

(c) in the twelve months immediately preceding that month was not less than twelve thousand shillings.

(4) The standard contribution for any month shall be paid by affixing to the card issued to the contributor, in the space provided for that contribution, a stamp with a value of twenty shillings which shall then be cancelled by writing thereon, in ink or by indelible stamp, the date on which it is so affixed.

(5) The special contribution for a financial year shall be assessed by the Commissioner on the chargeable income of every person liable as a contributor under this section for the last year of income ending before that financial year, and shall be levied on that chargeable income at the rate of one hundred and twenty shillings where that income exceeds twenty thousand shillings, or at the rate of two hundred and forty shillings where that income exceeds forty thousand shillings.

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(6) The special contribution assessed on any year of income shall be assessed, shall become due and payable, and shall be collected and may be recovered in all respects as if it were income tax payable under the Income Tax (Management) Act by an individual liable for income tax in respect of that year of income, and all the provisions of Part XII to Part XIV both inclusive of the said Act and of any rules made under section 148 of the said Act shall applymutatis mutandisin relation to that contribution:

Provided that any income accrued in or derived from Kenya or another East African territory before the date upon which that individual became resident in Kenya, or after the date upon which he ceased to be resident in Kenya, shall not be taken into account, and section 30 of the said Act shall not apply in relation to any special contribution.

(7) There shall be retained by the Commissioner out of the moneys received by him in any financial year in respect of special contributions such sum as the Minister may, with the concurrence of the Minister for the time being responsible for finance, agree with the Commissioner to be the expenses of the Commissioner in collecting and recovering those contributions, and subject as aforesaid all those moneys shall be remitted to the Fund without delay.

(8) Where the income of a married woman is deemed to be the income of her husband for the purpose of ascertaining his total income for income tax purposes that married woman shall not be liable as a contributor under this section, but her husband shall be liable as a contributor as if her income were his income.

(9) In this section –

(a) "chargeable income", "East African territory", "income tax", "resident in Kenya" and "total income" have the meanings assigned to those expressions by the Income Tax (Management) Act;

(b) "year of income" means a calendar year.

Voluntary contributors.4 of 1972, s.4.

5A. (1) In respect of any financial year, any person who –

(a) is ordinarily resident in Kenya; andwww.kenyalaw.org


(b) who has attained, or will before the end of that year attain, the age of eighteen years; and

(c) is not liable under section 5 of this Act to become a contributor iin that year, or who ceases to be so liable after the commencement of that year,

may, subject to the provisions of this section, by notice in writing in such form as the Minister may approve, elect to become a contributor for that year, and such election shall be irrevocable.

(2) In respect of any financial year any contributor may, by notice in writing in such form as the Minister may approve, elect to pay additional standard contributions in respect of such named wives or other persons as would otherwise not be entitled to benefits in respect of the standard contribution paid by such contributor on his own behalf, and such election shall be irrevocable.

(3) An election under subsection (1) or (2) of this section shall become operative on the first day of the month following that in which it is made and the person making the election shall be liable to pay the standard contribution for that month and for each succeeding month of that financial year:

Provided that the Minister may exempt any such person from such liability, or any part thereof, where he is satisfied that, on the ground of hardship, such exemption should be granted. (4) A notice of election under this section may he rejected for reasonable cause by an officer of the Fund, and any person who is aggrieved by any such rejection may appeal to the Minister whose decision thereon shall, subject to section 30 of this Act, be final.

(5) A person tendering an election under this section shall furnish the full names of all persons who are to be eligible to receive benefits by reason of that election and may be required by any officer of the Fund to furnish information regarding the present or previous health of such persons or such other information as may be prescribed.

(6) Any person who, being required under subsection (5) of this section or under any regulations made thereunder, knowingly makes any false statement whether orally or in writing, shall be guilty of an offence and liable to a fine not exceeding three thousand shillings, or to imprisonment for a term not exceeding three months, or to both such fine and imprisonment.

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(7) Notwithstanding the provisions of section 10 of this Act, no benefits shall be paid in respect of any expenses incurred by a person who becomes a contributor under this section if such expenses axe incurred within a period—

(a) of six months in the case of maternity benefit or

(b) of sixty days, in the case of any other benefit,

after the date upon which such person becomes liable to pay the standard contribution.

Payment of standard contributions by employers. 6. (1) Subject to the provisions of this section, and except

where regulations otherwise prescribe, every employer of a person who is required by this Act to pay a standard contribution for any month shall, in the first instance, be liable to pay that contribution, within the time and in the manner prescribed by section 5 of this Act, on behalf of and to the exclusion of that person:

Provided that an employer shall not be liable to pay a contribution for any month in respect of a person employed by him whose total income from that employment in the immediately preceding month was less than one thousand shillings.(2) An employer shall not be liable under this section to pay the standard contribution in respect of any person employed by him for any month -

(a) in which he was not at any time the employer of that person (except where the employment is terminated in the month immediately preceding that month);

(b) in which he was not the employer on the first day of that month, unless that contribution has not been paid before the day in that month when he becomes the employer, and then he shall only become so liable seven days after that day; or

(c) in respect of which the wages or remuneration payable by him, after all other lawful deductions have been made therefrom, are not sufficient to pay that contribution.

(3) An employer shall be entitled, subject to and in accordance with any regulations -

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(a) to deduct from the wages or remuneration of any person employed by him, notwithstanding anything in any law, the amount of any standard contribution paid by him, or to be paid by him within one month of such deduction, on behalf of that person;

(b) to obtain a card for any person employed by him where that person does not provide him with a card issued to that person, or where that person's card has been lost or destroyed;

(c) to retain possession of the card issued to a person employed by him, except when that person requires that card for the purpose of obtaining any benefit under this Act, until that card is required for surrender upon the issue of a new card for the next financial year.

(4) No sum deducted from the wages or remuneration of an employed person by his employer in accordance with the provisions of this Part shall be recoverable from that employer by that person after a stamp to the value of that sum has been fixed to a card issued to that person and duly cancelled:

Provided that nothing in this subsection shall affect the responsibility of the employer for the safe custody of that employed person's card.

(5) If for any reason an employer is unable to ascertain whether any person employed by him is liable to pay any standard contribution for any month he may apply to the Minister for a decision and, subject to the provisions of section 30 of this Act, any decision given by the Minister shall be final and binding on that employer.

(6) The obligations of an employer under this section may be performed in such manner other than that provided by this section as -

(a) in the case of the Government or the Organization, the Minister may approve; and

(b) in the case of any other employer, or class or description of employers, the Minister may prescribe.

(7) Any person who -

(a) fails without lawful excuse to pay, within the time and in the manner prescribed by this Act in relation to him, any standard

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contribution which he is liable as an employer to pay under this Act; or

(b) knowingly makes any deduction from the wages or remuneration of any person employed by him purporting to be a deduction in respect of any standard contribution, other than a deduction which he is authorized to make by this Act,

shall be guilty of an offence and liable to a fine not exceeding four thousand shillings.

Persons to be treated as employers.7. In relation to contributors who work under the general

control or management of some person other than their immediate employer, and in relation to any other case of employment for which it appears to the Minister that special provision is needed, regulations may provide that for the purposes of this Act the prescribed person shall be treated as their employer; and such regulations may provide for adjusting the rights between themselves of employers, persons prescribed as employers and employed persons.

Cards and evidence of payment of contributions.8. (1) Subject to the provisions of this section, there shall

upon application be issued to every person who is liable as a contributor to the Fund in any financial year, a National Hospital Insurance card for that year, and there shall be inscribed on that card, at such time and in such manner as may be prescribed, the full name of the contributor and such other particulars as may be prescribed.

(2) Before a card is issued to any person for any financial year, that person may be required by any officer of the Fund authorized to issue that card -

(a) to produce evidence that he is or is likely to be liable as a contributor in that year;

(b) to produce evidence that he has in that year and in the immediately preceding financial year paid every standard contribution that he was liable to pay; and

(c) to surrender any card issued to or in respect of that person for the immediately preceding financial year.

(3) For the purpose of ascertaining whether the standard contribution for any month has been paid by any person, any

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officer of the Fund may put such questions (whether orally or in writing) to that person, or require that person to furnish such information or particulars or to produce such documents or other papers as, in his opinion, are necessary for the purpose.


(a) knowingly makes any false statement, whether orally or in writing, relating to any matter affecting his liability to pay any standard contribution; or

(b) being required under the last foregoing subsection to answer any question, furnish information or particulars or produce any document or paper, refuses or neglects to do so, without reasonable cause,

shall be guilty of an offence and liable to a fine not exceeding three thousand shillings or to imprisonment for a term not exceeding three months, or to both such fine and such imprisonment.

(5) For the purposes of this section, the following shall constitute conclusive evidence that the standard contribution for any month in any financial year has been paid by any person, namely -

(a) a stamp duly affixed to a card issued to that person for that year, and duly cancelled, in accordance with section 5 (4) of this Act;

(b) a receipt issued under section 11 of this Act; or

(c) a record of payment in the register of contributors to the Fund kept in accordance with section 11 of this Act.

Penalty for late payment of standard contributions.4 of 1972, s.5

9. (1) Subject to the provisions of this section, if any standard contribution which any person is liable to pay under this Act in respect of any month is not paid on or before the day on which payment is due, a penalty equal to five per cent of the amount of that contribution shall be payable by that person for each month or part of a month thereafter that the contribution remains unpaid, and any such penalty shall be recoverable as a sum due to the Fund, and when recovered shall be paid into the Fund.

(2) If an employer fails to pay a standard contribution in respect of any person employed by him -

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(a) that employer shall be liable to pay the penalties provided for in the foregoing subsection;

(b) that employed person shall not be liable to any penalty under this section for so long as he is employed by that employer, but thereafter shall be liable to penalties under this section as if that contribution had become payable sixty days after he ceased to be so employed.

(3) Where a contributor is outside Kenya on th

Benefits

Benefits.4 of 1972, s.6

10. (1) The benefits that shall be paid out of the Fund shall include -

(a) a daily allowance in respect of hospital treatment of such amount and for such period as may from time to time be prescribed; and

(b) such other benefits in respect of medical treatment as may from time to time be prescribed.

(2) No benefits shall be paid except in respect of treatment received by a contributor or by his named wife (or named husband, as the case may be) or by any child of his or other named person, and the benefit paid shall not in any case exceed in amount the expenses incurred by the contributor for the treatment in respect of which that benefit is paid.

(3) No contributors shall be entitled to any benefit in respect of expenses incurred in any financial year unless he produces at the time he claims the benefits a card issued to him showing that the standard contribution has been paid for the last month in that year for which it has become due and for every preceding month in that year commencing with the first month in respect of which he became liable as a contributor or unless he produces such other evidence of those payments as may be prescribed.

(4) No benefit shall be paid in respect of any expenses incurred by a contributor before the month in which he first becomes liable to pay a standard contribution.

(5) Subject to any extension of that benefit by regulations, the daily allowance for hospital treatment -

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(a) shall not be paid to any contributor in respect of more than one hundred and eighty days in any financial year, unless in any particular case, the Minister determines, with the approval of the Advisory Council, that there are circumstances of exceptional hardship, in which case that benefit may be paid in respect of such further number of days in that period as the Minister may, with the approval of the Advisory Council, determine;

(b) shall be paid in respect of the day of admission to or the day of discharge from hospital, but not in respect of both days.

(6) In this section -

"child" means a child of a contributor (including a posthumous child, a step-child, an adopted child, and any child to whom the contributor stands in loco parentis) who -

(a) has not attained the age of eighteen years;

(b) having attained the age of eighteen years but not the age of twenty-one years, has no income of his own and is living with the contributor; or

(c) having attained the age of eighteen years, is undergoing a full-time course of education at a university, college, school or other educational establishment, or serving under articles or an indenture with a view to qualifying in a trade or profession and is not in receipt of any income other than a scholarship, bursary or other similar grant or award.

"hospital" means any hospital, nursing home or maternity home which has, pursuant to section 29 of this Act, been declared to be a hospital for the purposes of this Act;

"hospital treatment" means the care and maintenance afforded to an in-patient in a hospital and includes such other treatment or facilities (whether or not given in a hospital) as may be prescribed;

"husband" means a husband of a female contributor, and

"named husband" means, in any financial year, the husband of that contributor who is for the time being named on the card issued to her for that year;

"wife" means a wife of a male contributor, and "named wife" means, in any financial year, the wife of that contributor who is for the time being named on the card issued to him for that year.

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Register and receipts.11. (1) A register shall be kept for the Fund, which shall

contain the names of all contributors to the Fund, and there shall be entered in that register the particulars stated on every card issued to a contributor to the Fund, and particulars of all contributions or other payments to the Fund made by or in respect of a contributor in so far as they are evidenced by a card surrendered or shown to an officer of the Fund in accordance with subsection (2) of this section or by any receipt issued in accordance with that subsection.

(2) A contributor to the Fund shall be entitled upon request -

(a) upon the surrender of his card to an officer of the Fund, to a receipt acknowledging all the payments of contribution evidenced by that card;

(b) not more frequently than once in every three months, upon showing his card to an officer of the Fund, to have entered in the register a record of all the payments evidenced by that card;

(c) to a receipt acknowledging any payment to the Fund made by or in respect of him otherwise than by affixing a stamp to his card,

but save as aforesaid no person shall be required to issue any receipt to a contributor.

Stamps. 12. (1) There shall be offered for sale to the public, in

such quantities and at such times and places as the Minister considers necessary for the implementation of this Act, National Hospital Insurance stamps at a price of twenty shillings for each stamp.

(2) For the purposes of this section, the Minister shall cause stamps to be printed of such design (which may be varied from time to time) as he thinks fit, and the cost of the printing and public sale of such stamps shall be borne by the Fund.

13 to 18. (Repealed by 4 of 1972, ss 7 and 8 and Sch.)

Offences relating to benefits.19. (1) Any person who, for the purpose of obtaining the

payment of any benefit under this Act, knowingly makes any false statement, whether orally or in writing, shall be guilty of an offence and liable to a fine not exceeding three thousand shillings

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or to imprisonment for a term not exceeding three months, or to both such fine and such imprisonment.


(a) with intent to obtain the payment of any benefit under this Act, falsely represents himself to be some other person, living or dead;

(b) buys, sells or offers for sale, takes or gives in exchange, or pawns or takes in pawn any card or used stamp or any receipt issued under this Act; or

(c) affixes any used stamp to any card,

shall be guilty of an offence and liable to a fine not exceeding ten thousand shillings or to imprisonment for a term not exceeding two years, or to both such fine and such imprisonment.

Regulations regarding contributions.20. Regulations may provide –

(a) for any matters incidental to the payment and collection of any contribution under this Act, or to the issue of any stamps or to the issue or replacement of any cards issued under this Act;

(b) for the return of contributions paid under this Act in error;

(c) for the remission in whole or in part of penalties incurred under section 9 of this Act, in such circumstances and subject to such conditions as may be prescribed;

(d) in respect of contributions to the National Hospital (Voluntary) Insurance Fund, for giving such rebates as may be prescribed to contributors who have no dependants or who fulfil such other conditions or requirements as may be prescribed.

Regulations regarding benefits.4 of 1972, Sch.

21. Subject to the provisions of this Act, regulations shall prescribe the amount of any benefits and the period for which any benefits shall be payable out of the Fund for the time being, and regulations may –

(a) prescribe any conditions or limitations subject to which any benefit shall be paid;

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(b) provide for the manner of the making and determination of any claim to any benefit;

(c) provide for the postponement of any payment of benefit pending any relevant inquiry;

(d) make provision for enabling or requiring a person to be appointed to receive a benefit on behalf of any other person, or to exercise any right under this Act on behalf of a person entitled to a benefit who is unable for the time being to act.

Modification of Act in special cases.4 of 1972, Sch.

22. Regulations may modify in such manner as the Minister thinks proper the provisions of this Act in their application -

(a) to persons who are or have been outside Kenya while being contributors to the Fund;

(b) to persons who are employed on board any ship or aircraft.

Modification of Act in special cases.4 of 1972, Sch.

23. (1) Without prejudice to any specific power conferred by any provision of this Act, regulations may provide for facilitating the implementation of this Act, including in particular regulations -

(a) prescribing the particulars, information, proof or evidence to be furnished as to any question or matter arising under this Act, including any question or matter relevant to the payment of contributions by or in respect of any person, or the making-or validity of any claim or application for the payment of any benefit under this Act;

(b) prescribing, in respect of any action required or permitted to be taken under this Act, the time and manner of taking that action, the procedure to be followed, and the forms to be used.

(2) Any regulations made under this Act may make different provisions with respect to different cases or classes of case and for different purposes of this Act, may impose conditions and make exceptions, and may contain such incidental or supplementary provisions as appear to the Minister to be expedient for the purposes of the regulations.

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Consideration of regulations by Advisory Council.24. Before making any regulations under this Act, the

Minister may, if he thinks fit, submit a draft thereof to the Advisory Council, and the Advisory Council shall consider and report to the Minister on any draft regulations so submitted to them.

PART V - NATIONAL HOSPITAL INSURANCE ADVISORY COUNCIL

National Hospital Insurance Advisory Council.25. (1) There shall be constituted a council, to be called

the National Hospital Insurance Advisory Council, to advise and assist the Minister in connexion with the implementation f this Act and to perform any other duties allotted to them under this Act.

(2) The provisions of the Schedule to this Act shall have effect with respect to the Advisory Council.

(3) The Minister may from time to time refer to the Advisory Council for consideration and advice such questions relating to the operation of this Act as he thinks fit (including questions as to the advisability of amending this Act).

(4) The Advisory Council may at any time tender advice to the Minister on any matter relating to the operation of this Act as they think fit.

(5) The Minister shall furnish the Advisory Council with such information as they may reasonably require for the proper discharge of their functions under this Act.

PART VI - FINANCE, ADMINISTRATION AND LEGAL PROCEEDING

Finance

Investment of Fund.4 of 1972, Sch.Cap. 167

26. (1) All moneys in the Fund which are not for the time being required to be applied for the purposes of the Fund shall be invested in such investments, being investments in which trust funds (or part thereof) are authorized by the Trustee Act to be invested, as may be determined by the Minister with the approval of the Minister for the time being responsible for finance.

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(2) All investments made under this section in respect of the Fund shall be held for and on behalf of the Fund in the name of the Permanent Secretary to the Treasury.

Expenses of administering Fund.27. There shall be paid to the Treasury out of the Fund, at

such times and in such manner as the Minister for the time being responsible for finance may direct, such sum as the Minister may estimate in accordance with directions given by the Minister for the time being responsible for finance to be the expenses of the Minister and of any Government department in administering the Fund; and in estimating expenses for the purposes of this section there may be included -

(a) an amount representing the accruing liability in respect of any pensions benefits to which any officers or servants employed for the purposes of this Act will become entitled in respect of that employment;

(b) an amount representing the rental value of any premises belonging to the Government and used for the purposes of this Act.

Application to Fund of Cap. 412.28. The Fund shall be deemed to be a fund established

under section 28 of the Exchequer and Audit Act, and as such a fund shall be subject to Part V of that Act.

Administration29. (1) The Minister may, after consulting the Advisory

Council, by notice in the Gazette declare any hospital, nursing home or maternity home to be a hospital for the purposes of this Act.

(2) A declaration regarding any hospital made under this section may be made subject to such conditions as the Minister thinks fit as to the charges which may be made by that hospital to any contributor under this Act (including conditions as to the amount of such charges and conditions requiring the consent of the Minister to any variation thereof) and where any such conditions are made -

(a) the Minister may publish those conditions in the Gazette or in such other manner as he thinks fit; and

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(b) it shall not be lawful for that hospital to make any charge to any contributor under this Act which is contrary to any such condition.

(3) The Minister may at any time, after consulting the Advisory Council, by notice in the Gazette revoke any declaration made under this section.

Determination of claims and questions.30. (1) Subject to the provisions of this Act, regulations

may provide for the determination by an officer appointed by the Minister, or by a person or tribunal appointed or constituted in accordance with the regulations, of any question arising under or in connexion with this Act, including any claim for benefit, and subject to the provisions of the regulations the decision in accordance therewith of any such question shall be final.

(2) Regulations under subsection (1) of this section may provide -

(a) for enabling appeals to be brought from the decisions of any officer, person or tribunal to any other person or tribunal appointed or constituted in accordance with the regulations to hear such appeals;

(b) for the reference to the High Court for decision of any question of law arising in connexion with the determination of any question by any officer, person or tribunal, and for appeals to the High Court from the decision of any such officer, person or tribunal on any such question of law; and the Chief Justice shall have power to make rules of court for regulating such references and appeals, for empowering the court to make orders as to the costs of such references and appeals, and for limiting the time within which such appeals may be brought.

Officers of Fund. 4 of 1972, Sch. 31. For the purposes of this Act there may be appointed

such officers, inspectors and servants as may be necessary for the administration of the Fund and the operation of this Act.

Inspectors. 32. (1) An inspector appointed under this Act shall, for the

purpose of ascertaining whether this Act is being or has been complied with in any premises or place liable to inspection under this section, have power to enter any such premises or place at all reasonable times, and to examine every person whom he finds therein.

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(2) The occupier of any premises or place liable to inspection under this section, and any person who is or has been employing any person, and the servants and agents of any such occupier or other person, and any employee, shall furnish to an inspector all such information and produce for inspection all such documents as the inspector may reasonably require for the purpose of ascertaining whether standard contributions are or have been payable, or have been duly paid, by or in respect of any person, or whether any benefit is or was payable to or in respect of any person.

(3) The premises and places liable to inspection under this section are any premises or places where an inspector has reasonable grounds for supposing that any persons are employed, except that they do not include any private dwelling not used for the purpose of a trade or business.


(a) wilfully delays or obstructs an inspector in the exercise of any power under this section; or

(b) refuses or neglects to answer any question or to furnish any information or to produce any document when required to do so under this section,

shall be guilty of an offence and shall be liable to a fine not exceeding two thousand shillings:

Provided that no one shall be required under this section to answer any questions or to give any evidence tending to incriminate himself.

(5) Every inspector shall, if so required on applying for admission to any premises or place for the purposes of this Act, produce a certificate of his appointment signed by or under the authority of the Minister.

(6) Where any premises or place are or is liable to be inspected by a public officer for the purpose of enforcing any law other than this Act, the Minister may make arrangements for any of the powers and duties of inspectors under this section to be carried out by that public officer, and, where such an arrangement is made, that public officer shall have all the powers of an inspector under this section.

Exemption from stamp duty.Cap 480

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4 of 1972, Sch.33. No duty shall be chargeable under the Stamp Duty

Act in respect of any instrument executed by any person on behalf of or in favour of the Fund or in respect of the payment of any benefit or the refunding of any contribution under this Act in any case where, but for this exemption the Fund or any person acting on behalf of that Fund would be liable to pay such duty.

Legal Proceedings

General provisions as to offences.34. Proceedings for an offence under this Act may,

notwithstanding anything in any law to the contrary, be commenced at any time within the period of three months from the date on which evidence, sufficient in the opinion of the Minister to justify a prosecution for the offence, comes to his knowledge, or within the period of twelve months after the commission of the offence, whichever period last expires.

Proceedings to recover sums due to Fund.4 of 1972, Sch.

35. (1) The Court before whom any person is convicted of an offence under this Act may, without prejudice to any civil remedy, order such person to pay to the Fund, as the case may be, the amount of any standard contributions or any other sum, together with any penalty thereon, found to be due from such person to the Fund, and any sum so ordered shall be recoverable as a fine and paid into the Fund.

(2) All sums due to the Fund shall be recoverable as debts due to the Government, and without prejudice to any other remedy may be recovered by the Minister summarily as a civil debt.

(3) All criminal and civil proceedings under this Act may, without prejudice to any other power in that behalf, be instituted by any inspector or other officer of the Fund and, where the proceedings are instituted or brought in a magistrate's court, any such inspector or other officer may prosecute or conduct the proceedings.

(4) All sums recovered by legal proceedings in respect of sums which should have been but were not paid to the Fund shall be so paid.

Recovery of compensation or damages.

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Cap. 23636.Where a contributor to the Fund is entitled, whether

under the Workmen's Compensation Act or otherwise, to recover compensation or damages in respect of any injury or illness he shall not, to the extent to which such compensation or damages are recoverable, be entitled to any benefits in respect of any treatment undergone by him as a result of such injury or illness; and any benefits paid in respect of any such treatment shall, to the extent to which such compensation or damages have been recovered, be repaid to the Fund:

Provided that the payment of any benefit as aforesaid shall not preclude the right of the contributor to recover any compensation or damages.

Evidence.37. In any proceedings under this Act a copy of any entry

in the accounts of, or any extracts from the records or register of, the Fund shall, if stated to be a true copy by a certificate purporting to be signed by the Minister or a person authorized in that behalf by him, be received in evidence as prima facie evidence of the truth of the contents thereof.

38 to 40. [Spent.]

PART VII - REPEALS AND TRANSITIONAL

Disposal of European Hospital Treatment Relief Fund.14 of 1971, Sch.Cap. 249.

41. (1) Notwithstanding the provisions of the Hospital Treatment Relief (European) Act (in this section referred to as the said Act), upon the commencement of this Act there shall be transferred from the. European Hospital Treatment Relief Fund established under the said Act (in this section referred to as the said Relief Fund) to the National Hospital Insurance Fund the sum of thirty-nine thousand, eight hundred and eighty-one pounds.

(2) Notwithstanding the repeal of the said Act, benefits under the said Act shall be payable in accordance with the provisions thereof in respect of expenses incurred before 1st August, 1966, where those benefits have been claimed before 1st November, 1966, as if that Act had not been repealed.

(3) As soon as practicable after the commencement of this Act, the Minister shall establish a trust, the principal object of which shall be the care and maintenance on and after 1st August, 1966,

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of sick and indigent persons who were formerly contributors to the said Relief Fund within the meaning of the said Act, and the Minister shall appoint not less than three trustees of the said trust, and when the said trust has been established and the said trustees have been appointed the moneys remaining in the said Relief Fund, after all moneys payable into and out of the said Relief Fund under the said Act or under this Act have been so paid, shall be transferred to and vest in the said trustees to be held by them in accordance with the provisions of the said trust (which provisions shall not permit the trustees to receive or manage any moneys other than those so transferred).

(4) The transference of moneys from the said Relief Fund to the trust established in pursuance of subsection (3) of this section may be effected by instalments of such amounts transferred at such times as the Minister may, for the purpose of ensuring that there shall be continuity in the care and maintenance of contributors to the said Relief Fund, direct.

Disposal of Kenya Hospital Fund.14 of 1971, Sch.Cap. 250.

42. (1) Notwithstanding the provisions of the Hospital Treatment Relief (No. 2) Act (in this section referred to as the said Act), upon the commencement of this Act there shall be transferred from the Kenya Hospital Fund established by the said Act (in this section referred to as the said Fund) to the National Hospital Insurance Fund the sum of thirty-five thousand pounds and to the National Hospital (Voluntary) Insurance Fund the sum of thirty thousand pounds, or such larger sum as may be agreed between the Minister and the Kenya Hospital Fund Authority.

(2) Notwithstanding the repeal of the said Act, benefits under the said Act shall be payable in accordance with the provisions thereof -

(a) in the case of contributors under the said Act who are liable as contributors under this Act to the National Hospital Insurance Fund, in respect of expenses incurred before 1st August, 1966, where those benefits have been claimed before 1st November, 1966; and

(b) in the case of any other contributors under the said Act, in respect of expenses incurred before 1st January, 1967, where those benefits have been claimed before 1st April, 1967.

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(3) As soon as practicable after the commencement of this Act the Minister shall establish a trust, the object of which shall be the furtherance of medical education in or in association with the University of Nairobi, and the Minister shall appoint not less than three trustees of the said trust, and when the said trust has been established and the said trustees have been appointed the moneys remaining in the said Fund, after all moneys payable into and out of the said Fund under the said Act or under this Act have been so paid, shall be transferred to and vest in the said trustees to be held by them in accordance with the provisions of the said trust.

(4) The transference of moneys from the said Fund to the trust established in pursuance of subsection (3) of this section may be effected by instalments of such amounts transferred at such times as the Minister may, for the purpose of ensuring that there shall be continuity in the care and maintenance contributors to the said Fund, direct.

Savings and regulations.43. (1) For the purposes of implementing this Part, all the

provisions of the said Acts necessary for those purposes and all such provisions conferring powers on the Minister shall continue to apply, and the Authorities established by each of the said Acts shall continue to exist, as if those Acts had not been repealed.

(2) The Minister may by regulations make such provisions as appear to him to be necessary or expedient for the purpose of or in consequence of the winding up of the Authorities and the Funds established by each of the said Acts, or for the purpose of enabling either of the said Authorities to continue and conclude the performance of its functions, or generally for the purpose of facilitating the implementation of this Part of this Act.

Disposal of voluntary fund, etc.4 of 1972, s.9.

43A. (1) On the appointed day, all the funds, assets and other property which, immediately before that day, were vested in the voluntary fund shall, by virtue of this section and without further assurance, vest in the Fund.

(2) On and after the appointed day, any investments which, immediately before that day, were held in the name of the Permanent Secretary to the Treasury for and on behalf of the voluntary fund shall be held in the name of the Permanent Secretary for and on behalf of the Fund.

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(3) Notwithstanding the repeal of Part III of this Act, benefits under that Part shall continue to be paid to former contributors to the voluntary fund in respect of expenses incurred before the appointed day, or within the period which would have been covered by their respective contributions in existence immediately before the appointed day.

(4) Subsection (3) of section 5A of this Act shall not apply in the case of any person who, being a contributor to the voluntary fund immediately before the appointed day, elects within sixty days after the appointed day to become a contributor under the said section 5A.

(5) In this section -

"the appointed day" means the day upon which the National Hospital Insurance (Amendment) Act, 1972, comes into operation*;

"the voluntary fund" means the National Hospital (Voluntary) Insurance Fund as inbeing immediately before the appointed day.____________________________________________________

*1st July, 1972: L.N.133/1972.

Power of Minister to exempt.44. The Minister may, by notice in the Gazette, exempt

any class of person from all or any of the provisions of this Act, where in his opinion it is expedient so to do.

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SCHEDULE(s. 25(2))4 of 1972, Sch

CONSTITUTION, ETC OF THE NATIONAL HOSPITAL INSURANCE ADVISORY COUNCIL

1. The Advisory Council shall consist of not less than seven and not more than ten members appointed by the Minister of whom one shall be a person nominated by the Minister for the time being responsible for finance.

2. The Minister shall appoint from amongst the members of the Advisory Council a chairman who shall hold office for one year and shall be eligible for re-appointment.

3. The members of the Advisory Council may at any time by notice in writing addressed to the Minister resign his office; and if a member absents himself from three consecutive meetings of the Advisory Council without the permission of the Advisory Council, or becomes, in the opinion of the Minister, unfit to continue in office or incapable of performing his duties, the Minister may, in such manner as he thinks fit, declare the office of the member to be vacant.

5. The Minister shall appoint a public officer to act as secretary to the Advisory Council, and may appoint such other public officers to act as staff of the Advisory Council as he may consider necessary.

6. The members of the Advisory Council shall be paid such expenses as the Minister, with the consent of the Minister for the time being responsible for finance, may determine, and such expenses shall be charged to the Funds in such proportions as may be so determined.

7. The quorum for any meeting of the Advisory Council shall be four.

8. The Advisory Council may act notwithstanding any vacancy among the members of the Council.

9. The Advisory Council may, with the approval of the Minister make rules for regulating the procedure at its meetings.

L.N.19/1969.SUBSIDIARY LEGISLATION

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Regulations under sections 6 and 23

THE NATIONAL HOSPITAL INSURANCE (STANDARD CONTRIBUTIONS) (USE OF FRANKING MACHINE IN LIEU OF

STAMPS) REGULATIONS

1. These Regulations may be cited as the National Hospital Insurance (Standard Contributions) (Use of Franking Machine in Lieu of Stamps) Regulations.

2. In these Regulations, except where the context otherwise requires -

"frank" means an indelible impression made by a franking machine; and

"franking machine" means a mechanical device for making an indelible impression in the space provided for the affixing of National Hospital Insurance stamps on a National Hospital Insurance card.

3. (1) The Permanent Secretary to the Ministry for the time being responsible for health may, by licence under his hand, authorize an employer to perform his obligation to pay standard contributions in respect of his employees, under section6 of the Act, by using an approved franking machine to impress franks on cards.

(2) A licence issued under this regulation shall be subject to such conditions as the Permanent Secretary may, in his absolute discretion, impose.

(3) The true date of the making of every impression of franks indicating the payment of standard contributions made by a franking machine used under a licence under these Regulations, shall be shown on the National Hospital Insurance card in the space relating to the month in respect of which payment of the standard contribution is indicated by the frank.

(4) The franking of any National Hospital Insurance card by any duly authorized employer as provided for in this regulation if done in accordance with the terms of this regulation and of the licence, shall have the same effect as cancelling a National Hospital Insurance stamp to the value indicated by such franking on the date the impression was made.

(5) Any person other than an employer to whom a licence has been issued under this regulation, who impresses or causes to be impressed a frank on any National Hospital Insurance card, and any person, being a person to whom a licence has been issued as aforesaid, who fails to comply with any conditions of the licence, shall be guilty of an offence and liable to a fine not exceeding two thousand shillings.

L.N.231/1966,L.N.76/1967, L.N.81/1967,

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L.N.262/1968, L.N.263/1968, L.N.265/1969, L.N.96/1970, L.N.232/1970, L.N.203/1971, L.N.15/1972, L.N.37/1972, L.N.263/1972, L.N.187/1973, L.N.189/1973, L.N.191/1973, L.N.79/1974, L.N.80/1974, L.N.250/1974, L.N.277/1974, L.N.322/1974, L.N.97/1975, L.N.109/1975, L.N.168/1975, L.N.74/1976, L.N.198/1976.

Regulations under section 21

THE NATIONAL HOSPITAL INSURANCE (CLAIMS AND BENEFITS) REGULATIONS

1. (1) These Regulation may be cited as the National Hospital Insurance (Claims and Benefits) Regulations.

(2) These Regulations do not apply to any benefits payable under Part III of the Act.

2. In these Regulations -

"approved form" means such forms as the Minister may approve for the purposes of these Regulations;

"declared hospital" means any hospital, nursing home or maternity home declared to be a hospital by notice in the Gazette;

"hospital treatment" includes drugs and medicines administered during treatment.

3. A claim for the payment of any benefit shall be made in writing in the approved form, and shall be submitted to the Minister within ninety days or such longer period as he may allow from the date of commencement of the hospital treatment in respect of which it is made.

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4. The Minister may require such further evidence of identity and of entitlement as is in his opinion necessary to substantiate the claim for benefit, including production by the contributor of his card.

5. Where a claim is lodged in respect of hospital treatment received by a spouse who was not named on the contributor's card at the time of its issue, no benefit shall be paid in respect of hospital treatment received by that spouse within twenty-eight days immediately following the date upon which the name of that spouse was entered on the card if at that date such contributor had more than one spouse.

6. (1) The maximum rate of daily allowance which may be paid in respect of any hospital treatment shall be Sh.70.

(2) The maximum rate of daily allowance which may be paid in respect of any declared hospital specified in the first column of the Schedule to these Regulations shall be the rate specified in the second column of the said Schedule.

7. Except as provided in regulation 8 of these Regulations, no benefit shall be paid in respect of treatment received by a child within ten days of the birth of that child.

8. In maternity cases resulting in the confinement of a named wife, other than in an approved hospital, a benefit of up to Sh. 150 may be paid in respect of expenses necessarily incurred for services rendered by a registered or enrolled midwife or registered medical practitioner in connexion with that confinement.

SCHEDULE (r.6)

Declared Hospital Maximum rate of daily allowanceSh. cts.

1. H.H. The Aga Khan Platinum Jubilee Hospital, Nairobi ... ... ... ...

75 00

2. Katharine Bibby Hospital, Mombasa ... ... ... 75 003. Mater Misericordiae Hospital, Nairobi ... ... 75 004. Mount Elgon Hospital, Kitale ... ... 70 005. Mount Kenya Hospital, Nyeri ... ... 65 006. Nairobi Hospital, Nairobi ... ... ... 75 007. Nakuru War Memorial Hospital, Nakuru ... ... 70 008. Nanyuki Cottage Hospital, Nanyuki ... ... ... 65 009. Uasin Gishu Memorial Hospital, Eldoret ... ... 70 0010. Gertrude's Garden Children's Hospital, Nairobi ...

75 00

11. H.H. The Aga Khan Dispensary and Maternity Hospital, Kisumu ... ... ... ... ...

65 00

12. H.H. The Aga Khan Hospital, Mombasa ... ... 65 0013. Infectious Diseases Hospital, Nairobi ... ... ... 55 00

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14. Kisumu Nursing and Maternity Home, Kisumu ...

55 00

15. Noel Terese Hospital, Limuru ... ... ... ... 55 0016. Pandya Memorial Clinic, Mombasa ... ... ... 65 0017. Social Service League, Ngara Maternity Hospital, Nairobi ... ... ... ... ... ...

65 00

18. Social Service League, M.P. Shah Hospital, Nairobi

70 00

19. Victoria Hospital, Kisumu ... ... ... ... 65 0020. All Government Hospitals not approved for a higher rate ... ... ... ... ... ...

35 00

21. Alpha Maternity Home, Nairobi ... ... ... 50 0022. A.LM. Kapsorwar Hospital, P.O. Eldoret ... ... 35 0023. Beresford Memorial Hospital, Mauru, P.O. Meru ...

35 00

24. Kaloleni C.M.S. Hospital, Mombasa ... ... ... 55 0025. C.M.S. Maseno Hospital, P.O. Maseno ... ... 35 0026. Consolata Hospital, Chuka ... ... ... ... 35 0027. Consolata Hospital, Kyeni ... ... ... ... 35 0028. Consolata Hospital, Nkubu ... ... ... ... 55 0029. Consolata Hospital, Nyeri ... ... ... ... 65 0030. Franciscan Convent, Kanzalu ... ... ... ... 35 0031. Friends Hospital, Kaimosi ... ... ... ... 35 0032. Gaicanjiro Hospital, Thika ... ... .. ... 35 0033. Nangina Hospital ... ... ... ... ... 55 0034. Holy Rosary Hospital, Kilima Mbogo ... ... 35 0035. Ideal Nursing Home ... ... ... ... ... 60 0036. Janet Miranda Maternity Home, Nairobi ... ... 35 0037. Kendu Mission Hospital, P.O. Kendu Bay ... 35 0038. Lady Grigg Municipal Maternity Hospital, Mombasa

35 00

39. Lourdes Hospital, Mutomo ... ... ...... 35 0040. St. Mary Hospital, Mombasa............ 55 0041. Mwihila Hospital, Yala.. ... ... ...... 35 0042. Provincial General Hospital Annexe. Nakuru.. 70 0043. Nyina wa Mumbi Maternity Hospital, Riruta... 35 0044. P.C.E.A., Chogoria Hospital........... 60 0045. P.C.E.A. Hospital, Tumutumu, Karatina...... 55 0046. P.C.E.A. Hospital, Kikuyu............ 35 0047. Park Road Nursing Home............ 60 00

48. Pumwani Maternity Hospital, Nairobi...... 35 0049. Radiant Health Clinic, Nairobi......... 55 0050. St. Anne Hospital, Egoji............ 35 0051. St. Claire's Hospital, Kaplong............ 55 0052. St. Elizabeth Hospital, Mukumu......... 55 0053. St. John Bosco Hospital, Muthale. ...... 35 0054. St. Joseph's Hospital, Kilgoris........... 35 0055. Sunrise Hospital, Kitale............ 35 0056. Tennek Hospital, Bomet............ 35 00

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57. Thika Maternity Hospital............ 55 0058. Tigania Hospital............... 35 0059. Dr. Vibhaker's Maternity and Nursing Home, Mombasa.............

55 00

60. Visa Oshwal Dispensary and Nursing Home, Mombasa ... ... ... ... ...

35 00

61. African Inland Mission Hospital, Kijabe...... 55 0062. Miwani Sugar Hospital............... 60 0063. Amani Cheshire Home (Spinal Injury Unit) 65 0064. Lake Nursing Home, Kisumu............ 65 0065. Crauford Road Maternity Home, Nairobi...... 55 0066. Kisii Maternity and Nursing Home, Kisii...... 60 0067. Kenyatta National Hospital, Nairobi......... 40 0068. Embu Nursing Home............... 45 0069. Diocese of Marsabit Hospital, Wamba ..... 45 0070. Milimani Maternity and Nursing Home, Meru...

45 00

71. St. Joseph's Hospital, Nyabondo......... 45 0072. Nazareth Hospital, Riara Ridge......... 50 0073. Kikuyu Nursing Home.............. 55 0074. St. Charles Lwanga Hospital, Misikhu...... 55 0075. Chand Lane Nursing Home............ 50 0076. Nairobi Nursing Home............... 50 0077. Koru Nursing Home............... 55 0078. Menengai Nursing Home, Nakuru......... 60 0079. Kericho Nursing Home............... 50 0080. Eldoret Nursing Home............... 55 0081. Avenue Nursing Home............... 60 0082. Naivasha Nursing Home............ 55 0083. Christa Marianne Nursing Home......... 55 0084. Machakos Nursing Home........... 60 00

L.N.188/1971.


THE NATIONAL HOSPITAL INSURANCE (FOREIGN CLAIMS AND BENEFITS) REGULATIONS

1. (1) These Regulations may be cited as the National Hospital Insurance (Foreign Claims and Benefits) Regulations.(2) These Regulations do not apply to any benefits payable under Part III of the Act, but subject to the foregoing shall apply, not withstanding the provisions of section 10 (6) of the Act, to any claim in respect of hospital treatment received in a hospital, nursing home or maternity home situate outside Kenya which the Minister may, in his discretion, accept as a hospital for the purposes of the Act.


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"approved form" means such forms as the Minister may approve for the purposes of these Regulations;

"hospital treatment" includes drugs and medicines administered during treatment.

3. Subject to the provisions of the Act and these Regulations, benefit may, in the discretion of the Minister, be paid in respect of hospital treatment received out side Kenya by a contributor or by his named wife (or named husband, as the case may be) or by any child of his in consequence of any illness contracted or injury sustained whilst abroad or in circumstances in which the Minister is satisfied that it was necessary for such hospital treatment to be obtained whilst abroad.

4. A claim for the payment of any benefit shall be made in writing in the approved form, and shall be submitted to the Minister within a period of ninety days, or such longer period as he may allow, from the date of commencement of the hospital treatment in respect of which it is made.

5. The Minister may require such further evidence of identity and of entitlement as is in his opinion necessary to substantiate the claim for benefit, including production by the contributor of his card.

6. Where a claim is made in respect of hospital treatment received by a spouse who was not named on the contributor's card at the time of its issue, no benefit shall be paid in respect of hospital treatment received by that spouse within the period of twenty-eight days immediately following the date upon which the name of that spouse was entered on the card if at that date such contributor had more than one spouse.

7. The amount of any benefit payable pursuant to these Regulations shall not in any case exceed the amount specified in regulations 6 (a) or 7, as the case may be, of the National Hospital Insurance (Claims and Benefits) Regulations.

L.N.71/1967.L.N.232/1966, L.N.235/1969, L.N.97/1970, L.N.231/1970, L.N.188/1973, L.N.190/1973, L.N.77/1974, L.N.78/1974,

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L.N.249/1974, L.N.321/1974, L.N.96/1975, L.N.73/1976, L.N.197/1976.


THE NATIONAL HOSPITAL INSURANCE (VOLUNTARY CONTRIBUTIONS) REGULATIONS

1. These Regulations may be cited as the National Hospital Insurance (Voluntary Contributions) Regulations.


"approved form" means such form as the Minister may, from time to time, approve for the purpose of these Regulations;

"declared hospital" means any hospital, nursing home or maternity home declared as such under section 29 of the Act;

"Fund" means the National Hospital (Voluntary) Insurance Fund;

"hospital treatment" includes drugs and medicines administered during treatment; and

"medical treatment" shall include all in-patient treatment in a declared hospital.

3. The application of any person to become a contributor to the Fund for any year shall be made in writing in the approved form.

4. The Minister may require the applicant to submit in respect of himself and his named dependants at his own expense such further evidence of identity, age, income, medical or mental condition as is in the Minister's opinion necessary to determine the application to become a contributor.

5. Persons who have attained the age of 65 years before 1st January in any year shall not be eligible to become contributors to the Fund for that year:

Provided that -

(i) an applicant under the age of 70 years on 1st January, 1967, who contributed to the Kenya Hospital Fund or the European Treatment Relief Fund in 1966 shall be eligible to contribute for the year 1967;

(ii) an applicant under the age of 70 years on 1st January who ceases to be a contributor to the National Hospital Insurance Fund and who makes application to contribute to the Fund within three months of his last contribution to the National Hospital Insurance Fund shall be eligible to become a contributor; and

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(iii) an applicant under the age of 70 years on 1st January who had contributed throughout the previous year to the Fund shall be eligible to become a contributor.

6. Except as provided in regulation 8 the maximum rate of benefit payable in respect of hospital treatment to a contributor paying standard contributions shall be Sh. 20 per day.

7. Except as provided in regulation 8 the maximum rate of benefit payable in respect of medical treatment to a contributor paying additional contributions shall be Sh. 20 per day.

8. The maximum rate of daily allowance to be paid by the Fund in respect of treatment in a declared hospital shall not exceed the rate approved for that hospital by notice in the Gazette.

9. No benefit shall be payable in respect of any confinement or treatment necessitated by antenatal or obstetric requirements arising within six months of the date of payment of the first contribution for a year:

Provided that -

(i) this period shall be reduced to 28 days where the contributor had contributed to the Kenya Hospital Fund or the European Hospital Treatment Relief Fund throughout the previous year; and

(ii) this period shall be waived altogether where the contributor had contributed to the National Hospital Insurance Fund or the Fund throughout the previous year.

10. Benefits shall not be payable in respect of a contributor's dependant whose physical or mental condition at the time of his application to become a contributor indicates that excessive demands for benefit will be made upon the Fund in respect of that dependant or whose name does not appear on the contribution card issued to the contributor.

11. A claim for the payment of benefit shall be made in writing in the approved form and shall be submitted to the Fund within 90 days after the commencement of the hospital treatment or such longer period as the Minister may allow.

Hospitals, nursing homes and maternity homes declared to be hospitals for the purposes of the Act under section 29

L.N. 232/1966,L.N. 235/1969,L.N. 97/1970,L.N. 231/1970,L.N. 188/1973,L.N. 190/1973,L.N. 77/1974,

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L.N. 78/1974,L.N. 249/1974,L.N. 321/1974,L.N. 96/1975,L.N. 73/1976,L.N. 197/1976

All Government Hospitals.

H.H The Aga Khan Dispensary and Maternity Hospital, Kisumu.H.H. The Aga Khan Hospital, Mombasa.H.H. The Aga Khan Platinum Jubilee Hospital, NairobiAlice Beaton Nursing and Convalescent Home, Nairobi.Alpha Maternity Home, Nairobi.Berresford Memorial Hospital, Maura, P.O. MeruP.C.E.A. Hospital, P.O. Chogoria.Coast Nursing and Maternity Home, Mombasa.Gaicanjiro Hospital, Thika.Gertrude's Garden Children's Hospital, Nairobi.Ideal Nursing Home, Nairobi.Janet Miranda Maternity Home, Nairobi.Friends Hospital, Kaimosi.Kaloleni C.M.S. Hospital, P.O. MariakaniP.C.E.A Hospital, P.O. Karatina.Katherine Bibby Hospital, Mombasa.A.I.M. Kapsowar Hospital, P.O. Eldoret.Kendu Mission Hospital, P.O. Kendu Bay.P.C.E.A. Hospital, P.O. Kikuyu.Kisumu Nursing and Maternity Home, Kisumu.Lady Grigg Municipal Maternity Hospital, MombasaC.M.S. Maseno Hospital. P.O. Maseno.Mater Misericordiae Hospital, Nairobi.Mount Elgon Hospital, Kitale.Mount Kenya Hospital, Nyeri.Mwihila Hospital, Yala.Nairobi Hospital, Nairobi.Nakuru War Memorial Hospital, Nakuru.Holy Family Hospital, Nangina.Nanyuki Cottage Hospital, Nakuru.Catholic Hospital, Nkubu.Noel Terese Hospital, Limuru.Consolata Hospital, Nyeri.Pandya Memorial Clinic, Mombasa.Parkroad Nursing Home, Nairobi.Radiant Health Clinic, Nairobi.Social Service League Ngara Maternity Hospital, Nairobi.Social Service League Parklands Hospital, Nairobi.St. Claire's Hospital, Kaplong.St. Joseph's Hospital, Kilgoris.Sunrise Hospital, Kitale.Uasin Gishu Memorial Hospital, Eldoret.Dr. Vibhaker's Maternity and Nursing Home, Mombasa.

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Visa Oshwal Dispensary and Nursing Home, Mombasa.African Inland 'Mission Hospital, Kijabe.Miwani Sugar Hospital, Miwani.Amani Cheshire Home (Spinal Injury Unit).Lake Nursing Home, Kisumu.Crauford Road Maternity Home, Nairobi.Kisii Maternity-and Nursing Home.Nazareth Hospital.Kikuyu Hospital.St. Charles Lwanga Hospital, Misikhu.Chand Lane Nursing Home.Nairobi Nursing Home.Koru Nursing Home.Menengai Nursing Home, Nakuru.Kericho Nursing Home.Eldoret Nursing Home.Avenue Nursing Home.Naivasha Nursing Home.Christa Marianne Nursing Home.Machakos Nursing Home.

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Documents

National Hospital Insurance Act (Cap 255)