The Insurance Regulatory Authority reports that medical claims rose from Sh26.69 billion in 2021 to Sh52.61 billion in 2025, making medical insurance 41 percent of the general insurance market.

Aon’s 2026 Global Medical Trend Rates Report projects a 13.5 percent increase in Kenya’s medical costs this year, outpacing the global average of 9.8 percent and general inflation of 4.9 percent.

Employers are already feeling the pressure: NCBA’s staff medical expenses rose from Sh632.36 million to Sh727.76 million, while Co‑operative Bank’s costs increased from Sh849.92 million to Sh962.12 million in the latest reporting period.

Medical claims accounted for 51.2 percent of all claims paid by general insurers in 2025, and medical premiums jumped 22.3 percent, underscoring the financial strain on insurers.

The surge in claims reflects gaps in early detection: Kenya’s 2015 STEPS survey found 28.6 percent of adults aged 18‑69 had raised blood pressure, yet the 2014 Demographic and Health Survey showed only 9.4 percent of women and 3 percent of men aged 15‑49 were told they had hypertension.

Similarly, an analysis of the 2015 STEPS data published in Value in Health indicated that 53.4 percent of diabetes cases in Kenya were undiagnosed, highlighting missed opportunities for early intervention.

The article calls on corporate medical schemes to incorporate preventive metrics—such as screening rates and chronic disease management—into their annual reviews alongside traditional claims ratios.

Employers are also urged to clarify how private medical insurance interacts with Kenya’s public health financing, ensuring coverage gaps are identified without unnecessary duplication of benefits.