The Guy That Made Millions

I saw a post on Twitter regarding NHIF and it reminded me of a guy I know who fraudulently made millions from the ministry of health. I feel comfortable sharing this with all of you since the guy already left Kenya and relocated to a country somewhere in South America eating life with a big spoon.

Let’s call the guy X. Now, I’m sure you’re all familiar with the NHIF. Basically, with most types of medical insurance, you’re supposed to file a claim and provide receipts of any medical procedures / prescriptions etc that are involved in your treatment. However, this is not exactly what happens in Kenya (at least at the time of this heist) since hospitals are the ones in charge of filing these claims. It also happens that people in informal employment could also contribute towards NHIF under a voluntary membership plan.

Our friend X basically opened and registered clinics (offering both in-patient and out-patient services), laboratories to run basic tests, radiology labs to perform medical imaging, and chemists to dispense prescription medication. Now, this operation is basically end-to-end in that a patient would go to the clinic for a diagnosis, X would then send the patient to his lab, and consequently his chemist.

You have to understand that these patients only existed in paper. They were basically ghosts filing claims amounting to thousands per patient. Now you ask how did he register all these people for the insurance scheme and still made the premiums for all of them monthly? Well, X had approached me along with many of our friends for some money to kickstart his new operation. Personally, I couldn’t do it but X got a few millions from his own savings as well as people he knew and proceeded to register ghost NHIF beneficiaries. For a few months, X paid the required premiums and built a juggernaut of operation falsifying insurance claims and getting paid to the tunes of millions for it.

Someone (who had leant X money and was making fun of me for having missed out on the deal) told me that at his peak, X operated over 100 medical facilities in various parts of the country and thousands of ghost patients. Eventually, he closed shop and left the country temporarily but nobody has heard from him again. The guy who told me this claimed that X returned everyone’s early investment 3 times over before he left for South America with the loot.

It’s crazy every time I think about it because X was one of the most innocent-looking people I’d ever met - very small in stature, glasses and all, claimed that Jesus Christ was his personal savior.

1 Like

Story za jaba

What a jabaration!

Jamba


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Insurance claim is paid per policy holder , per ID per KRA pin. Did he also create those?