Unsettled bills: Hospitals seek court orders to sell properties

A storm is slowly brewing over runaway medical bills, with hospitals turning to court in a bid to force families to either have patients stay at home or be transferred to other medical facilities.

The cases before the court paint a dire picture of struggling Kenyans who can barely meet the cost of medical care, especially emergency, with the hospitals left with no option but to seek the court’s help as they cannot discharge the patients or transfer them to new facilities.

The latest case was filed by the Aga Khan on Thursday. The Private stated that the patient, whom we codename JGK for ethical purposes, has been on the sick bed for close to six months now, with his condition escalating to the Intensive Care Unit.

The court heard that so far, the cost of treating him has hit Sh 52 million and the family has only paid Sh 100,000, which guaranteed him an admission.

 It alleges that the patient’s family had promised to do a harambee to offset at least Sh 7 million, but the same was not forthcoming.

 From the Aga Khan’s documents, JGK was admitted on October 10 last year on an emergency basis at its ICU. 

By November 5, the bill was at Sh7 million. Five days later, the amount shot to Sh10 million.  Aga Khan claimed that the family had intimated that their relatives abroad would send some Sh3 million. Nevertheless, the next of kin, who is his son, allegedly declined to give consent for him to be transferred.

 According to the hospital, they then held a meeting on November 25, 2025, with the patients' services manager, and this time, JGK’s son allegedly promised that a loan was being processed to defray some Sh7 million.

Aga Khan claimed that JGK is now out of danger, but the cost of taking care of him is at Sh52 million. It stated that his son has allegedly refused to have him moved to the Kenyatta National Hospital ICU or any other health facilities or a nursing home.

Aga Khan’s clinical liaison officer Dr James Njenga swore an affidavit in support of the case. He explained that JGK’s blood circulation is now okay, and no longer needs tube feeding or an oxygen system to live.

He, however, said that he needs continuous care. According to Njenga, the services JGK needs could also be offered at public health facilities.

“I know the patient does require continuous medical treatment and such treatment is available at subsidized costs in public health facilities such as Kenyatta National Hospital and or several other health care facilities at the level of nursing homes, but the respondent has declined to consent and insists on having the Patient stay at an acute care facility,” argued Njenga.

 It is not the first time that the Aga Khan is seeking the court’s green light to either kick out a patient or even sell properties used to secure healthcare over ballooning medical costs.

Last year, it asked the court to be allowed to sell two properties owned by the parents of a 30-year-old patient, which they used to secure his release in a Sh 21 million medical bill.

In its case filed before the Commercial Court in Nairobi, alleged that the father, codenamed SOB and his wife JMO and another guarantor, codenamed KEN, had guaranteed to pay the amount from 2019 when the patient, codenamed JOO, was discharged.

Nevertheless, the hospital’s lawyer Brian Asin, said that from when JOO was discharged on or about June 20, 2019, the bill had not been settled.

“At the material times relevant to this suit, the plaintiff offered certain medical services to JOO whom the first, second and third defendants guaranteed payment of his bill accumulated during his stay at the hospital to the tune of Sh 21 million through guarantee of payment dated June 20, 2019,” claimed Asin.

 From the documents filed in court, JOO was at the hospital’s High Dependency Unit (HDU). In one document, it was indicated that he was insured by the UAP Insurance, but the maximum limit was Sh 898,000.

“Briefed him on charges which can go up to Sh2 million. Fully aware and promised to make payments by Wednesday,” the document dated February 16, 2019 read in part.

In the guarantee, SOB and JMO offered their title as security. In addition, documents before court show they committed to authorize the hospital and their employer to deduct the full amount if they did not clear the amount within the agreed timelines.

“Failing to which the Aga Khan University, Nairobi may take legal action if necessary to protect its interest. Any costs incurred by the Hopsital in the above process will be payable by me or us in the sum outstanding,” the agreement read.

At the time he was being discharged, JOO’s bill was Sh24.5 million. From the amount, the now-defunct National Health Insurance Fund(NHIF) paid Sh512,000.

A day before, there was a deposit of Sh200,000.

The remaining amount then was Sh23.6 million.

Aga Khan claimed that it had incurred a loss of Sh21.6 million since 2019.

It also separately sought to have an 18-year-old girl who was also in the ICU be transferred to another facility in yet another case of an unpaid bill.

The girl we name Jane had been in two hospitals. She was initially at Kenyatta University Teaching Referral and Research Hospital (KUTRRH), a government owned institution before she was admitted at the Aga Khan University Hospital.

The reason why she was moved from KUTRRH to Aga Khan was not explained.

However, Aga Khan asked the court to force her guardian to either transfer her to a hospital of her choice. If that did not happen, the private institution asked for orders, allowing it to take her to KNH.

It also had an idea of a nursing home in the offing.

In the case, the private hospital said that doctors found that Tuberculosis meningoencephalitis (TBM) had knocked her system. She is among at least 10 million persons who have or are suffering from the disease.

Jane was admitted to Aga Khan on  February 11, 2024. Aga Khan court papers indicate that she was brought into the facility as a referral from KUTRRH where she was initially admitted and being treated for TBM.

The doctors at the  Accident and Emergency Department flagged that she needed emergency care and she was then moved to the ICU. Doctors tried to manage seizures with antiepileptics, after which she was intubated.

Her mother was listed as a next of kin while her grandfather was named as her guarantor..

As of May 14, 2024, Jane’s medical bill had increased to Sh 24 million. Part of the bill, Sh 6.7 million, was paid by a well-wisher while the hospital paid Sh 13.5million. It then left her mother to find Sh3.8 million.

She was unable to pay the balance, Aga Khan stated.

Initially, the hospital said it had mooted to have the girl taken home to be treated there or a nursing home by March 11,2024. However, according to Njenga, a nursing home in Ngong, Trinity Care Nursing Home, had accepted to take up the girl.

At the time she was to be transferred, Njenga narrated that her condition changed and the plan aborted.

However, Njenga claimed that GNW had also declined to consent to have her transferred from Aga Khan’s critical care unit.

The hospital then withdrew the teen’s case without giving reasons.

 Aga Khan is not alone in this new trend. Karen Hospital too a month ago had the sons of an 83 year old man who was in the facility for a year be commit to take him to a nursing home as they figure out how to foot Sh25.7 million.

 In its case filed by lawyer Brian Asin, The Karen Hospital claimed that the patient, codenamed JAW was brought by his sons as an emergency patient on January 3, 2025, with a ruptured blood vessel in the brain and malignant hypertension, which has allegedly been treated.

Despite being discharged, Asin said that the man is still in the hospital as the two sons had allegedly refused to foot Sh25.7 million.

He further claimed that JAW’s sons have also declined to sign a consent for their father to be transferred to another hospital.

“Despite medical briefings and telephone conversations with the first and second respondents, they have both withheld consent for the transfer of the third respondent to home-based care or to an affordable healthcare facility and or nursing home, and the petitioner is unable to transfer the patient even though the hospital bill is skyrocketing,” claimed Asin.

 Article 43(2) of the Constitution requires hospitals to admit patients who are brought for emergency care.

In its case, Karen Hospital said it opened its doors for him to the extent that he was out of danger. According to Asin, the man has since stabilized and could be taken care of elsewhere.

He said that the hospital’s right to property and its ability to provide services to other patients was being affected by his continued stay.

The hospital’s financial controller, Peninnah Wambui, told the court that the sons of the senior citizen signed commitment letters that they would pay the required money. She said that it was an emergency admission under the cash scheme.

She said that a month after admission, the family was informed about the progress, and were advised to have him placed under home care as it was more cost-effective to the family.

She was of the view that the treatment he was receiving could also be offered in public institutions.

Wambui claimed that one of the sons provided a contract, claiming that he would pay once he was sorted, but did not honour his promise.

She further said that on June 18, 2025, he promised to pay Sh 10 million, then it was indicated that an insurance firm would take up the bill, but it did not.

According to her, the insurer alleged that it was a suspected case of fraud, which was under investigation.

She was of the view that the mode of payment was a moving target, with no solution in sight.

Documents filed in court indicated that the bill was Sh 29.8 million. However, the amount paid was Sh 2.4 million, leaving Sh 27.4 million as the balance.

Wambui alleged that her employer will incur losses if JAW remained under their roof.

JAW’s son told the court that they had found a nursing home to take him.

 JGK, Jane, JOO and JAW are examples of the high cost of healthcare in the country. They lay out the dilemma faced by both families who want them to live and hospitals, who are looking at the cost of it.