Definition of a Complaint

NHIMA defines a complaint as a means an expression of dissatisfaction by National Health Insurance Scheme(NHIS) stakeholder relating to the to the NHIS service service provided or withheld by NHIMA.

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What should you expect from us ?

i) Your complaint will be attended to quickly and fairly.

ii) We will investigate your complaint to identify the cause.

iii) We will ensure relevant steps are taken to avoid a reoccurrence.

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How can you submit your complaint?

You will be required to complete the NHIMA Complaints Form and attach all relevant documentation. Submission of the Complaint will include:

i) Visiting and NHIMA accredited facility and presenting your queries or complaints at the Customer Care desk,

ii) Presenting your complaint directly to the NHIMA offices both verbally and in writing. Kindly ensure that you include your contact number and address to enable us to give feedback,

iii) Dropping your query in the suggestion box available at our outlets, and

iv) Sending an email to complaints@nhima.co.zm

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How will we deal with your complaint?

i) Our aim is to deal with your complaint promptly,

ii) If the complaint requires further investigation, we will send communication within three (3) working days,

iii) If your complaint remains unresolved within ten (10) working days, we will send you a written update,

iv) For a company complaint, if after 30 days or receipt your complaint is unresolved, we shall advise on the updated position,

v) Within five (5) days of resolving your complaint, we will issue you with a resolution letter,

vi) However, if you are still not satisfied with our response, kindly contact the Health Complaints Committee of the Board enclosing copies of all correspondence with us and write to:

The Chairperson
Health Complaints Committee of the Board
National Health Insurance Management Authority,
First Floor, Levy Mwanawasa Medical University,
Great East Road,
P.O Box 31771,
LUSAKA.

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How will we deal with your complaint?

i) If aggrieved with the decision of the Health Complaint's Committee, the Complainant may within thirty (30) days of receiving the decision, appeal to the Board; and

ii) If aggrieved by the decision of the Board, the Complainant may appeal to the High Court of Zambia.

NOTE: All correspondences should be addressed to:

The Director General
National Health Insurance Management Authority,
First Floor, Levy Mwanawasa Medical University,
Great East Road,
P.O Box 31771,
LUSAKA.

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