COMPLAINTS HANDLING PROCEDURE

  • Step 1

Submit a complaint

  • Step 2

Acknowledgement & Investigation

  • Within 48 hours : NHIMA will investigate your complaint.
  • Complaint logged and acknowledged.
  • Member is given  reference number 
    • If resolved, you will receive feedback from Customer Care within 24 hours.
    • If not resolved, NHIMA will contact you with a new expected resolution date.
  • Within 30 Business Days: If the complaint is still not resolved, NHIMA will provide you with another update on the status and a final timeframe for conclusion.
  • If not resolved :  complainant is informed of expected timeframe and responsible unit.
  • Step 3

Resolution Stage

Customer Care will contact you within 24 hours of this resolution to:

  • Give you feedback on the action taken.
  • Establish if you are Satisfied or Dissatisfied.
  • Step 4

If You Are Dissatisfied (Appeal Process)

  • Appeal to the Board: If you are not satisfied with NHIMA’s resolution, you have 30 days from receiving the decision to appeal to the Health Complaints Committee of the Board.
  • Second Appeal (within 30 days) →If not satisfied with the resolution of the Health Complainant may within thirty (30) days of receiving the decision, appeal to the Board
  • Final Appeal → If not satisfied with the decision of the Board, the complainant may appeal to the High Court of Zambia.
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A national health insurance scheme established for all Zambians and established citizens 

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