NAICOM’S Guidelines For Foreign Health Insurance Providers: Key Compliance Considerations For Insurers And Policyholders In Nigeria

Introduction

On 31 March 2026, the National Insurance Commission (“NAICOM”) issued the Guidelines for the Operation of Foreign or International Health Insurance Providers (the “Guidelines”) pursuant to the Nigerian Insurance Industry Reform Act, 2025 (“NIIRA 2025”). The Guidelines establish, for the first time, a comprehensive regulatory framework governing foreign or international private medical insurers and reinsurers (“IPMI-R Providers”) seeking to provide health insurance services to entities registered or individuals who are resident in Nigeria.

Historically, international health insurance products were commonly procured directly from offshore insurers by multinational corporations, expatriates and high-net-worth individuals without any comprehensive regulatory framework governing such activities in Nigeria. Industry reports estimated that this resulted in approximately US$2 billion in annual premium outflows, while limiting regulatory oversight and the participation of domestic insurers. The Guidelines seek to address these gaps by requiring foreign health insurers to obtain NAICOM’s approval before operating in Nigeria, establishing approved local partnerships and complying with specified consumer protection, reporting and governance obligations.

In this newsletter, we examine the key provisions of the Guidelines and highlight some of the legal and commercial considerations for insurers and policyholders.

Who Do the Guidelines Apply To?

The Guidelines apply to all International Private Medical Insurers or Reinsurers (IPMI-R Providers) seeking to transact, market, underwrite or otherwise engage in health insurance business emanating from Nigeria.

Specifically, they apply to:

1. foreign health insurers and reinsurers offering products to entities registered in Nigeria;
2. foreign providers offering health insurance to persons residing in Nigeria; and
3. intermediaries and authorised representatives acting on behalf of foreign health insurers.

Accordingly, the regulatory focus is not the location of incorporation of the insurer but whether the health insurance business or clientele originates from Nigeria.

What are the Key Compliance Requirements?

1. Prior NAICOM Approval

The most significant change introduced by the Guidelines is that no foreign health insurer may transact, market or underwrite health insurance business originating from Nigeria without obtaining the prior written approval of NAICOM.

Similarly, no Nigerian entity or individual may transfer health insurance risks to an IPMI-R Provider unless that provider has received NAICOM’s approval.

The Guidelines further provide that where NAICOM does not communicate its approval or rejection within ten (10) working days after receiving complete documentation, the application shall be deemed approved.

2. Mandatory Local Partnership Model

Unlike the previous regulatory position, the Guidelines prohibit foreign insurers from directly issuing health insurance policies to Nigerian entities or persons residing in Nigeria except through an authorised representative domiciled in Nigeria.

Every approved IPMI-R Provider must adopt one of the following operational models:

• Model 1: Domestic Insurer Partnership;
• Model 2: Domestic Administrator or Intermediary Partnership; or
• Model 3: Health Maintenance Organisation (HMO) Partnership.

These partnership models ensure that licensed Nigerian entities participate in premium administration, claims support, regulatory reporting and other operational functions.

To obtain approval, an IPMI-R Provider must submit comprehensive documentation including:

1. evidence of incorporation in its home jurisdiction;
2. proof of regulatory licensing in its home jurisdiction;
3. detailed product descriptions;
4. a business plan;
5. premium worksheets;
6. proposed Nigerian intermediaries;
7. its preferred operational model; and
8. any additional information requested by NAICOM.

3. Consumer Protection Requirements

The Guidelines introduce several customer protection obligations designed to improve accountability and transparency.

Approved providers are required to:

1. provide clear information regarding policy terms and exclusions;
2. ensure products meet customers’ needs;
3. establish effective complaints management procedures;
4. include claims settlement procedures within policy documentation; and
5. ensure complaints are handled fairly through their Nigerian representatives or intermediaries.

These obligations significantly strengthen the position of Nigerian policyholders.

4. Reporting and Ongoing Regulatory Obligations

Approved providers are required to submit quarterly production returns to NAICOM and pay the prescribed Insurance Supervisory Service (ISS) Levy.

The Guidelines therefore establish continuing regulatory oversight rather than a one-time approval process.

Compliance Considerations

Pending further regulatory guidance, organisations that utilise international health insurance arrangements should consider the following.

a. Review Existing Insurance Arrangements

Multinational companies should determine whether their current international health insurance programmes involve IPMI-R Providers that have obtained, or intend to obtain, NAICOM approval.

b. Assess Existing Partnership Structures

Foreign insurers should evaluate whether their existing operating model aligns with one of the three partnership structures prescribed under the Guidelines and identify any restructuring that may be required.

c. Review Distribution and Intermediary Arrangements

Insurers, brokers, HMOs and third-party administrators should assess whether their contractual arrangements adequately reflect the roles and reporting obligations contemplated under the Guidelines.

d. Strengthen Compliance Frameworks

Organisations should establish internal governance procedures to monitor ongoing compliance with NAICOM’s approval requirements, reporting obligations and customer protection standards.

e. Review Existing Policies

The Guidelines permit policies issued before the effective date to continue until expiry. However, organisations should review renewal arrangements to ensure that future policies comply with the new regulatory framework.

Penalties for Non-Compliance

The Guidelines introduce significant sanctions for non-compliance.

1. Any entity registered in Nigeria or person residing in Nigeria that transacts health insurance business with an unapproved IPMI-R Provider may be liable to a penalty of not less than the total premium involved.
2. The Guidelines also required providers to regularise their operations within the prescribed ninety-day transitional period. Failure to satisfy the approval requirements may result in rejection of the application and suspension of the issuance of new policies and renewals.

Conclusion

With the Guidelines having taken effect on 31 March 2026, multinational employers, foreign insurers, HMOs, brokers and other intermediaries, should immediately prioritize assessing existing operational structures and contractual arrangements to ensure continued compliance with the new regulatory framework. Organisations that undertake this assessment proactively will be better positioned to navigate future regulatory developments while minimising compliance risks.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.