ABSTRACT: According to Kenya Demographic Health Survey (KDHS) (2022), uptake of health insurance in Kenya remains critically low, with 74% of females and 73.5% of males lacking any form of medical cover. In addition, persistent inefficiencies in the public Social Health Insurance Fund (SHIF), creates more market opportunities (Kamau et al., 2025). The large uninsured population presents an opportunity that medical insurance companies may have delayed to seize or grab. Therefore, this study sought to determine the influence of opportunity seizing capabilities on the performance of medical insurance companies in Kenya. The specific objectives were: to examine the effect of strategic decision-making on firm performance; to assess the effect of strategic innovation on firm performance; to determine the effect of resource mobilization on firm performance; and to investigate the effect of strategic partnerships on firm performance. The independent variable (opportunity seizing capabilities) was anchored on Dynamic Capabilities Theory while the dependent variable (performance) was underpinned by Customer Relationship Management Theory. The study adopted a descriptive research design targeting all 24 medical insurance companies registered with the Insurance Regulatory Authority (IRA). A purposive sample of 144 managers of different departments in each of the companies. Primary data was collected using structured questionnaires, achieving a 92.67% response rate (n=132). Data was analyzed using Pearson correlation, and multiple linear regression. Correlation analysis revealed a very strong, positive, and significant relationship between opportunity seizing capabilities and organizational performance (r = 0.888, p < 0.001). Among the four dimensions, strategic partnerships exhibited the strongest correlation with performance (r = 0.846, p = 0.000), followed by strategic decision-making (r = 0.837, p = 0.000), resource mobilization (r = 0.810, p = 0.000), and strategic innovation (r = 0.602, p = 0.000). The regression model was statistically significant (F = 123.634, p < 0.001) and explained 79.6% of the variation in performance (R² = 0.796). Strategic partnerships had the strongest influence (B = 0.421, β = 0.343, p < 0.001), followed by strategic decision-making (B = 0.345, β = 0.334, p < 0.001), resource mobilization (B = 0.222, β = 0.194, p = 0.014), and strategic innovation (B = 0.170, β = 0.114, p = 0.025). All four null hypotheses were rejected. The study concluded that opportunity seizing capabilities are fundamental to medical insurance company performance, with strategic partnerships being the most critical driver. The study recommends integrated application of these capabilities and urges the Insurance Regulatory Authority and medical insurance companies to create innovation sandboxes and partner with other relevant stakeholders to enable product testing.

KEYWORDS – medical insurance companies in Kenya, opportunity seizing capabilities, resource mobilization, strategic decision-making, strategic innovation, strategic partnerships.