At its most basic, an insurance contract is one where an insured promises to make payment of premiums in exchange for an insurance company’s promise to pay a claim when an insured event occurs.

CLAIM NOTIFICATION

This is a critical part of the claim process. Upon occurrence of a loss covered by the policy, notice must be given to the company of such occurrence. While the notice period is governed by the terms contained in your policy document, it is always advisable to give immediate written notice on occurrence of a claim event. Note though that WRITTEN notice must be given to the Company within the timeframe specified in your policy document, irrespective of whether verbal notice was given, and failure to provide such notice may invalidate your claim. A claim notification form is provided on the DOWNLOADS tab of this website which you should download, complete and sign
The completed form should be delivered to any of our offices countrywide, emailed to This e-mail address is being protected from spambots. You need JavaScript enabled to view it or sent by post to P.O. Box 30375 - 00100 Nairobi, Kenya. Upon receipt of the claim notification, we shall advise the claimant of the list of required documents and provide you with any forms that require to be completed. If you have any difficulties or queries, our staff will be happy to assist you in making your claim.

CLAIM REQUIREMENTS

Claim documentation will usually differ depending on the type of claim. We have outlined below the basic claim requirements for different claim types. Additional documents may be required depending on the circumstances of a particular claim. Our claim forms are available for download on the DOWNLOADS tab of this website.
Unlike the claim notification form which may be mailed or emailed, the actual claim documents must be presented by the claimant in person at any of our offices.


Death Claims:
Claim notification form (if not already submitted)
Original policy document
Original death certificate & copy
Burial permit copy
Claimant’s original identification document & copy (National ID or Passport)
Deceased insured’s ID or original letter of surrender of the ID
Proofs of Death forms - Claimant’s statement (Form 43 No 1) & Physician’s statement (Form 43 No 2) – supplied by us
Where beneficiary is a minor, their original birth certificate
Where beneficiary is a minor, original guardianship order from the Children’s court where claimant isn’t the biological parent
Letters of administration and confirmation of grant (to be advised depending on claim circumstances)
Police abstract and post-mortem report where death was due to an accident

PROOF OF DEATH FORM

Personal Accident Claims:

Claim notification form (if not sent already submitted)
Claim form duly completed – supplied by us
Police abstract for Road Traffic Accidents & police report for police cases
Doctor’s report in case of Permanent & Total Disability claims
Original death certificate & copy (where death is involved)
At its discretion, the company may send the insured to a doctor or specialist of its choice for examination and ascertaining the occurrence and extent of injuries

CLAIM NOTIFICATION FORM

Accident Indemnity Claims:
Claim notification form (if not sent already submitted)
Claim form duly completed (Form No 70A) duly completed – supplied by us
Police abstract for Road Traffic Accidents & police report for police cases
Sick-off sheets
Original treatment documents, including hospitals invoices, receipts, admission & discharge summaries, x-ray reports etc
Original death certificate & copy (where death is involved)

ACCIDENT INDEMNITY POLICY CLAIM FORM

CRITICAL ILLNESS CLAIM FORM

Mediflex Claims:
Claim notification form (if not already submitted)
Mediflex claim form duly completed (Form No 75A) duly completed – supplied by us
Police abstract for Road Traffic Accidents & police report for police cases
Original treatment documents, including hospitals invoices, receipts, admission & discharge summaries, x-ray reports, treatment notes etc
Original death certificate & copy (where death is involved)

MEDIFLEX CLAIM FORM

Critical Illness or Disability Claims:
Claim notification form (if not already submitted)
Relevant claim form duly completed – supplied by us
Detailed doctor’s/specialist’s report
Original treatment documents, including hospitals invoices, receipts, admission & discharge summaries, x-ray reports, treatment notes etc
At its discretion, the company may send the insured to a doctor or specialist of its choice for examination and ascertaining the occurrence and extent of illness/injuries

PA DISABILITY DEBILITY DISMEMBERMENT CLAIM FORM