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Application for copy of lost policy (by policyholder)
Download, print two copies, complete, sign and send both copies to our customer office together with your payment for kshs.250.00

Application for reinstatement and payment of premiums in arrears
  • Click here to submit your details to the Customer Service department who will advise you on the specific requirements.

Application of reinstatement and part payment of premium arrears
  • Click here to submit your details to the Customer Service department who will advise you on the specific requirements.


Policy loan application
Do you wish to take a policy loan? It's easy , download and read the instructions on the form (PS13).
  • Print, complete and sign two copies for each policy and send them to our office together with your policy document.
  • Important: Any loan outstanding on a policy reduces the benefits payable against it. Please make arrangements to repay the loan.

Application for Surrender of Insurance
Do you wish to surrender your policy?
  • Please read the questionnaire. If you wish to proceed with the surrender, print and complete the questionnaire and the surrender request form. Then submit them to our offices together with your original policy document.


Change of premium payment frequency
Click here to the download the Change in Premium Payment Frequency form.
  • Complete to double line and sign in DUPLICATE.
  • Must be signed by the insured or Owner; Also by the beneficiary if the right to change has not been reserved.
  • If the policy is Assigned, the form must also be signed by the Assignee.
  • Send both copies of form to our office for endorsement. One copy will be returned to be attached to the Policy.
  • Change of frequency to annual, semi annual or quarterly mode can only be effected as of the anniversary or the next due date after the anniversary.
Contact our Customer Service department if you require more details.

Application for a copy of lost policy (by agent)
  • Download, print two copies, complete and sign. Send both copies to our Customer Services and Conservation Department.
  • This form constitutes your authority for payment of the cost of the document from your account.


Authority for salary deduction to pay life assurance premiums/loan
To authorise your employer to remit money for premiums and/or policy loan repayment, download, print two copies complete and sign this salary deduction form. Send two copies to us for submissions to you employer.

Application for change of name/signature
Print, complete and sign two copies, then send them to us together with original policy document and proof of change of name. Incase of change of signature send forms with a copy of your identification.

Click here to download the change of name/signature form.

Beneficiary Designation
Sometimes situations in ones life change very fast and one hardly remembers to reflect these changes on one's insurance package, until it is too late. Do you have the intended beneficiary on your policy? If not, change now.

Instructions
  • Print, complete and sign in DUPLICATE
  • Must be signed by policy owner. Also by the beneficiary if right to change beneficiary has been reserved.
  • If policy is assigned the form must be signed by the Assignee.
  • If beneficiary is below the age of 18 years a guardian must be appointed.
Click here to complete form

Request for Policy Change

 
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