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New Policy Application From
New Policy Application From
Abigael Opondo
2019-10-09T10:16:32+03:00
Bancassurance - New General Insurance Policy Form
Policy Holder Information
Name
*
First
Last
Email
*
Phone
*
KRA PIN Number
*
Is this policy for an individual or a company?
*
Individual policy
Company/ Organization policy
National ID Number
*
Passport Number:
Please Use this if you do not have a National ID number.
Certificate of Incorporation Number
*
Please enter this number if you are creating a policy for a company.
Company/ Organization Name
*
Policy Options
What insurance cover would you like get today?
Fire and Peril Insurance
Theft/ Burglary Insurance
All Risks Insurance
Work Injury Benefit Act (WIBA)
Livestock Insurance
Health Insurance
Home Insurance
Motor Insurance
Golfers Insurance
Travel Insurance
Marine Insurance
Fire and Peril Insurance
Location of the building or structure to be insured?
List of assets and value.
Max. file size: 3 MB.
Use this section to attach a Word/ PDF form.
Phone
This field is for validation purposes and should be left unchanged.
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