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Customer E-Portal
Home > About us > Forms

Claim Forms

 

 

Pensions

 

 

 

1. Application Forms


BM (Boresha Maisha) Individual Pension Plan

 

 

 

2. Servicing Forms


Pensions Change of Beneficiary Request

 

 

 

 

3. Exit Forms


Retirement Benefit Claim Form

Boresha Maisha Claim Form

 

 

 

 

 

 

Life

 

 

 

 

 

1. Application Forms


Long-Form Health Certificate Application

Long-Form Health Certificate for Juveniles

Amendments-to-application-for-policy

 

 

 

2. Servicing Forms


Change of Premium Payment

Request for Part Surrender

Policy loan request

Change of Beneficiary

 

 

 

 

3. Claim forms


Certificate of Continued Disability Form

Critical Illness Claim Form

Death Claim Form

Personal Accident Claim Form

Physical Impairment Claim Form

Statement by Police Form

Proof of Death Claimant Statement Form

Proof of Death Physician Statement Form

Group Death Claims - Proof of Death

Termination Form

Disability Claimant's Statement Form

Funeral Claim Form

Retrenchment Claim Application Form

 

 

see also

About us

#about us

Our History

#about us

Group Structure

#about us

Executive Management

#about us

Board of Directors

#about us

Corporate Social Investment

#about us

Financial Results

#about us

Whistle Blowing

#about us

Privacy Disclaimer

#about us

Who we are

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Regulated by the Insurance Regulatory Authority
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All contents copyright © 2023 Liberty Life Assurance Kenya Ltd.
Regulated by the Insurance Regulatory Authority