Non-motor Quote Form (Individual)

Non Motor Quote Form

Please use the form below to get a quote for....

Proposer's Details (Whether business or individual)

Full Name of Proposer
Full Name of Proposer

Contact Details.

Please provide the period for which the insurance is required

Personal Accident

Does your occupation, require you to engage in manual labor?

Have you suffered from:

Any form of chronic illness
Varicose veins
Back strain
Slipped disc
Impairment of hearing
Impairment of sight
Or hearing complaint
Infection of eyes
Discharge from the ear
Heart disease
Duodenal or gastric ulcer
Fits or blackouts
Any form of paralysis
Have you any physical defect or infirmity?
Have you sustained any injury by accident(s) during the last five years?
(per week max 104 weeks)

Domestic Package

Is the premises a private dwelling house?
Is the dwelling solely in your occupation? (including your family and servants)
(all the said buildings are brick, stone or concrete built, with tile, concrete or metal roof)
The sum insured for the buildings should be the reinstatement value. i.e the cost of rebuilding the house including walls and outbuildings, making allowance for architects and surveyors consultancy fees and cost of debris removal.

Note 1: The sum should insure should be the replacement value less depreciation, wear and tear of the property.

Note 2:No one article (furniture excepted) shall be deemed of greater value than 5% of the total sum insured on the contents, unless such article is specifically insured.

Note 3:The value of platinum, gold and silver articles, jewellery will be deemed not to exceed one third of the total sum insured on the said contents unless specifically agreed upon with the insurer. If the said value exceeds the portion, the value of such property should be specified.

On furniture, household goods and personal effects of every description the property of the proposer or any member of the proposer's family normally residing with the proposer, and fixtures and fittings the proposer's own or for which the proposer is legally responsible, not being landlord's fixture and fittings, in the building of the proposer's residence.

Specify here any article of greater value than 5% of the total sum insured on the above contents

Complete this option if you wish to insure each item individually. Proposer's estimate of the value of individual items making up the contents Do not include a value for any item which is to be insured under the "ALL RISKS”

Please indicate the security arrangements you have put in place;

Own Watchman
Security Guards

Note: The sum insured should be the replacement value of the property less a deduction for wear, tear and depreciation Please give a detailed description and state separately the value of each item as provided below. For any items of jewellery with sum insured up to and in excess of KES:50,000 a valuation report must be submitted.

Limit of cover required
Subject to deductible of KES. 10,000/= each and every claim.
Occupier's & personal liability.

Professional Indemnity

Present legal constitution
  • In the case of partnerships-partners
  • In the case of incorporate companies, directors
  • In the case of limited companies, professionally qualified directors and employees

Total number of partners and staff

All Risk

Evidence of value required for items exceeding Ksh. 10,000

Golfers Insurance

Do you enjoy good health?
Have you ever sustained any accident, loss or breakages?
Do you have any other personal accident insurances?
Do you require any of the following benefits?