Home Insurance

Household Contents Insurance Cover

What is the value of items carried from the house? *

What is the value of household contents? *

Building Cover

Type of Building?

What is the value of the building? *

When do you want your cover to start?

First Name *

Last Name *

Mobile Number *

Email Address *

I accept our Terms and conditions

Building value:

Household Content value:

Risk Items Carried value:

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Underwriter

Title *

First Name *

Last Name *

Middle Name

Passport/ID Number *

Occupation *

KRA Pin *

Nationality *

Date of Birth *

Gender *

Male

Female

Contact Details

Physical address *

Postal Address *

Town/City *

Postal Code *

Mobile Number *

Email Address *

Personal Details

Questionaire

a) Of what materials is the dwelling constructed?

Walls:

Roof:

b) Is the building comprised of storeys?

Yes

c) Is any business, professional or trade carried on in any portion of the premises of which the dwelling forms a part?

Yes

d) Is the dwelling

A private dwelling house?

Rooms self contained

A self contained flat with a separate entrance exclusively under your control?

e) Is the dwelling solely in your occupation (including your family and servants)?

Yes

f) Will the dwelling be left without inhabitant for more than 7 consecutives days?

Yes

g) Are the buildings in a good state of repair and will they be so maintained?

Yes

h) Do you have burglar proof doors/window?

Yes

i) What other security arrangements do you have in place (e.g. Guards/alarms, etc)

Declaration

I here by declare and warrant on my behalf and on behalf of all persons proposed to be insured that the above statements are true and complete in all respects and that there is no other information which is relevant to this application for insurance that has to be disclosed. I agree that this proposal and the declaration shall be the basis of the contract between me and all persons to be insured and the Insurance Provider.

Yes

Vehicle Details

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PREVIEW YOUR DETAILS

Underwriter

Personal Details

First Name:

Middle Name:

Last Name:

Passport/ID Number:

Occupation:

Nationality:

KRA Pin Number:

Date of Birth:

Gender:

Contact Details

Address:

Mobile Number:

Email Address:

House Details

Building Value:

Household Content Value:

Risk Items Carried value:

Building Type:

Questionaire

Home Insurance

Household Contents Insurance Cover

Building Cover

Underwriter

Declaration

PREVIEW YOUR DETAILS

Underwriter

Personal Details

Contact Details

House Details

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