Insurance Quote Form

Enter your Name *

Phone *

Email Address

Street Address

Company NameEnter your name Company Name If you are a business, Please Enter your Company name

Select Insurance Products which Interest You * *Motor InsuranceMedical InsuranceFire / Properties InsuranceLife InsuranceOther General InsuranceTraining / Consultation / VisitationRisk Management, Claim & Underwriting

Type of Motor Insurance *Third party Insurance [Bima Ndogo]Comprehensive Insurance [Bima Kubwa]Aina ya bima ya gari

Plate Number *

Vehicle TypeCommercial [Biashara]Private [Binafsi]Aina ya Gari

Plate Number *

Vehicle TypeCommercial [Biashara]Private [Binafsi]Aina ya Gari

Value of the Vehicle *

Upload Vehicle card , Your ID (NIDA / Driving Licence/ Voters ID, Passport, TIN) and Vehicle pictures

Drag and Drop (or) Choose Files

Kadi ya Gari, Kitambulisho (NIDA / Leseni/ Pasipoti / TINI/ Kitambulisho cha mpiga Kura) na Picha za Gari

Select preffarable Amount per person per year for Medical / Health Insurance services *350,000 - 600,000600,000 - 800,000800,000 - 1,000,0001,000,000 - 1,300,0001,300,000 +

Age of the Member *Umri wa mwanachama

Preffered Insurance CompanyAssemble InsuranceJubilee Medical InsuranceStrategis InsuranceBritam Insurance

Value of the Property *Thamani ya Mali

Cover AgainstFireTheft / BurgarlyMachine BreakdownElectronics Damage

Select Life Insurance covers *GroupFuneral Cover / BenefitsPersonal SavingsEducation Child SupportPensionInvestmentLoan / Credit Life Insurance

Submit

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