How to File an Insurance Claim

Step-by-Step for Health, Motor, and Life Policies

Filing an insurance claim in Kenya can feel overwhelming—especially during a crisis. Whether you’re dealing with a hospital bill, a car accident, or the death of a loved one, knowing what to do, when to do it, and what documents to prepare can make all the difference. In 2025, insurers have improved digital access and claims processing, but delays still occur due to missing paperwork, late reporting, or policy misunderstandings.

This guide walks you through the step-by-step process for filing health, motor, and life insurance claims, including timelines, required documents, and common pitfalls to avoid.

1. Health Insurance Claims

When to File

  • Within 30 days of treatment or hospital discharge
  • Emergency claims should be reported within 48 hours

Step-by-Step Process

  1. Notify Your Insurer
    • Call the hotline or use the mobile app
    • Provide your policy number and hospital details
  2. Gather Required Documents
    • Hospital invoice and discharge summary
    • Doctor’s report and prescriptions
    • NHIF or SHIF statement (if applicable)
    • National ID and insurance card
    • Claim form (download from insurer’s website or app)
  3. Submit the Claim
    • Upload via app, email, or deliver to branch
    • Request a claim reference number
  4. Follow Up
    • Insurers typically respond within 7–14 working days
    • Use the app or portal to track progress

Common Pitfalls

  • Submitting incomplete medical reports
  • Using non-accredited hospitals
  • Delayed notification beyond policy limits
  • Exceeding coverage limits without prior approval

2. Motor Insurance Claims

When to File

  • Notify insurer within 24–48 hours of accident or theft
  • Police abstract must be filed within 24 hours

Step-by-Step Process

  1. Secure the Scene
    • Take photos of damage, license plates, and surroundings
    • Exchange details with other parties
    • Call police and obtain a police abstract
  2. Notify Your Insurer
    • Call or WhatsApp your insurer or agent
    • Provide accident details and abstract number
  3. Submit Required Documents
    • Duly filled claim form
    • Police abstract
    • Driver’s license copy
    • Logbook copy
    • Insurance certificate
    • Repair estimate from approved garage
    • Medical report (if injuries occurred)
  4. Assessment and Approval
    • Insurer assigns an adjuster within 48–72 hours
    • Repairs authorized or cash-in-lieu offered
    • Write-off cases settled within 30–90 days

Common Pitfalls

  • Late reporting beyond 48 hours
  • Missing police abstract or inspection report
  • Unapproved garage repairs
  • Driving without a valid license or insurance

3. Life Insurance Claims

When to File

  • Within 90 days of death
  • Some policies allow up to 12 months, but earlier is better

Step-by-Step Process

  1. Notify the Insurer
    • Visit branch or call customer care
    • Provide policy number and date of death
  2. Prepare Required Documents
    • Original death certificate
    • National ID of deceased and beneficiary
    • Original policy document
    • Claimant’s statement
    • Physician’s report or post-mortem
    • Police abstract (if accidental death)
    • Guardianship order (if beneficiary is a minor)
    • Letters of administration (if no named beneficiary)
  3. Submit the Claim
    • Deliver documents in person or via portal
    • Request a claim reference number
  4. Processing Timeline
    • Most insurers respond within 14–30 working days
    • Payouts made via bank or mobile money

Common Pitfalls

  • No named beneficiary on policy
  • Mismatched names or ID numbers
  • Missing legal documents (e.g. guardianship, probate)
  • Policy lapse due to unpaid premiums

Final Tips for All Claims

  • Keep digital copies of all documents
  • Track your claim using reference numbers
  • Follow up regularly via app, email, or agent
  • Know your policy terms—coverage limits, exclusions, and timelines
  • Appeal if denied—you can escalate to IRA or file a formal complaint

Final Thoughts

Filing an insurance claim in Kenya doesn’t have to be stressful. With the right documents, timely action, and clear communication, you can navigate the process smoothly—whether it’s a hospital bill, a car accident, or a life insurance payout. In 2025, insurers are more responsive than ever, but your preparation is key.