Kindly take note of the claims documentation.

Domestic Travel Claim form and requirements.

For Accidental Death Claims

Certified copies of the following documents
b) Police Report
c) Medical Cause of death or Death Certificate
d) Burial Permit
e) NRC of the Deceased
f) NRC of the claimant.
g) Claim Notification Period for this Section will be 30 days.

Emergency Medical Expenses

Certified copies of the following documents
b) Police Report of Road Traffic Accident
c) National Registration Card (NRC) of the Insured
d) Medical Bills from the Clinic or Hospital where the insured patient was attended to immediately after the Road Traffic Accident
e) Name of the Medical Practitioner as well as his address and telephone number.
f) Medical Expenses claims must be submitted to Mlife within 30 days

Permanent Disability

b) Medical Report Certifying Permanent Disability
c) NRC of the Claimant
d) Police Report of the Road Traffic Accident

A. Ordinary Claims Documentation

    1. Original Policy Document/Lost policy affidavit
    2. Copy of National Registration Card/Valid Passport
    3. Declaration by Claimant and discharge Form 16
    4. Copy of payslip
    5. Letter of claim from the Assured

 

B. Death Claims Documentation

    1. Death Claims Documentation
    2. Originally Certified copy Death Certificate/Medical Certificate of cause of death
    3. Originally Certified Copy of Deceaseds NRC
    4. Originally Certified Copy of administrators NRC
    5. Originally Certified Copy Birth records of Beneficiaries (if minors)
    6. Original Policy Document/ Certified Lost policy affidavit
    7. Certificate of Medical Attendant(when requested)
    8. Declaration by Claimant and discharge Form 16
    9. letter of Claim from Beneficiary (if a minor letter of claim from Administrator )
    10. letter of Authorisation from other beneficiaries (if many )
    11. Incase of accident as cause of death – police report on the accident. Is required

 

C. Loan Application’s

    1. Stoporder form – 6 /DDACC MANDATE FORM(TO ADJUST PREMIUMS)
    2. Policy Loan Agreement Form-14
    3. Quotation of values form-18
    4. Declaration by Claimant and discharge Form 16
    5. Original Policy Document/Lost policy affidavit
    6. Letter of claim from the Assured
    7. Paystatement(payslip)
    8. copy of NRC

 

D. SURRENDERS/CANCELLATION CLAIMS

    1. Original Policy Document/Lost policy affidavit
    2. Copy of National Registration Card/Valid Passport
    3. Declaration by Claimant and discharge Form 16
    4. Copy of payslip
    5. Letter of claim from the Assured

 

E. CASH AND SECURITY BENEFIT RIDER(BONUS)

    1. Original Policy Document/Lost policy affidavit
    2. Copy of National Registration Card/Valid Passport
    3. Declaration by Claimant and discharge Form 16
    4. Copy of payslip
    5. Letter of claim from the Assured

 

F. MATURITY CLAIMS

    1. Original Policy Document/Lost policy affidavit
    2. Copy of National Registration Card/Valid Passport
    3. Declaration by Claimant and discharge Form 16
    4. Copy of payslip
    5. Letter of claim from the Assured

Kindly take note of the claims documentation.

A. Ordinary Claims Documentation

    1. Original Policy Document/Lost policy affidavit
    2. Copy of National Registration Card/Valid Passport
    3. Declaration by Claimant and discharge Form 16
    4. Copy of payslip
    5. Letter of claim from the Assured

 

B. Death Claims Documentation

    1. Death Claims Documentation
    2. Originally Certified copy Death Certificate/Medical Certificate of cause of death
    3. Originally Certified Copy of Deceaseds NRC
    4. Originally Certified Copy of administrators NRC
    5. Originally Certified Copy Birth records of Beneficiaries (if minors)
    6. Original Policy Document/ Certified Lost policy affidavit
    7. Certificate of Medical Attendant(when requested)
    8. Declaration by Claimant and discharge Form 16
    9. letter of Claim from Beneficiary (if a minor letter of claim from Administrator )
    10. letter of Authorisation from other beneficiaries (if many )
    11. Incase of accident as cause of death – police report on the accident. Is required

 

C. Loan Aplications

    1. Stoporder form – 6 /DDACC MANDATE FORM(TO ADJUST PREMIUMS)
    2. Policy Loan Agreement Form-14
    3. Quotation of values form-18
    4. Declaration by Claimant and discharge Form 16
    5. Original Policy Document/Lost policy affidavit
    6. Letter of claim from the Assured
    7. Paystatement(payslip)
    8. copy of NRC

 

D. SURRENDERS/CANCELLATION CLAIMS

    1. Original Policy Document/Lost policy affidavit
    2. Copy of National Registration Card/Valid Passport
    3. Declaration by Claimant and discharge Form 16
    4. Copy of payslip
    5. Letter of claim from the Assured

 

E. CASH AND SECURITY BENEFIT RIDER(BONUS)

    1. Original Policy Document/Lost policy affidavit
    2. Copy of National Registration Card/Valid Passport
    3. Declaration by Claimant and discharge Form 16
    4. Copy of payslip
    5. Letter of claim from the Assured

 

F. MATURITY CLAIMS

    1. Original Policy Document/Lost policy affidavit
    2. Copy of National Registration Card/Valid Passport
    3. Declaration by Claimant and discharge Form 16
    4. Copy of payslip
    5. Letter of claim from the Assured

DOWNLOADS

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DOMESTIC TRAVEL CLAIM FORM 363.62 KB 30 downloads

Domestic Travel insurance Claim form.   ...
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Declaration and Claimant 193.15 KB 1369 downloads

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Policy Loan Agreement 295.76 KB 869 downloads

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Life ass premium stop order form 294.50 KB 594 downloads

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LOST policy affidavit & Indemnity 212.06 KB 543 downloads

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Quotation of values 361.74 KB 595 downloads

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