Kenya Insurance Guidebook Overview
Kenya Insurance Guidebook Overview
GUIDEBOOK
INSURANCE GUIDEBOOK
Introduction TABLE OF CONTENTS
Insurance is broadly divided into two: General or Non-Life Insurance (short-term) A. Common Insurance Terms 6
and Life Insurance (long-term). B. Roles and Responsibilities of Insurance consumer 11
The information in this handbook intends to equip readers with basic knowledge C. LIFE INSURANCE
of the various types of insurances that are available as well as what they cover.
1. Personal Life Insurance 14
This publication has covered the most common insurances that individuals, Small, 2. Group Life Insurance 20
and Medium Enterprises (SMEs) require. 3. Pension 24
For further discussion on the insurance classes outlined in this handbook and 4. Annuities
those not covered, we encourage readers to get in touch with the insurance 5. Funeral Insurance Cover 35
companies listed at the back of this publication. Readers can also get in touch
with any insurance agent or broker of their choice. D. GENERAL INSURANCE
1. Domestic Package (DP) Insurance 39
The Association of Kenya Insurers developed this Guidebook. We welcome
2. Personal Accident and Group Accident Insurance 41
feedback through the contact details below.
3. Medical Insurance and Group Medical insurance 41
Association of Kenya Insurers | AKI Centre, Mimosa Road, Mucai Drive, Off 4. Travel Insurance 42
Ngong Road
5. Professional Indemnity Insurance 43
P.O. Box 45338 – 00100, Nairobi
6. Work Injury Benefits Act (WIBA) Insurance 44
Tel: +254 709640000 | Mobile: 0722 204149/0733 610325
7. Employers’ Liability (EL) Insurance 45
Email: [email protected]
8. Public Liability Insurance 46
Website: www.akinsure.com
9. Products Liability Insurance 46
Facebook: AKIKenya
10. Fire and Perils Insurance 48
Twitter: AKI_Kenya
11. Business Interruption Insurance 48
12. Burglary or Theft Insurance 49
13. Money Insurance 50
14. Fidelity Guarantee Insurance 52
15. Marine Insurance 52
16. Goods in Transit (GIT) Insurance 53
17. Carriers Legal Liability Insurance 55
Member Organizations 56
Notes 59
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A. Common Insurance Terms
Insurance – A contract in which date to the expiry or end date. affected by the insured actions. Pre-existing condition – A medical
an insurance company promises to Premium – The amount the insured problem or illness you had before
compensate an insured. Third-party claim – A claim filed by
pays an insurance company. It could a third party against the first party’s applying for health care coverage.
Insurer – The company that accepts be a one off payment or regular
risks after receiving premiums and insurance policy. Beneficiary – The person, people, or
installments or as per the agreement
pays claims. Sum insured – It relates to the value entity who will receive benefits from an
with the insurer.
Insured – The person who has taken of the insurance and this is the basis insurance policy or an annuity contract.
Claim – A request for payment when
insurance and pays premium upon which premium is calculated and Accident – An unforeseen, unintended
the insured event occurs as per the
claim paid. event.
Agent – A person or a group of people terms of the insurance policy.
selling insurance on behalf of an Excess – The amount the insured pays Co-pay – The percentage of each Insurable interest – Any financial
insurance company. when making a claim. The amount is health care bill people must pay out interest a person has in the property,
Broker – An independent insurance specified in the policy. of their own pocket. This is under the person or liability.
professional licensed under the Liability – The effects of your actions medical health insurance.
Loss history – The number of
Insurance Act who advises customers or lack of actions on others while Endorsement – A written agreement
on insurance. In Kenya, most brokers insurance claims previously made by
undertaking your responsibilities. expanding or limiting the terms and an insured. An insurance company will
are members of the Association of
Grace period – The time - usually 31 conditions of a policy. consider loss history when underwriting
Insurance Brokers of Kenya (AIBK).
Underwriter – The person who days - during which a policy remains in Rider – An additional benefit on a a new policy or considering renewal of
calculates how much premium to force after the premium is due but not policy. an existing policy.
charge for various insurance products paid. The policy lapses after 31 days if Exclusions or limitations – Provisions Market value – The current value of
and accepts or rejects risks on behalf premium is not paid. that exclude or limit coverage of a the asset you are insuring such as your
of insurance companies. Lapse – The termination of an policy. home, motor vehicle etc.
Underwriting – The process an insurance policy because premium has Towing coverage – The motor Risk/Peril - An occurrence that
insurance company uses to decide not been paid.
insurance benefit that pays for towing can cause loss to an individual or a
whether to accept or reject an Cancellation Notice – Termination charges when a car cannot be driven. business for example fire, theft, death,
application for an insurance cover. of an insurance policy by either the It also pays labour charges, such as accidents and others. A named-peril/
Proposal Form – An application form Insurance Company or the insured changing a flat tyre at the place where risk policy covers the insured only for
completed by a potential client for an before the renewal date. the car broke down. the risks identified in the policy. An all-
insurance cover. Renewal – Continuation of a policy Material misrepresentation – A risk policy covers all causes of loss
Policy – A formal contract /document after expiry date and payment of
issued by an insurance company to the significant untruth on an application except those specifically excluded.
premium.
insured setting out terms on which the form which, if a company had access Refund - An amount of money returned
First/ Second / Third Party – The
insurance cover has been provided. to, they might have rejected the to the insured for overpayment of
first party is the insured, the second is
Policy period – The period a policy is insurance company and the third party application. premium or when a policy is cancelled.
in force, from the beginning or effective is any other person(s) who may be
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INSURING THE DIFFERENT STAGES OF LIFE
With each phase of life, our priorities change.
What was a priority when you were in your
twenties, may change when you are in your Married with children
forties. As we evolve, so do our insurance Life insurance. Education policy.
needs. For that reason, our stage of life, not Health insurance. Investments
just our age, is often a great indicator of our and retirement planning.
insurance needs.
Young Single
Full of life. Few responsibilities.
Get Travel insurance as
you see the world. Protect
yourself with personal accident
insurance to cover for any
injuries or disabilities. Plan
your career growth with an
education policy. Protect your Business owner
treasured electronics and If you are running a business
home appliances with home it should also be protected.
insurance. Depending on the nature
of the business there
are several options, from
professional indemnity,
Married business interruption, goods-
Protect the lifetime union in-transit, money insurance,
with life insurance. Health theft insurance, fire and perils.
insurance. Credit life insurance If you have employees, group
when purchasing a home via insurances such as health, life,
mortgage. Home insurance and pension are also key.
to protect that valued asset.
Creating wealth for long term.
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Employed
Establish what kind of insurance
B. Roles and Responsibilities of Insurance Consumer
your employer provides, then
depending on which stage of
How to buy insurance
life you are in, you can fill in
the gaps of insurance that you Contact any insurance company (contacts are at the back of this publication),
require. For example, your insurance agent or broker for your insurance needs. Check the insurance
employer may provide health regulatory authority website to ensure the agent or broker you use is licensed.
insurance but no life insurance
or pension. It then becomes Honesty
your responsibility to plan for It is the responsibility of the consumer to be honest with the information given to
retirement and to protect your the insurance company.
life.
Reading and understanding the policy document
This is the contract between a customer and an insurance company. It is very
important for customers to read and understand the policy document. Contact
Retirement the company or agent/broker on any area that is not clear within two weeks of
Planning for retirement is critical receiving it.
and this should start as early The policy outlines what is covered and what is not covered. It also contains other
as possible. Insurance offers critical details that the customer or the insured needs to know.
many options for planning
The document outlines the necessary details of the contract including:
for retirement in the form of
schemes and annuities. ÒÒ The type of policy
ÒÒ The name and address of the insured and the insurer
ÒÒ The event /circumstances upon occurrence in which the loss becomes payable
ÒÒ The incidences in which a loss is not payable
It is important for us to stress that the above pointers are simply guidelines based ÒÒ Duration of cover
on the needs of the general public. This publication outlines the various insurance
ÒÒ The sums insured and other benefits
available. Each individual has their own personal needs and there is no one-size
fits all product in the market. ÒÒ Premium amount
If you are unsure about your needs, go talk to an agent that you trust. Remember
to set a budget for yourself. Insurance policies are meant to insure yourself
against adverse circumstances in life, not take over your life completely with high
premiums.
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Making changes to an insurance policy
Making a change to your insurance policy is possible. Get in touch with the
insurance company, insurance agent or broker.
Communication
You should always communicate with the insurance company, agent or broker in
case of any issues regarding the insurance products.
LIFE INSURANCE
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LIFE INSURANCE LIFE INSURANCE
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►► Completing a proposal form 6. What do I need to look out for when taking life insurance?
►► Paying the initial premium When taking out life insurance there are several things that you need to look
►► Providing the required documents like I.D card, Pin number, etc as out for including: The Policy document, the policy term or period, the amount
requested by the company of premium and the frequency of payments, and the bonus (if any).
►► Undergoing a medical examination if necessary. There are many policies Other things to look out for are cancellation clauses, the cash surrender value
where medical reports are not required. (the amount the insurance company will pay you if you cancel your policy
►► The insurance company reviews the proposal and documents submitted after 3 years but before maturity), policy loan (you can take a loan from the
and issues the policy document insurance company against your policy after an agreed period).
7. What factors are considered when calculating premiums for life
insurance?
Age, occupation, health status. Sometimes gender and lifestyle (e.g. smoker
Before vs. non-smoker) also influence premium rate.
buying a life insurance
policy, it is important to evaluate 8. What is a Policy Document and what does it contain?
your needs and goals as well as A life insurance policy document is a formal contract that the insurance
those of your family. Once you have company gives to the insured. It serves as legal evidence of the insurance
your needs and goals, you will be agreement and sets out the exact terms on which the life cover has been
able to select a type of cover provided. It outlines details such as:
that suits you. ►► The type of policy
►► The name and address of the insured and the insurance company
►► The event upon occurrence in which the benefit becomes payable
►► Duration of cover
►► Amount of premium and frequency of payment
►► The sum assured and other benefits
Contact the company in case you have not received your policy document
within one month of signing up for the cover. It is very important to read your
policy document and contact the company on any area that is not clear.
Grace period for review of policy document: You may cancel your life
insurance by returning the policy document to the insurance company within
15 days after you receive it if you feel that it does not reflect what you agreed
upon when buying the policy. The premium that you have paid (less any
medical fees incurred) is refundable.
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9. Who is a beneficiary and why is it important to nominate one? 14. What happens if I die before my policy matures?
A beneficiary is the person who receives the benefits outlined in the policy In the event of death, the policy benefits are paid to your nominated beneficiary
following the demise of the insured. Choosing a beneficiary ensures that (ies). Some policies have riders that come into play to keep the policy in force
your benefits go to the right people. If you chose minors (below 18 years) as until maturity. For example, Education policies pay some benefits upon the
beneficiaries ensure to also nominate a responsible guardian. demise of the insured but the policy remains in force until maturity to enable
the children complete their education as per the original plan of the insured.
10. What do I do if I need to make changes to my life insurance policy?
Circumstances may change and it may require an adjustment to your life 15. How do I make a claim and how long does it take?
insurance policy document. You need to make a request to your insurance When the policy matures, the insurance company will contact you to collect
company in writing and they will advise you on the next steps required to effect your benefits. The insured or beneficiaries can also get in touch with the
the changes. insurance company if they have not made contact.
11. What happens if I am unable to keep up with my premium pay- In the event of death or disability, the insurance company should be notified
ments? immediately. The necessary forms should be completed and the person
If you are unable to pay premiums within the first two to three years, your making the claim will be advised on the required documents to facilitate
policy may lapse. After three years however, the policy gains value and as processing of the claim.
such the insurance company is able to refund a portion of the paid premium. Claims are settled within 30 days of submitting the required documents.
The insurance company will advise you on other options to keep the policy in
force e.g. the already paid premium can be utilized to fully pay premiums for
a policy of a lower value. What
happens if I die before my
12. Can a lapsed policy be reinstated? policy matures? In the event
A lapsed policy may be reinstated. However, the insurance company will of death, the policy benefits
require the insured to meet certain conditions such as medical checkup at the are paid to your nominated
time of reinstatement and payment of outstanding premiums beneficiary (ies).
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LIFE INSURANCE LIFE INSURANCE
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PENSION
Government Sponsored Plans – The National Social Security Fund
1. What is pension? provides basic financial security to Kenyans upon retirement. Contribution is
Pension is a regular payment that is made during a person’s retirement from compulsory for employers and employees. However, the benefits paid out are
an investment fund to which that person or their employer has contributed often not sufficient to provide for a comfortable retirement.
during their working life.
A pension or retirement benefit scheme is a form of insurance. The scheme 5. Who can join a personal pension scheme?
protects members against the risk of poverty in old age by ensuring that they Anyone over 18 years of age who is either employed or self-employed. You
are able to provide for themselves in retirement. join a personal pension scheme simply by completing an application form and
making your first contribution. Membership is open to the following:
2. What is a personal pension plan?
• Those working in organizations that do not have a retirement benefits
A personal pension plan, also referred to as a retirement plan, is a vehicle
scheme.
or service offered by insurance companies to build up a sum of money that
can be used upon retirement. The money you put in is invested to generate a • People in seasonal or contractual employment.
regular income referred to as pension. • Self-employed.
• People working in the Diaspora.
3. Why should I plan for retirement?
• Members of existing schemes who are changing jobs and would like to
You may be active today, but a time will come when you will have to slow down
transfer their pension funds form the employer-sponsored scheme.
and retire and thanks to advances in medicine, we now live longer. Our living
expenses such as food, utility (water, electricity) bills, medical bills, housing • Members of existing pension schemes who seek to enhance their retire-
and others, do not retire. Planning for retirement helps us create an income ment savings.
that will cater for these expenses and ensure that the quality of life led in old • Small to medium sized employers who cannot afford to set a Staff Retire-
age is still as good as when one was active. ment Scheme
Planning for retirement is also important given today’s economic realities • Partnerships and Practice set up.
where it will be difficult to rely on other people for your daily needs. The family • Non-Governmental organizations etc
unit is weakening and the traditional notion of parents relying on their children
is fading.
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6. What are the benefits of joining a pension scheme? payment of up to Ksh600,000. Any amounts above that are taxed as
►► The contributions have a 100% capital guarantee. Retirement benefits illustrated in the tables below.
schemes managed by insurance companies guarantee that your funds will
not be lost. They also guarantee a minimum rate of return. Below 50 years or below 15 years in the Scheme
►► Contributions are flexible depending on your financial ability and needs. If you are below 50 years, or have been a member of a retirement scheme for
less than 15 years, the pension amounts are subject to tax as per the table
►► Contributions are easy to make through deductions from your salary, direct
debits, mobile money etc below:
►► The fund earns compound interest. This allows contributions to grow into Lump Sum Max Ksh600,000 0
significant retirement savings over time
►► It gives one the discipline to save and improve financial security in his/her On the first Ksh121,968 10%
retirement On the next Ksh114,912 15%
►► It offers a pooling advantage. Funds from various members are pooled On the next Ksh114,912 20%
together to form a huge fund that allows a larger scale of investments On the next Ksh114,912 25%
resulting in higher returns.
►► Allows one to create a fund which 60% may be used as additional security On the balance 30%
for a mortgage in line with RBA Regulations.
Above 50 years or above 15 years in the Scheme
►► The accumulated fund plus investment income are paid to beneficiaries
upon the death of the insured, providing a financial cushion for them If you are above 50 years, or have been a member of a retirement scheme
►► Withdrawal terms are flexible for more than 15 years, the cash amounts are subject to tax as per the table
below:
►► An employer can contribute on behalf of the employee as long as the
combined contributions do not exceed 30% of the employees’ salary.
Up to Ksh400,000 10%
►► Provides various flexible payments to a member at retirement i.e. lump
Ksh400,000 – Ksh800,000 15%
sum, pension/annuity and even the option to keep the savings invested
and draw an income from it. Ksh800,000 - Ksh1,200,000 20%
Ksh1,200,000 – Ksh1,600,000 25%
Tax Benefits and calculations
Above Ksh1,600,000 30%
►► Contributions are tax deductible. The Income Tax Act allows for a maximum
tax deductible contribution of Ksh20,000 per member per month (or 30% of
the salary, or whichever is less) 7. Do contributions made to the scheme earn interest?
►► Income earned from investments is tax-free and therefore generates more Yes. The contributions are invested and start earning income from the day the
funds for reinvestment. contributions are received by the insurance company. Your total accumulated
►► On retirement before 65 years, the annual tax free pension is Ksh300,000.
fund is made up of your contributions and the investment returns.
Pension and lump sum payments after the age of 65 are tax-free.
►► At retirement or withdrawal, you are entitled to receive tax free lump sum
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8. Who forms the personal pension scheme? means that the insurance company guarantees the capital (contributions) put
Insurance companies are the main founders of personal pension schemes. into the scheme plus a minimum rate of return. This means that if money is
The schemes are registered under the Retirement Benefits Authority (RBA) lost in the course of investment, the clients’ money is fully protected and it is
and Kenya Revenue Authority (KRA). The personal pension schemes enjoy the insurance company that bears the loss.
all the benefits gained from saving for retirement.
13. How do I know how much I have contributed to the scheme and
9. Can my employer contribute to my personal pension scheme? the interest earned?
Yes. Your employer can contribute a percentage of your monthly salary towards At the end of every year, the Insurance company sends a statement to
your personal pension plan based on the agreement reached between you each member clearly reflecting the contributions made by the member,
and them. The employer is allowed to treat the contributions as a tax allowable the contributions made by the employer if any and the income earned
expense in their books of expense. from these respective contributions.
10. What happens when I change employers? 14. What happens if I die or become incapacitated whilst working?
The individual pension plan belongs to you and is not affected by job changes. The total fund arising from contributions and investments is paid to the
If your current employer is contributing towards your plan, you should nominated beneficiary immediately upon loss of life. The total fund is also
negotiate with your future employer to also contribute if they do not have a payable to you or your beneficiary in case of incapacitation.
staff retirement scheme. 15. What happens when I retire?
If you are part of your employer’s pension scheme, you can transfer from the If it is a pension
previous scheme to your current employer’s scheme if they have one. Be sure scheme, you are allowed
to check the terms and conditions of your new employer’s scheme before to take a third of the total
transferring to ensure that it is registered with KRA to enable you continue pension fund as cash at
enjoying the tax benefits. the time of retirement. The
11. What happens when I leave employment? remaining two thirds of the
fund is converted into a monthly
The individual pension plan belongs to you and is not affected by job changes. pension which is paid to you at
If you are part of your employer’s pension scheme, the current laws allow the end of every month. For the
you to withdraw 100% of your own contributions to the scheme plus interest rest of your life.
earned and a further 50% of the employer’s contributions plus interest earned.
The balance of 50% must be retained in the scheme until age 50. This is a If it is a provident scheme,
legal requirement to safeguard people against old age poverty. then the entire fund (subject to
applicable taxes) is paid to you
12. Can I lose my retirement fund? as a lump sum at retirement.
No. The contributions have a 100% capital guarantee. The retirement benefit
schemes managed by insurance companies are guaranteed funds, which
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ANNUITIES
16. The National Social Security Fund (NSSF) 1. What is an annuity?
Current monthly contributions to NSSF are at Ksh400 for the employed and An annuity is a contract between an individual and an insurance company
Ksh200 for self-employed. The NSSF Act, 2013 (which is yet to come into where the individual pays a premium and the insurance company pays an
effect due to an ongoing court case) proposes to increase the contributions to income to the individual for the rest of their life after retirement.
12% of gross monthly salary, where the employee pays 6% and the employer
also puts in 6%. 2. What is their purpose?
The proposed contributions are divided into Tier 1 and Tier 2, which are An annuity is a savings tool that enables you to have an income during
determined by salary scales that NSSF will provide. retirement. The lifetime retirement income, guaranteed by an insurance
company, is a valuable benefit and security that an annuity can provide.
All employers and employees must contribute towards Tier 1. For Tier
2 contributions, an employer has the option of contracting out to a private An annuity is also a saving (financial planning) tool that can also be used to
retirement benefits scheme, which offer better returns. The employer however, plan for when you will not have an income. For example, if you plan to take
has to first make an application to the Retirement Benefits Authority to contract time off from your income earning activity (business or employment) you can
out. use an annuity to ensure you have an income during that period.
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4. Types of annuity The amount of income payment you will receive upon retirement will depend
Immediate annuity – the income payments begin within 12 months after you on:
buy the annuity. This is suitable for those who are about to retire or have ►► The amount you pay to purchase the annuity;
already retired. The premium for an immediate annuity is paid as a lump sum ►► Your age when you purchase annuity and your gender (women live longer
at the time of purchase. than men)
For example if you retire at age 55 and you make a lump sum premium ►► The benefits options you choose.
contribution to the insurance company, you will receive your first income
You can choose to have your income paid every month, every three months,
payment within 12 months after paying the lump sum premium.
every six months or once a year.
Deferred annuity –this type of annuity is for people who would like a
guaranteed income after retirement but still have working years ahead of 6. Benefit options for annuities
them and therefore do not need it to start right away. The premium in this Level annuity without guaranteed period – pays a fixed regular income
case is paid well in advance and this can be a lump sum payment or periodic after retirement for as long as you live.
payments until retirement. Level annuity with a guaranteed period – pays a fixed regular income for a
For example, at the age of 30, you may purchase a deferred annuity that guaranteed period say 10 years or for the rest of your life, whichever is longer.
begins income payments at age 55. You can choose to either pay a lump sum Increasing annuity – pays an income which increases each year at a
premium then or make yearly premium payments until you are 54. The lump specified rate to partially protect your income from inflation. With increasing
sum premium paid at age 30 will be smaller compared with what you have to annuity, the starting income is lower than you would get from a level annuity,
pay if you purchase an immediate annuity at age 54. Also the future income but it will provide you with better income years later in your retirement period.
will be higher because the premium paid at age 30 will be invested by the
insurance company and accumulate interest over the years. Joint-life annuity – pays an income for the rest of your life, and then continues
to pay the income to your partner for the rest of his/her life, after your demise.
5. Choosing the right annuity However, income to your partner may be at a reduced amount.
The type of annuity you choose and other additional benefits will determine the 7. How do I pay for an annuity?
amount of income you will receive during retirement. As you plan to purchase
an annuity, it is also important to understand how much you will need to earn To purchase an annuity plan, you may pay to an insurance company a lump
during retirement. A study by Retirement benefits Authority shows that you sum premium just before retirement. Alternatively, you can make periodic
require approximately 60% of your last salary to maintain a similar standard premium payments until your selected retirement age. Upon retirement, the
of living in retirement. insurance company would provide income payments for the rest of your life.
You can buy annuities from any life insurance company, which offers annuity
Before choosing an annuity, check all the options being offered by various products.
insurance companies to ensure you get the best deal.
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GENERAL INSURANCE GENERAL INSURANCE
►► Cover for your children will end when you pass away, or when they pass away
or when they turn 21, whichever comes first. As long as your premiums are up
to date. If your children are unmarried full-time students, mentally or physically
impaired then in some cases their cover may be extended to the age of 25.
Will my family remain covered after my death?
Yes, provided premiums are paid by the family members covered on the policy.
No amount
of money can take your
place, however, a funeral
insurance cover can go a long way
GENERAL INSURANCE
to minimize the financial drain on
your loved ones.
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GENERAL INSURANCE GENERAL INSURANCE
General Insurance, also known as Non-Life insurance, 1. Domestic Package (DP) Insurance
is a contract where the insurer (insurance company) This policy insures the home. It combines coverage for the home that is,
the building and household contents as well as domestic workers against
promises to compensate the insured in the event that
death or injury while in the course of employment. The policy also covers
there is a loss /damage to property or against liability. the homeowners or occupiers against lawsuits for injury or property damage
General insurance typically covers any insurance caused to other people (third parties).
other than life. Most general insurances are annual or What does DP insurance cover?
short-term contracts. Domestic package insurance covers the following risks:
• Domestic package insurance policy has five (5)
General Insurance for Individuals
sections, A to E, as broken down below;Sec-
As individuals, we require insurance that will provide a cover to protect our tion A - Cover for the structure (building) of
interests. Insurance covers that can be taken out by individuals include personal your home
accident, professional indemnity, domestic package, medical insurance, travel
• Section B - Cover for your personal
insurance and others outlined in this guidebook.
belongings or contents of the building
General Insurance for SMEs • Section C - Cover for items you move
With little resources in hand, Small and Medium Enterprises (SMEs) often view with outside the house such as mobile
insurance as a luxury. However, insurance is a necessity and should be part of the phones, watches, IPads, laptops, rings,
important costs for SMEs. cameras, spectacles. This section is also
referred to as All Risks
Depending on the nature of the business, every SME is exposed to some risks,
which when they occur may mean the end of the business. It is therefore important • Section D - Liability protection, this covers
to identify and insure those risks. Lack of insurance could potentially cause more domestic workers for injury or death while under-
damage to the business if anything goes wrong. taking domestic work.
When running a business, it is important to make sure that you have covered all • Sections E and F - Coverage of owners and occupiers against lawsuits for
aspects, including your liability towards your staff, customers, members of the injury or property damage caused to other people.
public, your business activities and your possessions, including the building and Can I purchase DP insurance if I am renting a house?
its contents. Yes. You can purchase Domestic Package insurance if you are renting a
Depending on the type of business, insurances that cater for SMEs include fire, house, a flat or an apartment.
burglary, business interruption, work injury benefits, employee liability insurance,
public and product liability, electronic equipment insurance, medical insurance, Why is it important to take a home inventory before purchasing DP
marine insurance, goods in transit, money, fidelity guarantee and others outlined Insurance?
in this guidebook. Before you purchase domestic package insurance, you will be required to
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provide a home inventory. A home inventory is a list of all the things in your What are the benefits under this cover?
house including electronics, furniture, kitchen equipment and jewelry. It is ►► Accidental Death – Pays the fixed amount or multiple of salary for loss of
important to record the serial numbers of the major appliances, keep the life due to an accident
receipts and user manuals safely.
►► Permanent Disablement – Pays a certain percentage of the fixed amount
Having an up-to-date home inventory will help you insure the correct value of or multiple of salary in the event of permanent disablement caused by an
property and get your insurance claim settled faster. accident
How often should I review my policy? ►► Weekly payment – Pays a weekly income for temporary disablement
Domestic Package insurance is an annual cover. However, if in the course resulting from accidental injury
of the year you make improvements to your home such as fire and burglar ►► Medical Expenses – Reimburses you for medical expenses that arise from
alarm systems, upgraded plumbing or electrical system or if you make a an accident including dental and optical expenses.
major purchase. Inform your insurance company about the improvements or ►► Emergency Evacuation – Covers emergency medical evacuation
changes. expenses.
You may need additional cover if there is a change in the value of your home ►► Pay for the cost of artificial appliances that arise from an accident such as
or its contents. crutches, hearing aid and prosthetics
What should I do if I am leaving the house unoccupied for some time? ►► Repatriation Expenses – pays for the return of the deceased to place of
residence.
If you are leaving your house without an occupant for eight (8) or more
consecutive days, you will need to inform your insurance company. Cover may Who is a beneficiary and why is it important to nominate one?
be suspended for the period, or extended to cover the period of un-occupancy Beneficiary is a person who receives the benefits following death of the
on payment of an additional premium.
insured. The person applying for insurance is required to nominate preferred
2. Personal Accident and Group Accident Insurance beneficiaries and the percentage allocation of benefits.
A Personal accident insurance provides financial benefits to an individual if If a child below 18 years is appointed, then a responsible guardian who will
he/she is involved in an accident resulting in injuries or death. While, Group administer benefits upon sudden death should also be appointed. Choosing a
personal accident insurance provides financial benefits to a group of people beneficiary ensures that the benefits go to the right people.
such as a family, employees, chamas, learning institutions, SMEs or any other
group of people with common interest. 3. Medical Insurance and Group Medical insurance
For employers who take the cover on behalf of their employees, the claim Medical insurance policy, also referred to as health insurance, covers the
is paid to the employer for onward transmission to the employee or their medical expenses incurred by the insured or their dependents. It covers
appointed beneficiaries. numerous illness and or bodily injuries.
When calculating premiums to be charged for the above insurances, the It can be taken by an individual or a group of people.
following factors are considered: Age, location, occupation, current physical The policy can be out-patient (walk in and out of hospital) only or in-patient
health status and lifestyle, type and amounts of benefits. (admission) only. It can also have a combination of both in and out patient.
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Does medical insurance cover all medical bills? ►► Medical treatment for injuries caused due to travel
Each medical insurance is different in terms of the medical ►► Accidental death (including transportation of remains)
treatments it can cover. This is dependent on the type
of cover and on the premium paid. It is therefore very What is not covered?
important to review the policy document together ►► Natural disasters
with your insurer to confirm you have clearly ►► Severe weather
understood what is covered and what is not ►► Crimes committed against you or a member of your traveling party
covered.
►► Lost travel documents or identification papers
It is also important to understand the expenses
►► Civil unrest
that NHIF card will pay for as these are
excluded from the private medical insurance ►► Unannounced strikes that render your carrier unable to operate
cover.
5. Professional Indemnity Insurance
Most medical insurance policies can be extended
to cover additional benefits such as optical and dental This insurance policy covers liability to a third party arising from the performance
cover, congenital defects, maternity expenses, pre- of, or failure to perform services by a professional. Insurance is provided in
existing conditions, chronic ailments, psychiatric conditions accordance with the limits, conditions and activities defined in the policy.
among others. Who is a professional?
Most covers exclude cosmetic surgery or treatments, age related senility or There is not one standard definition of a professional
insanity, family planning and treatments not administered by a registered but they do possess the following characteristics:
medical practitioner.
►► Skills and knowledge highly valued by society
Travel Insurance covers specific events. The insurance is dependent on ►► Usually a member of a professional association –
coverage limits, which also determine the premium paid. Covered risks and for regulation purposes
exclusions vary significantly by policy type, insurer, and travel preferences. ►► May have a special license to provide the
The risks typically covered include: specialized service
►► Trip interruptions ►► Advice/ Service is usually in exchange for a fee
►► Cancellations (entire trip or a section of the trip) Traditional professions - accountants, architects,
►► Lost or delayed baggage engineers, advocates, insurance brokers, doctors/
►► Carrier or service provider failures nurses
►► Emergency evacuations (due to physical threats and medical emergencies) Non-Traditional - advertising agents, property
valuers, real estate agents, event planners, debt
►► Theft and other crimes
collectors and consultants
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What professional liabilities does the insurance cover? • Any Injury by accident /or disease attributable to war or war like activities
►► Negligent acts, errors or omission • Any Injury by accident/ or disease outside the course of duty
►► Misleading statements
• Injury caused by deliberate and willful misconduct
All employers should read the Workmen Benefits Injury Act under the Kenyan
►► Unintentional breach of confidentiality
Laws for detailed understanding of their responsibilities to their employees.
►► Libel or slander ( defamation)
►► Dishonest, fraudulent or malicious acts, omissions by any former or 7. Employers’ Liability (EL) Insurance
present employee Employers’ liability insurance protects employers from their legal liability to an
employee for injury arising out of, and in the course of employment. The policy
What liabilities are not covered under this insurance?
protects the Employers against lawsuits brought against them by employees
►► Performance guarantees due to allegations of injuries or contracting diseases because of employer
►► Intentional acts by the professional negligence. The employee must prove negligence on the part of the employer
►► Patents/trade secrets e.g. if injury is a result of lack of a helmet – which the employer failed to
►► Prior claims/circumstances
provide.
►► Policy excess Employers Liability compliments WIBA and picks common law claims after
WIBA has dealt with statutory claims.
6. Work Injury Benefits Act (WIBA) Insurance
The Work Injuries Benefits Act No. 13 of 2007, requires that all employers What are the Policy exclusions?
must provide compensation to employees for work related injuries or diseases • Any injury by accident or disease sustained outside the
contracted as a result of work. geographical area of operation.
• Any injury by accident or disease attributable to civil
WIBA insurance policy responds to the requirements of the above Act. It
war Injury or disease caused by goods supplied or
covers employees whilst on duty against accidental bodily injury, disablement
remedial treatment.
or death. Compensation is payable in accordance with the provisions of
• Fines and Penalties incurred by the employee
the WIBA Act 2007. The maximum benefit is set at 96 months’ salary. The
• Any claim (in the event of cancellation or non-renewal
insurance also covers funeral expenses, medical expenses and artificial
of this policy) not first reported in writing against the in-
appliances or prosthetics.
sured as specified in specific in the policy.
WIBA policy does not cover the armed forces, minors, business owners and • Any known losses before policy inception
employees deployed outside Kenya. • Any losses as a result of policy cancellation
What are the key exclusions under WIBA? or non-renewal
• Any injury by accident or disease sustained outside Kenya
• Any liability arising out of any court proceedings
• Any liability arising out of pre-existing medical conditions unless previously
declared.
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GENERAL INSURANCE GENERAL INSURANCE
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10. Fire and Perils Insurance Business Interruption Insurance is taken together with fire insurance (see 10
The basic fire and perils insurance covers loss or damage to above) to ensure both the business and the assets/materials are covered.
property caused by fire, lighting or explosion. Both covers have to be valid for a claim to be settled.
The cover can also be extended to cover riots, Business Interruption insurance covers loss of Gross Profits, wages that are
strike, malicious damage, storm, earthquake, paid while production is interrupted and auditors fees incurred in preparation
impact by vehicles, aircraft or other aerial devices,
of the claim.
subterranean fire, spontaneous combustion or
overflowing water from tanks and pipes. 12. Burglary or Theft Insurance
This insurance covers assets such as buildings,
Burglary or theft insurance covers loss or
plant and machinery, stock insurance, office
equipment, furniture, fixtures and fittings. damage of insured property because of
The insurer guarantees to pay for the loss or damage theft accompanied by visible, forcible
to the property for the specified period (usually one year). and violent entry into, or exit out of the
The valuation of property is made according to the market value. insured premises.
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GENERAL INSURANCE GENERAL INSURANCE
13. Money Insurance gunpoint. However, cover for such risks can be extended at an additional
All businesses handle money in some form – cash, cheques, credit card premium or insured under a separate cover.
slips, bankers’ drafts and others- making this form of insurance essential for
What are the common exclusions in money insurance?
businesses large and small.
►► Any loss of money in which an employee of the Insured or member of the
Money insurance covers loss or damage of cash in transit, cash in premises, Insured’s family is directly or indirectly involved
cash in safe, cash with authorised staff and damage to safe/strong rooms.
►► Unexplained losses and/or shortages due to errors or omissions
The policy will cover loss of money in varying scenarios including hold up,
burglary and by use of force or threat of the person with the money. A Personal ►► Any damage or loss of money occurring because of use of any keys,
Accident cover is also included for those carrying money. unless access obtained by force, violence, assault or threat.
►► Theft or loss of money by employees through manipulation of any computer
Policy features can include: software.
►► Money in transit to and from banks, carried by employees
►► Personal assault cover 14. Fidelity Guarantee Insurance
►► Money on business premises, in or out of safes Fidelity Guarantee insurance covers an employer against loss of money,
►► Personal and safe damages business equipment, securities or other goods belonging to the business
►► Cover for money in the home of employee or director resulting from an act of fraud or dishonesty by employees for improper
►► Cover for money in safety deposits
personal financial gain in the course of their duties.
Why should you consider it? Why is Fidelity Guarantee Insurance Important?
►► Essential protection of financial assets Companies are exposed to significant financial losses, due to crime committed
►► Protection for employees and others who transport
by employees. Companies most often seek fidelity guarantee insurance where
monies employees are more likely to cause financial loss because of their constant
►► Peace of mind security, minimising disruption exposure to cash, stocks or other assets.
to your business
Who is covered?
►► May cover risks that are excluded Fidelity Guarantee covers all employees engaged under a contract of service,
in other insurance policies for example storekeepers, sales people, staff authorized to handle cash
Does Money insurance cover money in among others.
M-pesa, Airtel, Equitel, Orange and other It covers actions such as forgery, misappropriation of funds, embezzlement or
such accounts? diversion of money and theft of money or property.
Money insurance does not cover mobile/ Fidelity insurance may include a single employee or a group of employees and
electronic money i.e. Money in the mobile
the cover extends to measurable financial losses only. The type and extent of
phone transferred following hold up / threat at
cover you chose will depend on your particular business.
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GENERAL INSURANCE GENERAL INSURANCE
Who is not covered? There are two types of marine cargo insurance:
The cover does not insure all the staff and it excludes the following: ►► Marine Open Cover
►► The business owner The Marine open cover is an umbrella cover and is ideal for those engaged in
continuous or regular import and export of goods. It is an agreement to provide
►► A director, partner or sole proprietor of the Business, a trustee
insurance cover on all shipments of the insured at pre-agreed rates and terms.
►► Commission agent, consignee, contractor or other agent or representative
►► Voyage Policy
of the Business
This is a single policy cover that covers the goods from one place to another
►► Any employee or category of employees not in the Schedule of the Policy
irrespective of the duration involved. The policy therefore ceases or lapses
or an employee not on permanent terms of service.
once the goods are delivered to the destination.
Can compensation occur if loss is discovered after a staff member has The insurance cover contains the policy number, name of the assured, name
left employment? of the transporting vessel, details of the voyage, description of goods, type of
Yes. However, this has to be within 3-6months after policy expires or the cover, sums insured and the premium.
termination of the employment whichever comes first. The policy runs for one
year and the 3-6months is referred to as ‘discovery period’. 16. Goods in Transit (GIT) Insurance
Goods in Transit Insurance covers loss or damage to goods and/or
What happens when staff are hired or resign? merchandise while moving it from one place to another.
The policy allows the insured to add, replace or remove staff during the period
This cover is restricted to Kenya but can be extended to cover East Africa
of insurance by advising insurance company accordingly.
subject to agreement with the insurance company.
What is excluded under this policy? The insurance covers loss or damage to goods when:
The policy excludes such form of losses as; damage by fire, political and ►► Loading, carrying or unloading from any vehicle
terrorism, unexplained losses, consequential loss of any kind, loss by use of ►► Collision, overturning or derailment of the conveying vehicle
electronic equipment. ►► Theft and pilferage following collision, overturning or derailment of the
conveying vehicle.
15. Marine Insurance
This insurance can extend to cover expenses reasonably and necessarily
Marine insurance is broadly divided into three categories namely: Marine Hull incurred in respect of;
Insurance, Marine Cargo Insurance and Marine Third Party Liability.
►► Cost of debris removal of property damaged from the site where damage
a) Marine Hull insures risks associated with boats, canoes, dhows, vessels, ships occurred
and other marine vessels. ►► Transferring property from the vehicle following an accident and reloading
b) Marine Third Party Liability insures the vessel owner; vessel charterer in to another conveyance
respect of legal liabilities to third parties. It does not cover loss or damage ►► Security and protection at the site of accident
to the vessel. ►► Damage to tarpaulins, trailer curtains, ropes, chains, webbing straps and
c) Marine Cargo Insurance covers shipments from starting point to the final packing material following an accident.
destination. The same insurance can cover any shipment by road, rail or air. ►► Political violence and terrorism is currently a common extension.
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What is not covered by GIT? 17. Carriers Legal Liability Insurance
The insurance policy does not cover loss, destruction or damage caused by: Carriers Legal Liability Insurance insures a carrier (person or entity providing
►► Loss from an unattended vehicle transportation for hire) against legal liability claims.
►► Wear and tear The insurance covers accidental loss or damage to goods in the custody or
►► Defective or inadequate packaging or insulation. control of the insured whilst in transit by road, rail, inland waterway, air or any
other specified means. The cover territory is within Kenya however, it can
►► Wilful misconduct of the Insured, theft or dishonesty
extend to East Africa based on agreement with the insurer.
►► Delay or loss of market
The insurer shall not be liable to pay in respect of liability arising from:
This Policy does not cover loss of or damage to the following goods unless
►► Loss of any kind, delay or loss of market.
specifically agreed:
►► Political violence and terrorism, war, confiscation by authority.
►► Deeds, bonds, bills of exchange, promissory notes, money or other
negotiable currency, securities or stamps; ►► Loss or damage to goods belonging to the insured or to an employee or
agent of the Insured
►► Documents, manuscripts, business books, computer systems records,
patterns, models, moulds, plans or designs; ►► Carriage of illicit, illegal, contraband or smuggled goods.
►► Electrical or electronic equipment, cameras, photographic or binocular ►► Illegal sale, conversion or wrongful disposal of goods in the custody or
platinum or silver articles, furs, watches, curios, or works of art Insured’s employees, disappearance of or unexplained inventory shortage.
►► Glass and other articles of a brittle nature except as a direct result of fire, ►► Defective or inadequate packaging or insulation.
theft or accident to the conveying vehicle; ►► Damage, destruction and deterioration to goods caused by change in
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Member Organizations
Kenya Orient Insurance Company Ltd
Capex Life Assurance Ltd
AAR Insurance Company Ltd &
7th Floor, Galana Plaza, Wind D Suite 01, Galana Geminia Insurance Company Ltd
George Williamson House, Kenya Orient Life Assurance Ltd
Rd, off Argwings Khodek 6th Floor, Geminia Plaza Upper Hill
2nd Floor, 4th Ngong Avenue Capitol Hill Towers, 6th Floor
6th Floor Avenue Office Suites, Ngong Road Email: [email protected]
Email: [email protected] Cathedral Road, Nairobi
Emil: [email protected] Website: www.geminia.co.ke
Website: www.aar-insurance.com/ke Email: [email protected]
Website: www.capexlifeassurance.co.ke
Website: www.korient.co.ke
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Occidental Insurance Company Ltd
Sanlam General Insurance (formerly Gateway
Insurance)
Notes
7th Floor, Crescent Business Centre - Cresent & Sanlam Life Insurance (Formerly Pan Africa
Road, Parklands, Opposite M.P Shah Hospital Life Insurance)
Email: [email protected] Pan Africa Life House, Kenyatta Avenue
Website: www.occidental-ins.com Email: [email protected]
Website: https://www.sanlam.com/kenya
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Notes Notes
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Notes