PERSONAL ACCIDENT Claim form The Jubilee Insurance Company of Kenya Limited Head Office: Jubilee Insurance House, Wabera Street, P.O. Box 30376 - 00100 GPO, Nairobi, Kenya Tel: +254 20 328 1000 Fax::.

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How to fill out the Jubilee Insurance Claim Form online

This guide provides clear instructions on how to accurately complete the Jubilee Insurance Claim Form online. Follow the detailed steps to ensure that your submission is thorough and meets all necessary requirements.

Follow the steps to fill out the Jubilee Insurance Claim Form online.

  1. Click ‘Get Form’ button to obtain the form and open it in an editor.
  2. Begin by entering the claim number at the top of the form. This helps in identifying your claim and tracking its progress.
  3. For the 'Policy No.' field, enter your policy number exactly as it appears in your policy documents.
  4. Fill in the full name of the insured person in the 'Name of Insured in full' section.
  5. Complete the 'Name of Claimant' section with the full name of the person filing the claim. Ensure these names match official documents when possible.
  6. Provide your postal address and postal code for correspondence regarding the claim.
  7. Enter the telephone numbers: office, house, and mobile. Include accurate contact information for follow-up.
  8. Complete the email field with a current email address for receiving updates on your claim.
  9. In the 'Occupation' field, state your job title or profession.
  10. Fill in your date of birth in the format (DD/MM/YY). Ensure accuracy for identity verification.
  11. Indicate the date of the last premium payment to confirm coverage prior to the accident.
  12. Record the date of the accident, using the same (DD/MM/YY) format.
  13. Describe where the accident occurred and provide details on how the accident happened in the specified section.
  14. Provide the name, address, and occupation of a witness if available. This information may support your claim.
  15. Document the time the accident occurred (am/pm).
  16. Detail the nature and extent of your injuries and attach any available medical reports to support your claims.
  17. List the names and addresses of doctors or hospitals involved in your treatment for these injuries.
  18. Indicate the number of days you were entirely confined to your bed, room, or house following the accident. Specify the duration for each location separately.
  19. State the extent and duration of your inability to attend your business or occupation, providing dates for partially and wholly disabled status.
  20. Answer whether you have provided any direct support or supervision of your business since the accident.
  21. Declare if you are entitled to compensation from any other sources and provide detailed information if applicable.
  22. State your monthly earnings for the month prior to the accident to support the claim assessment.
  23. Complete the declaration section confirming the truthfulness of the information provided, then input the date and sign the form.
  24. Make sure to attach the medical certificate completed by your healthcare provider before submitting your claim to ensure completeness.
  25. Review all entered data for accuracy and completeness before finalizing the process. You can save changes, download, print, or share the filled form as needed.

Start the process of filing your Jubilee Insurance claim online today!

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How do I fill out an insurance claim form?

Name. Fill in the name of the insured person who was hospitalised as mentioned in his KYC documents and bank documents. Gender. Select the gender of the insured. Age year. ... Date of birth. ... Relationship to primary insured. ... Occupation. ... Address.

: a document with information about why a person should be given money filled out an insurance claim form.

CLAIM FORM - PART A' to 'CLAIM FORM FOR HEALTH INSURANCE POLICIES OTHER THAN TRAVEL AND PERSONAL ACCIDENT - PART A. TO BE FILLED BY THE INSURED. The issue of this Form is not to be taken as an admission of liablity.

Step 1: Written Intimation. ... Step 2: Complete the Claim Form along with relevant documents. ... Step 3: Submit required documents along with the Claim Form. ... Step 4: Settlement.

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