FAQs

What is medical insurance, and is it important?

• Medical insurance in Kenya provides a financial tool that helps cover the cost of medical treatment, including hospital stays, outpatient visits and specialized treatment for critical, chronic and congenital illnesses. It protects families and individuals from the high costs of illnesses or accidents and ensures access to quality healthcare without the financial strain

What are the types of health insurance covers?

1. Inpatient cover: This covers hospital stays requiring at least one overnight admission or a day surgery under general anaesthesia 
2. Outpatient cover: This covers treatment that does not require hospital admission, e.g consultations, diagnostic tests and prescribed medications.
3. Additional Covers: These include maternity, dental and optical covers.

Who is eligible for medical insurance in Kenya?

Eligibility varies based on the insurance provider. Specifically

1. Newborns (after hospital discharge) born between 37-38 weeks up to 75 years can join most policies.
2. Some policies cater to senior citizens or children only.

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What factors should I consider when choosing a health insurance cover in Kenya?

1. Scope of cover: Ensure the policy covers your specific needs. (Chronic conditions, maternity, outpatient, dental and optical)
2. Premiums: How much will I be paying for the medical insurance per year.
3. Waiting periods: Time you have to wait before you can access certain benefits, e.g maternity cover, chronic conditions, cancer treatment, etc.
4. Copayment and deductibles: Understand how much you will pay out of pocket to access medical services.
5. Provider Network/Panel: Confirm if your preferred hospitals and doctors are included.

Are there waiting periods for medical insurance benefits?

Yes, waiting periods apply for some benefits:

1. Maternity coverage often requires a 9-12 month waiting period.
2. Pre-existing conditions may have a waiting period of up to 1 year, depending on the insurer.
3. Emergency treatments typically have no waiting period 
4. 30 days for acute illness, both inpatient and outpatient
5. Up to 2 years for cancer treatment
6. Up to 5 years for organ transplant

Can I use my medical insurance outside Kenya?

• Yes, many insurers offer overseas treatment coverage for conditions not treatable locally. The common destination is India. This usually requires a referral and preauthorization from the insurer 

What happens if I exhaust my coverage limits?

Once your annual limit is exhausted:

1. There are no extensions unless specified by the policy.
2. Consider registering for government schemes like SHIF/SHA.

Are dependents covered under medical insurance policies?

Yes, dependents such as spouses and children are often covered:

1. Children are typically covered up to 21 years or 25 years if in full-time education.
2. Disabled dependents may remain covered beyond this age limit under some schemes

What exclusions should I be aware of?

Common exclusions include:

1. Cosmetic procedures
2. Experimental treatments
3. Certain drugs or devices not approved by the insurer
4. Self-treatment and prescription
5. Services sought outside the insurer's panel of providers without prior approval.

How do I register for medical insurance in Kenya?

Registration depends on the provider:

1.  For government schemes like SHA/SHIF, registration is mandatory and can be done online.
2.  Private insurers require filling out an application form and submitting necessary documents like identification and medical history records.

Can I switch health facilities under my cover?

• Yes, most plans allow you to change your preferred healthcare facility.

What happens if I lose employment but have employer-provided insurance?

1. For employer-provided schemes like SHI/SHA, coverage may continue temporarily after job loss.
2. Members can transition to individual contributions to maintain their cover private health insurance in Kenya

Are there benefits for preventive care under medical insurance?

Yes, many plans include preventive care, such as:

1. Annual check-ups
2. Vaccinations
3. Family planning services
4. Nutrition counseling

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What types of car insurance are available in Kenya?

Car insurance companies in Kenya offer three primary types of car insurance:

1. Third-Party Only TPO: Third-Party Only covers liabilities for injuries, deaths, or property damage caused to others but does not protect your vehicle
2. Third Party, Fire, and Theft: Third-Party, Fire, and Theft adds coverage for your vehicle if it is stolen, damaged by fire, or involved in a riot
3. Comprehensive Insurance: Provides the broadest protection, covering accidental damage to your car, third-party liabilities, theft, fire, natural disasters, and additional benefits like emergency medical costs and towing services

Is car insurance mandatory in Kenya?

• Yes. Under the Kenya Insurance Act Cap 405, all vehicles on public roads must carry at least Third-Party Only TPO insurance to cover liabilities to third parties. Driving without valid insurance can result in fines, vehicle impoundment, or legal action.

How much does car insurance cost in Kenya?

Costs vary by coverage type and motor vehicle specifics

1. Third-party-only policies start as low as KSH 4,500 annually, making them the most affordable option.
2. Comprehensive car insurance premiums depend on factors such as the car's market value, age since year of manufacture, driver's experience, and make and model of the vehicle.
3. Newer, high-value vehicles typically incur higher premiums 

What documents are required to purchase car insurance?

To get car insurance in Kenya, you will need:

1. A copy of your motor vehicle's logbook,
2. A valid national ID or passport,
3. KRA pin
4. Valuation report for the vehicle (required for comprehensive policies). This can be done within 14 days after getting comprehensive car insurance in Kenya
5. Driver's license
6. Insurers may also request proof of prior no-claim discounts.

How does the claims process work?

To file a claim:

1. Report the incident immediately to your insurer and the police (for accidents or theft).
2. Submit the required documents, including a police abstract, repair estimates, and photos of damages.
3. An assessor will evaluate the damage and approve repairs or compensation.
4. For third-party claims, the insurer handles liabilities directly. Claim processing times vary from one car insurance company to another and may depend on factors such as the extent of damage, availability of spare parts, if the claim is subject to investigation and the complexity of the circumstances leading to the claim. 

Can I pay premiums in installments?

Yes. Some insurers allow paying 30%-50%  of the premium upfront to activate a one-month policy, with the balance due later to extend coverage up to a maximum of 4 instalments. In the event of a claim, you will be required to pay the full premium. However, full payment often provides better terms and avoids lapses in protection

What optional car insurance benefits can I add to my policy?

Car insurance companies in Kenya offer additional add-ons/optional benefits such as:

1. Courtesy car access during repairs.
2. Personal accident cover for the owner of the car.
3. Excess protectors to reduce excess payments under accidental damages benefit for comprehensive car insurance.
4. Political violence coverage for damages during political and terrorism related damages.

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Are there discounts available?

Yes. Insurers may reduce premiums for:

1. Fleet policies: insuring two or more vehicles for individuals and between 3 and 5 and more motor vehicles depending on the car insurance company in Kenya
2. No-claim bonuses for accident-free periods.
3. Installation of anti-theft devices or tracking systems, which lowers theft-related excesses.

What is excluded from car insurance policies?

Common exclusions include:

1. Deliberate damage to your vehicle.
2. Driving under the influence of alcohol or drugs.
3. Wear and tear or mechanical failures.
4. Unapproved modifications to the vehicle.

How are total theft claims handled?

If your car is stolen:

1. Report the theft to the police and insurer within 24 hours.
2. Provide a police abstract and proof of ownership and fill it the required documentation with your insurance company.
3. Insurers require a three-month waiting period to confirm non-recovery before paying out
4. Vehicles with tracking devices qualify for lower excess payments of 2.5% of the value of the vehicle.

Can I transfer my insurance to a new owner if I sell my vehicle?

No. Insurance policies are tied to both the owner and the vehicle. When selling a car, the new owner must purchase a new policy under their name..

What penalties apply for uninsured driving?

1. Fines range from KSH 10,000 to KSH 50,000, and police may impound uninsured vehicles.
2. Repeat offenders risk license suspension or legal prosecution.

How do insurers determine the value of my car?

For comprehensive car insurance in Kenya policies, car insurance companies in Kenya can either:

1. use market valuation reports based on the vehicle's age, make, and condition. This can be done by having the car valued by the insurance company's approved valuer 
2. Overestimating your car's value can lead to higher premiums, while underestimating may reduce claim payouts.

Are emergency medical costs covered?

Comprehensive policies often include emergency medical expense coverage for occupants injured in accidents, typically up to KSH 100,000 for the driver and the passengers.

What happens if I cause an accident?

Your insurer will cover:

1. Third-party injuries or deaths up to the specified limit in the policy
2. Third-party property damage up to KSH 20 million or as specified under your policy
3. Legal defense costs if sued.

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Life insurance is a contractual agreement between an individual and an insurance company, where the insurer promises to pay a designated beneficiary a sum of money upon the occurrence of specific events such as the following:

1.  Insured's death.
2. Critical illness.
3. Disability.

Life insurance protects the financial interests of your family by providing crucial support in the event of critical illness, disability, or sudden death.

What is home insurance?

Home insurance is also referred to as Domestic Package Insurance. It is an insurance policy that is meant to protect residential properties and their contents against risks like fire, theft, natural disasters, and third-party liability.

It is structured into distinct sections A E or A F, depending on the insurance company in Kenya each addressing specific aspects of risks, such as the physical building, personal belongings, portable items, and legal liabilities.

 Tenants, homeowners, and landlords can customize policies to match their needs, ensuring flexibility in coverage 

What Does Home Insurance in Kenya Typically Cover?

1. Structure of the Home Section A

This covers the physical building, including attached structures like garages, perimeter walls, and fences, against risks such as fire, explosions, earthquakes, storms, floods, and vandalism.

Repairs or reconstructions are typically based on rebuilding costs rather than market value.

2.   Personal Belongings Section B

Contents insurance protects furniture, electronics, and other household items against theft, fire, or accidental damage. Insurers often replace old items with new ones, subject to policy terms 

3.   All-Risks Coverage Section C

This extends protection to portable items like laptops, mobile phones, and jewelry when taken outside the home, covering accidental damage or theft.

4.   Liability Protection Sections D and E

•  Domestic Workers WIBA Mandatory coverage for injuries, disabilities, or deaths of domestic employees under the Work Injury Benefits Act WIBA.
•  Third-Party Liability: Protects against lawsuits arising from injuries or property damage caused to others on the insured property.

5.   Additional Benefits

• Alternative Accommodation: Covers temporary housing costs if the home becomes uninhabitable.
• Freezer Contents: Reimburses spoilage due to power outages.
• Debris Removal: Includes costs for clearing damaged structures after a covered event.

How Much Does Home Insurance Cost in Kenya?

Premiums vary based on property value, location, and coverage scope. Basic home insurance in Kenya costs usually start from KSh 5,000.  Comprehensive home insurance policies in Kenya can have additional covers such as golfer?s cover, home office, political violence and terrorism cover, and electrical short circuiting, which come at an additional cost. Home insurance insurers calculate premiums using factors such as rebuilding costs, security features (e.g., alarms), and risk exposure (e.g., flood-prone areas)

What Is the Difference Between Tenant and Homeowner Insurance?

1. Tenant Insurance: This covers personal belongings, liability, and domestic workers, excluding the building structure and liabilities
2. Homeowner Insurance: This covers the physical structure, contents, and liability, often including landlord-specific protections like legal liabilities for tenant injuries 

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How Do I Choose the Right Policy?

1. Assess Coverage Needs: Calculate rebuilding costs for the structure and inventory belongings to avoid underinsurance.
2. Compare Policies: Evaluate inclusions, exclusions, and add-ons/additional covers (e.g., political violence cover, electrical short circuiting or golfer?s cover) 
3. Review Insurer Reputation: Go for providers with transparent claims processes and regulatory compliance.
4. Update Regularly: Inform your home insurance company of home upgrades (e.g., purchase of additional home assets, moving homes, security systems) to maintain adequate coverage.

What Are Common Exclusions?

1. Wear and Tear: Gradual deterioration or maintenance-related damage.
2. Mechanical Breakdowns: Failures in appliances or systems not caused by insured events.
3. Unexplained Losses: Items lost without evidence of theft or damage.
4. High-Value Items: Jewelry or art exceeding policy limits require separate declarations. 

How Does the Claims Process Work?

1. Report Promptly: Notify the insurer immediately after a loss, providing details and evidence (e.g., police reports for theft)
2. Submit Documentation: Include photos, repair estimates, and proof of ownership.
3. Cooperate with Adjusters: Facilitate inspections to expedite assessments.
4. Receive Settlement: Compensation may involve repairs, replacements, or cash payouts, less the excesses

Is Home Insurance Mandatory in Kenya?

While not legally required, mortgage lenders often mandate it to protect their investments 

Landlords may also require tenants to have contents insurance as part of lease agreements.

Can I Customize My Policy?

Yes. Additional cover such as:

1. Domestic employee cover through WIBA
2. Golfer?s cover (for sports equipment) can be included for specialized protection.
3. Electrical short circuiting, commonly known as electrical clause 3

Why Is Home Insurance Important?

Beyond financial protection, it ensures:

1. Peace of Mind: Safeguarding against unpredictable events.
2. Compliance: Meeting mortgage or rental agreement requirements.
3. Liability Mitigation: Shielding against costly lawsuits.

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