How to File an Insurance Claim in Kenya — A Step-by-Step Guide

Most rejected insurance claims in Kenya are not rejected because the cover is invalid — they are rejected because of missing documents, late reporting, or simple paperwork errors. This guide walks you through the exact process for the four most common claim types so you get paid quickly.

The golden 24-hour rule

Almost every Kenyan insurance policy requires the incident to be reported within 24 hours. Miss the window and you give the underwriter a clean legal ground to reject the claim. Two phone calls, made immediately, protect you: (1) your insurer or agency's 24/7 line, and (2) the relevant authority (police for motor and theft, hospital for medical, fire brigade for fire incidents).

Step-by-step: motor insurance claim

1. At the scene: photograph the damage, the other vehicle, registration plates, and any visible injuries.
2. Call the police. Get an abstract from the OCS at the police station — this is non-negotiable.
3. Call your insurer or agency within 24 hours and get a claim number.
4. Lodge the claim form within seven days, attached to the police abstract, the driver's licence copy, the logbook copy, and your photos.
5. The insurer appoints an assessor; do not start repairs before assessment.
6. Once approved, your car is admitted to an authorised garage on the panel.

Step-by-step: home / fire insurance claim

1. Call the fire brigade or police and your insurer immediately.
2. Do not move damaged items until the assessor visits.
3. Photograph everything — the damaged area, the cause if visible, and undamaged contents.
4. Lodge the claim form with receipts or proof of ownership for high-value items, an inventory, and any incident reports.
5. The insurer appoints a loss adjuster who quantifies the loss and recommends settlement.

Step-by-step: medical insurance claim

For inpatient admissions, the hospital usually liaises directly with the insurer via smart card or pre-authorisation. For outpatient or out-of-network treatment paid out of pocket, file a reimbursement claim within 30 days attaching the original receipt, the duly stamped claim form from the doctor, and prescription receipts.

Step-by-step: WIBA or GPA claim

1. Notify your insurer within 24 hours of the workplace incident.
2. File DOSH Form 1 (employer's first notification of accident) within seven days.
3. Collect the P3 form, treatment records, and a medical board assessment for permanent injuries.
4. Submit to the insurer who processes payment under the WIBA scale of benefits.

The top reasons claims get rejected

• Late reporting (the 24-hour rule)
• Driver was unlicensed, expired or under the influence
• Vehicle being used for a purpose not declared (e.g. Uber on a private policy)
• Missing or altered documents
• Claim falls under an explicit exclusion the client never read
• Premium was in arrears at the time of loss