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Life Insurance Proposal Form (Kenya)

Life Insurance Proposal Form (Kenya)

LIFE INSURANCE PROPOSAL FORM — LONG-TERM INSURANCE BUSINESS

IRA-LICENSED LONG-TERM INSURER Insurance Act Cap. 487 — Long-Term Insurance Business Proposal Date: [Commencement Date]

PART A — PROPOSER DETAILS

1. Proposer Name: [Proposer Name] 2. NIC Number: [Proposer NIC] 3. KRA PIN: [Proposer KRA PIN] 4. Address: [Proposer Address] 5. Telephone: [Proposer Phone] 6. Email: [Proposer Email] 7. Life Assured Same as Proposer: [Life Assured Same as Proposer] 8. Life Assured Name (if different): [Life Assured Name] 9. Nature of Insurable Interest: [Insurable Interest]

PART B — LIFE ASSURED PERSONAL DETAILS

2. Date of Birth: [Life Assured DOB] 11. Gender: [Life Assured Gender] 12. Occupation: [Life Assured Occupation] 13. Employer: [Employer Details]

PART C — POLICY DETAILS

3. Policy Type: [Policy Type] 15. Sum Assured: [Sum Assured] 16. Policy Term: [Policy Term] years 17. Premium Frequency: [Premium Frequency] 18. Commencement Date: [Commencement Date] 19. Mortgagee / Assignee Lender: [Mortgagee Lender] 20. Tax Relief Election (Section 31, ITA Cap. 470): [Tax Relief Election]

PART D — HEALTH DECLARATION

4. Height and Weight: [Height/Weight] 22. Smoking Status: [Smoking Status] 23. Pre-existing Conditions: [Pre-existing Conditions] Details: [Condition Details] 24. Hospitalised in Last 5 Years: [Hospitalised Last 5 Years] Details: [Hospitalisation Details] 25. Family History: [Family History] 26. Hazardous Activities: [Hazardous Activities] Details: [Hazardous Activity Details] 27. Life Insurance Previously Declined: [Life Insurance Declined] Details: [Decline Details]

PART E — BENEFICIARY NOMINATION

Nominated Beneficiaries (Law of Succession Act Cap. 160): 1. Name: [Beneficiary 1 Name] | Relationship: [Beneficiary 1 Relationship] | Share: [Beneficiary 1 Share]% 2. Name: [Beneficiary 2 Name] | Relationship: [Beneficiary 2 Relationship] | Share: [Beneficiary 2 Share]%

PART F — DECLARATION

I/We declare that the answers given in this Proposal Form are true and complete. I/We have not withheld any material fact that might influence the insurer's assessment of this risk. I/We agree that this Proposal Form forms the basis of the life assurance contract. I/We authorise the insurer to obtain medical records from any doctor or hospital to verify the health declarations made herein. I/We understand that non-disclosure of any material fact entitles the insurer to avoid the policy under Section 158 of the Insurance Act Cap. 487. Signed by Proposer: _____________________________ Date: _______________ Name: [Proposer Name] Signed by Life Assured (if different): _____________________________ Date: _______________ Name: [Life Assured Name]

Proposer

________________

Signature

Life Assured (if different from proposer)

________________

Signature

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What Is a Life Insurance Proposal Form (Kenya)?

A Life Insurance Proposal Form Kenya is the legally required document through which a proposer applies to an IRA-licensed long-term insurer for a life assurance policy — covering term assurance, whole-of-life assurance, endowment assurance, or investment-linked life assurance. The Life Insurance Proposal Form Kenya initiates the underwriting process under Part VI of the Insurance Act Cap. 487, which governs long-term insurance business in Kenya, and activates the duty of utmost good faith between the proposer and the life insurer.

The Insurance Regulatory Authority (IRA), established under Section 3A of the Insurance Act Cap. 487, separately licenses and regulates long-term insurance business from general (short-term) insurance business. A company must hold a distinct long-term insurance business licence under Section 6 of the Insurance Act Cap. 487 to write life assurance policies in Kenya. The IRA's Long-Term Insurance Business Regulations prescribe minimum policy terms, surrender values, disclosure obligations, and the format of the proposal form to be used by licensed life insurers.

The principle of insurable interest is a core requirement for life insurance proposals in Kenya. Section 3 of the Life Assurance Act (repealed and consolidated into the Insurance Act Cap. 487) and common law require that the proposer have an insurable interest in the life assured at the time of taking out the policy. A person always has unlimited insurable interest in their own life. A spouse has insurable interest in the life of their spouse under Section 11 of the Married Women's Property Act Cap. 10. An employer has insurable interest in key employees, and a creditor has insurable interest in the life of a debtor to the extent of the debt.

The Kenya Revenue Authority (KRA) provides income tax relief on life insurance premiums under Section 31 of the Income Tax Act Cap. 470. An individual may deduct qualifying life insurance premiums paid in a year of income, subject to the annual limit prescribed by the KRA, reducing the individual's taxable income. This tax benefit makes life insurance proposals in Kenya financially attractive and underscores the importance of correctly recording the proposer's KRA PIN and employment details on the proposal form.

Under the Law of Succession Act Cap. 160, a life insurance policy paid on death forms part of the deceased's estate unless a valid nomination of beneficiary has been made on the proposal form. Where a proper nomination is made and noted on the policy, the death benefit is paid directly to the nominated beneficiary without going through probate at the High Court of Kenya's Succession Division. The Retirement Benefits Authority (RBA), established under the Retirement Benefits Act No. 3 of 1997, regulates life policies written in connection with pension schemes, and such proposals must additionally comply with RBA guidelines.

The forms-legal.com Kenya Life Insurance Proposal Form template captures all IRA-required sections including personal details, health declaration, lifestyle disclosures, beneficiary nominations, and the long-term insurance declaration of utmost good faith, aligned with Insurance Act Cap. 487 and applicable IRA guidelines for long-term insurers.

The legal framework governing the Life Insurance Proposal Form (Kenya) in Kenya draws on several key statutes and regulatory bodies. Under Kenyan law, the Data Protection Act No. 24 of 2019 and the Office of the Data Protection Commissioner (ODPC) govern personal data processing. The Oaths and Statutory Declarations Act (Cap. 15) governs sworn documents. Section 4 of the Marriage Act No. 4 of 2014 recognises five forms of marriage in Kenya. The Children Act No. 8 of 2001 governs child welfare. The High Court Family Division and Kadhi Courts handle family disputes. Parties executing a Life Insurance Proposal Form (Kenya) in Kenya should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Insurance Act Cap. 487 sets the foundational requirements.

When Do You Need a Life Insurance Proposal Form (Kenya)?

A Kenya Life Insurance Proposal Form is required whenever an individual or group seeks life assurance cover from an IRA-licensed long-term insurer, whether for personal protection, mortgage security, savings, or estate planning purposes.

A Life Insurance Proposal Form Kenya is needed when an individual seeks term assurance to provide a death benefit for dependants — a spouse, children, or aged parents — in the event of the life assured's death during the policy term. Term assurance is the most affordable form of life cover and is commonly recommended by financial advisers regulated by the Capital Markets Authority (CMA) or the IRA as part of a thorough financial plan.

A Life Insurance Proposal Form is required when a bank or mortgage lender in Kenya requires mortgage protection insurance as a condition of granting a home loan. The Housing Finance Corporation (HFC) and commercial banks routinely require borrowers to assign a life policy equal to the outstanding loan balance, confirming the loan is repaid from the death benefit if the borrower dies before the mortgage is fully settled. The proposal form must note the bank as the policy assignee.

A Life Insurance Proposal Form Kenya is needed when an employer establishes a Group Life Assurance Scheme for employees, providing a multiple of salary death benefit to the family of any employee who dies while in service. The Occupational Safety and Health Act No. 15 of 2007 and the Employment Act No. 11 of 2007 create obligations on employers to provide safe workplaces and, in practice, group life cover is a standard employment benefit in formal sector employment in Kenya.

A Life Insurance Proposal Form is required when a person seeks an endowment policy as a savings vehicle — combining life cover with a guaranteed maturity benefit payable at the end of the policy term, which may be used to fund school fees, retirement, or a property purchase. Endowment policies in Kenya are regulated under the Insurance Act Cap. 487 and the IRA's Long-Term Insurance Business Regulations.

A Life Insurance Proposal Form Kenya is needed when a business partner or company wishes to insure the life of a key man — a director, founder, or specialist employee whose death would cause significant financial loss to the business. Keyperson insurance proceeds are paid to the company and compensate for lost revenue, recruitment costs, and business disruption caused by the death of the key individual.

What to Include in Your Life Insurance Proposal Form (Kenya)

A Kenya Life Insurance Proposal Form under the Insurance Act Cap. 487 must contain the following essential elements to enable proper underwriting by an IRA-licensed long-term insurer and to create a valid life assurance contract.

Proposer and Life Assured Details: Full legal name, date of birth, gender, National Identity Card (NIC) number, KRA PIN, occupation, employer name and address, residential address, and contact details. Where the proposer and life assured are different persons — for example, a company insuring a key employee — both sets of details must be provided together with the nature of the insurable interest.

Policy Type and Sum Assured: The class of long-term insurance sought — term assurance, whole-of-life, endowment, or investment-linked assurance — the sum assured in Kenya Shillings (KES), the policy term in years, and the premium payment frequency (monthly, quarterly, semi-annual, or annual). The premium quoted by the insurer is based on actuarial tables approved by the IRA's appointed actuary under Section 52 of the Insurance Act Cap. 487.

Health Declaration: A full medical history declaration covering pre-existing conditions, hospitalisations, surgical procedures, chronic medications, family history of hereditary diseases, and current state of health. This section triggers the insurer's duty to arrange a medical examination or to obtain attending physician statements under IRA long-term underwriting guidelines. The proposer's duty of utmost good faith under the Insurance Act Cap. 487 requires complete and accurate health disclosure — non-disclosure of a pre-existing condition at the time of the proposal entitles the insurer to avoid the policy.

Lifestyle and Hazardous Activities: Disclosure of tobacco and alcohol use (frequency and quantity), participation in hazardous sports or occupations (aviation, deep-sea diving, mining, or security), and whether the life assured has applied for, or been declined, life insurance by any other insurer within the preceding five years. These disclosures affect the premium loading and exclusions applied by the underwriter.

Beneficiary Nominations: The full names, dates of birth, national identity details, relationship to the life assured, and percentage entitlement of each nominated beneficiary. The nomination must comply with the Law of Succession Act Cap. 160 and the Married Women's Property Act Cap. 10 (where applicable). Where the policy is taken under a Married Women's Property trust, the trust terms must be recorded on the proposal form to prevent the policy proceeds forming part of the life assured's estate.

Premium Payment and Tax Relief: The proposed premium payment method — standing order, M-Pesa recurring payment, or payroll deduction — and the proposer's tax relief election under Section 31 of the Income Tax Act Cap. 470. The IRA requires insurers to issue an annual premium certificate confirming the premium paid to enable the proposer to claim income tax relief from the KRA.

Declaration and Medical Authorisation: The mandatory declaration of utmost good faith signed by the proposer and the life assured (if different), authorising the insurer to obtain medical records from any healthcare provider, and acknowledging that the proposal form forms the basis of the life assurance contract. The forms-legal.com Kenya Life Insurance Proposal Form template includes all IRA-compliant sections and the statutory declarations required under the Insurance Act Cap. 487 for long-term insurance business, with beneficiary nomination fields aligned to the Law of Succession Act Cap. 160.

Additional compliance elements for a Life Insurance Proposal Form (Kenya) used in Kenya include: Under Kenyan law, the Data Protection Act No. 24 of 2019 and the Office of the Data Protection Commissioner (ODPC) govern personal data processing. The Oaths and Statutory Declarations Act (Cap. 15) governs sworn documents. Section 4 of the Marriage Act No. 4 of 2014 recognises five forms of marriage in Kenya. The Children Act No. 8 of 2001 governs child welfare. The High Court Family Division and Kadhi Courts handle family disputes. Forms-legal.com provides this template as a starting point for Kenya-compliant documentation.

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  author       = {{Forms Legal}},
  title        = {Life Insurance Proposal Form (Kenya) (Kenya)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/kenya/personal/insurance/life-insurance-proposal-form-kenya}},
  note         = {Free legal document template}
}

Frequently Asked Questions

Statute-referenced template — Template last modified June 2026

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

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