Life Insurance Application (Nigeria)
LIFE INSURANCE APPLICATION FORM
Insurer: [Insurer Name]
Date: [Application Date]
SECTION A: PERSONAL DETAILS OF LIFE ASSURED
Full Name: [Applicant Name]
Date of Birth: [Date of Birth]
Gender: [Gender]
Residential Address: [Applicant Address]
Occupation: [Occupation]
Employer: [Employer Name]
Phone: [Phone Number] | Email: [Email]
NIN: [NIN] | BVN: [BVN]
SECTION B: POLICY DETAILS
Policy Type: [Policy Type]
Sum Assured: [Sum Assured]
Policy Term: [Policy Term] years
Commencement Date: [Commencement Date]
Premium Frequency: [Premium Frequency]
Estimated Premium: [Premium Amount]
SECTION C: BENEFICIARY NOMINATION
Beneficiary 1: [Beneficiary 1 Name] ([Beneficiary 1 Relationship]), DOB: [Beneficiary 1 DOB], Share: [Beneficiary 1 %]%
Beneficiary 2: [Beneficiary 2 Name] ([Beneficiary 2 Relationship]), Share: [Beneficiary 2 %]%
SECTION D: HEALTH DECLARATION
Smoker/Tobacco user: [Smoking Status]
Pre-existing conditions: [Health Conditions]
DECLARATION
I, [Applicant Name], declare that all the information provided in this application is true, complete, and accurate. I understand that this application is subject to the duty of utmost good faith (uberrimae fidei) under the Insurance Act 2003 and that non-disclosure or misrepresentation of material facts will entitle [Insurer Name] to void the policy. I consent to [Insurer Name] obtaining medical reports and information from my physicians for the purpose of underwriting this application, in compliance with the Nigeria Data Protection Act 2023 (NDPA 2023).
Applicant / Life Assured
________________
Signature
Insurance Advisor / Agent
________________
Signature
What Is a Life Insurance Application (Nigeria)?
A Life Insurance Application in Nigeria records the particulars needed to apply for the registration, permit or approval it concerns.
The Insurance Act 2003 (Cap I17, Laws of the Federation of Nigeria 2004) is the primary statute governing life insurance in Nigeria. Section 65 of the Act requires that life insurance contracts be evidenced in writing. NAICOM, established under the National Insurance Commission Act (Cap N53, LFN 2004), regulates all insurance companies operating in Nigeria, approves life insurance products, and sets minimum capital requirements — currently NGN 8 billion for composite insurance companies and NGN 2 billion for life-only insurers under the NAICOM Recapitalisation Guidelines 2022.
The utmost good faith principle (uberrimae fidei) is fundamental to all Nigerian insurance contracts, including life insurance. Under the Insurance Act 2003 and common law, the applicant has a duty to disclose all material facts — including pre-existing medical conditions, hazardous occupations, and other life insurance policies held — before the policy is issued. Non-disclosure of material facts entitles the insurer to void the policy ab initio, as confirmed by Nigerian courts including the Court of Appeal in various insurance disputes.
Life insurance companies licensed by NAICOM and operating in Nigeria include Leadway Assurance, AXA Mansard, FBN Insurance, Custodian Life Assurance, AIICO Insurance, and Coronation Life Assurance. Group life insurance for employees is mandatory for employers in certain sectors under the Pension Reform Act 2014, which requires employers with 3 or more employees to maintain a Group Life Insurance policy of at least three times the annual total emolument of each employee.
The legal framework governing the Life Insurance Application (Nigeria) in Nigeria draws on several key statutes and regulatory bodies. Under Nigerian law, the Companies and Allied Matters Act 2020 (CAMA) regulates corporate entities through the Corporate Affairs Commission (CAC). The Labour Act (Cap L1 LFN 2004) and the National Industrial Court of Nigeria (NICN) govern employment disputes. The Nigeria Data Protection Regulation (NDPR) 2019 and the Nigeria Data Protection Commission (NDPC) protect personal data. The Federal Inland Revenue Service (FIRS) administers tax obligations under the Companies Income Tax Act. The Federal High Court and state High Courts have jurisdiction over civil matters. Parties executing a Life Insurance Application (Nigeria) in Nigeria should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Contract Law (received English common law) sets the foundational requirements.
When Do You Need a Life Insurance Application (Nigeria)?
A Life Insurance Application in Nigeria is needed whenever an individual or organisation wishes to obtain a life insurance policy from a NAICOM-licensed insurer.
A life insurance application is needed when an individual wishes to purchase an individual life insurance policy — whether a term assurance policy (pure protection for a specified period), a whole-of-life policy, an endowment policy, or a unit-linked policy — to provide financial protection for their dependants or to build a savings element alongside coverage.
A life insurance application is required when an employer must comply with the mandatory Group Life Insurance requirement under Section 9(3) of the Pension Reform Act 2014, which requires private sector employers with 3 or more employees and all Federal Government of Nigeria agencies to maintain a Group Life Insurance policy for each employee with a sum assured of at least three times the employee's annual total emolument.
A life insurance application is needed when a borrower is required by a Nigerian bank or mortgage lender — such as the Federal Mortgage Bank of Nigeria (FMBN), a primary mortgage bank, or a commercial bank — to assign a life insurance policy as security for a mortgage loan or personal loan facility, to confirm the loan is repaid if the borrower dies during the loan term.
A life insurance application is required when a professional — such as a medical doctor, lawyer, engineer, or accountant — wishes to obtain a keyman insurance policy for their business or professional practice, providing the business with a sum assured on the death of a key person whose loss would materially affect the business's ability to meet its financial obligations.
A life insurance application is needed when a Nigerian who is a member of the Contributory Pension Scheme under the Pension Reform Act 2014 wishes to supplement their Retirement Savings Account (RSA) with a private life insurance or annuity product from a NAICOM-licensed life insurer.
Parties in Nigeria should prepare a Life Insurance Application (Nigeria) proactively rather than waiting for a dispute to arise. Courts interpret agreements based on the written terms rather than oral representations. Under Nigerian law, the Companies and Allied Matters Act 2020 (CAMA) regulates corporate entities through the Corporate Affairs Commission (CAC). The Labour Act (Cap L1 LFN 2004) and the National Industrial Court of Nigeria (NICN) govern employment disputes. The Nigeria Data Protection Regulation (NDPR) 2019 and the Nigeria Data Protection Commission (NDPC) protect personal data. The Federal Inland Revenue Service (FIRS) administers tax obligations under the Companies Income Tax Act. The Federal High Court and state High Courts have jurisdiction over civil matters. Where the transaction involves regulated activities, prior approval from the relevant authority may be required before execution.
What to Include in Your Life Insurance Application (Nigeria)
A Life Insurance Application in Nigeria must contain the following essential components to enable the insurer to assess the risk and issue a policy.
Personal Details: Full legal name, date of birth, gender, residential address, occupation, and National Identification Number (NIN) issued by the National Identity Management Commission (NIMC) of the applicant. The BVN (Bank Verification Number) from the CBN's biometric system may also be required for premium payment processing.
Sum Assured and Policy Type: The amount of cover sought and the type of life insurance product — term assurance, whole life, endowment, or unit-linked — with the proposed policy term and commencement date.
Health Declaration: Full and accurate disclosure of the applicant's current health status, pre-existing medical conditions, smoking and alcohol habits, history of serious illness, family medical history, and whether the applicant has been refused insurance before. The duty of utmost good faith (uberrimae fidei) under Nigerian insurance law requires complete and honest disclosure.
Occupation and Lifestyle: Details of the applicant's occupation — particularly whether it is a hazardous occupation attracting a higher premium loading under the insurer's underwriting guidelines — and any hazardous pursuits such as flying, motor racing, or offshore oil and gas work.
Beneficiary Nomination: The full name, date of birth, address, and relationship of each nominated beneficiary, together with the percentage of the sum assured allocated to each. Under Nigerian law, nominations made on application forms held by the insurer are typically revocable by the policyholder during their lifetime.
Premium Payment Terms: The premium amount (monthly, quarterly, or annual), the payment method (direct debit from a Nigerian bank account, standing order, or employer deduction under a group scheme), and the premium paying term.
Declaration and Consent: A signed declaration by the applicant confirming the accuracy of all information provided, acknowledging the duty of disclosure, and consenting to the insurer obtaining medical reports from the applicant's doctors under the Nigeria Data Protection Act 2023 (NDPA 2023).
Additional compliance elements for a Life Insurance Application (Nigeria) used in Nigeria include: Under Nigerian law, the Companies and Allied Matters Act 2020 (CAMA) regulates corporate entities through the Corporate Affairs Commission (CAC). The Labour Act (Cap L1 LFN 2004) and the National Industrial Court of Nigeria (NICN) govern employment disputes. The Nigeria Data Protection Regulation (NDPR) 2019 and the Nigeria Data Protection Commission (NDPC) protect personal data. The Federal Inland Revenue Service (FIRS) administers tax obligations under the Companies Income Tax Act. The Federal High Court and state High Courts have jurisdiction over civil matters. Forms-legal.com provides this template as a starting point for Nigeria-compliant documentation.
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Forms Legal. (2026). Life Insurance Application (Nigeria) (Nigeria) [Legal document template]. Forms Legal. https://forms-legal.com/nigeria/personal/insurance/life-insurance-application-nigeria
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title = {Life Insurance Application (Nigeria) (Nigeria)},
year = {2026},
howpublished = {\url{https://forms-legal.com/nigeria/personal/insurance/life-insurance-application-nigeria}},
note = {Free legal document template. Based on Contract Law (received English common law)}
}Frequently Asked Questions
Failure to disclose a material medical condition on a life insurance application in Nigeria constitutes a breach of the duty of utmost good faith (uberrimae fidei), which is a fundamental principle of all insurance contracts under Nigerian law. If the insurer discovers a non-disclosed condition — either during the underwriting process or when a claim is submitted — the insurer is entitled to void the policy from inception, meaning the policy is treated as if it never existed. In this case, the insurer typically returns the premiums paid but refuses to pay the sum assured to the beneficiaries. This position is supported by the Insurance Act 2003 and has been upheld by Nigerian courts in numerous insurance disputes. Material facts include any medical condition that would affect a prudent insurer's decision to accept the risk or the premium rate to be charged. Common examples of material non-disclosures in Nigeria include failure to disclose hypertension, diabetes, HIV status, history of cancer, or prior cardiac conditions. Applicants should disclose all conditions even if they believe them to be minor or controlled by medication.
When a life insurance policyholder dies in Nigeria, the nominated beneficiary (or the policyholder's estate if no valid nomination exists) makes a claim to the NAICOM-licensed insurer by submitting: a completed claim form; a certified copy of the death certificate from the State Registry of Births, Deaths and Marriages; the original policy document; a completed beneficiary identification form with BVN and NIN; and, where required, a medical cause of death certificate from the treating physician or hospital. The insurer has a statutory obligation under the Insurance Act 2003 and NAICOM's Claims Settlement Guidelines to assess and pay valid claims within a prescribed period — currently 30 days from receipt of all required documents for life claims under NAICOM's Market Conduct Guidelines. Payment is made by bank transfer to the beneficiary's Nigerian bank account. Where the claim is disputed (for example, on grounds of non-disclosure or exclusion), the matter can be referred to NAICOM's Consumer Complaints Bureau or to the court of competent jurisdiction.
Group life insurance is mandatory for employers with 3 or more employees in Nigeria under Section 9(3) of the Pension Reform Act 2014 (as amended by the Pension Reform (Amendment) Act 2023). The law requires that every employer in the private sector with 3 or more employees and every federal government agency must maintain a Group Life Insurance policy for each employee, with a minimum sum assured of three times the employee's annual total emolument. The policy must be obtained from a NAICOM-licensed life insurance company, and premiums are to be paid annually by the employer. Non-compliance with the mandatory group life insurance requirement is an offence under the Pension Reform Act 2014, and the National Pension Commission (PenCom) and NAICOM jointly supervise employer compliance. In practice, many Nigerian employers fulfil this obligation by purchasing group term assurance policies from life insurers such as Leadway Assurance, AIICO Insurance, or FBN Insurance, with the sum assured for each employee calculated as three times the employee's basic salary plus allowances.
A Nigerian life insurance policyholder can change the nominated beneficiary on their policy at any time during the policy term, provided the nomination is revocable. Under Nigerian insurance practice and the Insurance Act 2003, the default position is that a beneficiary nomination on a life insurance proposal form is revocable — meaning the policyholder can change, add, or remove beneficiaries by submitting a written request to the insurer and completing a change of beneficiary form. The change takes effect when the insurer records it in the policy file. An irrevocable nomination, by contrast, cannot be changed without the written consent of the nominated beneficiary — this type of nomination is sometimes used in the context of mortgage-assigned policies. Policyholders should review their beneficiary nominations periodically, particularly following major life events such as marriage, divorce (under the Marriage Act, Cap M6, LFN 2004), birth of children, or the death of a nominated beneficiary, to ensure that the correct persons are named to receive the sum assured.
NAICOM (National Insurance Commission) has set minimum capital requirements for insurance companies operating in Nigeria under the NAICOM Recapitalisation Guidelines 2022 (and subsequent circulars). For life insurance business, the minimum paid-up share capital is NGN 8 billion for composite insurers (those writing both life and non-life business) and NGN 2 billion for life-only insurers. These capital requirements represent a significant increase from prior levels and are part of NAICOM's broader effort to strengthen the Nigerian insurance industry and improve its capacity to meet policyholder claims. Insurance companies that do not meet the recapitalisation requirements by the prescribed deadline risk losing their operating licences under Section 42 of the Insurance Act 2003 (Cap I17, LFN 2004). Policyholders should verify that the life insurer they are purchasing a policy from holds a valid operating licence from NAICOM — the current list of licensed insurers is published on the NAICOM website and updated regularly.
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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