Family Health Insurance Quote Request

Name *

First

Last

Phone Number *

ANNUAL INPATIENT Cover Limit (KShs)?

InPatient treatment is any treatment required where it is necessary for you to occupy a hospital bed, either for the day (which is called 'day-patient treatment') or overnight. Please read policy terms and conditions for details on each policy.

Do you have any pre-existing medical condition? *

For members with chronic or pre-existing conditions, a waiting period may apply once the member is admitted on cover. Please see the 'Waiting Periods' section on the quotations page.

Do you your dependents have any pre-existing medical condition? *

For members with chronic or pre-existing conditions, a waiting period may apply once the member is admitted on cover. Please see the 'Waiting Periods' section on the quotations page.

Date Of Birth *