Fill the form below to purchase your Professional Indemnity Cover.
Secure your peace of mind with our
Professional Indemnity Cover. Ready to proceed?
Personal Details
First Name
*
Middle Name
Last Name
*
Date of Birth
*
Gender
*
Select
Male
Female
NACOA Membership Number
*
Proposer Details
KRA PIN No.
ID No/Passport No.
Mobile No.
Email Address
Postal Address: P.O. Box
Town
Select Your Limit of Liability
Limit of Liability (KES)
Select
KES 2,000,000
KES 2,500,000
KES 5,000,000
KES 7,500,000
KES 10,000,000
KES 15,000,000
KES 20,000,000
Tell us more about yourself
Where are you currently employed?
*
Do you engage in locum activities?
*
Yes
No
Input Annual Gross Income from the Locum activities (KES)
*
Do you have any retroactive claim?
*
Yes
No
Give more details
Do you have any criminal offence?
*
Yes
No
Please contact your Administrator.
Has your previous application been declined?
*
Yes
No
Give more details
Are you currently covered for Professional Indemnity?
*
Yes
No
Give more details
When would you like the policy to begin?
Start Date
Payment to be made before the starting date. If made after, the policy will commence on the payment date.
Upload Documents
Upload Certificate of Practice
*
Upload ID/Passport
*
Upload KRA Pin
*
Allowed file types: PDF, JPEG, PNG only.
I confirm that the information I have provided is accurate and complete to the best of my knowledge. I understand that submitting incorrect or incomplete information may result in delays or issues with processing.
I agree and accept the AAR Insurance
Privacy Policy
and
Terms and Conditions
.
Proceed to Payment
