Answers to the questions we hear most.

The premium depends on the type of cover, who or what is being insured, age, benefits, limits and the insurer’s terms. Two people asking for medical cover, or two vehicles, will not necessarily pay the same amount. Tell us what you need and we will help you compare options against the budget you have in mind. A quote is an illustration until the insurer accepts the risk.

Look past the premium. Check what is covered, what is excluded, any waiting period, the benefit limits, the excess you would pay on a claim, and which hospitals, garages or other providers you can use. We explain those points in plain language so you can compare suitable policies before you commit.

Insurers commonly ask for a national ID or passport, and details of the people, vehicle or business being insured. Medical cover may also need dates of birth and, in some cases, a medical report. Motor cover needs the vehicle details. The exact list depends on the insurer and the cover. We tell you what is required before you apply.

No. The Social Health Authority is Kenya’s public health scheme. Private medical insurance is a separate policy with its own benefits, hospital network, limits and exclusions. Many people keep both. We can help you understand what a private policy adds, but it does not replace your obligations under the public scheme.

Yes. Individual and family medical cover can be arranged for a principal member and dependants such as a spouse and children, subject to each insurer’s age and eligibility rules. Benefits, limits and premiums are set out in the policy. If a full family plan is not the right fit yet, standalone children’s medical cover is also available.

Lako’s children’s medical cover is for children from 38 weeks to 17 years, with an extension for college students who can show proof of enrolment. Other family policies may use different age bands. A newborn is usually added after discharge from hospital, and some benefits have a waiting period. We confirm the rule that applies to the policy you are considering.

Only if the policy includes a maternity benefit. Most insurers apply a waiting period, so joining while already pregnant often means the current pregnancy is not covered. Dental, optical and maternity are not automatic on every plan. Ask us to point out whether those benefits are included, optional, or excluded.

A pre-existing condition is an illness, injury or symptom that existed before the policy started, whether or not it had been diagnosed. Many medical policies exclude these for a period, or permanently, unless the insurer has agreed to cover them. Our seniors medical cover is designed with support for chronic and pre-existing conditions, subject to enrolment rules and the insurer’s terms. Always disclose your medical history. Non-disclosure can affect a claim.

Yes. Seniors medical cover through Lako is for ages 65 to 85 at enrolment, including support for chronic and pre-existing conditions. Once a member is enrolled there is no upper age limit on that policy. Acceptance, benefits and premium still depend on the insurer’s assessment.

Often yes, if the people being covered live in Kenya and meet the insurer’s residency and age rules. The principal member is usually an adult. We will tell you which documents are needed and whether the policy covers treatment in Kenya only or also outside the country.

Third-party cover meets the legal minimum. It protects you against liability for injury to other people and damage to their property. It does not pay for damage to your own vehicle. Comprehensive cover adds protection for your vehicle against accidental damage, fire and theft, subject to the policy excess, limits and exclusions. We can also arrange cover for corporate fleets.

Insurers look at the vehicle value, make and use, the driver’s age and record, where the car is kept, the cover type and the excess. A car used for business or by several drivers can cost more than a privately used car. We compare options rather than assuming the cheapest premium is the most suitable.

The Work Injury Benefits Act requires employers in Kenya to take out insurance for employees against work-related injury or illness. WIBA is separate from private medical cover and from group personal accident. If you employ staff, ask us to check that the cover matches your headcount and wage roll.

An SME package can bring together medical cover, annual check-ups, WIBA, group personal accident, travel, pension and motor cover for a business with roughly 3 to 100 employees. General business cover can also protect a shop, office or enterprise against property damage and third-party claims. The mix is built around the business, not a single fixed bundle.

Tell us as soon as you can. Share your policy details, what happened and when. The insurer will ask for documents that fit the claim, such as a claim form, identification, photos, invoices, medical records or a police abstract. You can also start from our claims support portal. The insurer decides the claim against the policy wording, limits and exclusions. We help you understand what is needed and follow up.

A visit can fall outside the policy. Common reasons are a hospital that is not on the insurer’s panel, a benefit you have already used up, a condition that is excluded or still in a waiting period, a required referral you do not have, or a co-pay stated in the policy. If this happens, keep the receipts and contact us so we can check the position with the insurer.

Some insurers allow instalments, often through a premium financing arrangement with a bank. It is not available on every product, and financing has its own cost and terms. We will say clearly whether the policy you are considering can be paid annually or in instalments.

Changes such as adding a dependant, a vehicle or a higher limit are possible, but the insurer has to agree and may reprice the policy. Cancellation and any refund depend on the policy wording and how long the cover has been in force. Do not assume a pro-rata refund. Talk to us before you stop paying a premium, so the cover does not lapse by accident.

Upgrades are usually considered at renewal, and sometimes mid-term if the insurer agrees. A higher medical plan can require a medical review, and new benefits may have their own waiting period. We review the renewal with you before it falls due so there is time to compare alternatives.