Golfers | KOIL

Personal Details

First Name / Corporate Name

Last Name

Mobile No.

Email Address

Which Kenya Orient branch do you want to be served from?

Period of Insurance

StartDate

EndDate

Cover Type

Other Details

Any personal accidents suffered by you while playing golf on any golf club ?

Please provide details

Losses or breakage suffered in respect of golfing Equipment ?

Please provide details

Losses or damage suffered in respect of your personal Effects ?

Please provide details

Any Third Party Claim against you arising from your playing golf at any golf club ?

Please provide details

Has any Insurer in respect of any of the risks to which this proposal applies declined to insure you, or required special terms to insure you, or Cancelled or refused to renew your insurance ?

Please provide details

Please supply details of Insurance policies which you hold with this Company or which you propose to effect in the near future.

Beneficiary Details

Beneficiary 1

Full Name

Relationship

Date Of Birth

Type

ID/Passport Number

Tel. no

Email Address

Postal address

Physical Address

Percentage of benefit

Remove

Golfers Quotation

Personal Details

Period of Insurance

Other Details

Beneficiary Details