GENERAL INSURANCE
1. Domestic Package (DP) Insurance
This policy insures the home. It combines coverage for the home that is, the building and household contents as well as domestic workers against death or injury while in the course of employment. The policy also covers the homeowners or occupiers against lawsuits for injury or
property damage caused to other people (third parties).
What does DP insurance cover? Domestic package insurance covers the following risks:
• Domestic package insurance policy has five (5) sections, A to E, as broken down below;Section A – Cover for the structure (building) of your home • Section B – Cover for your personal belongings or contents of the building • Section C – Cover for items you move with outside the
house such as mobile phones, watches, IPads, laptops, rings, cameras, spectacles. This section is also referred to as All Risks • Section D – Liability protection, this covers domestic workers for injury or death while undertaking domestic work. • Sections E and F – Coverage of owners and occupiers against lawsuits for injury or property damage caused to other people. Can I purchase DP insurance if I am renting a house
2) Personal Accident and Group Accident Insurance
A Personal accident insurance provides financial benefits to an individual if he/she is involved in an accident resulting in injuries or death. While, Group personal accident insurance provides financial benefits to a group of people such as a family, employees, chamas, learning institutions, SMEs or any other group of people with common interest. For employers who take the cover on behalf of their employees, the claim is paid to the employer for onward transmission to the employee or their appointed beneficiary
What are the benefits under this cover?
► Accidental Death – Pays the fixed amount or multiple of salary for loss of life due to an accident
► Permanent Disablement – Pays a certain percentage of the fixed amount or multiple of salary in the event of permanent disablement caused by an accident
► Weekly payment – Pays a weekly income for temporary disablement resulting from accidental injury
► Medical Expenses – Reimburses you for medical expenses that arise from an accident including dental and optical expenses.
► Emergency Evacuation – Covers emergency medical evacuation expenses.
► Pay for the cost of artificial appliances that arise from an accident such as crutches, hearing aid and prosthetics
► Repatriation Expenses – pays for the return of the deceased to place of residence.
3) Medical Insurance and Group Medical insurance
Medical insurance policy, also referred to as health insurance, covers the medical expenses incurred by the insured or their dependents. It covers numerous illness and or bodily injuries. It can be taken by an individual or a group of people. The policy can be out-patient (walk in and out of hospital) only or in-patient (admission) only. It can also have a combination of both in and out patient.
This is dependent on the type of cover and on the premium paid. It is therefore very important to review the policy document together with your insurer to confirm you have clearly understood what is covered and what is not covered. It is also important to understand the expenses that NHIF card will pay for as these are excluded from the private medical insurance cover. Most medical insurance policies can be extended to cover additional benefits such as optical and dental cover, congenital defects, maternity expenses, preexisting conditions, chronic ailments, psychiatric conditions among others. Most covers exclude cosmetic surgery or treatments, age related senility or insanity, family planning and treatments not administered by a registered
4) Professional Indemnity Insurance
This insurance policy covers liability to a third party arising from the performance of, or failure to perform services by a professional. Insurance is provided in accordance with the limits, conditions and activities defined in the policy. Who is a professional? There is not one standard definition of a professional but they do possess the following characteristics:
► Skills and knowledge highly valued by society
► Usually trained in the specific skill
► Usually a member of a professional association – for regulation purposes
► May have a special license to provide the specialized service
► Advice/ Service is usually in exchange for a fee Traditional professions – accountants, architects, engineers, advocates, insurance brokers, doctors/ nurses Non-Traditional – advertising agents, property valuers, real estate agents, event planners, debt collectors and consultants
What professional liabilities does the insurance cover?
► Negligent acts, errors or omission
► Misleading statements
► Unintentional breach of confidentiality
► Libel or slander ( defamation)
► Dishonest, fraudulent or malicious acts, omissions by any former or present employee
What liabilities are not covered under this insurance?
► Performance guarantees
► Intentional acts by the professional
► Patents/trade secrets
► Prior claims/circumstances
► Policy excess
5) Fire and Perils Insurance
The basic fire and perils insurance covers loss or damage to property caused by fire, lighting or explosion. The cover can also be extended to cover riots, strike, malicious damage, storm, earthquake, impact by vehicles, aircraft or other aerial devices, subterranean fire, spontaneous combustion or overflowing water from tanks and pipes. This insurance covers assets such as buildings, plant and machinery, stock insurance, office equipment, furniture, fixtures and fittings. The insurer guarantees to pay for the loss or damage to the property for the specified period (usually one year). The valuation of property is made according to the market value.
What is not covered?
► Items like precious stones, curios or works of art, manuscripts, plans, drawings, securities, obligations or documents of any kind, stamps, coins or paper money, cheques, books of accounts or other business books, computer systems records, explosives, manuscripts etc. unless specifically declared in the policy.
► Damaged cold storage stocks due to change of temperature.
► Loss / damage/ destruction of any electrical and/or electronic machine, apparatus, fixture or fitting arising from over running, excessive pressure, short circuiting, arcing, self-heating or leakage of electricity.
► Loss / damage / destruction of Boilers, Economisers or other Vessels, machinery or apparatus which generates steam
6) Business Interruption Insurance
This policy provides cover for loss of profits caused by reduction or interruption of production due to damage caused by fire and allied perils to the insured’s premises. Allied perils are perils such as earthquake, flood, explosion, malicious damage that are insured in addition to fire at additional premium. Business Interruption Insurance is taken together with fire insurance (see 10 above) to ensure both the business and the assets/materials are covered. Both covers have to be valid for a claim to be settled. Business Interruption insurance covers loss of Gross Profits, wages that are paid while production is interrupted and auditors fees incurred in preparation of the claim.
7)Burglary or Theft Insurance
Burglary or theft insurance covers loss or damage of insured property because of theft accompanied by visible, forcible and violent entry into, or exit out of the insured premises. The policy extends to cover damage to the doors, windows, walls and roof by intruders in their attempt to gain entry and exit. As well as damage to the contents in the event of an attempted breakin to the premises.
Which losses are not covered under this burglary/theft insurance? The policy excludes losses such as:
► Damage by fire
► Theft by trick, pilferage, shoplifting
► Entry by use of key unless by force
► Where employee(s) collude with outsiders in perpetration of the crime
8) Money Insurance
All businesses handle money in some form – cash, cheques, credit card slips, bankers’ drafts and others- making this form of insurance essential for businesses large and small. Money insurance covers loss or damage of cash in transit, cash in premises, cash in safe, cash with authorised staff and damage to safe/strong rooms. The policy will cover loss of money in varying scenarios including hold up, burglary and by use of force or threat of the person with the money. A Personal Accident cover is also included for those carrying money. Policy features can include:
► Money in transit to and from banks, carried by employees
► Personal assault cover
► Money on business premises, in or out of safes
► Personal and safe damages
► Cover for money in the home of employee or director
► Cover for money in safety deposits Why should you consider it?
► Essential protection of financial assets
► Protection for employees and others who transport monies
► Peace of mind security, minimising disruption to your business
► May cover risks that are excluded in other insurance policies Does Money insurance cover money in M-pesa, Airtel, Equitel, Orange and other such accounts? Money insurance does not cover mobile/ electronic money i.e. Money in the mobile phone transferred following hold up / threat at gunpoint. However, cover for such risks can be extended at an additional premium or insured under a separate cover. What are the common exclusions in money insurance?
► Any loss of money in which an employee of the Insured or member of the Insured’s family is directly or indirectly involved
► Unexplained losses and/or shortages due to errors or omissions
► Any damage or loss of money occurring because of use of any keys, unless access obtained by force, violence, assault or threat.
► Theft or loss of money by employees through manipulation of any computer software.
9) Fidelity Guarantee Insurance
Fidelity Guarantee insurance covers an employer against loss of money, business equipment, securities or other goods belonging to the business resulting from an act of fraud or dishonesty by employees for improper personal financial gain in the course of their duties.
Why is Fidelity Guarantee Insurance Important? Companies are exposed to significant financial losses, due to crime committed by employees. Companies most often seek fidelity guarantee insurance where employees are more likely to cause financial loss because of their constant exposure to cash, stocks or other assets. Who is covered? Fidelity Guarantee covers all employees engaged under a contract of service, for example storekeepers, sales people, staff authorized to handle cash among others. It covers actions such as forgery, misappropriation of funds, embezzlement or diversion of money and theft of money or property. Fidelity insurance may include a single employee or a group of employees and the cover extends to measurable financial losses only. The type and extent of cover you chose will depend on your particular business.
Who is not covered? The cover does not insure all the staff and it excludes the following:
► The business owner
► A director, partner or sole proprietor of the Business, a trustee
► Commission agent, consignee, contractor or other agent or representative of the Business
► Any employee or category of employees not in the Schedule of the Policy or an employee not on permanent terms of service. Can compensation occur if loss is discovered after a staff member has left employment? Yes. However, this has to be within 3-6months after policy
expires or the termination of the employment whichever comes first. The policy runs for one year and the 3-6months is referred to as ‘discovery period’. What is excluded under this policy? The policy excludes such form of losses as; damage by fire, political and terrorism, unexplained losses, consequential loss of any kind, loss by use of electronic equipment
10) Carriers Legal Liability Insurance
Carriers Legal Liability Insurance insures a carrier (person or entity providing transportation for hire) against legal liability claims. The insurance covers accidental loss or damage to goods in the custody or control of the insured whilst in transit by road, rail, inland waterway,
air or any other specified means. The cover territory is within Kenya however, it can extend to East Africa based on agreement with the insurer.
The insurer shall not be liable to pay in respect of liability arising from:
► Loss of any kind, delay or loss of market.
► Political violence and terrorism, war, confiscation by authority.
► Loss or damage to goods belonging to the insured or to an employee or agent of the Insured
► Carriage of illicit, illegal, contraband or smuggled goods.
► Illegal sale, conversion or wrongful disposal of goods in the custody or control of the Insured
► Wilful misconduct of the Insured, theft or dishonesty on the part of the Insured’s employees, disappearance of or unexplained inventory shortage.
► Defective or inadequate packaging or insulation.
► Damage, destruction and deterioration to goods caused by change in temperature resulting from total or partial breakdown of any refrigeration or cooling equipment unless such breakdown has been caused by an event not excluded from this Policy.
► A motor vehicle driven by you, or anyone with your permission while the driver is under the influence of alcohol or any other intoxicating substance or drug.
► Abandonment of consignment
11) Goods in Transit (GIT) Insurance
Goods in Transit Insurance covers loss or damage to goods and/or merchandise while moving it from one place to another. This cover is restricted to Kenya but can be extended to cover East Africa subject to agreement with the insurance company.
The insurance covers loss or damage to goods when:
► Loading, carrying or unloading from any vehicle
► Collision, overturning or derailment of the conveying vehicle
► Theft and pilferage following collision, overturning or derailment of the conveying vehicle. This insurance can extend to cover expenses reasonably and necessarily incurred in respect of;
► Cost of debris removal of property damaged from the site where damage occurred
► Transferring property from the vehicle following an accident and reloading to another conveyance
► Security and protection at the site of accident
► Damage to tarpaulins, trailer curtains, ropes, chains, webbing straps and packing material
following an accident.
► Political violence and terrorism is currently a common extension. What is not covered by GIT? The insurance policy does not cover loss, destruction or damage caused by:
► Loss from an unattended vehicle
► Wear and tear
► Defective or inadequate packaging or insulation.
► Wilful misconduct of the Insured, theft or dishonesty
► Delay or loss of market This Policy does not cover loss of or damage to the following goods unless specifically agreed:
► Deeds, bonds, bills of exchange, promissory notes, money or other negotiable currency, securities or stamps;
► Documents, manuscripts, business books, computer systems records, patterns, models, moulds, plans or designs;
► Electrical or electronic equipment, cameras, photographic or binocular equipment
► Bullion, jewellery, non-ferrous metals, precious stones, precious metals, platinum or silver articles, furs, watches, curios, or works of art
► Glass and other articles of a brittle nature except as a direct result of fire, theft or accident to the conveying vehicle;
► Explosives;
► Livestock/living creatures
12) Work Injury Benefits Act (WIBA) Insurance
The Work Injuries Benefits Act No. 13 of 2007, requires that all employers must provide compensation to employees for work related injuries or diseases contracted as a result of work. WIBA insurance policy responds to the requirements of the above Act. It covers employees whilst on duty against accidental bodily injury, disablement or death. Compensation is payable in accordance with the provisions of the WIBA Act 2007. The maximum benefit is set at 96 months’ salary. The insurance also covers funeral expenses, medical expenses and artificial appliances or prosthetics. WIBA policy does not cover the armed forces, minors, business owners and employees deployed outside Kenya.
What are the key exclusions under WIBA?
• Any injury by accident or disease sustained outside Kenya
• Any liability arising out of any court proceedings
• Any liability arising out of pre-existing medical conditions unless previously declared.
• Any Injury by accident /or disease attributable to war or war like activities
• Any Injury by accident/ or disease outside the course of duty
• Injury caused by deliberate and willful misconduct All employers should read the Workmen Benefits Injury Act under the Kenyan Laws for detailed understanding of their responsibilities to their employees
13) Employers’ Liability (EL) Insurance
Employers’ liability insurance protects employers from their legal liability to an employee for injury arising out of, and in the course of employment. The policy protects the Employers against lawsuits brought against them by employees due to allegations of injuries or
contracting diseases because of employer negligence. The employee must prove negligence on the part of the employer e.g. if injury is a result of lack of a helmet – which the employer failed to provide. Employers Liability compliments WIBA and picks common law claims after
WIBA has dealt with statutory claims.
What are the Policy exclusions?
• Any injury by accident or disease sustained outside the geographical area of operation.
• Any injury by accident or disease attributable to civil war Injury or disease caused by goods supplied or remedial treatment.
• Fines and Penalties incurred by the employee
• Any claim (in the event of cancellation or non-renewal of this policy) not first reported in writing against the insured as specified in specific in the policy.
• Any known losses before policy inception
• Any losses as a result of policy cancellation or non-renewal
14) Travel Insurance Travel Insurance covers specific events.
The insurance is dependent on coverage limits, which also determine the premium paid. Covered risks and exclusions vary significantly by policy type, insurer, and travel preferences.
The risks typically covered include:
► Trip interruptions
► Cancellations (entire trip or a section of the trip)
► Lost or delayed baggage
► Carrier or service provider failures
► Emergency evacuations (due to physical threats and medical emergencies)
► Theft and other crimes
► Medical treatment for injuries caused due to travel
► Accidental death (including transportation of remains) What is not covered?
► Natural disasters
► Severe weather
► Crimes committed against you or a member of your traveling party
► Lost travel documents or identification papers
► Civil unrest
► Unannounced strikes that render your carrier unable to operate
15. CONTRACTORS’ ALL RISKS (C.A.R) INSURANCE
UNDERWRITING GUIDELINES
What is C.A.R ?
It is a Policy Cover meant for Contractors undertaking Building and Civil Engineering Works covering risks surrounding the construction process of an actual property being built or developed at a specified Contract Site. It is a Term Policy, not an annual Policy i.e. based on the Contract Period which can range from one month to a mega risk of four years equivalent of (48) months. C.A.R is an ALL RISKS Cover i.e. Policy on All Risks basis – covers everything except what is specifically EXCLUDED. The policy is structured in three sections 1(A) Contract Works 1(B) Contractors Plant and Machinery 2.Public Liability.
WHAT IS COVERED BY THE POLICY?
i) Contract Works
ii) Contractors’s Plant and Machinery/Equipment commonly referred to as CPM
iii) Materials on Site
iv) Public Liability
EXCLUSIONS
A) Loss or Damage due to Faulty Design
B) Defective Materials and/or poor Workmanship
C) Loss discovered only at the time of taking stock
D) Wear and Tear
E) Penalties to the Insured for non-compliance of Contract Terms
F) Consequential Loss
G) Loss or Damage which is specifically covered by another Policy (aside from the four mentioned here)
16. Marine Insurance
Marine insurance is broadly divided into three categories namely: Marine Hull Insurance, Marine Cargo Insurance and Marine Third Party Liability.
a) Marine Hull insures risks associated with boats, canoes, dhows, vessels, ships and other marine vessels.
b) Marine Third Party Liability insures the vessel owner; vessel charterer in respect of legal liabilities to third parties. It does not cover loss or damage to the vessel.
c) Marine Cargo Insurance covers shipments from starting point to the final destination. The same insurance can cover any shipment by road, rail or air.
There are two types of marine cargo insurance:
► Marine Open Cover
The Marine open cover is an umbrella cover and is ideal for those engaged in continuous or regular import and export of goods. It is an agreement to provide insurance cover on all shipments of the insured at pre-agreed rates and terms.
► Voyage Policy
This is a single policy cover that covers the goods from one place to another irrespective of the duration involved. The policy therefore ceases or lapses once the goods are delivered to the destination. The insurance cover contains the policy number, name of the assured, name of the transporting vessel, details of the voyage, description of goods, type of cover, sums insured and the premium.
17. PERFORMANCE BONDS
A Performance Bond is a documented legal undertaking by an insurer given to the Principal in a contract guaranteeing the due performance of the contract by the second party to the contract (our Insured).
Performance Bonds are not insurance risks in the real sense of the word and description of an insurable risk as these dwell more on the integrity of the party being guaranteed(our Insured) as opposed to a risk capable of scientific and financial evaluation. The amount for a Performance Bond is normally a percentage of the Contract Value, normally between 5% and 10% BUT can never be the same amount as the Contract Value.
18. TENDER / BID BONDS
These are similar to Performance Bonds only that they are in different use/purpose. They are only used by Bidding Contractors when tendering for Projects.