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Protect Your Business in Minutes

Answer a few questions about your business and employees, and we'll prepare your Employers Liability (Common Law) proposal for a Geminia advisor to quote.

About you

Proposer's details

Part 1 of the official Geminia Employers Liability proposal form.

Please enter the proposer's name.
Enter a valid email address.
Please enter the location of the premises.
Please have your Certificate of Incorporation and KRA PIN Certificate ready — your advisor will request copies.
Premises & machinery

A few questions about your premises

The truth of these statements is a condition precedent to liability — please answer in full.

Please let us know.
Please let us know.
Please let us know.
Please let us know.
Quick check

Prior insurance & employee health

A few background questions.

Please let us know.
Please let us know.
Your employees

Employee schedule

Employees being workers as defined by Section 5 of the Work Injury Benefits Act, 2007.

Employee group 1
Please describe this employee group.
KES
Employee group 2 (optional)
KES
Employee group 3 (optional)
KES
More occupation groups? List the rest with your advisor on a supplementary sheet.
It's a condition of this policy that estimated annual wages, salaries and earnings are certified annually by your auditors within 3 months of the expiry date of the period of insurance.
History

Salary confirmation & claims history

A quick check, then your accident/claims record for recent years.

Please let us know.
Year 1 (most recent, optional)
KES
KES
KES
Year 2 (optional)
KES
KES
KES
More years of history? Share the rest with your advisor.
Your cover

Limits of liability

Choose the option that fits your business.

Please choose an option.
Part 3

General insurance history

A few short questions so we can price you fairly.

Please let us know.
Please let us know.
Please let us know.
Almost done

Contact & declaration

Part 4 of the form — how you'd like us to reach you and confirm the declaration.

Please enter a name.
Sign here
Draw with your mouse, or your finger on a touchscreen. This is embedded into your proposal PDF.
Please sign before submitting.
By signing and submitting, you declare that the statements set forth herein are true and complete, that you have not suppressed or misrepresented any material fact, and that you have fairly estimated the wages, salaries and other earnings declared.
Review

Does everything look right?

Take a quick look before we prepare your quotation.

Thank You! 🎉

We've received your request. A Geminia Insurance advisor will prepare your quotation and contact you shortly.

If we need any additional information, we'll reach out to you.

Have a question? Our team is ready to help you.
+254 709 551 000 Request Callback
Head Office Le'Mac, 5th Floor, Church Road
Off Waiyaki Way, Westlands
P.O. Box 61316-00200
+254 709 551 000 Mon – Fri, 8:00am – 5:00pm
info@geminia.co.ke

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