Claims Notification Form
Life Policy
Death Claim
Policy Number
Name of Life Assureed
Date Death Occured
email Address
Phone Number
*
Medical Certificate of Cause of Death
(please tick if available )
* Police Report, in case of accidental death
(please tick if available )
*
Birth Certificate
(please tick if available )
*
please submit to the nearest NEM office
Maturity Claim
Name of Life Assured
Policy Number
Date of maturity
email Address
Phone Number
Non - Life Policy
Name ofthe Insured
Policy Number
Class of insurance and cover
Period of insurance
Date of loss/Accident
Place of loss/Accident
Breif details of the loss/Accident
Detail of Third Party Involvement (if any)
email Address
Phone Number
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