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Last Expense Form

Claim for Last Expense and Group Life - Civil Servants and Disciplined Services Medical Scheme

Guidelines:

1. Part I of this form should be completed by the District/County Head of Department of the deceased officer.
2. Part II should be filled by the Claimant/Next of Kin in the presence of the District/County Head of Department of the deceased officer and countersigned by the Bank's authorized representative and stamped.
3. Part III of this form should be completed by the Head of Human Resource Management in the
   Ministry/Department Headquarters. The Head of Human Resource Management should certify that the claimant is the eligible beneficiary.
4. Original burial permit should be attached in support of a claim for Last Expense.
5. Original death certificate should be attached in support of a claim for Group Life.
6. The original burial permit and death certificate will be returned to the Claimant on completion of the claim process.