Secure digital service

Get Insured

Complete your application in a clear, guided process. You can upload supporting documents and sign online.

Secure online application

Get insured

Choose a product and cover level, then provide the details available to you. KYC uploads, next-of-kin details, declaration acceptance and signature are optional.

✓Your information is sent securely to the Rise Capital team.

1Product

2Your details

3Family & health

4KYC & declaration

Choose your protection

Your selection will display the configured monthly premium.

Product * Level of cover * Cover type *

Indicative monthly premium—

Final premium is subject to the selected cover and application assessment.

Life assured

Tell us about the principal person to be covered.

Title * First name * Surname * Date of birth * National ID * E.C. Number Email * WhatsApp contact number * Residential address *

Next of kin and dependants

Add next-of-kin and dependant details where available. These fields are optional.

Next of kin

Full name (optional) National ID (optional) Contact number (optional) Relationship (optional)

Dependants

Health questions

Do you have any medical conditions? * Have you been scheduled for a surgical procedure in the past 12 months? * Provide details for any “Yes” answer

KYC and declaration

KYC uploads, declaration acceptance and electronic signature are optional at this stage.

National ID copy (optional)PDF, JPG or PNG Current payslip or proof of income (optional)PDF, JPG or PNG

Electronic signature (optional)

You may use your mouse or finger to sign inside the box, or leave it blank.

Declaration

I declare that the information supplied in this application is true and complete. I understand that inaccurate or incomplete information may affect acceptance of the application or any future claim. I authorise Rise Capital to use the information supplied for underwriting, administration and regulatory purposes in accordance with applicable law.

I have read, understood and accept this declaration.