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Application forms

Forms that you are able to apply for certain products

Individual Plan Offerings Application Form
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Soma Plan Application Form
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Kuza Plan Application Form
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Claims forms

Complete the necessary claims forms. Please note: submit all completed funeral claim forms and follow ups to funeralclaims@liberty.co.ug

Certificate of Continued Disability Form
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Critical Illness Claim Form
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Death Claim Form
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Disability Claimant’s Statement Form
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Confidential Extract from Records Form (PMA)
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Funeral Claim Form
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Hospital Cash Plan Claim Form
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Personal Accident Claim Form
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Physical Impairment Claim Form
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Retrenchment Claim Form
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Statement by Police Form
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