Fill your Group Policy Claim

Claim Request Type *Select Claim Request TypeGroup/AssociationChurchBoafa Pa

Type of policy *Select Type of policyGroup FuneralAlumni PolicyWelfare (Yiedie)

Name of Group/Church *

Type of claim request *Select Type of claim requestDeathCritical illnessTotal Permanent DisabilityMarriageChildbirthHospitalization

Policy Number

Boafo Pa Policy Number

Name of Policy Holder *

First

Last

Deceased Details

Name of deceased/Insured *

First

Last

Date of Death/incident *

Place of death/incident *

Age of deceased/Insured *

Relationship to Policyholder *

Death Document(s) Attached

Please selected document available *

• Letter from the Church/Group
• Endorsers' form
• Mortuary Receipt
• Burial Permit
• Police Report
• Post Mortem Report
• Death Certificate
• Medical Cause of death
• Medical/Doctor's report
• Other

Upload Document *

Click or drag files to this area to upload. You can upload up to 10 files.

Payment Options *Select your preferred payment optionMobile Money (Below GH¢5000)Bank Transfer

Mobile Money Number

Mobile Money NetworkSelect Mobile NetworkMTNTelecelAirtelTigo

Select BankSelect your bankGhana Commercial Bank (GCB) BankEcobank GhanaAbsa Bank GhanaStandard Chartered Bank GhanaFidelity Bank GhanaCalBankStanbic Bank GhanaZenith Bank GhanaUnited Bank for Africa (UBA) GhanaAccess Bank GhanaFirst National Bank GhanaRepublic Bank Ghana (formerly HFC Bank)Consolidated Bank Ghana (CBG)Prudential Bank GhanaBank of Africa GhanaOmniBSIC Bank Ghana (merged from OmniBank and BSIC)Agricultural Development Bank (ADB)National Investment Bank (NIB)Guaranty Trust Bank (GTBank) GhanaSociété Générale Ghana

Account Holder Name

Account Number

Branch Code

Branch Name

Name of Scheme Administrator *

First

Last

Mobile Number *

Email Address

Submit

MOtor claims

Non-MOtor claims

Life Insurance Claim