First Assurance Health Insurance: The Agent Guide
First Assurance has been in the Kenyan market for decades. Their health products aren't the flashiest, but they're solid and competitively priced.
Here's what you need to know to sell them effectively.
Table of Contents
- Company Overview
- Product Portfolio
- Coverage Options
- Premium Structures
- Target Markets
- Selling Strategies
- Commission Structures
- Underwriting Requirements
- Claims Process
- Network and Access
- Competitive Positioning
- Objection Handling
- Agent Support
- The Bottom Line
- Next Steps
Company Overview
First Assurance Company Ltd is one of Kenya's established insurers with a strong presence in both general and life insurance.
| Aspect | Details |
|---|---|
| Established | 1984 |
| Ownership | Part of Pan Africa Group |
| Strengths | Competitive pricing, established network |
| Market position | Mid-tier, value-focused |
Product Portfolio
Individual Health Plans
| Product | Target Market | Key Features |
|---|---|---|
| First Health Individual | Individuals, families | Basic to comprehensive options |
| First Health Plus | Higher coverage needs | Enhanced limits, wider network |
| First Senior Care | Seniors 60+ | Age-specific coverage |
Group Health Plans
| Product | Target Market | Key Features |
|---|---|---|
| First Corporate Health | SMEs and corporates | Scalable coverage |
| First SME Package | Small businesses | Affordable group rates |
| First Managed Care | Large employers | Integrated healthcare management |
Coverage Options
Inpatient Benefits
| Tier | Annual Limit | Key Inclusions |
|---|---|---|
| Basic | KES 500,000 | Hospital, surgery, ICU |
| Standard | KES 1,000,000 | Above + pre-existing (waiting period) |
| Premier | KES 2,000,000 | Above + international emergency |
| Executive | KES 5,000,000+ | Comprehensive with higher sub-limits |
Outpatient Benefits
| Tier | Annual Limit | Key Inclusions |
|---|---|---|
| Basic | KES 50,000 | GP, lab, pharmacy |
| Standard | KES 100,000 | Above + specialist visits |
| Premier | KES 150,000 | Above + wellness benefits |
| Executive | KES 250,000+ | Comprehensive outpatient |
Optional Add-Ons
| Benefit | Typical Limit |
|---|---|
| Maternity | KES 100,000–200,000 |
| Dental | KES 30,000–50,000 |
| Optical | KES 20,000–40,000 |
| Last expense | KES 50,000–100,000 |
Premium Structures
Individual Premiums (Estimated)
| Cover Level | Individual (25–35) | Family (4 members) |
|---|---|---|
| Basic | KES 25,000–35,000 | KES 70,000–100,000 |
| Standard | KES 45,000–65,000 | KES 130,000–180,000 |
| Premier | KES 80,000–120,000 | KES 220,000–320,000 |
Group Premiums
| Factor | Impact on Premium |
|---|---|
| Industry risk | Higher risk = higher premium |
| Average age | Older workforce = higher premium |
| Claims history | More claims = higher renewal |
| Group size | Larger groups = better rates |
Target Markets
Best-Fit Clients
| Client Type | Why First Assurance Works |
|---|---|
| Price-sensitive individuals | Competitive premiums |
| SMEs with limited budget | Affordable group options |
| Clients wanting basics done well | No frills, reliable coverage |
| Budget-conscious families | Good value per person |
Harder Sells
| Client Type | Challenge |
|---|---|
| Premium-seekers | Not the most prestigious brand |
| International coverage needs | Limited international network |
| Luxury hospital expectations | Some exclusions on high-end facilities |
Selling Strategies
Value Positioning
Don't compete on prestige. Compete on value.
| Talk About | Not About |
|---|---|
| Premium savings | Brand prestige |
| Adequate coverage | Luxury features |
| Reliable claims | Maximum bells and whistles |
| Network accessibility | Exclusive facilities |
Comparison Approach
When comparing to premium competitors:
| Competitor Issue | First Assurance Advantage |
|---|---|
| Higher premiums | Save KES X per year |
| Similar actual coverage | Get what you need, pay less |
| Brand premium | Value-focused, same protection |
SME Pitch
Focus on:
- Affordable group rates
- Minimum lives for group: often lower than competitors
- Flexible plan structures
- Easy administration
Commission Structures
Typical Rates
| Product Type | Commission Range |
|---|---|
| Individual health | 15–20% |
| Family health | 15–20% |
| SME group (5–20 lives) | 12–15% |
| Corporate group (20+) | 10–12% |
| Renewals | 5–10% |
Production Bonuses
| Annual Production | Bonus |
|---|---|
| KES 1–3 million | 2–3% of premium |
| KES 3–5 million | 3–5% of premium |
| KES 5 million+ | 5%+ and special incentives |
Underwriting Requirements
Individual Applications
| Requirement | When Needed |
|---|---|
| Completed application form | Always |
| ID copies (all members) | Always |
| Medical questionnaire | Always |
| Medical exam | Age 50+ or high sums |
Group Applications
| Requirement | When Needed |
|---|---|
| Company registration | Always |
| Employee census | Always |
| Previous claims data | If transferring |
| Individual questionnaires | Groups under 10 sometimes |
Claims Process
Outpatient Claims
| Method | Process |
|---|---|
| Direct billing | Present card at network facility |
| Reimbursement | Pay, submit claim, get refunded |
| Turnaround | Direct instant, reimbursement 2–4 weeks |
Inpatient Claims
| Step | Timeline |
|---|---|
| Pre-authorization | Within 24 hours (emergencies faster) |
| Hospital admission | After approval |
| Direct billing | Hospital bills insurer |
Claims Tips for Agents
| Do | Why |
|---|---|
| Set expectations clearly | Avoid client disappointment |
| Help with first claim | Build relationship |
| Know the network | Guide clients to right facilities |
Network and Access
Hospital Network
| Category | Access |
|---|---|
| Public hospitals | Wide access |
| Private hospitals | Selected panel |
| Premium hospitals | Limited/co-pay |
| Upcountry | Generally good coverage |
Pharmacy Network
| Type | Coverage |
|---|---|
| Network pharmacies | Direct billing |
| Non-network | Reimbursement |
| Chronic medications | Usually covered with limits |
Competitive Positioning
First Assurance vs Competitors
| Factor | First Assurance | Premium Competitor |
|---|---|---|
| Premium | Lower | Higher |
| Network | Good | Extensive |
| Brand prestige | Moderate | High |
| Claims experience | Good | Good |
| Digital tools | Developing | Advanced |
When to Recommend First Assurance
| Situation | Recommendation |
|---|---|
| Budget is primary concern | Yes |
| Need basic to standard coverage | Yes |
| SME needing affordable group | Yes |
| Premium hospital is must-have | Maybe not |
| International coverage critical | Maybe not |
Objection Handling
"I've never heard of them"
"First Assurance has been in Kenya since 1984 — they're part of the Pan Africa Group, one of the region's largest insurance groups. They're established and reliable, just focused on value rather than flashy marketing."
"Are they financially stable?"
"Yes. They're regulated by IRA, have adequate reserves, and have been operating profitably for decades. Your claims will be paid."
"My friend is with [Premium Insurer]"
"Great insurers. The question is: what coverage do you actually need? If First Assurance gives you the same coverage for KES X less per year, that's money in your pocket."
Agent Support
What First Assurance Provides
| Support | Details |
|---|---|
| Training | Product and sales training |
| Materials | Brochures, rate cards |
| Dedicated staff | Agent support team |
| Commissions | Competitive rates |
| Systems | Agent portal for quotes and tracking |
Getting Started
- Complete agent registration
- Get licensed (if not already)
- Attend product training
- Receive agent code
- Start selling
The Bottom Line
First Assurance is your go-to when:
- Client cares about value
- Budget is a constraint
- Basic to mid-tier coverage is sufficient
- SME needs affordable group cover
Position them as the smart choice for value-conscious clients who don't need the premium brand.
Next Steps
- Get familiar with current rate cards
- Understand network hospitals in your area
- Identify value-focused clients in your pipeline
- Compare against premiums from competitors
- Use: BimaSasa Quote Comparison Tool
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