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Learn the WIBA claims process in Kenya, including DOSH 1, medical reports, employer duties, compensation assessment, documents and claim delays.
When an employee is injured at work, the first priority is medical care—not paperwork. But once the immediate danger has been addressed, the employer must move quickly.
A delayed accident report, incomplete DOSH form, missing payroll record or unclear medical assessment can turn a straightforward workplace injury into a long and frustrating claim.
This guide explains the WIBA claims process in Kenya, including employer responsibilities, DOSH forms, medical reports, temporary and permanent incapacity, death benefits, supporting documents and the role of the insurer.
Quick answer: After a workplace accident, the employer should arrange immediate medical attention, record the incident, notify the Directorate of Occupational Safety and Health Services using the prescribed DOSH form, inform the WIBA insurer and preserve all medical, employment, payroll and accident evidence.
Imana Insurance Agency Kenya Ltd helps Kenyan employers compare WIBA insurance quotations, understand claim requirements and coordinate communication with insurers.
For assistance, visit the WIBA Insurance page, submit a corporate quotation request or compare business insurance options through ImanaInsurance.com.
A WIBA claim is a statutory compensation process arising from an employee’s occupational accident or work-related disease.
The Work Injury Benefits Act, 2007 provides a framework for compensating employees who suffer injury, disablement, occupational disease or death arising out of and in the course of employment.
The Directorate of Occupational Safety and Health Services—commonly known as DOSHS or DOSH—administers the statutory work-injury process. DOSHS describes WIBA as covering work-related injuries and occupational diseases contracted in the course of employment.
WIBA insurance helps an employer finance this statutory exposure, subject to the policy terms. However, purchasing insurance does not remove the employer’s legal obligation to report accidents, maintain employment records, cooperate with investigations and protect employees.
The injured employee should receive appropriate first aid and be taken to a suitable medical facility when necessary.
In an emergency, treatment should not be delayed while waiting for:
The employer should record the name of the hospital or clinic, the treating doctor, the time of admission and the treatment provided.
Where possible, inform the medical facility that the injury occurred at work. This helps ensure that the medical notes clearly record the history and circumstances of the injury.
The employer should prevent further injury, isolate dangerous machinery or equipment and preserve the scene where an investigation may be required.
Do not destroy or alter relevant evidence unless this is necessary to rescue an injured person or remove an immediate danger.
Preserve:
Enter the accident in the workplace accident register and notify the responsible supervisor, human-resources officer, safety officer or management representative.
Record the basic facts while memories are still fresh:
Notify the insurer or Imana Insurance Agency immediately. Do not wait until treatment is completed or permanent incapacity is established.
Early notification allows the insurer to:
Insurance notification and statutory reporting to DOSHS are related but separate responsibilities. Informing the insurer does not automatically constitute notification to DOSHS.
The Ministry of Labour states that fatal accidents should be reported to the appropriate DOSHS county office within 24 hours, while non-fatal accidents should be reported within seven days using the prescribed DOSH 1 form.
An employee should also notify the employer as soon as reasonably possible after an accident.
Employers should not treat seven days as a waiting period. Report immediately once management learns of the occupational injury.
Where the accident involves a road traffic accident, assault, suspected criminal conduct, death or another reportable event, the police may also need to be informed.
ML/DOSH Form 1 is the official accident notification form used to report an occupational accident or disease to the Director of Occupational Safety and Health Services.
The Ministry of Labour publishes the current DOSH 1 Accident Notification Form through its official forms portal.
The form captures information about:
The employer should complete the relevant employer section accurately and submit it through the applicable DOSHS channel.
For a non-fatal injury, the medical practitioner may complete the medical-assessment section after examining or treating the employee. Where treatment is continuing, a final assessment may only be possible after the employee’s condition has stabilised.
Never submit a blank form bearing an employer’s signature or stamp. Keep a complete copy of every form submitted.
The expression “DOSH 2” is sometimes used loosely in workplace claims discussions to refer to a medical or follow-up assessment document. Employers must be careful because DOSH form numbering has changed over time, and unrelated occupational-safety forms also carry numbers beginning with “DOSH 2”.
Under the current WIBA process, the central accident-notification document is ML/DOSH Form 1. For non-fatal injuries, the medical practitioner records the assessment—including temporary incapacity or permanent disablement—in the applicable medical portion of the prescribed documentation.
Recent Kenyan decisions describe the non-fatal claim process as involving a completed DOSH 1, followed by medical assessment after treatment. The Director may then calculate the benefit and issue a DOSH/WIBA 4 demand for payment.
Therefore, an employer should not download an unofficial “DOSH 2” from an unverified website and assume it is the correct claim form.
Always confirm the exact current form required with:
This protects the employer from submitting an obsolete or unrelated document.
The medical evidence establishes the nature, cause, duration and severity of the employee’s injury or illness.
Depending on the claim, the employer or insurer may require:
The medical history should clearly connect the condition to the reported occupational accident or workplace exposure.
Medical practitioners should avoid assigning final permanent incapacity before the employee’s condition has stabilised. The insurer or Director may request a further examination where the initial evidence is incomplete or inconsistent.
An occupational injury usually arises from an identifiable workplace event.
Examples include:
The date, time, location and mechanism of injury can normally be identified.
An occupational disease may develop gradually because of workplace exposure.
Examples can include:
An employee and employer may need medical and occupational evidence showing that the disease arose from or was materially connected to the employment.
This may require:
A diagnosis alone does not automatically establish occupational causation.
Temporary incapacity occurs where an employee is unable to perform normal work for a limited period but is expected to recover.
It may be:
Evidence may include:
Employers should maintain contact with the employee and document any suitable modified duties offered.
A temporary incapacity claim should not be closed merely because the employee has returned to work if treatment is continuing or a permanent impairment remains possible.
Permanent incapacity arises where an employee is left with a lasting physical or functional impairment after reaching maximum medical improvement.
The medical practitioner assesses the extent of permanent disablement using the applicable statutory framework. The Director then considers the medical assessment, earnings and WIBA provisions when determining compensation.
Permanent incapacity may be:
Examples can include:
The insurer should not independently invent a disablement percentage. The statutory process and assessment by the Director remain central to the WIBA award.
A fatal workplace accident requires urgent action.
The employer should:
A fatal claim may require:
The identification of dependants is a statutory process. Employers should not decide informally who receives the compensation.
Recent WIBA proceedings describe the Director as calculating fatal benefits after identifying the dependants, apportioning the compensation and issuing the applicable demand for payment.
WIBA provides for reasonable funeral expenses in a qualifying fatal occupational claim, subject to the applicable statutory framework and policy arrangements.
The employer should retain:
Do not promise the family a specific reimbursement before the insurer and DOSHS confirm the applicable benefit and required evidence.
Funeral expenses are separate from compensation payable to the deceased employee’s lawful dependants.
WIBA compensation calculations can depend on the employee’s earnings and assessed degree of incapacity.
The employer may be asked for:
Recent court proceedings describing DOSHS requirements identify payslips for the month of the accident, the preceding month and the following month among the documents requested for private-sector claims.
Cash-paid and casual employees are not automatically outside the WIBA process. Employers should maintain credible records showing when the employee worked, what duties they performed and how much they earned.
Unclear payroll records can delay the calculation of compensation.
An employer’s responsibility does not end after buying a WIBA policy.
Employers should:
The employer remains responsible for compensation where required by law. Insurance is the financial mechanism used to transfer eligible WIBA exposure; it is not a substitute for compliance.
After receiving notification, the insurer may:
The insurer may investigate the claim, but DOSHS has the statutory role of administering and determining work-injury benefits.
Once an award is determined, DOSH/WIBA Form 4 may be issued as the demand for payment. After payment, DOSHS indicates that a WIBA 7 payment certificate is issued and the investigation file may be closed.
There is no honest one-size-fits-all settlement period.
A straightforward temporary-incapacity claim with complete documents may progress faster than a claim involving:
The employer can reduce avoidable delays by reporting promptly, keeping a complete claim file and responding quickly to document requests.
Never publish a guaranteed settlement timeline unless it appears in the specific insurer’s written service commitment and applies to that particular claim.
Common causes include:
Delayed notification makes it harder to investigate the scene, interview witnesses and verify the employee’s account.
Missing signatures, blank sections, incorrect dates or absent employer stamps can cause forms to be returned.
A claim cannot be assessed properly without evidence of the diagnosis, treatment, recovery period and final outcome.
Permanent incapacity cannot always be determined until the employee’s condition stabilises.
Incomplete payroll or casual-worker records can prevent accurate benefit calculation.
The employer may dispute whether the injured person was an employee, contractor, visitor or unauthorised worker.
Questions may arise about whether the injury happened during employment or whether an illness was caused by workplace exposure.
Differences between the employee’s statement, employer’s report, medical history and witness evidence may trigger investigation.
Fatal claims may be delayed while lawful dependants are identified and their documents verified.
The insurer may need to investigate employees, occupations or earnings that were not properly declared when the policy was arranged.
For broader guidance, read Why Insurance Claims Are Delayed or Declined in Kenya.
WIBA and Group Personal Accident insurance are not the same.
WIBA addresses an employer’s statutory responsibility for occupational injuries and diseases arising out of and in the course of employment.
GPA normally provides defined accident benefits under the policy and may operate on a broader basis, such as 24-hour accident protection, where that wording has been purchased.
GPA does not automatically replace WIBA. Many employers arrange both:
The policy schedules, insured persons, occupations, territorial limits and benefit structures should be reviewed carefully.
Before submitting the claim, check whether you have:
The exact requirements will depend on the circumstances. Ask for a written claim checklist at the beginning of the process.
Where an affected party disagrees with the Director’s decision, the objection and appeal procedures provided under WIBA should be followed.
The Ministry of Labour publishes an OSH/WIBA objection and appeal form through its forms portal.
Do not ignore a DOSHS assessment or demand. Obtain professional guidance promptly because statutory objection periods may apply.
Imana Insurance Agency Kenya Ltd can help an employer by:
Imana does not replace DOSHS, determine incapacity percentages or issue statutory awards. Those responsibilities remain with the authorised medical practitioners, DOSHS and other relevant authorities.
Employers should establish a written internal accident procedure before an incident happens.
The procedure should identify:
A claim file should be opened immediately for every reported occupational accident, even where the injury initially appears minor.
Small injuries can develop into serious or permanent conditions. Paperwork should not begin only after the employee’s condition worsens.
WIBA pricing is influenced by:
An office-based employer will generally present a different risk from a construction company, factory, transport operator, security company or logistics business.
Do not compare WIBA quotations using premium alone. Compare:
Visit the WIBA Insurance Authority Page or submit the Corporate Insurance Quotation Form.
You can also use:
The employer should report the accident to DOSHS using the prescribed form and notify the WIBA insurer. The employee should inform the employer as soon as possible.
DOSH 1 is the prescribed accident-notification form at the centre of the current DOSHS work-injury process.
A late report should still be submitted immediately, accompanied by an honest explanation. Late reporting may complicate the investigation and should never be treated casually.
An apparently minor injury can worsen. Employers should record every workplace accident and obtain guidance on statutory reporting instead of making assumptions based only on the initial appearance.
The answer depends on the facts, the statutory connection to employment and the policy terms. Ordinary commuting should not automatically be treated as covered or excluded without examining the circumstances.
WIBA can respond to qualifying occupational diseases, but medical and workplace evidence must establish the required relationship between the disease and employment.
A qualified medical practitioner assesses the medical impairment, while the Director of Occupational Safety and Health Services administers the statutory compensation process.
No. GPA and WIBA serve different purposes. Employers may purchase both as part of a wider employee-protection programme.
No. The insurer and DOSHS handle the relevant insurance and statutory decisions. Imana assists with documentation, communication and follow-up.
For WIBA claims guidance, policy review or quotation comparison, contact:
Imana Insurance Agency Kenya Ltd
4th Floor, Krishna Centre
Woodvale Grove, Westlands, Nairobi
Call/WhatsApp: +254 796 209 402
Websites:
Imana Insurance Agency Kenya Ltd is a Westlands-based insurance intermediary helping individuals, families and businesses compare insurance quotations from licensed Kenyan insurers across Motor, Medical, WIBA, PSV, Travel, Motorcycle, Cyber, SME/Corporate and other insurance classes.
Author: Raymond Momanyi
Founder & CEO, Imana Insurance Agency Kenya Ltd
Disclaimer: This article provides general information and does not replace the Work Injury Benefits Act, official DOSHS instructions, legal advice or the terms and conditions of a particular insurance policy. Employers should confirm current forms and procedures with DOSHS and their insurer.