---
title: "Omba Bima ya Maisha Tanzania | Life Insurance Request Form"
description: "Jaza fomu ya kuomba bima ya maisha. Tutawasiliana nawe haraka. Fill life insurance request form. We'll contact you quickly."
url: "https://www.milvik.co.tz/bima-ya-maisha-ombi"
language: "en"
---

[ Rudi kwa Orodha ya Bei Back to Pricing ](/bima-ya-maisha)

#  Omba Bima ya Maisha Request Life Insurance

Jaza fomu hapa chini na tutawasiliana nawe ndani ya masaa machache Fill the form below and we'll contact you within a few hours

Jina Lako Kamili Your Full Name \*

Nambari ya Simu Phone Number \*

Tutatumia nambari hii kukupigia simu We'll use this number to call you

Umri Wako Your Age \*

Umri 18-65 tu Age 18-65 only

Mpango Unaopendelea Preferred Plan \* \-- Chagua Mpango -- Msingi \(TSh 2,500/mwezi\) Premium Chini \(TSh 4,500/mwezi mtu mmoja\) Premium Wastani \(TSh 6,500/mwezi mtu mmoja\) Premium Juu \(TSh 11,000/mwezi mtu mmoja\)

Idadi ya Familia Yako Your Family Size

💡 Hii inasaidia kujua ni mpango gani unafaa zaidi 💡 This helps us know which plan suits you best

Kwa Nini Unahitaji Bima ya Maisha? Why Do You Need Life Insurance?

💡 Mfano: Nataka kulinda elimu ya watoto wangu, nina mkopo wa nyumba, nataka kusaidia mke wangu... 💡 Example: Want to protect my children's education, have house loan, want to help my spouse...

Maswali Mengine au Maoni Other Questions or Comments \(Si Lazima\) \(Optional\)

Tuma Ombi Langu Submit My Request

Maelezo yako ni salama na yatatumika tu kwa mawasiliano na BIMA Your information is secure and will only be used by BIMA to contact you

##  Ahsante Sana\! Thank You\!

Ombi lako la bima ya maisha limepokewa. Timu yetu itawasiliana nawe kupitia simu ndani ya masaa machache kuelezea zaidi na kusaidia kumaliza usajili. Your life insurance request has been received. Our team will contact you by phone within a few hours to explain more and help complete registration.

**Je, una swali la haraka?** **Have an urgent question?**

[ 0659 071 001 ](tel:0659071001) [ WhatsApp ](https://wa.me/255658104193)

[ Rudi kwa Orodha ya Bei Back to Pricing ](/bima-ya-maisha)

Au wasiliana nasi moja kwa moja: Or contact us directly:

[ 0659 071 001 ](tel:0659071001) | [ 0658 104 193 ](https://wa.me/255658104193) | \*150\*01\#