SURVEY OF LIFE INSURANCE

"QUESTIONNAIRE"

PART A (BACKGROUND INFORMATION)

1. Name : _________________________

2. Age (in years) : _________________________

3. Sex :

a) Male b) Female

4. Marital Status :

a) Married b) Unmarried
_________________________
5. Educational Qualifications :

a) Illiterate b) Below Matric

c) Matric d) Graduate

e) Post-graduate f) Any Other

6. Source of earning : _________________________

7. Nature of Job :

a) Temporary b) Permanent

8. Family Income :
 Any other

SURVEY OF LIFE INSURANCE

PART - B

1. Are you insured?

a) Yes b) No

2. From which sector you insured

a) Public b) Private

3. From which private insurance company you are insured?

a) ICICI Prudential b) Bajaj Allianz
c) HDFC Standard d) Any other _____________
(Please mentioned the name)
4. Who influence you to get insured?
a) Insurance agent b) Electronic media
c) Print media d) Friends & relative
5. How many insurance policies you have?
a) Up to 3 b) More than 6
b) 4 to 6
6. For what you have insured your self?
a) For saving b) For covering risk to life
c) For tax benefits d) For security to family
e) All of the above f) None of the above
7. Which of the following policies you have?
a) Endowment policy b) Single premium policy
c) Children policy d) Pension plan policy
e) Money back policy f)
 No

8. What is the term of the policy?

a) Up to 5 years b) 6 to 10 years
c) 11 to 15 years d) 16 to 20 years
e) Above 20 years
9. Have you received survival benefits so for against money back
policy?
a) Yes b) No
10. If yes, how many times you have received it?
a) 1 b) 2 c) 3
11. How would you like to pay premium?
a) Monthly b) Quarterly
c) Half yearly d) Yearly
12. Are you regularly paying the premium?
a) Yes b) No
13. Has your policy lapsed any time due to non-payment of insurance
premium?
a) Yes b) No
14. Have you received any incentive from insurance agent on
insurance premium?
a) Yes b) No
15. If yes, up to what percentage?
a) 10 b) 26-50
c) Above 50
16. Are you aware about accidental insurance claims?
a) Yes b) No
17. Are you aware about the insurance bonus of the polices?
a) Yes b)