Personal details:
1. Name: ___________________________________________
3. Email: ___________________________________________
4. Age: ___________________________________________
6. Occupation
Student
Self- employed
Professional
Retired
Service
7. Monthly Income:
Less Than 15000
15000 - 30000
30000 - 45000
45000 - 60000
More Than 60000
10-15 year
15-20 years
20-25 years
25-30 years
30-35 years
Family security
Retirement
Children’s future
Investment
Tax benefits
9. Do you have a Life Insurance Policy with any Life Insurance Company?
Yes
No
If Yes, Name the company ___________________________________________
Name the policy which you own _________________________________
10. What criteria do you consider while selecting a life insurance company?
Premium Outflow
Company Reputation
Service Quality
Product Quality
Return on Investment
14. Are you satisfied with your current Life Insurance Company?
Yes
No
15. How do you rate the service offered by your Life Insurance Company?
Excellent
Very Good
Good
Average
Poor
16. Would you like to communicate the service offered by your Life Insurance Company
to others?
Yes
N0
18. Would you like to continue with the same Life Insurance Company?
Yes
No