Fire Insurance Questionnaire

A fire insurance questionnaire is a document drafted whenever an individual approaches an insurance company for insuring his property or vehicle from damages caused due to fire. The questionnaire comprises of questions regarding the kind of vehicle or property the individual wants to insure. The questionnaire also helps the insurance company to know whether the individual has taken any security measures to protect the object from fire. The premium amount and the sum assured are calculated based on this questionnaire.

Sample Fire Insurance Questionnaire:


Name: _____________________

Street Address: _________ Street ____________ City: ___________, State: ___________, PIN: _____________

Mobile number: _______________

Home phone number: _________________

Working Phone Number: ______________

Email Address: _____________________

Q1. What is the object that you want to insure?

a)   Vehicle

b)   Property

Q2. If it is a vehicle, what kind of vehicle is it?

a)   Car

b)   Bus

c)   Two wheeler

d)   Truck

e)   Other

Q3. If it is a property, what kind of property is it?

a)      Building

b)      Apartment

c)      Bungalow

d)     Mansion

Q4. Do you have any of the following security measures to protect the property from fire?

a)   Fire extinguisher

b)   Fire alarm

c)   Water sprinkler

Q5. How far is the property from the nearest fire station?

a)   Less than one kilometer

b)   Less than five kilometers

c)   Less than ten kilometers

d)   More than ten kilometers

Q6. Has there ever been damage due to fire earlier?

a)   Yes

b)   No

Q8. If yes, what was the reason for fire?


Q7. Was the property ever insured earlier?

a)   Yes

b)   No

Category: Insurance Questionnaire

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