General Insurance Questionnaire
A general insurance questionnaire is a useful document to gauge the consumer attitude and acceptance of the general insurance policies. The questionnaire can be analysed for developing the performance of such policies.
Sample General Insurance Questionnaire:
First Name: _______________________ Last Name: _____________
Full Address: _____________________________
Phone Number: ________________________
Email address: _________________________
Gender: ______
Date of Birth: ___/___/___
Q1. Please mention your gross income
$ ______________
Q2: Please mention your type of occupation
a) Private employee
b) Government employee
c) Own business
d) Others, please mention ___________________________________
Q3: What is your duration of work experience?
Experience in months: __________
Q4. Which of the following general insurance policies have you taken?
a) Home insurance
b) Car insurance
c) Fire insurance
d) Health insurance
e) Any others, please mention ________________________________
Q5: Have you undergone any medical surgeries or treatments earlier?
a) Yes
b) No
Q6. If the answer to the above question is ‘yes’, please provide the details of the medical history
Illness: ______________ Treatment: _________________________ Date: ___________
Illness: ______________ Treatment: _________________________ Date: ___________
Q7. Please provide the current status of these illnesses
Illness: ______________ Status: _____________________________________________
Illness: ______________ Status: _____________________________________________
Q8: For which of the following do you want to take a general insurance?
a) Two-wheeler
b) Four-wheeler
c) Home
d) Health
e) Travel
f) Accident Cover
g) None
Q9. If the answer to the above question is ‘none’, please provide a reason for not opting for these general insurance policies
___________________________________________
Q10. Have you ever claimed reimbursement for any insurance coverage for loss incurred?
a) Yes
b) No
Q11. If the answer to the above question is ‘yes’, please provide your opinion on the kind of response received from the insurer?
___________________________________________
Category: Insurance Questionnaire
