Insurance Questionnaire Template

The primary objective of an insurance questionnaire is to help insurance advisors, experts from the insurance industry, and insurance professionals to determine how people are making investments in insurance. It is all about understanding what people need and then satisfy that need. The insurance questionnaire template is a ready to use document and can be created in such a way that it addresses people’s insurance requirements – both existing and future.

Sample Insurance Questionnaire Template:

Name: ____________________________ [Name of the insured]

Address: ___________________________________ [Home Address of the insured]

Gender: _____________________ [Gender of the insured (M/F)]

Age: ___________________ [Age of the insured]

Email: ______________________________ [Email Address of the insured]

Policy Number: _______________________ [Insurance policy number of the insured]

Type of Insurance: _____________________ [Insurance policy type of the insured]

Q1. How long have you had this insurance cover?

  • Less than a year
  • More than 1 year
  • More than 2 years
  • 2-5 years
  • More than 5 years

[The participant needs to check one option. This answer will show the duration of insurance policy covers]

Q2. Which of the following other insurance covers do you currently own?

  • Renter Insurance
  • Fire Insurance
  • Home insurance
  • Car Insurance
  • Health Insurance
  • Pet Insurance
  • Accident Insurance
  • Life Insurance
  • Travel Insurance
  • Other Insurance

[The participant can check multiple options depending on the insurance policies they own. Highlights the most in demand policy covers]

Q3. Do you stay in an area where the following natural catastrophes are predominant?

  • Earthquake
  • Volcano
  • Hurricane
  • Hail storm
  • Wildfire
  • Avalanche
  • Tornado
  • Flash floods
  • Don’t stay in such an area

[The participant needs to check one/multiple options.]

Q4. Do you have any insurance policy for the above? If yes then please specify if the cover is an add-on or full policy cover.

  • Yes
  • No
  • Type of policy:_____________________________

[The participant needs to provide information regarding the type of natural catastrophe policy that they have and how long they have had it]

Q5.  Have you paid a deductible on your insurance policy cover? If yes then please mention the amount.

  • Yes
  • No
  • Deductible: $____________

[The participant needs to mention the amount of deductible.]

Category: Insurance Questionnaire

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