A travel insurance questionnaire helps in determining which travel policy the client is eligible for and what should be the stipulated policy amount. Based on the response to this questionnaire, the policy is issued. A travel policy questionnaire is made by travel agencies prior to the commencement of the travel.

Sample Travel Insurance Questionnaire

Name: _____________________________________________

Date of Birth: _________________

Please answer the questions given below.

1. What insurance category will you opt for? (Please tick all the correct options).

a. Health Insurance

b. Life Insurance

c. Wealth and Commodities Insurance

2. What will be the total duration of your journey?

a. Less then 1 week

b. 1 week – 3 weeks

c. More than 3 weeks

3. What will be the total no. of persons with you for the journey? (Please provide the total no. of heads including you)

a. Less than 3

b. 3 – 5

c. 5 – 8

d. More than 8

4. Are you planning for insurance for all the travellers?

a. Yes

b. No. Please provide the names of the persons, their ages and the type of insurance- _________________________________________________________________________________________________________

5. Provide the amount of cash and the monetary value of the articles that you will be taking during the journey?

a. Less then $20,000

b. $20,000 – $ 35,000

c. $35,000 – $50,000

d. More than $50,000

6. Does any of the travellers have been hospitalised during the last 6 months? (This question is applicable only if you are opting for a health insurance)

a. Yes. Please provide details _________________________________

b. No