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1. Name :

2. Age :

3. Occupation :

4. Monthly income: (TICK THE APPROPRIATE ONE)

< Rs 5000 Rs 5001-Rs 10,000 Rs 10,000- RS 15,000

Rs 15,001-Rs 20000 Rs 20,001-Rs 25,000 > Rs25,000

5. Do you have a Life Insurance Policy with any Life Insurance Company?

Yes No

6. If yes, name the Company___________________________________

7. What factors do you consider while buying a life insurance policy?

Premium Outflow Company Reputation

Service Quality Product Quality

Return on Investment

8. Which factors influenced to buy Life Insurance Policy?

Personal interest Friends Family

Agents Advertisements

Others

9. Do you prefer to invest your money in a Insurance company or in a Bank?

Insurance Company Bank

10. Are you satisfied with your current Life Insurance Company?

Yes No

If Yes Why? ___________________________________________

If No Why? ___________________________________________
11. How do you rate the service offered by your Life Insurance Company? (Tick on one)

Excellent Very Good Good Average Poor

12. How many Life insurance Companies do you know?

<5 5-7

8-10 >10

13. How do you rate the following Life Insurance Companies?

LIC

HDFC

ING VYSYA

MET LIFE INDIA INSURANCE

BAJAJ ALLIANZ

ICICI Prudential

TATA AIG

Others

14. Would you like to continue with the same Life Insurance Company?

Yes No

THANK YOU