QUESTIONNAIRE

Penetration level in Mumbai city by Insurance organizations

Dear Sir/Madam,

We are conducting a survey on Penetration level in Mumbai city by Insurance organizations. We hope
for your kind coordination. Any information provided by you will be treated as “Confidential” and will
not be disclose for any other purposes.

Name: Mob No:

Address:

Marital Status: - Married/ Unmarried (mark) Age:

Sex: - M / F (mark)

Profession: E-mail:

1. Family Members: (Please tick)

a)1-4 [ ] b) 4-8 [ ] c) 8-12 [ ]

d) 12-16 [ ] e) 16> [ ]

2. Number of dependent family members: (Please Tick)

a) 1-2 [ ] b) 2-4 [ ] c) 4-6 [ ]

d) 6-8 [ ] e) More: …………………………

3. Occupation: (Please Tick)

a) Service [ ] b) Business [ ] c) Professional [ ]

b) d) Any other: ………………………………………...

 4. Annual Income: (Please Tick)

a) 50000-100000 [ ] b) 100000-300000 [ ] c) 300000-500000 [ ]

c) 500000-1000000 [ ] e) 1000000 [ ]

5. In which would you like to invest? (Please Tick)

a) Fixed deposit [ ] b) Post office [ ] c) Mutual fund [ ]

d) Share buying [ ] e) Insurance policy [ ]

6. Do you have any insurance policy? (Please Tick)

a) Yes [ ] b) No [ ]

7. Which sector do you prefer? (Please Tick)

a) Public Sector [ ]

b) Private Players [ ]

8. Do you have any Insurance policy in the Following companies? (Please Tick)

a) LIC [ ] b) Tata AIG [ ] c) Birla Sun life [ ]

c) ICICI [ ] e) Max New York [ ] f) Any Other: …………

9. Which type of policy do you prefer? (Please Tick)

a) Life Insurance [ ] b) Vehicle Insurance [ ] c) Pension plan [ ]

d) Medi claim [ ] e) Any Other: ……………………

10 How do you come to know about these company products?

a. News paper
b. Agent
c. Advertisement
d. Mouth of spread

11 Are you satisfy with the plans of these companies?

a. Yes b. No

Any Comments:

………………………………………............………………………………................................
………………………………………………………………………………….…………...
………………………………………………………………………………………………………
………....

Thank you, for your kind co-operation.

Signature: …………………………………..

Date: ………………………………………..