Scribd
Upload
119 views4 pages

Customer Questionnaire: PART-1 (General Information)

The document is a customer questionnaire for a life insurance company. It collects general customer information including name, age, gender, occupation, income and current insurance company. It asks how long the customer has been with their current insurance company and their primary purpose for purchasing life insurance. The second part evaluates customer expectations regarding the insurance company's service quality. It addresses tangible aspects like technology, facilities and employee appearance. It also evaluates the company's responsiveness, assurance through employee knowledge and courtesy, and empathy through attention to individual customer needs.

Uploaded by

Abhinav Rana
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
119 views4 pages

Customer Questionnaire: PART-1 (General Information)

The document is a customer questionnaire for a life insurance company. It collects general customer information including name, age, gender, occupation, income and current insurance company. It asks how long the customer has been with their current insurance company and their primary purpose for purchasing life insurance. The second part evaluates customer expectations regarding the insurance company's service quality. It addresses tangible aspects like technology, facilities and employee appearance. It also evaluates the company's responsiveness, assurance through employee knowledge and courtesy, and empathy through attention to individual customer needs.

Uploaded by

Abhinav Rana
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Customer Questionnaire

PART-1 (General Information)

1) Name:

2) Age:

3) Sex: □ Male □ Female

4) Occupation: □ Business
□ Service
□ Agriculture

□ Others

5) Monthly Income: □ Up to ₹20,000

□ From ₹21,000 to ₹40,000

□ From ₹41,000 to ₹60,000

□ From ₹61,000 to ₹80,000

□ From ₹81,000 and above

6) Please choose your life insurance company from below:

□ Bajaj Allianz Life Insurance Co. Ltd.

□ Birla Sun Life Insurance Co. Ltd

□ HDFC Standard Life Insurance Co. Ltd.


7) For how long have you been a customer of your present Life
Insurance Company?
□ Less than 3 years
□ 3-6 years
□ 6-9 years
□ Above 9 years

8) What is your purpose of buying the insurance policy?


(Rate from 1*5 according to your reason for buying ‘’1’’ meaning
the most important reason and ‘’5’’ meaning least important.)

□ Tax Saving

□ Pension

□ Other
PART – 2 (Expectation Section)
Please check your extent of agreement or disagreement with the
feature described by each statement related to the Life Insurance
Companies that would deliver excellent quality of service:

Tangible Dimension Strongly Agree Neutral Disagree Strongly


Agree Disagree
Q Will have service equipment
1 and will support latest
technology.
Q Will have physical
2 infrastructure which is
visually appealing.
Q Employees and agents will
3 be smart and have an
attractive appearance.
Q Responsiveness
Will provide detail Strongly Agree Neutral Disagree Strongly
4 information about products Agree Disagree
andDimension
packages.
Q Will have a clean service
Q1 Personnel of the company will
5 area.
tell patients exactly when
services will be performed.
Q2 Personnel of the company will
always be willing to help
customers.
Q3 Personnel of the company will
never be too busy to respond
to customer’s request.
Q4 The employees of the
company will provide prompt
service.
Q5 Employees of the company
take actions immediately
when I make complain.

Assurance Strongly Agree Neutra Disagree Strongly


Agree l Disagree
Dimension
Q1 The behaviour of personnel in
the company instils
confidence in you.
Q2 You feel safe in your dealings
with the company.
Q3 Personnel in the company
are consistently courteous
with you.
Q4 Personnel in the company
have the knowledge to
answer your question.
Q5 Employees of the company
are knowledgeable about
their products.
Empathy Strongly Agree Neutra Disagree Strongly
Agree l Disagree
Dimension
Q1 The company gives you
individual attention.
Q2 The personnel of the
company understand your
specific needs.
Q3 The company has operating
hours convenient to all its
customers.
Q4 The company has my best
interest at heart.
Q5 The employees of the
company give you personal
attention.

You might also like