Amity School of Insurance, Banking & Actuarial

Science
Questionnaire: Health Insurance Need & Adequacy
Part- A. General information
1. Name:

____________

2. Place:

____________

3. Gender:

a. Male

b. Female

4. Age:
a. Less than 30 years

b. 30-40 years

c. 40-50 years

d. Above 50 years

5. Occupation
a. Employed

b. Self employed

c. Labour

d. Housewife

e. Unemployed

f. Professional

g. Family owned business

h. Retired

6. Income per annum (in Rs.):

a. Less than 100000

b. 100000-200000

d. 300000-400000

e. Above 400000

c. 200000-300000

7. Do you have health insurance policy?

a. Yes

b. No

If Yes, then provide the answer for Part-B and if No, then provide the answer for Part-C
Part-B. For Health Insurance Policy Holder
8. Who is your insurer?
a. Public Company

b. Private company

c. Any other (specify) ___________

9. What type of Health Insurance Policy you have?
a. Individual Health Insurance

b. Group Health Insurance

c. Family Floater Health insurance

d. Other (specify) __________

10. Who persuaded you to purchase the policy?

a. Insurance officials

b. Relatives

c. Friends

d. Advertisement

e. Income Tax Advocate

f. Colleagues

g. yourself

h. Other (specify) ___

11. Do you agree that the services provided by the insurance companies are delivered
effectively?
a. Yes

b. No

c. Indifferent

12. Are you willing to pay more for additional services, which can be included in your health
insurance package?
a. Yes

b. No

13. Do you think the promotional efforts being taken by insurance company are
sufficient?
a. Yes

b. No

14. How the awareness of health insurance can be increased? Rank the following by assigning 1
to most effective way of enhancing awareness and 10 to least effective way of enhancing
awareness.
a. Newspapers
b. Conference and Seminars
c. Incentives to policy holders

d. Renewal notice by insurance companies

e. Advertisement
f. Sponsoring event by insurance companies
g. Internet (World Wide Web)
h. Road shows, fare & festivals
i Introducing saving linked insurance
j. Making health insurance mandatory

15. Have you ever logged claim with the insurance company?
a. Yes
b. No

16. If yes, how would you rate the following factors? Please give your response on five point
Likerts Scale ranging from Strongly Agree to Strongly Disagree:
Note: - SA Strongly Agree, A Agree, I Indifferent, D Disagree, SD Strongly
Disagree.
Statements

SA A

SD

a. Hassle free claim application process

b. Hassle free claim settlement
c. Claim settlement within a limited period
d. Claim logged fully Settled
e. Claim logged partially settled
f. Claim settled with limited terms and conditions
g. Cooperation and attitude of TPAs
17. Which of the following mode you have resorted in case of partial or no settlement of
health insurance claim?
a. Ombudsmen

b. Insurance Regulatory Development Authority cell

c. Consumer Court

d. Any other (specify) __________

Part- C. For Non Health Insurance Policy Holders

18. Do you know about Health Insurance?
a. Yes

b. No

19. If yes, what are the sources of information?

a. TV

b. Newspaper

c. Agents

d. Family

e. Friends

f. Movies

g. Employees of Insurance Companies

h. Tax consultants and Doctors
i. Other (specify) ______

20. Why you have not taken Health insurance Policy? Please give your response for the
followings on the five point likerts Scale ranging strongly agree to strongly disagree:
Note: - SA Strongly Agree, A Agree, I Indifferent, D Disagree, SD Strongly Disagree.
Statements

SA

SD

a) Low salary/non availability of funds

b) Dont feel the need for it
c) Prefer to invest money in some other areas
d) Unaware about it
e)
f)
g)
h)
i)
j)
k)
l)

No one suggested about it

Difficulty to approach insurance agents
Inadequacy of knowledge on the part of insurance agents
Linked hospitals are not easily accessible
Difficulty in availing services in hospitals
More copayment involved
More deductible applicable
More hidden cost involved

21. Which insurance company you will prefer?

a. Public Company

b. Private company

c. Any other (specify) _____

22. Which type of health insurance policy do you prefer more?

a. Individual Health Insurance

b. Family Health Insurance

c. Family Floater Health Insurance

d. Other (specify) __________

23. At what age would you ideally prefer to get selves and family insured?
a. 0-25

b. 25-35

c. 35-45

d. 45-55

e. 55-65

f. 65 & Above

24. How you would like to pay health insurance premium amount?
a. Half monthly

b. Monthly

d. Half yearly

e. Yearly

c. Quarterly

Thanks for providing valuable time and cooperation in this study.