TERM QUESTIONNAIRE
Name of the Organization:
_________________________________________________________
Type of Group:
Type of Industry:
Service
Formal
Informal
Software
IT
Manufacturing BPO
Others please specify
_______________________________________
Name of the Contact Person:
______________________________________________________
Designation:
Head
Number of employees in the organization:
__________________________________________
Do you have Group Term Life Insurance policy:
Yes
No
If yes, name of the current Insurer:
________________________________________________
How many years has the scheme been in force?
or more
1 year 2 years 3 years
Renewal month of the GTL policy:
_______________________________________________
Sum assured:
Graded
Multiple of Salary
Premium size:
___________________________________________________________
Premium rate per 1000 Sum assured (Ex ST):
_______________________________________
Is broker involved?
Yes No
Flat cover
If yes, then name of the Insurance broker:
__________________________________________
Are you happy with the service of the current insurer with respect to claim
settlement? Yes No