Insurance Research Survey
A. PREAMBLE
In order to ascertain the overall preferences from demographic aspect, please check the appropriate box.


A1. Personal Details:

a. Age Group

21-30  31-40  41-50  51-60  60 +

b. Sex

Male  Female

c. Marital Status

Married  Single  De-facto

d. Employment Status

Full Time  Part Time Student  UnemployedNever employed
 
e. Work Status

Employee  Self-employed  Contractor  Casual  Not applicable (N/A)

f. Industry

IT  Education  Accounting  Finance Sales Engineering  Health
Hospitality  Construction  Legal Not applicable (N/A) Other (specify) 

g. Income

up to $49,999  $50,000 - $74,999  $75,000 - 99,999 $100,000 - $149,999 $150,000 - $199,999  $200,000 +

h. Dependents

Nil  One  Two  Three  Four Five and more 
A2.    Living in Australia
a. How long have you lived in Australia?

Less than 5 years More than 5 years  More than 10 years More than 20 years  Whole life

b. What is your residential status?

Australian Citizen  Permanent Resident  Temporary Resident

c. Please select your background:

Africa Arab States Asia Europe North America Pacific Islands (Oceania) South America (Carribeans) 
B.    INSURANCE


B1.   Car Insurance
a. Do you have any car insurance?

Yes  No (please go to next section)

b. Which cover do you have?

Comprehensive  Third Party Damage Third Party Damage plus Fire and Theft

c. Please tick your car insurance company

AAMI  Allianz  CGU  GIO  NRMA  QBE Vero 
Other (please specify) 

d. Which car do you own?

Alfa Romeo Audi Bentley BMW
Chevrolet Chrysler Ford Holden
Honda Jeep Lexus Mercedes Benz
Nissan Saab Suzuki Subaru Toyota
Volkswagen  Other (please specify) 

e. Please specify the year your car was made

For example: 2010
f. How long do you have this cover for?

Less than 1 year  1 – 2 years  2 – 5 years 5 - 10 years More than 10 years

g. You bought this car as:

New  Used


h. How did you apply this cover?

Online  Over the phone  Through broker 

i. How did you hear about the company?

TV advertisement  Paper advertisement  Search Engine Word of mouth  Broker’s recommendation Other (please specify) 

j. Are you looking to change the company?

No
Yes (please specify what you are not happy about) 

k. Please rank the company for their service from 1 to 10 (min-max)
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l. Please rank the company for their premium cost from 1 to 10 (min-max)

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m. Please rank the company overall from 1 to 10 (min-max)
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n. Any comment (what you like or not like about this company)

B2.   Health Insurance
a. Do you have any health insurance?

Yes No (please go to next section)

b. Which cover do you have?

Hospital and Extras Cover Hospital Cover Only Extra Cover Only

c. Please tick your private health insurance company:

AHM  HCF  MBF  Medibank  NIB  Other, please specify 

d. How long do you have this cover for?

Less than 1 year  1 – 2 years  2 – 5 years 5 – 10 years  More than 10 years

e. How did you apply this cover?

Online  Over the phone  Paper Application

f. How did you hear about the company?

TV advertisement  Paper advertisement  Search Engine Word of mouth from  iSelect (broker) Friends Family  Other, please specify 

g. In the next renewal time, Are you looking to change the company?

No
Yes(If Yes, please specify what you are not happy about) 

h. What do you like or not like about the company, please rate the Service
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i. What do you like or not like about the company, please rate the Cost
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j. Please rate this company below
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k. Any comments for this company

B3. Life insurance
a. Do you have any life insurance?

Yes  No (please go to next section)

b. Which cover do you have?

Life  TPD (Total and Permanent Disability)  Trauma  Income Protection
 
c. Is your cover through superannuation?

No
Yes (If Yes, did apply or increase the cover within superannuation, please type in Y/N. N means you are covered through super by default)

d. Please tick your Life insurance company

AIA  AMP  Asteron  Aviva  AXA  CommInsure  ING  Macquarie Tower  Other (please specify) 

e. How long do you have this cover for?

Less than 1 year  1 – 2 years  2 – 5 years 5 – 10 years  More than 10 years

f. How did you apply for this cover?

Direct  Through broker Online  Paper based

g. In the next renewal time, Are you looking to change the company?

No
Yes(please specify what you are not happy about) 
h. What do you like or not like about the company, please rate the service

from 1 to 5 (min-max)
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i. What do you like or not like about the company, please rate the cost

from 1 to 5 (min-max)
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j. Please rate this company below

from 1 to 10 (min-max)
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k. Any comments for this company

C.  Through Broker (only if any of the above insurance cover is applied through broker)
a. Which cover do you have through broker?

Car Insurance  Health Insurance  Life Insurance No (please go to next section)

b. How long do you know this broker (If more than one broker for a particular insurance, please specify)?


NoneLess than a year 1-2 years 3- 5 years 5+ years
Car Insurance
Health Insurance
Life Insurance

c. How did you hear about the broker?

TV advertisement  Paper advertisement  Search Engine Word of mouth from  Employer Friends Family  Other, please specify 

d. Would you recommend this broker to others?

No Yes (If Yes, and more than one company involve, please type whichever applies:Car/Health/Life) 
e. Please rate this broker (out of 10)

1  2  3  4  5  6  7  8  9  10 If more than one, please specify 
D.    Direct (only if any of the above insurance cover is applied directly)
f. Which cover do you have direct?

Car Insurance  Health Insurance  Life Insurance No (please go to next section) 

g. How long do you have this cover?


Less than a year 1-2 years 3- 5 years 5+ years
Car Insurance
Health Insurance
Life Insurance
h. How did you hear about the company?

TV advertisement  Paper advertisement  Search Engine Word of mouth from  Employer Friends Family  Other (please specify) 

i. Would you recommend this company to others?

No Yes(If Yes, and more than one company involve, please pick whichever applies: Car/Health/Life) 
E. CLAIMS
1. Have you made any insurance claim?

Car Insurance Health Insurance Life Insurance No (please submit to completed the survey)
2. How long ago did you make the claim?


Less than a year 1-2 years 3- 5 years 5+ years
Car Insurance
Health Insurance
Life Insurance

3. How was your experience? Please rank

From 1 to 10 (easiest to hardest)
1  2  3  4  5  6  7  8  9  10  Please specify 

4. Any comments

FDM