Insurance Assessment Framework for Individuals

 

Objective

This framework helps individuals assess their insurance needs by evaluating their personal, financial, health, and risk profiles. The scoring system ensures that users receive data-driven recommendations tailored to their specific circumstances.


Step 1: Personal Information Assessment

Criteria Options Score Rationale
Age Below 25 1 Low insurance needs, basic health & term life recommended
  25-35 2 Start family planning, health & life insurance becomes important
  36-50 3 High insurance needs for family, assets, and retirement planning
  50-60 4 Peak health risk; critical illness & retirement plans required
  60+ 5 Highest risk; comprehensive health, life, and estate planning needed
Marital Status Single 1 Basic personal coverage (health, accidental)
  Married 3 Family security through health & term life insurance
Dependents (Children/Parents) No 1 Limited life insurance need
  Yes 4 High need for term life, child education plans, and health insurance
Location Metro 4 Higher living costs mean greater insurance needs
  Tier 1 3 Moderate insurance needs
  Tier 2 2 Basic coverage sufficient
  Rural 1 Minimal but essential coverage required
Annual Income Below ₹3L 1 Focus on essential health and term life insurance
  ₹3-6L 2 Can afford additional policies like child education plans
  ₹6-12L 3 Need for home, liability, and investment-linked insurance
  ₹12-20L 4 High coverage across all insurance categories needed
  ₹20L+ 5 Premium coverage with advanced wealth protection required

Step 2: Financial Stability & Liabilities

Criteria Options Score Rationale
Existing Loans No Loans 1 Lower insurance need
  Home Loan 4 Home loan protection insurance needed
  Car Loan 3 Car insurance required
  Business Loan 4 Business insurance, keyman coverage needed
  Multiple Loans 5 Comprehensive life & health insurance required
Monthly Household Expenses Below ₹30K 1 Basic health & term life coverage
  ₹30K-₹50K 2 Mid-range insurance coverage needed
  ₹50K-₹1L 3 High financial risk; increased insurance need
  ₹1L+ 4 Critical illness, asset protection & liability insurance required
Emergency Savings Yes 4 Lower immediate need for insurance
  No 1 Higher insurance priority for risk management

Step 3: Health & Risk Profile

Criteria Options Score Rationale
Family Medical History No Critical Illness 1 Basic health coverage sufficient
  Some History 3 Need for higher health coverage & riders
  High-Risk History 5 Critical illness & term life insurance mandatory
Existing Health Insurance Yes 3 May need enhancement
  No 1 Urgent need for health coverage
Term Life Insurance Yes 3 Check if coverage is sufficient
  No 2 Consider term life for financial protection
Driving a Vehicle Yes 3 Car & accident insurance needed
  No 1 Lower accident insurance need
Chronic Health Conditions None 1 Basic health insurance needed
  Minor 3 Higher medical coverage recommended
  Major 5 Critical illness & high sum insured necessary

Step 4: Future Planning & Goals

Criteria Options Score Rationale
Planning to Buy a House? Yes 4 Home loan & property insurance needed
  No 1 Lower insurance priority
Child Education Savings Yes 3 Child plans & education policies required
  No 1 Focus on family term insurance
Retirement Planning Yes 5 Pension plans & annuities needed
  No 1 Basic coverage sufficient
Self-Employed/Business Owner Yes 4 Business insurance & income protection needed
  No 1 Standard health & life insurance sufficient

Step 5: Final Insurance Score & Recommendations

Total Score Calculation

  • 0 – 50: Basic health & life coverage recommended.
  • 51 – 100: Moderate health, life, and accidental insurance.
  • 101 – 150: Comprehensive term life, health, home, and business insurance.
  • 151 – 200: Premium coverage including wealth protection, retirement planning, and high-risk coverage.

Final Recommendation Table

Score Range Insurance Type Required
0 – 50 Health Insurance (Basic) & Term Life (Minimal)
51 – 100 Health, Life, & Accidental Coverage
101 – 150 Critical Illness, Home, Business, & Retirement Plans
151 – 200 Advanced Estate Planning, High-value Asset Protection

Conclusion & Next Steps

  1. Assess your total score using the tables above.
  2. Choose the right policies based on your score range.
  3. Compare multiple insurers for best premiums & benefits.
  4. Ensure honesty in declarations to avoid claim rejections.
  5. Review your policy annually as financial & personal situations change.

 

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