Fact Find Tool (Copy) 8 Aug Written By Rupert Gough Professional Insurance Fact Find Tool đĸ Insurance Fact Find Tool đ â New Fact Find đ Load Selected â Insurance Menu Section 1 of 16 Saved đ Initial Assessment Professional Fact Find Session Comprehensive insurance needs analysis and recommendation development tool for professional advisers. Session Type Select session type... Initial Consultation Annual Review Policy Replacement Review Life Event Review Post-Claim Review Client Type Select client type... Individual Couple/Partnership Family Business Owner High Net Worth Meeting Location Select location... Office Client's Home Client's Workplace Video Call Phone CafÊ/Public Space Conducting Adviser Loading adviser details... Initial Session Notes đ Privacy Consideration Meeting in public space detected. You may want to minimize the visual summary panel for client privacy. Hide Summary Panel đ¤ Primary Client Details First Name Last Name Preferred Name Date of Birth Age (Auto-calculated) Gender Select... Male Female Other Prefer not to say Marital Status Select... Single De facto Civil Union Married Separated Divorced Widowed Smoking Status Select... Never smoked Former smoker Current smoker Occasional/Social smoker đĨ Partner/Spouse Details Partner Information Complete this section if the client has a partner/spouse requiring coverage or involved in financial planning. Does the client have a partner/spouse? Yes No First Name Last Name Date of Birth Age (Auto-calculated) Gender Select... Male Female Other Prefer not to say Smoking Status Select... Never smoked Former smoker Current smoker Occasional/Social smoker đ Contact Information đ Primary Residence Street Address Suburb City Postcode Home Ownership Select... Owned (mortgage-free) Owned (with mortgage) Rented Family owned Other arrangement Time at current address Select... Less than 1 year 1-2 years 3-5 years 6-10 years More than 10 years đą Contact Details Primary Phone Secondary Phone Primary Email Preferred Contact Method Select... Mobile phone Home phone Email Text/SMS đŧ Employment & Occupation đ¤ Primary Client Employment Employment Status Select... Employed (Full-time) Employed (Part-time) Employed (Casual) Self-employed Business Owner Contractor Unemployed Retired Student Home duties Occupation/Job Title Employer/Company Occupational Risk Assessment Select... No special risks Manual labor/Physical work Working at heights Heavy machinery operation Chemical/Hazardous materials Frequent travel/Remote locations Emergency services Military/Defense Aviation industry Other risks đĨ Partner Employment Employment Status Select... Employed (Full-time) Employed (Part-time) Employed (Casual) Self-employed Business Owner Contractor Unemployed Retired Student Home duties Occupation/Job Title Employer/Company Occupational Risk Assessment Select... No special risks Manual labor/Physical work Working at heights Heavy machinery operation Chemical/Hazardous materials Frequent travel/Remote locations Emergency services Military/Defense Aviation industry Other risks đ° Financial Position đ Financial Snapshot Comprehensive overview of assets, liabilities, and financial commitments to determine appropriate coverage levels. đ Assets Family Home Value ($) Investment Property(s) ($) KiwiSaver Balance ($) Other Superannuation ($) Savings & Term Deposits ($) Shares & Investments ($) Vehicles ($) Business Interests ($) Other Assets ($) Total Assets $0 đ Liabilities Home Mortgage ($) Investment Property Mortgage(s) ($) Personal Loans ($) Car Loans ($) Credit Card Limits ($) Buy Now Pay Later ($) Student Loan ($) Other Debts ($) Total Liabilities $0 Net Worth $0 đĩ Income & Living Expenses đ° Income Analysis Detailed income and expense analysis to determine appropriate insurance benefit levels and affordability. đ¤ Primary Client - Annual Income Base Salary/Wages ($) Overtime/Extra Hours ($) Commission/Bonuses ($) Business/Self-Employment Income ($) Investment Income ($) Rental Income ($) Government Benefits ($) Other Income ($) Client 1 Total Income $0 đĨ Partner - Annual Income Base Salary/Wages ($) Commission/Bonuses ($) Business Income ($) Other Income ($) Client 2 Total Income $0 đ Monthly Living Expenses Housing (Rent/Mortgage payments) ($) Utilities (Power, Gas, Water, Internet) ($) Food & Groceries ($) Transport (Car, Fuel, Public Transport) ($) Current Insurance Premiums ($) Healthcare & Medical ($) Childcare & Education ($) Entertainment & Recreation ($) Debt Payments (Personal loans, Credit cards) ($) Savings & Investments ($) Other Regular Expenses ($) Total Monthly Expenses $0 Combined Annual Income $0 Annual Expenses $0 Net Annual Cash Flow $0 đĨ Medical History - Primary Client đ Confidential Medical Information This information is collected for insurance underwriting purposes only and is subject to strict privacy protections. đ Physical Measurements Height (cm) Weight (kg) BMI (Auto-calculated) - Medical History Questionnaire Please answer honestly. Any undisclosed conditions may affect future claims. High blood pressure or heart conditions Yes No Unsure Diabetes or blood sugar problems Yes No Unsure Mental health conditions (depression, anxiety, stress) Yes No Unsure Cancer or tumors (past or present) Yes No Unsure Back, neck or joint problems Yes No Unsure Respiratory conditions (asthma, lung disease) Yes No Unsure Hospitalization or surgery in last 5 years Yes No Unsure Currently taking prescription medications Yes No Unsure Medical history details đ¯ Insurance Needs Analysis đ Professional Needs Assessment Determine appropriate insurance types and coverage levels based on client circumstances and objectives. đ¤ Primary Client - Insurance Requirements đĄī¸ Life Insurance Required Not Required Recommended Amount ($) Primary Purpose Select... Debt clearance Income replacement Family protection Estate planning Business protection Rationale for amount đ° Income Protection Required Not Required Monthly Benefit Needed ($) Recommended Waiting Period Select... 14 days 30 days 60 days 90 days Recommended Benefit Period Select... 2 years 5 years To age 65 To age 67 Coverage Type Select... Own occupation Any occupation Activities of daily living â¤ī¸ Trauma/Critical Illness Required Not Required Recommended Amount ($) Coverage Type Select... Standalone Accelerated (from life cover) Additional to life cover âī¸ Compliance Confirmation I confirm that the difference between accelerated and standalone Trauma cover has been explained to the client(s) đŗ Budget & Affordability đ° Affordability Guidelines Most New Zealand families invest 3-5% of their gross household income on personal insurance premiums. Let's find the right balance for your clients. Household Gross Income (Auto-filled) $0 3% of Income (Monthly) $0 5% of Income (Monthly) $0 đ¸ Client Budget Preferences Maximum comfortable monthly premium ($) Preferred payment frequency Select... Weekly Fortnightly Monthly Annual Priority insurance type (if budget limited) Select... Life insurance Income protection Trauma cover Health insurance Disability cover Budget flexibility Select... Very tight - must stay within budget Some room for the right coverage Flexible if good value demonstrated Cost not the primary concern Cost Considerations & Preferences Would you consider stepped premiums (lower initial cost, increases with age)? Yes No, prefer level Depends on savings Interested in reviewing premiums annually for potential savings? Yes No, set and forget Preference for insurance provider type? Best price regardless Established brands only No preference Budget discussion notes đ¤ Professional Network & Referrals đ Building Your Support Network Connect clients with trusted professionals to provide comprehensive financial planning support. âī¸ Legal Services Do you have a lawyer? Yes No Need lawyer referral? Yes No Lawyer Name Law Firm Phone Are wills up to date? Select... Yes, current Needs updating No will in place Unsure đ Accounting Services Do you have an accountant? Yes No Need accountant referral? Yes No Accountant Name Accounting Firm đ Mortgage Services Do you have a mortgage broker/bank manager? Yes No Need Mortgage Adviser referral? Yes No Adviser/Manager Name Company/Bank đ đ General Insurance Do you have a general insurance broker? Yes No Need general insurance referral? Yes No Broker Name Brokerage đ¯ Referral Preferences How do you prefer to receive referrals? Direct introduction Just contact details Email introduction đĄī¸ Current Insurance Coverage Do you currently have any insurance policies in place? Yes No Unsure đ¤ Primary Client - Current Insurance Life Insurance Sum Assured ($) Annual Premium ($) Insurance Provider Loadings/Exclusions Income Protection Monthly Benefit ($) Annual Premium ($) Waiting Period Select... 14 days 30 days 60 days 90 days 180 days 365 days Benefit Period Select... 2 years 5 years To age 65 To age 70 Trauma/Critical Illness Sum Assured ($) Annual Premium ($) Total Annual Premiums (Auto-calculated) $0 Policy Considerations Are you satisfied with your current coverage levels? Yes No Unsure Would you consider replacing existing policies for better value? Yes No Maybe đļ Dependents & Family Do you have dependents requiring financial support? Yes No Number of dependents Select... 1 2 3 4 5+ đĨ Dependent Health Insurance Needs Do your dependents need private health insurance? Yes No Unsure Dependent care considerations đ Additional Information đ Additional Considerations Capture any additional information that may be relevant to the insurance recommendations. Additional Health Information Additional Financial Information Client Concerns & Questions Future Goals & Plans Adviser Observations âī¸ Legal & Compliance đ Mandatory Compliance Checklist Disclosure Statement: Client(s) provided with and acknowledged Disclosure Statement. đ Generate Disclosure Statement Scope Of Service: Client(s) provided with Scope of Service document. Appointment As An Adviser: The client has been provided with an Appoint as an Adviser form. Complaints Process: A complaints process is included in my Disclosure Statement. Information Accuracy: The client confirms that all information provided is true and accurate Meeting Date Scheduled Follow-up Date Advisor Notes & Next Steps â Summary & Statement Generation đ¯ Fact Find Complete! Ready to generate comprehensive insurance recommendations using AI analysis. đ¤ AI Statement of Advice Options Statement Type Comprehensive Statement of Advice Targeted Product Recommendation Replacement Analysis Annual Review Summary Presentation Style Detailed (Technical) Simplified (Plain English) Executive Summary Visual/Infographic Style Special instructions for AI analysis đ Statement Preview â Previous Next â đ¯ Generate Statement of Advice Rupert Gough
Fact Find Tool (Copy) 8 Aug Written By Rupert Gough Professional Insurance Fact Find Tool đĸ Insurance Fact Find Tool đ â New Fact Find đ Load Selected â Insurance Menu Section 1 of 16 Saved đ Initial Assessment Professional Fact Find Session Comprehensive insurance needs analysis and recommendation development tool for professional advisers. Session Type Select session type... Initial Consultation Annual Review Policy Replacement Review Life Event Review Post-Claim Review Client Type Select client type... Individual Couple/Partnership Family Business Owner High Net Worth Meeting Location Select location... Office Client's Home Client's Workplace Video Call Phone CafÊ/Public Space Conducting Adviser Loading adviser details... Initial Session Notes đ Privacy Consideration Meeting in public space detected. You may want to minimize the visual summary panel for client privacy. Hide Summary Panel đ¤ Primary Client Details First Name Last Name Preferred Name Date of Birth Age (Auto-calculated) Gender Select... Male Female Other Prefer not to say Marital Status Select... Single De facto Civil Union Married Separated Divorced Widowed Smoking Status Select... Never smoked Former smoker Current smoker Occasional/Social smoker đĨ Partner/Spouse Details Partner Information Complete this section if the client has a partner/spouse requiring coverage or involved in financial planning. Does the client have a partner/spouse? Yes No First Name Last Name Date of Birth Age (Auto-calculated) Gender Select... Male Female Other Prefer not to say Smoking Status Select... Never smoked Former smoker Current smoker Occasional/Social smoker đ Contact Information đ Primary Residence Street Address Suburb City Postcode Home Ownership Select... Owned (mortgage-free) Owned (with mortgage) Rented Family owned Other arrangement Time at current address Select... Less than 1 year 1-2 years 3-5 years 6-10 years More than 10 years đą Contact Details Primary Phone Secondary Phone Primary Email Preferred Contact Method Select... Mobile phone Home phone Email Text/SMS đŧ Employment & Occupation đ¤ Primary Client Employment Employment Status Select... Employed (Full-time) Employed (Part-time) Employed (Casual) Self-employed Business Owner Contractor Unemployed Retired Student Home duties Occupation/Job Title Employer/Company Occupational Risk Assessment Select... No special risks Manual labor/Physical work Working at heights Heavy machinery operation Chemical/Hazardous materials Frequent travel/Remote locations Emergency services Military/Defense Aviation industry Other risks đĨ Partner Employment Employment Status Select... Employed (Full-time) Employed (Part-time) Employed (Casual) Self-employed Business Owner Contractor Unemployed Retired Student Home duties Occupation/Job Title Employer/Company Occupational Risk Assessment Select... No special risks Manual labor/Physical work Working at heights Heavy machinery operation Chemical/Hazardous materials Frequent travel/Remote locations Emergency services Military/Defense Aviation industry Other risks đ° Financial Position đ Financial Snapshot Comprehensive overview of assets, liabilities, and financial commitments to determine appropriate coverage levels. đ Assets Family Home Value ($) Investment Property(s) ($) KiwiSaver Balance ($) Other Superannuation ($) Savings & Term Deposits ($) Shares & Investments ($) Vehicles ($) Business Interests ($) Other Assets ($) Total Assets $0 đ Liabilities Home Mortgage ($) Investment Property Mortgage(s) ($) Personal Loans ($) Car Loans ($) Credit Card Limits ($) Buy Now Pay Later ($) Student Loan ($) Other Debts ($) Total Liabilities $0 Net Worth $0 đĩ Income & Living Expenses đ° Income Analysis Detailed income and expense analysis to determine appropriate insurance benefit levels and affordability. đ¤ Primary Client - Annual Income Base Salary/Wages ($) Overtime/Extra Hours ($) Commission/Bonuses ($) Business/Self-Employment Income ($) Investment Income ($) Rental Income ($) Government Benefits ($) Other Income ($) Client 1 Total Income $0 đĨ Partner - Annual Income Base Salary/Wages ($) Commission/Bonuses ($) Business Income ($) Other Income ($) Client 2 Total Income $0 đ Monthly Living Expenses Housing (Rent/Mortgage payments) ($) Utilities (Power, Gas, Water, Internet) ($) Food & Groceries ($) Transport (Car, Fuel, Public Transport) ($) Current Insurance Premiums ($) Healthcare & Medical ($) Childcare & Education ($) Entertainment & Recreation ($) Debt Payments (Personal loans, Credit cards) ($) Savings & Investments ($) Other Regular Expenses ($) Total Monthly Expenses $0 Combined Annual Income $0 Annual Expenses $0 Net Annual Cash Flow $0 đĨ Medical History - Primary Client đ Confidential Medical Information This information is collected for insurance underwriting purposes only and is subject to strict privacy protections. đ Physical Measurements Height (cm) Weight (kg) BMI (Auto-calculated) - Medical History Questionnaire Please answer honestly. Any undisclosed conditions may affect future claims. High blood pressure or heart conditions Yes No Unsure Diabetes or blood sugar problems Yes No Unsure Mental health conditions (depression, anxiety, stress) Yes No Unsure Cancer or tumors (past or present) Yes No Unsure Back, neck or joint problems Yes No Unsure Respiratory conditions (asthma, lung disease) Yes No Unsure Hospitalization or surgery in last 5 years Yes No Unsure Currently taking prescription medications Yes No Unsure Medical history details đ¯ Insurance Needs Analysis đ Professional Needs Assessment Determine appropriate insurance types and coverage levels based on client circumstances and objectives. đ¤ Primary Client - Insurance Requirements đĄī¸ Life Insurance Required Not Required Recommended Amount ($) Primary Purpose Select... Debt clearance Income replacement Family protection Estate planning Business protection Rationale for amount đ° Income Protection Required Not Required Monthly Benefit Needed ($) Recommended Waiting Period Select... 14 days 30 days 60 days 90 days Recommended Benefit Period Select... 2 years 5 years To age 65 To age 67 Coverage Type Select... Own occupation Any occupation Activities of daily living â¤ī¸ Trauma/Critical Illness Required Not Required Recommended Amount ($) Coverage Type Select... Standalone Accelerated (from life cover) Additional to life cover âī¸ Compliance Confirmation I confirm that the difference between accelerated and standalone Trauma cover has been explained to the client(s) đŗ Budget & Affordability đ° Affordability Guidelines Most New Zealand families invest 3-5% of their gross household income on personal insurance premiums. Let's find the right balance for your clients. Household Gross Income (Auto-filled) $0 3% of Income (Monthly) $0 5% of Income (Monthly) $0 đ¸ Client Budget Preferences Maximum comfortable monthly premium ($) Preferred payment frequency Select... Weekly Fortnightly Monthly Annual Priority insurance type (if budget limited) Select... Life insurance Income protection Trauma cover Health insurance Disability cover Budget flexibility Select... Very tight - must stay within budget Some room for the right coverage Flexible if good value demonstrated Cost not the primary concern Cost Considerations & Preferences Would you consider stepped premiums (lower initial cost, increases with age)? Yes No, prefer level Depends on savings Interested in reviewing premiums annually for potential savings? Yes No, set and forget Preference for insurance provider type? Best price regardless Established brands only No preference Budget discussion notes đ¤ Professional Network & Referrals đ Building Your Support Network Connect clients with trusted professionals to provide comprehensive financial planning support. âī¸ Legal Services Do you have a lawyer? Yes No Need lawyer referral? Yes No Lawyer Name Law Firm Phone Are wills up to date? Select... Yes, current Needs updating No will in place Unsure đ Accounting Services Do you have an accountant? Yes No Need accountant referral? Yes No Accountant Name Accounting Firm đ Mortgage Services Do you have a mortgage broker/bank manager? Yes No Need Mortgage Adviser referral? Yes No Adviser/Manager Name Company/Bank đ đ General Insurance Do you have a general insurance broker? Yes No Need general insurance referral? Yes No Broker Name Brokerage đ¯ Referral Preferences How do you prefer to receive referrals? Direct introduction Just contact details Email introduction đĄī¸ Current Insurance Coverage Do you currently have any insurance policies in place? Yes No Unsure đ¤ Primary Client - Current Insurance Life Insurance Sum Assured ($) Annual Premium ($) Insurance Provider Loadings/Exclusions Income Protection Monthly Benefit ($) Annual Premium ($) Waiting Period Select... 14 days 30 days 60 days 90 days 180 days 365 days Benefit Period Select... 2 years 5 years To age 65 To age 70 Trauma/Critical Illness Sum Assured ($) Annual Premium ($) Total Annual Premiums (Auto-calculated) $0 Policy Considerations Are you satisfied with your current coverage levels? Yes No Unsure Would you consider replacing existing policies for better value? Yes No Maybe đļ Dependents & Family Do you have dependents requiring financial support? Yes No Number of dependents Select... 1 2 3 4 5+ đĨ Dependent Health Insurance Needs Do your dependents need private health insurance? Yes No Unsure Dependent care considerations đ Additional Information đ Additional Considerations Capture any additional information that may be relevant to the insurance recommendations. Additional Health Information Additional Financial Information Client Concerns & Questions Future Goals & Plans Adviser Observations âī¸ Legal & Compliance đ Mandatory Compliance Checklist Disclosure Statement: Client(s) provided with and acknowledged Disclosure Statement. đ Generate Disclosure Statement Scope Of Service: Client(s) provided with Scope of Service document. Appointment As An Adviser: The client has been provided with an Appoint as an Adviser form. Complaints Process: A complaints process is included in my Disclosure Statement. Information Accuracy: The client confirms that all information provided is true and accurate Meeting Date Scheduled Follow-up Date Advisor Notes & Next Steps â Summary & Statement Generation đ¯ Fact Find Complete! Ready to generate comprehensive insurance recommendations using AI analysis. đ¤ AI Statement of Advice Options Statement Type Comprehensive Statement of Advice Targeted Product Recommendation Replacement Analysis Annual Review Summary Presentation Style Detailed (Technical) Simplified (Plain English) Executive Summary Visual/Infographic Style Special instructions for AI analysis đ Statement Preview â Previous Next â đ¯ Generate Statement of Advice Rupert Gough