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Claims Survey
Fields marked with
*
are REQUIRED
*
Name
enter first and last name
*
Address
*
City
*
Phone Number
*
Date of Loss
dd-mm-yyyy
*
Insurance Company
*
Policy Number
*
Your broker was friendly and knowledgeable.
Stongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
Your broker clearly explained the claims process to you.
Stongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
Your broker answered all of your questions in one call.
Stongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
Your broker offered support in the event that you were not immediately contacted by an adjuster.
Stongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
You were contacted by an adjuster in a timely manner.
Stongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
Your adjuster was professional and knowledgeable.
Stongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
Your adjuster explained your coverage to your satisfaction.
Stongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
Your adjuster returned your calls in a timely manner.
Stongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
Your settlement/repairs were to your satisfaction.
Stongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
Your claim experience will influence your decision to keep your business with the insurance company.
Stongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
You see value in your brokers role in the claims process.
Stongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
You would recommend your broker to others.
Stongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Additional Comments
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