Skip to content
Insurance Customer Feedback Template
1.
Which of the following types of insurance do you currently have? (Check all that apply)
Casualty
Disability
Health
Pet
Life
Long-term care
Business
Liability
Mortgage
Credit
Property
Home
Automobile
Renter's
Other (please specify)
2.
Which type of insurance is most important to you?
Liability
Automobile
Business
Life
Mortgage
Property
Long-term care
Credit
Home
Disability
Health
Pet
Casualty
Renter's
Other (please specify)
3.
How much did you spend, in U.S. dollars, last month on automobile insurance?
4.
Which sources of information do you use when choosing an insurance agent? (Check all that apply)
Family or friend recommendations
Association or club recommendations
Insurance rating agencies (e.g., A. M. Best)
Insurance brokers
Internet
Other (please specify)
5.
Which source of information do you find most helpful when choosing an insurance agent?
Insurance rating agency (e.g., A. M. Best)
Association or club recommendation
Family or friend recommendation
Insurance broker
Internet
Other (please specify)
6.
Are you satisfied or dissatisfied with your automobile insurance agent?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
7.
How likely are you to continue using our business in the future?
Extremely likely
Quite likely
Moderately likely
Slightly likely
Not at all likely
8.
How likely is it that you would recommend your automobile insurance agent to a friend or colleague?
Not at all likely - 0
1
2
3
4
5
6
7
8
9
Extremely likely - 10
Not at all likely - 0
1
2
3
4
5
6
7
8
9
Extremely likely - 10
Current Progress,
0 of 8 answered