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New Auto Insurance Study
1.
Please fill out the following information so we may contact you.
Name
City/Town
State/Province
Email Address
Phone Number
2.
What is your gender?
Male
Female
3.
Which of the following categories includes your age?
Under 25
25-35
36-45
46-55
56-65
66+
4.
Which of the following types of insurance do you currently have?
Auto insurance
Life insurance
Homeowners insurance
Renters insurance
Condo insurance
Other
I do not currently have any type of insurance
5.
If you have auto insurance, what company do you currently have for your auto insurance?
6.
If you have auto insurance, have you filed a claim in the last...
I filed my claim recently and my claim is still open
I filed my claim within the last month and it is closed
I filed my claim within the last 2 months and it is closed
I filed my claim over 3 months ago but within the last 6 months and it is closed
I filed my claim over 6 months ago
I filed my claim 6-9 months ago
I filed my claim 12 months ago
I have never filed a claim
7.
If you have ever filed an auto claim, what was the claim for? (i.e. body damage, etc.)
8.
If you filed a claim was it through your own insurance company?
Yes
No
I have not filed a claim
9.
How would you describe your ethnic background?
Caucasian/White
African American/Black
Hispanic/Latino
Asian
Other (please specify)
Current Progress,
0 of 9 answered