Skip to content
Insurance Customer Feedback Template
1.
Which of the following types of insurance do you currently have? (Check all that apply)
Disability
Pet
Home
Property
Liability
Mortgage
Casualty
Life
Health
Business
Long-term care
Credit
Automobile
Renter's
Other (please specify)
2.
Which type of insurance is most important to you?
Pet
Disability
Mortgage
Casualty
Automobile
Credit
Health
Home
Business
Life
Long-term care
Liability
Property
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)
Insurance rating agencies (e.g., A. M. Best)
Family or friend recommendations
Association or club recommendations
Insurance brokers
Internet
Other (please specify)
5.
Which source of information do you find most helpful when choosing an insurance agent?
Family or friend recommendation
Insurance broker
Association or club recommendation
Insurance rating agency (e.g., A. M. Best)
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