Skip to content
Insurance Customer Feedback Template
1.
Which of the following types of insurance do you currently have? (Check all that apply)
Automobile
Property
Pet
Casualty
Life
Liability
Disability
Health
Credit
Long-term care
Business
Home
Mortgage
Renter's
Other (please specify)
2.
Which type of insurance is most important to you?
Liability
Health
Pet
Long-term care
Mortgage
Disability
Business
Home
Casualty
Automobile
Credit
Property
Life
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