Claims Satisfaction Survey

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1. Policy Number

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2. Adjuster's Name

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3. Was the claims process explained to me clearly?

Yes

No

Partially

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4. Overall when contacting your Adjuster, was a response received in a timely manner:

	Most of the time	Sometimes	Rarely	Not Applicable
Telephone	Telephone Most of the time	Telephone Sometimes	Telephone Rarely	Telephone Not Applicable
Email	Email Most of the time	Email Sometimes	Email Rarely	Email Not Applicable

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5. Overall, I would describe the Claims Staff as:

	Most of the Time	Sometimes	Rarely	Not Applicable
Positive and Helpful	Positive and Helpful Most of the Time	Positive and Helpful Sometimes	Positive and Helpful Rarely	Positive and Helpful Not Applicable
Courteous	Courteous Most of the Time	Courteous Sometimes	Courteous Rarely	Courteous Not Applicable
Knowledgeable	Knowledgeable Most of the Time	Knowledgeable Sometimes	Knowledgeable Rarely	Knowledgeable Not Applicable
Informative	Informative Most of the Time	Informative Sometimes	Informative Rarely	Informative Not Applicable
Met Expectations	Met Expectations Most of the Time	Met Expectations Sometimes	Met Expectations Rarely	Met Expectations Not Applicable

Comments?

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6. Was your claim settled promptly?

Yes

No

Not certain

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7. Overall were you satisfied with how your claim was handled?

Very satisfied

Satisfied

Neutral

Dissatisfied

Very dissatisfied

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8. If you would like to provide any additional comments on your claims experience please provide in the space below:

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9. If you would like a representative at West Wawanosh Mutual to contact you to discuss your experience or any other product or service, please provide your information below:

Name:

Contact Number:

Email: