Policyholder Satisfaction Survey

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* 1. Name

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* 2. Email address

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* 3. Policy Number

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* 4. Agent/Broker Name

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* 5. Overall when contacting your Agent/Broker, 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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* 6. Overall, how would you describe your experience:

	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
Professional	Professional Most of the Time	Professional Sometimes	Professional Rarely	Professional Not Applicable

Comments?

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* 7. Was your request dealt with promptly?

Yes

No

Not certain

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* 8. Was your policy/coverage explained to you clearly?

Yes

No

Partially

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* 9. How satisfied were you with the coverage options available?

Very satisfied

Satisfied

Unsatisfied

Comment

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* 10. Overall were you satisfied with your experience?

Very satisfied

Satisfied

Neutral

Dissatisfied

Very dissatisfied

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* 11. How likely is it that you would recommend our company to others?

Yes

No

Maybe

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* 12. If you would like to provide any additional comments or suggestions to improve your policyholder experience please provide in the space below:

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* 13. 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: