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