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Claims Satisfaction Survey
First Name
Last Name
Email
Claim Number
Date Claim Occurred
Claim Representative
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Unknown
Auto Glass Claim Only
Auto Tow Claim Only
Abbott, Alex
Bauerle, Samantha
Benjamin, John
Biskupski, Brian
Blake, Kevin
Bolden, Valerie
Burkett, Dennis
Carr, Jake
Carr, David
Congram, Cherie
Delp, Amy
Dougherty, John
English, Brent
Gharib, Phillip
Ginda, John
Gonzales, Gabriel
Hendryx, Rick
Hensley, Angela
Jones-Sowinski, Jackie
Kremer, Gina
Larr, Walt
McMichael, Lesa
Moss, Kenneth
Niemeier, Ted
Ogden, Jeniffer
Richart, Allison
Ritter, Jodi
Rosebrock, Tammy
Sanders, June
Seitz, Noah
Shaker, Jeff
Smith, Ashlie
Solomon, Amy Jo
Taylor, Gina
Thiesing, Ian
Waggoner, Georgia
Walton, Darrin
Wilson, Mike
Wilson, Jessica
Please select a representative.
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Not Applicable
I was satisfied with how quickly the adjuster contacted me after I reported my claim.
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Not Applicable
The reporting of my claim was easy and convenient
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Not Applicable
I was satisfied with how quickly my automobile or home was inspected.
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Not Applicable
I was satisfied with how quickly my claim was paid.
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Not Applicable
Overall, my expectations were met.
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Not Applicable
Additional Comments
0 / 1000
Would you like to be contacted?
Yes
No
Name of Contact
Contact name is required.
Phone Number
Enter a valid phone number.
Best Time to Call
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Reason for Contact
0 / 1000
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