Client Claims Processing Experience Report Form
Please share your feedback on your recent claims processing experience to help us improve our services.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Claim Reference Number
*
Type of Claim
*
Please Select
Auto Insurance
Home Insurance
Health Insurance
Travel Insurance
Other
How did you submit your claim?
*
Online Portal
Email
Phone Call
In Person
Other
How would you rate the following aspects of your claims experience?
*
Rows
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Ease of submitting claim
1
2
3
4
5
Clarity of instructions
6
7
8
9
10
Timeliness of processing
11
12
13
14
15
Communication during process
16
17
18
19
20
Professionalism of staff
21
22
23
24
25
How satisfied are you with the outcome of your claim?
*
1
2
3
4
5
Was your claim resolved within your expected timeframe?
*
Yes
No
What did you find most positive about the claims process?
What could be improved in our claims process?
May we use your feedback for internal service improvement purposes?
*
Yes, I agree.
No, please keep my feedback confidential.
Submit Feedback
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