Claims Survey

First Name*

Last Name*

Email*

Phone

1. Based on your experience with this particular claim, please rate your overall level of satisfaction with Lloyd Bedford Cox, Inc. on a scale of 1 to 5, with 1 being the lowest level of satisfaction, and 5 being the highest level of satisfaction.

Overal Satisfaction

1 – Very Dissatisfied
2 – Dissatisfied
3 – Mostly Satisfied
4 – Satisfied
5 – Very Satisfied

2. Using the same scale as in question 1, please rate your level of satisfaction for the following categories.

Ease of Submitting the Claim

1 – Very Dissatisfied
2 – Dissatisfied
3 – Mostly Satisfied
4 – Satisfied
5 – Very Satisfied

Explanation of Claim Process

1 – Very Dissatisfied
2 – Dissatisfied
3 – Mostly Satisfied
4 – Satisfied
5 – Very Satisfied

Promptness of Contact from Insurance Carrier

1 – Very Dissatisfied
2 – Dissatisfied
3 – Mostly Satisfied
4 – Satisfied
5 – Very Satisfied

Courteous & Professional Service

1 – Very Dissatisfied
2 – Dissatisfied
3 – Mostly Satisfied
4 – Satisfied
5 – Very Satisfied

3. Is there anything Lloyd Bedford Cox, Inc. could have done better or differently to achieve greater satisfaction from you?

Any improvements needed?

Yes
No

If yes, please explain:

4. Do you have any other feedback or questions?