This insurance claim satisfaction survey template gathers honest feedback from policyholders after a claim, with 16 questions covering how easy the claim was to start, how well they were kept informed, whether the process felt fair, and how satisfied they were with the outcome. It prints on two pages and takes about four minutes to complete.
What this survey measures
The rating grid captures the parts of the journey that shape satisfaction: ease of filing, communication at each step, perceived fairness, settlement time, and the helpfulness of your staff. An ease-of-resolution scale and an overall satisfaction scale give you numbers to track across claim types, outcome and settlement-fairness questions flag where results fell short, a frustration checklist shows which steps cause the most pain, a renewal question and a likelihood-to-recommend question measure loyalty, and an open comment box surfaces the specific frictions your fixed questions miss.
How to use it on paper
Hand the form to claimants at a branch or adjuster visit, include it with a claim settlement letter, or leave copies at your service desk with a drop box. Respondents fill the checkboxes with a blue or black pen. Collect the completed forms and scan them in batches with PaperSurvey, which reads the checkbox answers with optical mark recognition and converts the handwritten comments to text automatically, so results reach your dashboard without any manual data entry.
Customize this template
Reword the statements to match auto, home, health, or travel claims, add questions about specific touchpoints such as the adjuster or the app, or drop the claim reference field for anonymous feedback. The paper layout reflows automatically as you edit, and every copy you print stays scannable.
Preview the PDF above, or use this template to start collecting claims feedback today.