Insurance Claim Feedback Survey Template

Insurance claim satisfaction survey with 5 questions on ease of filing, communication, fairness, and resolution. Print, hand out, and scan for results.

Use this template

Copy this template into your account, then customize it to suit your needs.

This insurance claim satisfaction survey template gathers honest feedback from policyholders after a claim, with 5 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 a single sheet and takes about two 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 overall ease-of-resolution scale gives you a single number to track across claim types, a satisfaction question flags where outcomes fell short, 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.

Questions in this template

  1. Claim reference (optional)
  2. Please rate your agreement with the following statements.
  3. How easy was it to get your claim resolved?
  4. Was your claim resolved to your satisfaction?
  5. How could we improve the claims process?

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