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  1. Please select your insurance company from the following list:

     
  2. What insurance policy/policies do you have with this company?
    (select all that apply)
    Auto   Home   Health   Life   Other

     
  3. How long have you had a policy with this company?
    Less Than 1 Month
    1 to 6 Months
    6 Months to 1 Year
    1 to 3 Years
    Over 3 Years

     
  4. Overall, how satisfied are you, with your insurance company?
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    Very Satisfied
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    Unsatisfied
    Very Unsatisfied

     
  5. How likely are you to renew your insurance policy/policies with this insurance company?
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    Probably
    Might or Might Not
    Probably Not
    Definitely Not

     
  6. Would you recommend this insurance company to your friends and family?
    Definitely
    Probably
    Might or Might Not
    Probably Not
    Definitely Not

     
  7. Have you ever had occasion to file a claim with your company? YES   NO

     
  8. Please provide any comments about your insurance company that would be useful to other consumers.
                 
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