Claims Survey for


Claims Administrator:
Claims Office/Branch:

Claims Management Satisfaction Survey
06/09/2026

I have had no claims experience in the last 6 months. If you have checked this box, please proceed to the end of this survey, provide your name and company name and click on submit & close.

PLEASE RATE ONLY THE MOST RECENT SIX MONTHS OF EXPERIENCE.

Please select a rating for each of the following items. Choose from the sliding scale below:

1 -Very Satisfied/Excellent 2 - Above Average 3 - Average 4 - Below Average 5 - Not Satisfied/Poor
or NA - Not Applicable


1.	Please rate your overall satisfaction with your claims management service provider. 1 2 3 4 5 NA
2.	If you are calling in your new claims, how would you rate the Tele-reporting intake process? 1 2 3 4 5 NA Comment:
3.	If you are web-reporting your claims, how would you rate the web-based system? 1 2 3 4 5 NA Comment:
4.	Are you using the web based claim system to follow your claims? If not, why not? Yes No Comment:
5.	Are reserves being accurately and timely set for your respective claims? 1 2 3 4 5 NA Comment:
6.	Please rate the provider on processing WC medical bills in a timely manner? 1 2 3 4 5 NA Comment:
7.	Please rate the provider on processing Lost time/compensation payments (TTD checks) in a timely fashion? 1 2 3 4 5 NA Comment:
8.	Please rate the provider as to how well the adjuster involves you in their claims investigations and file evaluations? 1 2 3 4 5 NA Comment:
9.	Please rate the adjuster as to their responsiveness to your questions? 1 2 3 4 5 NA Comment:
10.	Please rate the adjuster(s) as to how promptly they return telephone calls and e-mails? 1 2 3 4 5 NA Comment:
11.	Please rate your opinion of how effective claim reviews (telephonic or in person) have been in resolving claims for your company? 1 2 3 4 5 NA Comment:
12.	Please rate your claims adjuster(s) as to how well they listen to your input and suggestions for action plans? 1 2 3 4 5 NA Comment:
13.	Please rate your working relationship with your adjuster? 1 2 3 4 5 NA Comment:
14.	Please rate how proactive you feel your adjuster(s) is/are? 1 2 3 4 5 NA Comment:
15.	Please rate your feelings on how well the claims adjuster(s) end results on your claims is/are? 1 2 3 4 5 NA Comment:

I would like to recommend the following adjuster(s) for recognition:

Name at least one thing you really like about your claims administrator:

If there were something you could change about your claims administrator, what change would you make?

Please call me to discuss this further: Yes No

Additional Comments:


Name:
Job Title:
Company:
Phone:
Email: