Evaluation Form

Name

Mobile

Type of service provided New Insurance Request Claim settlement Complaint Follow Up Others

Evaluation Very satisfied Satisfied neutral not satisfied Very dissatisfied

If the rating level is very dissatisfied or dissatisfied, Please choose the correct reason from below

If the service is "New Insurance Request" Price Delay in policy assurance Level of employee cooperation Insurance policy terms & covers Others

If the service is a "Claim settlement" Settlement amount Excess amount Delay in claim settlement Delay in payment transfer Delay in repair order Delay in settling total loss claim Vehicle Repair / Total Loss Quality of vehicle repair Others

If the service is "Complaint Follow Up" Difficulty in making a complaint Delay in processing a complaint Provided service by customer service representative No updates on current complaint Result of a complaint Others