CUSTOMER EXPERIENCE SURVEY

Dear Customer

The Ombudsman for short-term insurance thanks you for giving us the opportunity

to assist you. Please help us serve you better by taking a couple of minutes to tell us

about the service that you have received.

On a scale from 1-5, with 1 being poor and 5 being superior;

Please rate the level of professionalism of our staff.

1. Poor 2. Low 3. Average 4. High 5. Superior

Please rate how the complaints process was explained to you.

1. Poor 2. Low 3. Average 4. High 5. Superior

How easy was it to make contact with this office?

1. Poor 2. Low 3. Average 4. High 5. Superior

From the experience you had when submitting your complaint to OSTI, how could the process be improved?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please add any comments below.

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

How did you hear about this Office?

a. Word-of-mouthb. Newspaperc. Radiod. Televisione. Internet/social mediaf. Other Ombudsman g. Your insurerh. Your policy document i. Broker/Attorney/bank

Thank you for your feedback. We sincerely appreciate your honest opinion and will

take your input into consideration.

THE OMBUDSMAN FOR SHORT-TERM INSURANCE

Name: _____________________

File reference number: _____________________