QuestionPunkQuestionPunk
Start free
All templates

Insurance Agent Performance & Trust Evaluation

Measures how policyholders experience their insurance agent — responsiveness, product knowledge, coverage fit, and claims support — with an AI follow-up that digs into the specific moment that shaped their trust (or distrust) in the agent. Built for agencies and carriers running periodic agent scorecards.

Use this templateBrowse more templates

Sample questions

A preview of what’s in the template. Every question is editable before you launch.

14 questions · ~7 min
Q01
Message

Hi! We'd like your honest feedback on the insurance agent who handles your policy. This takes about 8 minutes and helps us recognize great agents and coach the ones who need it.

Q02
Multiple ChoiceRequired

Which type(s) of insurance does this agent handle for you?

  • Auto
  • Home or property
  • Life
  • Health
  • Business
  • Umbrella or other
Q03
Multiple ChoiceRequired

In the last 12 months, how many times have you contacted this agent (calls, emails, texts, or in-person)?

  • None
  • 1-2 times
  • 3-5 times
  • 6 or more times
Q04
MatrixRequired

Based on your experience, how would you rate your agent on each of the following?

5 rows × 5 columns
  • Knowledge of insurance products
  • Clarity of explanations
  • Responsiveness to your questions
  • Professionalism
  • Honesty and trustworthiness
Columns: Poor · Fair · Good · Very good · Excellent
Q05
Opinion ScaleRequired

Overall, how satisfied are you with this agent?

Scale: 1 – 5
Min:Very dissatisfiedMax:Very satisfied
Q06
Opinion ScaleRequired

How likely are you to recommend this agent to a friend or family member?

Scale: 0 – 10
Min:Not at all likelyMax:Extremely likely
Q07
Multiple ChoiceRequired

Thinking about the coverage your agent recommended, how well did it match your actual needs?

  • Matched my needs well
  • I felt over-insured (paying for more than I need)
  • I felt under-insured (gaps in my coverage)
  • Not sure / never discussed in detail
Q08
Multiple Choice

If you filed a claim in the last 12 months, how would you rate the agent's support during that process?

  • Excellent support, they advocated for me
  • Good support, but slow at times
  • Poor support, I felt on my own
  • Haven't filed a claim in the last 12 months
Q09
AI Interview

Reconstruct the specific interaction or decision that most shaped this respondent's trust in their agent. Anchor on their recommendation score and coverage-fit answer: if the score is low or they felt over/under-insured, probe exactly what happened, what the agent said or failed to say, and whether they've considered switching agents or carriers. If the score is high, find the one moment that earned that trust so it can be replicated by other agents.

Q10
Multiple ChoiceRequired

How likely are you to continue using this agent for your insurance needs next year?

  • Very likely
  • Somewhat likely
  • Unsure
  • Somewhat unlikely
  • Very unlikely
Q11
Multiple Choice

How long has this person been your insurance agent?

  • Less than 1 year
  • 1-3 years
  • 4-9 years
  • 10+ years
  • Not sure
Q12
Multiple Choice

Which age group do you fall into?

  • Under 25
  • 25-34
  • 35-44
  • 45-54
  • 55-64
  • 65 or older
  • Prefer not to say
Q13
Multiple Choice

How do you describe your gender?

  • Woman
  • Man
  • Non-binary
  • Prefer to self-describe
  • Prefer not to say
Q14
Message

Thank you for sharing your experience! Your feedback goes directly into your agent's coaching and recognition review — it's never shared with them word-for-word, but the patterns you helped surface are.

What’s included

  • AI follow-ups

    Adaptive probes on open-ended answers that pull out detail a static form would miss.

  • Attention checks

    Built-in safeguards against rushed answers and low-quality respondents.

  • AI-drafted copy

    Wording, ordering, and branching written by the AI — tuned to your research goal.

  • Auto report

    Themes, quotes, and a plain-English summary write themselves once responses come in.

How it compares

We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.

Why this template

  • Includes a dedicated AI follow-up interview that reconstructs the specific interaction or decision that shaped the policyholder's trust (or distrust), not just a rating.
  • Combines structured measurement (matrix ratings on responsiveness, product knowledge, coverage fit, claims support) with open-ended adaptive probing in one flow.
  • Captures coverage-fit and claims-support perception directly, plus satisfaction, NPS-style likelihood to recommend, and retention intent — giving agencies a full scorecard, not a single-metric survey.
  • Auto-generates a per-response report so agencies can review individual agent feedback without manually reading transcripts.

QuestionPro

Insurance agent survey questions + sample questionnaire template

This is a questionnaire/sample-questions page for insurance agent evaluation rather than a single ready-to-field template with a fixed flow. It covers the same general subject matter (agent evaluation) and gives question ideas, but appears to function more as a guide plus a customizable builder than a packaged survey with built-in analysis.

What it does well

  • Directly focused on the insurance agent evaluation use case
  • Backed by a large established survey platform with broad customization and distribution tools
  • Provides sample questions that can be a useful starting reference for question wording

Where it falls short

  • Presented as sample questions/guide content rather than a fielding-ready template with a fixed structure
  • No adaptive AI follow-up — cannot dynamically probe the specific moment that shaped a policyholder's trust
  • No automated per-response quality scoring or auto-generated agent-level report mentioned

Jotform

Agent Performance Evaluation Form Template

This is a generic agent performance evaluation form, not specific to insurance agents, coverage fit, or claims support. It's ready to field as a form but is a static questionnaire built for broad 'agent' use cases rather than insurance-specific trust and product-knowledge dynamics.

What it does well

  • Ready-to-use, easily editable form builder with drag-and-drop customization
  • Generic enough to be adapted across different agent-type contexts
  • Simple, familiar form format for quick deployment

Where it falls short

  • Not insurance-specific — lacks built-in items on coverage fit, claims support, or product knowledge
  • Static form with no adaptive AI follow-up to probe the specific interaction that shaped trust
  • No automated quality scoring or auto-generated report; results require manual review

Ready to launch?

Open this template in the editor. Every part is yours to change before the first respondent sees it.

Use this templateStart free