Claims Satisfaction Survey

First Name

Enter a first name

Last Name

Enter a last name

Claim Number

Enter a claim number

Claim Month

Please select a month.

Claim Year

Please select a year.

Claim Representative

Please select a representative.

Insurance Type

Please select a line of business.

Overall, were your expectations met?

YES thumb_up

NO thumb_down

Additional Comments

Would you like to be contacted?

Yes

Name of Contact

Contact name is required.

Phone Number

Enter a valid phone number.

Best Time to Call

Contact time is required.

Reason for Contact

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Indiana Farm Bureau Insurance is the marketing name for property and casualty insurance products underwritten by United Farm Family Mutual Insurance Company and life insurance products provided by United Farm Family Life Insurance Company in Indiana. Product availability is limited and subject to underwriting guidelines, review, and approval.

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