Insurance Surveys

DEPARTMENT OF VETERANS AFFAIRS
Insurance Center
Wissahickon Avenue and Manheim Street
P. O. Box 8570
Philadelphia PA 19101

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In Reply Refer To:
310/295-S
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Dear XXXXXXXXXXXXXX:
We recently processed a beneficiary designation for you on your VA Life Insurance. Now we would like
to know if we did the best possible job. You can help us by doing the following:
1. Fill out the enclosed survey.
2. Send it to us in the enclosed envelope. (We've paid for the postage.)
This survey is voluntary, for services provided by the VA Life Insurance Center, and completing it will
help us improve our service.
Thank you for taking your time to help us. Please return your survey as soon as possible to make sure
we can include your responses in the results.
If you have any questions about your insurance policy, then please feel free to contact us.

Sincerely yours,

Chief, Insurance Claims Division

Enclosures
Survey
Postage Paid Envelope

Insurance Toll-free (1-800-669-8477) Insurance Toll-free fax (1-888-748-5828)
Website & E-mail (www.insurance.va.gov) Hours of operation: (Mon. – Fri. 8:30 a.m. – 6:00 p.m. ET)
Best days to call (Wed. and Thurs.) Automated policy access (24 hours, 7 days a week)

310-290-S
VA GOVERNMENT LIFE INSURANCE
BENEFICIARY DESIGNATION SURVEY
Strongly
Agree

Agree

Neither Agree
nor Disagree

Disagree

Strongly
Disagree

1. It was easy to request the designation form.

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2. You received the form quickly.

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3. It was easy to complete the form.

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4. You received a confirmation copy of your
beneficiary designation timely.

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5. The overall quality of our service was good.

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6. Our service was good when compared with
other life insurance companies.

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No Other
Insurance

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7. How can we improve our service?

MMMMYYYY

(survey #)

Public Reporting Burden Statement: VA may not conduct or sponsor, and respondent is not required to respond to this collection of information unless it
displays a valid OMB Control Number. Public reporting burden for this collection of information is estimated to average 6 minutes per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection
of information. If you have comments regarding this burden estimate or any other aspect of this collection of information, call 1-800-827-1000.

(OMB Approval No. 2900-0771)