MEMBER SURVEY GENERAL MANAGER/ CEO CONTACT DETAILSName* First Last Council/ Organisation*Albury City CouncilArmidale Regional CouncilBallina Shire CouncilBalranald Shire CouncilBathurst Regional CouncilBega Valley Shire CouncilBellingen Shire CouncilBerrigan Shire CouncilBland Shire CouncilBlayney Shire CouncilBogan Shire CouncilBourke Shire CouncilBrewarrina Shire CouncilBroken Hill City CouncilByron Shire CouncilCabonne CouncilCampbelltown City CouncilCanterbury Bankstown CouncilCarrathool Shire CouncilCastlereagh-Macquarie County CouncilCentral Coast CouncilCentral Darling Shire CouncilCentral Murray County CouncilCentral Tablelands CountyCessnock City CouncilCity of Canada Bay CouncilCity of RydeClarence Valley CouncilCobar Shire CouncilCobar Water BoardCoffs Harbour City CouncilCoolamon Shire CouncilCoonamble Shire CouncilCootamundra Gundagai Regional CouncilCowra Shire CouncilDungog Shire CouncilEdwards River CouncilEurobodalla Shire CouncilFederation CouncilForbes Shire CouncilGeorges River CouncilGilgandra ShireGlen Innes Severn CouncilGoldenfields Water County CouncilGoulburn Mulwaree CouncilGreater Hume Shire CouncilGriffith City CouncilGunnedah Shire CouncilGwydir Shire CouncilHawkesbury River County CouncilHay Shire CouncilHilltops CouncilHornsby Shire CouncilInner West CouncilInverell Shire CouncilJunee Shire CouncilKempsey Shire CouncilKu-ring-gai CouncilKyogle CouncilLachlan Shire CouncilLake Macquarie City CouncilLeeton Shire CouncilLismore City CouncilLithgow City CouncilLiverpool Plains Shire CouncilLockhart Shire CouncilMaitland City CouncilMid Coast CouncilMoree Plains Shire CouncilMosman Municipal CouncilMurray River CouncilMurrumbidgee CouncilMuswellbrook Shire CouncilNambucca Shire CouncilNarrabri Shire CouncilNarrandera Shire CouncilNarromine Shire CouncilNew England TablelandsNewcastle City CouncilNorfolk Island Regional CouncilNorth Sydney CouncilNorthern Beaches CouncilOberon CouncilPort Macquarie-Hastings CouncilPort Stephens CouncilQueanbeyan Palerang CouncilRandwick City CouncilRiverina Water County CouncilRous County CouncilShoalhaven City CouncilSingleton CouncilSnowy Monaro Regional CouncilSnowy Valleys CouncilStrathfield CouncilSutherland Shire CouncilTamworth Regional CouncilTemora Shire CouncilTenterfield Shire CouncilTweed Shire CouncilUpper Hunter County CouncilUpper Hunter Shire CouncilUpper Lachlan Shire CouncilUpper Macquarie County CouncilUralla Shire CouncilWagga Wagga City CouncilWalcha CouncilWalgett Shire CouncilWaverley CouncilWarren Shire CouncilWarrumbungle Shire CouncilWeddin CouncilWentworth Shire CouncilWilloughby City CouncilWingecarribee Shire CouncilWoollahra Municipal CouncilYass Valley CouncilOTHEROrganisation NameEmail* PhoneMEMBER SURVEY1. How long have you personally had direct dealings with Statewide Mutual?* Less than 1 year 1 to 2 years 2 to 3 years 3 to 5 years > 5 years 2. How regularly do you have contact with Statewide Mutual?* Daily Weekly Fortnightly Monthly Quarterly Annually Bi-annually 3. Which of the following types of contact have you had with Statewide Mutual in the past 12 months?* Annual renewal process Chair visit Statewide Mutual Risk Management Conference Claim / incident process / claim resolution General enquiry Insurance advice and services On-site inspection / audit Risk management advice and services None of the above Other Please provide detail4. Do you know the members of your Service Delivery Team?*Please tick all that apply Board Member Executive Officer Account Chair Account Manager Regional Risk Manager Claims Consultant 5. When did you last meet with one of these contacts?*6. On a scale of 1 to 5, please rank the following performance of your Service Delivery Team?(1 star being unsatisfactory and 5 stars being excellent.)a) Builds rapport with you and your staff*a) please provide more detailb) Responds to queries within your expected timeframes*b) please provide more detailc) Provides quality advice*c) please provide more detaild) Provides up to date advice on risk, insurance and Mutual related developments*d) please provide more detaile) Proactive in identifying and addressing potential changes needed to your risk program*e) please provide more detailf) Responds promptly to claims notifications*f) please provide more detailg) Keeps you up to date on contentious claims issues*g) please provide more detailh) Provides satisfactory advice, information and assistance in managing and settling claims*h) please provide more detail7. To assist us in producing relevant content in our educational and marketing material, please identify which of the following topics are of interest to you?* Emerging trends and issues Claims updates on relevant successful and unsuccessful claims and legal cases Claims case studies and trends Risk management practices and approaches Training, education and tools Other 7a. Please provide other topics of interest(Click the + sign for a new line) 8. How would you rate the importance of the following?*(on a scale of 1 to 5, 1 being do not value at all and 5 being highly value):9. Please rank the following in order of importance:(1 being the most important and 5 being the least important)10. Do you feel adequately equipped to respond to your stakeholders and elected members in relation to Statewide Mutual and your insurance arrangements?* Yes No Please provide more detail11. What is the most important part of our service delivery to you and your organisation?*12. What improvements to our service delivery would you like to see developed?*13. Do you believe there is value in being part of Statewide Mutual?* Yes No Please provide additional detailsThis field is hidden when viewing the formHow would you rate the usefulness of the following?*14. What industry events have you attended in the last 12 months?* Statewide Mutual Risk Management Conference Statewide Mutual Mock Trial A presentation or workshop presented by your Regional Risk Manager or Account Manager LGNSW Annual Conference IPWEA Annual Conference Local Government NSW Property Professionals Conference LG Professionals NSW LG Professionals Australia ALGA National General Assembly Other Please list any other industry events attended 15. Overall, have we successfully implemented your risk program, including placement and provided your team with the necessary tools, products and services?* Yes No 16. Have we demonstrated a clear understanding of your business?* Yes No 17. Are we delivering key services as expected by you?* Yes No 18. Please provide any additional comments or feedback you would like us to considerConsent I am happy to be contacted to discuss my feedback further.
