Auto and home insurance

Use this form to submit your request securely.


Use this form to change the bank account you use to pay for your home or auto insurance.

Changes will not be made to scheduled withdrawals for the next five business days.

If your request concerns a scheduled withdrawal in the next five business days, please contact us at 1-877-700-7778.

Insurance policyholder

The change of bank account applies to which insurance policies?
Contains between 8 and 11 characters
Contains between 8 and 11 characters
Contains between 8 and 11 characters

Bank account holder

Bank account holder
Co-holder (joint account) or agent of the bank account (optional)

New bank account information

Do you also want to change the date of the preauthorized withdrawals?

Information regarding the request (optional)

Maximum of 5,000 characters
Character count:

The personal information collected by iA Financial Group and its affiliates regarding your claim will only be used and shared to the ends to which you have already consented.

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