CHANGE MY METHOD OF PAYMENT

Auto and home insurance

Use this form to submit your request securely.

IMPORTANT

Use this form to change your home or auto insurance payment method.

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.

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Insurance policyholder

First name

Last name

Email address

Date of birth

mm-dd-yyyy

The change of bank account applies to which insurance policies?

My auto policy

Policy number Contains between 8 and 11 characters

My home insurance

Policy number Contains between 8 and 11 characters

My leisure vehicle and RV insurance

Policy number Contains between 8 and 11 characters

Bank account holder

First name

Last name

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

First name

Last name

New bank account information

1- Transit/branch no.

2- Institution no.

3- Account no.

New method of payment

Desired method of payment

The date on which future payments will be made

Choose a payment date

mm-dd-yyyy

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.

To review your consent preferences or to learn more, please refer to our Privacy Notice.

I confirm that I am the owner of the above-mentioned policy(ies) and am authorized to make this request.

I understand that the requested change(s) will take effect when I receive confirmation by email or by telephone.