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The Allied Authorization form represents a significant step in streamlining the payment process for insurance premiums, making transactions simpler and more efficient for policyholders. With the Flex Chek option, customers benefit from automatic withdrawals that eliminate the need for writing checks or mailing payments, thereby reducing the risk of missed deadlines. This authorizes Nationwide Mutual/AMCO/Allied Property and Casualty to withdraw specified amounts from your bank account, ensuring your insurance coverage remains uninterrupted. The form guides users through essential steps, including verifying bank details and submitting a payment check, whether for an existing policy or a new one. Additionally, it guarantees that any changes to the payment amounts will be communicated well in advance, allowing for transparency in financial planning. By taking just a few minutes to complete and submit this form, customers can enjoy the peace of mind that comes with hassle-free insurance premium payments.

Allied Authorization Example

Please fill out this form and fax back to: 1-800-811-5386 Or mail to: LRO Personal Lines Processing Center

3820 109th St, Dept 5672

Des Moines, IA 50391- 5672

Authorization for Flex Chek

Allied® provides a service to you, our valued customers, enabling automatic account withdrawals for payment of your insurance premium. This is just one more way that we are On Your Side, by making your life easier and your interaction with us more convenient. No more writing checks or buying stamps to mail your payment. Be secure knowing your insurance protection won’t lapse due to a lost or delayed payment.

Instead of receiving a bill from Nationwide Mutual/AMCO/Allied Property and Casualty each month, your automatic payment will show up on your monthly bank statement. Should there be a change in the payment amount deducted from your account, we will notify you about 20 days before your account is changed.

To start enjoying the convenience of Flex Chek, just follow these simple steps.

1.Complete the attached Authorization form.

2.If you are already a Allied policyholder, write a check for the current minimum due (shown on your billing statement). New Allied policyholders: your check for just one month’s premium is all it takes.

3.Send us:

Your check

Return portion of your billing statement

Completed Authorization form and a voided check (to allow us to verify your bank and account number)

I authorize Nationwide Mutual/AMCO/Allied Property and Casualty Insurance to withdraw funds from the account identified below for payment of my insurance premium. The bank (or financial institution) named below is authorized to deduct funds from my account using the Flex Chek option.

Billing Account Number (see your billing statement) _________________________

Name of bank or financial institution_______________________________________________

Bank Address_______________________________________________

City, State ________________________________ Zip____________

Bank/ABA Number_______________________________________________

Checking Account Number_______________________________________________

Home Address_______________________________________________

City, State ________________________________Zip_____________

Name (Please print)_______________________________________________

Signature______________________________Date______________

Name (Please print) – if joint account_______________________________________________

Signature_____________________________ Date______________

File Breakdown

Fact Name Description
Purpose of Authorization The Allied Authorization form allows customers to set up automatic withdrawals for insurance premium payments, ensuring timely transactions without the hassle of checks or stamps.
Easy Completion Completing the form requires basic information, including the policyholder’s details and banking information, making it user-friendly.
No More Delays By utilizing Flex Chek, customers can avoid delays or lapses in insurance coverage due to lost or delayed payments.
Notification of Changes If there is a change in the payment amount, customers will be notified approximately 20 days in advance of the adjustment.
Initial Payment Requirement New policyholders only need to submit one month’s premium, while existing policyholders must include the current minimum payment shown on their billing statement.
Mailing and Faxing Instructions The completed form can be faxed to 1-800-811-5386 or mailed to LRO Personal Lines Processing Center in Des Moines, IA.
Information Necessities The form requires filling out specific banking details, including the bank address and account numbers, to facilitate the payment process.
Authorization Scope By signing, customers give authorization to Nationwide Mutual, AMCO, and Allied Property and Casualty Insurance to withdraw funds from their designated account.
Verification Process Customers are required to attach a voided check to verify their bank and account information for the automatic payments.
Applicable Governing Law The form is governed by applicable insurance laws specific to the state of residence of policyholders, which can vary based on local regulations.

Guide to Using Allied Authorization

Filling out the Allied Authorization form is a straightforward process. After completing the form correctly, you will need to submit it either by fax or by mail. This will allow your automatic account withdrawals for your insurance premium to begin, simplifying your payment process.

  1. Locate the Allied Authorization form provided in your documents.
  2. Fill out the form with your personal details, including your name, address, and the name of your bank or financial institution.
  3. For existing Allied policyholders, write a check for the current minimum due as indicated on your billing statement.
  4. If you are a new Allied policyholder, write a check covering just one month’s premium.
  5. Attach the following documents together:
    • Your check
    • The return portion of your billing statement
    • The completed Authorization form
    • A voided check for verifying your bank and account number
  6. Fax your completed materials to 1-800-811-5386 or mail them to the LRO Personal Lines Processing Center at 3820 109th St, Dept 5672, Des Moines, IA 50391-5672.

Get Answers on Allied Authorization

What is the purpose of the Allied Authorization form?

The Allied Authorization form allows customers to set up automatic withdrawals from their bank accounts for the payment of insurance premiums. This service, known as Flex Chek, streamlines the payment process, eliminating the need to write checks or mail payments. By using this form, customers can ensure their insurance remains active without the worry of missed or delayed payments.

How do I complete the Allied Authorization form?

To complete the Allied Authorization form, follow these steps:

  1. Fill out the Authorization form with accurate information, including your billing account number and bank details.
  2. If you are an existing Allied policyholder, include a check for the current minimum due as indicated on your billing statement. New policyholders need only to include a check for one month's premium.
  3. Gather the following items: your check, the return portion of your billing statement, and the completed Authorization form with a voided check attached to verify your bank details.

Where should I send the completed form and payment?

You can send the completed Authorization form and payment by fax or mail. The fax number is 1-800-811-5386. If you prefer to mail your documents, use the following address:

LRO Personal Lines Processing Center
3820 109th St, Dept 5672
Des Moines, IA 50391-5672

Will I be notified of changes to the payment amount?

Yes, if there is any change in the payment amount that will be deducted from your account, you will receive notification approximately 20 days before the change takes effect. This ensures that you remain informed about your payment schedule and can manage your finances accordingly.

What happens if I change my bank account?

If you change your bank account and wish to continue using the Flex Chek service, you need to complete a new Allied Authorization form. Include the updated bank details and submit it as per the instructions. It's important to allow adequate time for the changes to be processed to avoid any disruption in your premium payments.

Is there a fee to use the Flex Chek service?

No, there are no fees associated with using the Flex Chek service for automatic premium payments. This service is designed to save you time and ensure the continuity of your insurance protection without incurring extra costs.

Common mistakes

When filling out the Allied Authorization form, many people overlook important details that can lead to processing delays or complications. One common mistake is failing to provide complete and accurate information. For instance, you must include your billing account number exactly as it appears on your statement. Missing or incorrect digits in this number can result in your auto-payment not being set up correctly.

Another frequent error is neglecting to sign the form. A signature is crucial because it serves as your formal authorization for the automatic withdrawals. Without it, the form is invalid, and your request cannot be processed. Double-check to ensure you’ve signed in all required areas, especially when dealing with a joint account.

Many individuals submit their forms without including a voided check, which is necessary for verifying your bank details. The check must clearly show your account and routing numbers. Skipping this step not only slows down the process but may lead to manual verification steps that could have been avoided.

When typing your bank’s information, errors can easily occur. It’s essential to accurately fill out the name of your bank or financial institution, the bank address, and the ABA number. A minor mistake in any of these fields can cause significant confusion and prevent the withdrawals from occurring on schedule.

People also often forget to include the current minimum due check, especially if they are existing policyholders. This is a fundamental requirement that serves to cover your initial payment and ensure that your account is active before you transition to automatic payments.

Finally, it’s important to ensure you send the completed form to the correct address or fax number. Misrouting your Authorization form can lead to delays. Always verify the contact details before submission to avoid frustration.

Documents used along the form

The Allied Authorization form is an essential document used for automatic premium payments with Allied Insurance. When completing this process, you may also need other important forms and documents. Here is a list of commonly used documents that go hand in hand with the Allied Authorization form:

  • Billing Statement: This document shows your current insurance premium amount owed. It provides details on the due date and payment amount necessary to initiate the automatic withdrawal.
  • Check: A personal check may be required as an initial payment, especially for new policyholders. This check should reflect the monthly premium indicated on your billing statement.
  • Voided Check: A voided check is necessary to verify your bank account information. It ensures that the correct account will be debited for premium payments.
  • Policyholder Agreement: This document outlines the terms of your insurance policy with Allied. It includes coverage details and responsibilities of both the insurer and the policyholder.
  • Change Request Form: If you need to change any details related to your coverage or payment method, this form must be submitted to update your information accurately.
  • Cancellation Notice: If you decide to cancel your policy, this document formally informs Allied of your decision. It helps manage the termination of your payments and coverage.
  • Claim Form: Should you need to file a claim, this form initiates the process. It's vital for receiving benefits under your policy and may influence premium calculations.
  • Account Verification Form: This document provides additional confirmation of your bank account details if there are discrepancies or if your information changes.
  • Annual Review Document: This form outlines any annual changes to your policy or premiums. It helps in understanding how your coverage might have adjusted over the year.

Utilizing these documents in conjunction with the Allied Authorization form ensures a smoother process for managing your insurance premiums. Keeping these items organized will help maintain your policy and payments in good standing.

Similar forms

  • Direct Debit Authorization Form: This document allows an individual to authorize a company to withdraw funds directly from their bank account, similar to the Allied Authorization form. Both simplify payment processes and ensure timely transactions by eliminating the need for checks.

  • Recurring Payment Agreement: Like the Allied Authorization form, this document outlines an agreement between a customer and a service provider for automatic recurring payments. Both provide clarity on payment amounts and dates.

  • Auto-Pay Enrollment Form: This form enables customers to enroll in an automatic payment system, similar to the Flex Chek feature. Both aim to enhance convenience and reduce the effort involved in regular payments.

  • Bank Withdrawal Authorization: This document gives permission to a bank or financial institution to withdraw specific amounts from an account. It functions in much the same way as the Allied Authorization form by facilitating automatic withdrawals.

  • Payer Authorization Form: This form allows third-party organizations to access a payee's account for automated payments. Like the Allied Authorization form, it minimizes manual payment chores.

  • Insurance Premium Financing Agreement: Similar to the Allied Authorization form, this document outlines the agreement between an insured party and a financing company for their insurance premium payments, ensuring payments are automatically processed.

  • Standing Order Form: This document establishes a standing order with a bank for regular payments, mirroring the automatic payment features found in the Allied Authorization form.

  • Monthly Payment Deduction Form: Just like the Allied Authorization form, this document enables a company to automatically deduct monthly payments from a customer’s bank account.

  • Virtual Account Management Form: This form allows customers to manage their payments online, enabling automatic debit features similar to those in the Allied Authorization form.

  • Account Verification Form: While primarily used to verify account details, this document operates alongside the Allied Authorization form to ensure proper automatic deductions.

Dos and Don'ts

When filling out the Allied Authorization form, careful attention to detail can prevent future complications. Here are six essential do's and don'ts to consider during this process:

  • Do ensure all fields are filled out accurately, including your name, address, and bank information.
  • Do provide a voided check to facilitate verification of your bank account details.
  • Do check your billing statement for the exact amount due if you are an existing policyholder.
  • Do send the completed form along with the necessary payment, whether it’s a check or the return portion of the billing statement.
  • Don't leave any required fields blank, as missing information could delay your authorization process.
  • Don't forget to sign and date the form, ensuring it’s legally binding.

By following these guidelines, you help ensure a smooth submission and continuation of your insurance coverage.

Misconceptions

Understanding the Allied Authorization form is crucial for all customers, yet several misconceptions persist. Here is a list of common misunderstandings about the form and the payment option it represents.

  1. It’s mandatory to use this payment method. Many believe that automatic withdrawal via Flex Chek is a requirement for all Allied policyholders. This is not true; you can choose how to pay your premiums.
  2. Allied will deduct more than the agreed amount. Customers often worry that they will face unexpected deductions from their accounts. However, Allied commits to notifying you about any changes to your payment amount 20 days in advance.
  3. This form is only for new policyholders. Existing policyholders can also take advantage of this authorization. Completing the form enables automatic withdrawals for those who are already insured.
  4. Filling out the form is complicated. The process is straightforward. Just complete the required fields, attach a voided check, and send it in with your billing statement.
  5. Allied will share my banking information. This concern is common, yet Allied assures that your banking data is secure and will only be used for the purpose of withdrawals.
  6. Payment can be processed without my approval. Your consent is necessary to initiate the automatic withdrawals. By signing the authorization, you give permission for these deductions.
  7. This service won’t save me time. Many may think the Flex Chek option is just as time-consuming as writing checks. In reality, it eliminates the hassle of preparing payments and mailing them.
  8. Once I sign, I can’t change my payment method. Incorrect! You can modify or discontinue your automatic payment at any time by informing Allied.
  9. Using this form doesn’t benefit me. On the contrary, the Flex Chek system provides peace of mind, ensuring your payment arrives on time and helping you avoid potential lapses in coverage.

By clarifying these misconceptions, you can make informed choices about your payment options and enjoy the convenience that Allied offers.

Key takeaways

Filling out and utilizing the Allied Authorization form is key for effortless payment processing. Understanding the process can enhance your experience and ensure timely insurance premium payments. Here are important points to consider:

  • The form must be completed accurately and submitted via fax or mail to the designated address.
  • For existing Allied policyholders, enclosing a check for the minimum current due is necessary. New policyholders should provide a check for just one month’s premium.
  • Ensure the required documents are included: the completed authorization form, the return portion of your billing statement, and a voided check. Each of these elements is critical for processing.
  • Payment changes will be communicated about 20 days prior to adjustments, so monitor your communications to stay informed.
  • Using the Flex Chek option simplifies your payments and helps prevent lapses in your insurance coverage, adding peace of mind.