The Authorization And Direction Pay form is a document that allows a policyholder to direct their insurance company to pay a specific body shop directly for repairs related to a claim. This streamlined process helps ensure that payments are handled efficiently and correctly. For those needing to fill out this form, click the button below to get started.
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The Authorization and Direction Pay form is a crucial document in the insurance claims process, particularly in vehicle repair situations. It allows the insurance company to pay the repair facility directly, ensuring that the necessary work can proceed without delay. Alongside this form, several other documents may be required to facilitate the claims process efficiently. Here are some commonly used forms and documents that accompany the Authorization and Direction Pay form:
Each of these documents plays a significant role in the claims process, helping to streamline communication between the policyholder, the insurance company, and the repair facility. Together, they ensure that claims are processed efficiently and accurately, minimizing delays and misunderstandings.
DIRECTION TO PAY FORM
OWNER/CLAIM INFORMATION
Name _________________________________________________________________ License Plate ______________________________
Address ___________________________________________________________________________________________________________
Home Phone _________________________________________
Business/Cellphone __________________________________________
Year _____________________ Make _____________________
Model _ _____________________________________________________
Insurance Company ___________________________________
Claim # _____________________________________________________
DIRECTION TO PAY
I authorize ____________________________________________ Insurance Company to pay ____________________________________
directly on claim number ________________________________ in the amount of $___________________. In the event the insurance
or adjustment company inadvertently mails the settlement/supplement check to me in error, I hereby agree to notify the repair facility immediately and deliver the check to that facility within 24 hours of my receipt of said check.
Customer Printed Name
Customer Signature
Date
Body Shop _________________________________________________________________________________________________________
Body Shop Tax ID ___________________________________________________________________________________________________
Body Shop Address _________________________________________________________________________________________________
Body Shop Phone __________________________________________________________________________________________________
Body Shop Contact _________________________________________________________________________________________________