The Authorization and Direction Pay form is a crucial document that facilitates direct payment from an insurance company to a designated repair facility following a claim. This form streamlines the payment process, ensuring that repairs can commence without unnecessary delays. By completing this form, the owner not only authorizes the insurance company to make payments but also commits to promptly notifying the repair facility in case of any misdirected funds.
The Authorization And Direction Pay form serves as a crucial document in the claims process, facilitating direct payments from insurance companies to repair facilities. This form streamlines the transaction, ensuring that the necessary funds reach the appropriate body shop without unnecessary delays. It requires essential information such as the owner's name, vehicle details—including license plate, make, and model—and the specifics of the insurance claim. The form also mandates the inclusion of the repair facility's information, including the tax ID and contact details. By signing this document, the vehicle owner authorizes their insurance company to pay the specified amount directly to the repair shop, thereby simplifying the payment process. Additionally, the form stipulates that if a settlement check is mistakenly sent to the owner, they must promptly notify the repair facility and deliver the check within 24 hours. This mutual understanding helps maintain clear communication and accountability among all parties involved in the claim process.
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 _________________________________________________________________________________________________
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When filling out the Authorization And Direction Pay form, consider the following key takeaways: