Payment Term Change Form

MM slash DD slash YYYY

Payment Plan Selection

Full Pay - One Full Payment  

Triannual - 3 Installment Payments (40%,30% & 30%) 

Monthly Plan - 11 Installment Payments (Initial Payment 16.67% plus 10 equal payments) only applicable to New Business Policies transacted after 10/27/2023 and Policies with renewal effective date of 12/01/2023 and beyond. 

Disclosures: The payment plan selection can not be used for same day processing of premium payments

A payment plan request must be submitted at least 5 business days prior to the next payment due date. Payment change requests are processed in the order received Forms received with incomplet information may cause additional delays in processing times.

California Earthquake Authority (CEA) Policies incur a $1.00 per installment fee and California FAIR Plan Commercial Policies incur a $2.50 per installment fee.

The average Payment Plan change process typically takes from 1-5 business days to process.

E-Mail the completed form to

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