The Payment Authorization Form grants Openly consent to charge the payment method on file. This form is required for all policies that use electronic funds transfer (EFT) or credit card (CC) billing methods to ensure automatic withdrawal of renewal-term premiums.
How to Access the Form
- Electronic Delivery: Policyholders opted-in to electronic documents will receive the form via email. Once eSigned, it automatically returns to Openly.
- Manual / Wet Signatures: Blank authorization forms are available under the Documents tab.
- Identifying Payment Details: You can also use a blank form to verify the last four digits of the EFT or CC payment method on file, which are located on page two of the form.
How to Upload the Completed Form
If you have a physical or manually signed form, follow these steps to upload it:
- Locate the policy in the portal and click View.
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Navigate to the Documents tab and click Upload Document on the right side of the screen.
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Select CC or EFT Authorization Form from the dropdown menu, then choose the file from your computer or drag it into the designated upload area.
Note: The uploaded form must match the active payment method in the portal for this option to appear in the dropdown menu.
- Click Save.
Once the submission is successful, the UI receipt confirmation will update the policy's status to Authorized on the Billing tab.
If you need further assistance or a new authorization form sent via email, contact us via our webform or Live Chat.