top of page

This document empowers a collision repair facility to act on behalf of the vehicle owner in insurance-related matters. It authorizes:

  • โœ… The shop to perform repairs and communicate directly with the insurer

  • ๐Ÿ’ฐ Direct payment from the insurance company to the repair facility

  • ๐Ÿ›  Full coverage of initial and supplemental repairs tied to the claim

  • โš– Legal right to pursue payment if the insurer fails to indemnify fully

This form protects both the vehicle owner and the repair facility by clarifying responsibilities and streamlining insurance interactions.

Direction to Pay with Customer Responcibility Section

$5.99 Regular Price
$3.00Sale Price
    bottom of page