1. Payments made by Credit Card or Debit Card through the Secure Payment Form will incur a Convenience Fee equal to 3.25% of the Transaction Amount.
2. Payments to Highview National Insurance Company made through the Secure Payment Form does not guarantee, or entitle payee to, binder or reinstatement of insurance coverage unless specifically confirmed by Highview National Insurance Company in writing. By making payment through this Secure Payment Form, you agree to the above terms of use.
I hereby authorize this company to debit my bank account through the electronic Automated Clearing House (ACH) network within one to three business days from the date of this payment. I am aware that in the event this company is unable to secure funds from my bank account for this transaction for any reason, including but not limited to, insufficient funds in my account or insufficient or inaccurate information I provided when I submitted the electronic payment, further collection action may be undertaken by this company, including application of returned check fees to the extent permitted by law. If the payment is returned by my bank, I am still responsible for making a payment to this company.
1 Alpine Ct, Suite 102, Spring Valley, NY 10977 / 845.363.0500 | 845.596.9937
