Tell us about you and your business

Consent to Doing Business Electronically

By consenting to do business electronically you agree that:

• You are who you say you are when transacting business through this website.
• If you are transacting business on behalf of your employer, you have the appropriate authority to conduct business electronically on its behalf.
• This consent applies only to this transaction and withdrawal of your consent for future transactions is not required.
• You have access to a computer with a current Internet browser and an operating system that allows you to save files or print web pages and documents.
• You may print this consent and any electronic record or you can contact us to request a paper copy from us.
• Your online activity may be viewed, monitored, and recorded for the purposes of fraud prevention and fraud detection and to improve the user experience.

If you do not consent, you will not be able to conduct this transaction online.

Insurance Fraud Warning