Accident Medical ACH forms 

Processing a check by phone is a convenient way to pay initial premiums, policy endorsements and even routine bills.

To make a single payment from a checking or savings account, complete the appropriate Automated Clearing House (ACH) form and submit it along with a new application, billing statement or policy endorsement. Account and routing numbers are required to process the payment.

Nationwide^® policies

To issue premium payment for a Nationwide^® policy, please use the Nationwide ACH form (PDF).

National Casualty policies

To issue premium payment for a National Casualty Company (a division of Scottsdale Insurance) policy, please use the National Casualty ACH Form (PDF).

Fax the completed ACH form and any supporting documentation detailing the premium due to:

1-413-214-7761
Attn: Policy Administration

PDFs require Adobe^® Reader^®