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These form need to be completed, signed, and submitted to our Setup Team ( in order for RPM to commence services on behalf of a policy. The policy will need to be bound according to the instructions at the top of the form in order for RPM to facilitate Pay-As-You-Go services. If you would like to inquire about a carrier not listed below, click HERE.

Choose an Insurance Carrier below to download our Authorization for Premium Remittal Form*

*This comprehensive list includes all carriers currently insuring our clients. Inclusion on this list doesn’t imply endorsement or legal obligations to RPM from any specific carrier.