This form should be used only for Renewal of your policy as per the terms indicated in your Renewal Notice posted to you. If your policy is lapsed/expired, YOUR INSURANCE COVERAGE IS AFFECTED. You should NOT use this form but contact your Customer Service Representative immediately. Contact details are available on this website.
You may also be able to obtain Premium Financing for your payment through our associate company Northwest Premium Finance Limited.
Should you encounter difficulties, do not press
the Back button. Please call us at The Beacon Insurance Company Limited,
or e-mail us at firstname.lastname@example.org immediately. Do not press your browser’s ‘Back’ button to re-enter the transaction.