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Customer Service - Life Insurance

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Premium Billing Mode Election Form

When to Use This Form

Use the ``Premium Billing Mode Election" form to select or change the frequency and/or method in which you wish to pay your premiums.

Other than annual, available payment modes are semiannual (a payment every six months), quarterly (a payment every three months), and monthly (12 payments a year).  Monthly payments can be made either by electronic fund transfer (EFT) from your bank account or by direct bill. 

(Note: The minimum payment amounts required for each payment mode are listed on the form.)

Call for More Information on Modal Payments

Please contact your Aurora Agent, or our office at (800) 265-2652, for more information about modal payments and associated administrative charges.

To access our Premium Billing Mode Election Form, please click on the button below.

Premium Billing Election Form

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Copyright ©2000 Aurora National Life Assurance. All rights reserved. Site last modified: Nov 29, 2000