Vantage Point Risk — Secure Portal

Secure Payment Portal

Secure Payment Portal

Your information is transmitted over an encrypted connection (TLS) and stored encrypted using AES-256. Card and bank details are handled in accordance with PCI DSS and EFT security standards, including Regulation E, NACHA Operating Rules, and GLBA.

Policy Approval & Payment Information

Review and approve your policy, then provide payment details for your carrier. No payment is processed on this page — your information is collected securely and shared only with your insurance carrier.

1Your Info

2Policy

3Payment

4Authorize

Company

This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Business Name (if applicable)

Phone(Required)

Email(Required)

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

What do you need to do?(Required)

Start a New Policy

Update Billing on an Existing Policy

Effective Date(Required)

As Quoted

Specific Date

Policy Start Date(Required)

MM slash DD slash YYYY

Policy Number

Found on your policy documents or billing statement. Leave blank if you don’t have it handy.

Payment Type(Required)

ACH / EFT (Bank Account)

Credit Card

Card Type(Required)

Visa

Mastercard

Discover

AMEX

Card Number(Required)

Expiration (MM/YY)(Required)

CVV(Required)

Confirm Billing ZIP Code(Required)

Re-enter the ZIP code on your card’s billing address.

Routing Number(Required)

Account Number(Required)

Account Type(Required)

Payment Option(Required)

Pay in Full

Monthly Installments

Monthly installments may incur a monthly service fee.

Authorization(Required)

I authorize Vantage Point Risk to securely share my payment information with the insurance carrier for the purpose of initiating or updating my insurance policy billing. I understand that this form does not process any payment and is solely for secure data collection.

Signed By (type your full legal name)(Required)

Date(Required)

MM slash DD slash YYYY

Twitter
Facebook
LinkedIn
YouTube

•

Terms and Conditions