Hanover Direction to Pay Form - Ultra Shine Collision 2026

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The document is an authorization form for payment related to vehicle repairs under the Citizens/Hanover Insurance Companies' Express Claims program. It requires signatures from the vehicle owner and a witness after repairs are completed, certifying satisfaction with the work done. The form includes details such as claim and policy numbers, repair shop information, and outlines responsibilities regarding deductibles and depreciation. It must be submitted electronically or via fax within 48 hours of repair completion for payment processing.

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Click ‘Get Form’ to open the Hanover Direction to Pay Form in the editor.
Begin by entering the Underwriting Company Name from the Appraisal Assignment, followed by the Claim Number and Policy Number. These fields are essential for processing your payment.
Fill in the Vehicle Owner’s Name and Insured’s Name accurately. This ensures that all parties involved are correctly identified.
In the section for Repair Shop details, input Ultra Shine Collision as the name of the repair shop, along with their phone number, tax ID, address, city, state, and zip code.
Complete the financial sections detailing any applicable deductibles and adjustments for depreciation or betterment. Ensure that these amounts are accurate as they affect your total payment.
Sign and date where indicated for both the vehicle owner and witness. The repair facility must also sign to certify compliance with Express Claims program guidelines.
Finally, review all entries for accuracy before submitting. Email or fax this completed form within 48 hours of repairs to ensure timely processing of your payment.

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