PL - IA 01/01/2013 Rates and Manuals - Western National Insurance ...

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Direct Billing Guidelines 8________________________________________________________________________________________________________________________________________________________________________________EXAMPLE OF INSURED’S BILLING STATEMENT – INDIVIDUALLY BILLED POLICIESRETURN THIS PORTIONPlease make your check payable to Western NationalPolicy Number 01 PAP 40000243 Amount EnclosedNotice Date MARCH 3, 2001 Payment Due 03/21/01Insured WILLIAM JOHNSON To Pay in Full $312.00Payor WILLIAM JOHNSON Minimum Due $4564 MILL LAKE ROAD 312.00MINNEAPOLIS MN 55403Installment 1234567Insured's copyPREMIUM NOTICEWESTERN NATIONAL MUTUAL INS COPolicy Number 01 PAP 40000243 WILLIAM JOHNSONNotice DateMARCH 3, 2001Page 1 of 1Agent WNI-000 ABC AGENCY Phone (612) 831-1234123 W MAIN ST MINNEAPOLIS MN 55435Type of Insurance PERSONAL AUTO Policy Period MARCH 1, 2001 to SEPTEMBER 1, 2001Policy Number Description Effective Date AmountPrevious Balance 0.00Payment 82.00-PERSONAL AUTO 01 PAP 400000243 NEW POLICY MARCH 1, 2001 394.00Your business is appreciated. Please continue to contact your agentif you desire any changes to your present coverage.Due Date Minimum Due To Pay in Full03/21/01 312.00 or 312.00If you have questions on your bill, call (952) 921-9280 or (800) 862-6070 ext. 280________________________________________________________________________________________________________________________________________________________________Western National Insurance Group 3/26/2012
Direct Billing Guidelines 9________________________________________________________________________________________________________________________________________________________________________________EXAMPLE OF INSURED’S BILLING STATEMENT – ACCOUNT-BILLED POLICIESRETURN THIS PORTIONPlease make your check payable to Western NationalAccount No. 10030 Amount EnclosedStmt Date AUGUST 1, 2001 Payment Due 08/19/01To Pay in Full $7,087.00Insured COMMERCIAL BUSINESS Minimum Due $4564 MILL LAKE ROAD 638.00MINNEAPOLIS MN 55403Statement 1234567Insured's copyACCOUNT STATEMENTWESTERN NATIONAL INSURANCE GROUPNotice DateAUGUST 1, 2001Page 1 of 1Account No. 10030 Agent WNI 000Insured COMMERCIAL BUSINESS Name ABC AGENCYPhone (612) 831-1234Policy Number Description Effective Date AmountPrevious Balance 8,543.00Payment 1,461.00-STATEMENT FEE 5.00Your business is appreciated. Please continue to contact your agentif you desire any changes to your present coverage.POLICY NUMBERTOTAL DUE MINIMUM DUECOMMERCIAL AUTO 01 CA 300000013 1,255.00 50.00WORKERS COMPENSATION 01 WC 300000011 5,827.00 583.00STATEMENT FEE 5.00 5.00Due Date Minimum Due To Pay in Full08/19/01 638.00 or 7,087.00If you have questions on your bill, call (952) 921-9280 or (800) 862-6070 ext. 280________________________________________________________________________________________________________________________________________________________________Western National Insurance Group 3/26/2012
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