Electronic Funds Transfer Authorization Agreement Form

Please use this form to automatically receive your Argus Health Payments directly to your preferred Bank Account. Alternatively, click here to download a hard copy of the form and submit it us by email, mail or in person.

Note: transfers may only be made to the primary insured member's account.

To complete your request you will need:

  1. Health insurance information (eg. certificate number)
  2. Banking information (eg. bank name and bank account number)
  3. Government issues photo identification. Please note: only jpeg and jpg file types may be uploaded. File size limit is 6MB

If you have any questions, please don't hesitate to send us an email at clientinfo@argus.bm or call 298-0888

Complete Form

Please note: The online submission of this form is secured using a Digicert EV SSL certificate. Information entered by you and sumitted to Argus using a web address beginning with "https" is encrypted and protected.

Fields indicated by an asterisk * are mandatory

Personal Employee Information:

Numbers only, no special characters, spaces, or dashes allowed
(must be a valid email address)

Banking Information:

Please note: transfers may only be made to the primary payee member's account.

(as it appears on account)
Must be either a savings or current account based in Bermuda Numbers only, no special characters, spaces, or dashes allowed

Declaration:

Communications:

Upload Photo Identification:

Government issues photo identification. Please note: only jpeg and jpg file types may be uploaded. File size limit is 6MB

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