Please make all checks payable to International Medical Group, Inc . Enter the annual GCMI Premium that corresponds to your age, gender and deductible. Overnight Fee - Certificate will be overnighted to the maling address you provided upon approval. All paymens must be made in US dollars at the time application for coverage is made. This authorization will remain in effect until revoked by me in writing, and until IMG actually recieves notice.
Coverage purchased by credit card is subject to validation and acceptance by credit card company.
For any mode other than Annual, I pre-authorize IMG to debit my credit card for the proper installment amount on the due date of the installment.