Tuesday, May 13, 2014

ACORD 130 Workers Compensation Application Signature Section

How to Complete the Signature Section of the Workers Compensation Application


At the top hand corner of the signature section of the ACORD 130 workers compensation application is a check box you need to check to state that you have given this insured a copy of the Notice of Information Practices form.

This is the ACORD 38 form for most states. The following states have their own form as of this writing...

ACORD 38AR - Arkansas
ACORD 38AZ - Arizona
ACORD 38CA - California
ACORD 38CT - Connecticut
ACORD 38DE - Delaware
ACORD 38GA - Georgia
ACORD 38IL - Illinois
ACORD 38MT - Montana
ACORD 38NH - New Hampshire
ACORD 38NJ - New Jersey
ACORD 38NV - Nevada
ACORD 38OR - Oregon
ACORD 38RI - Rhode Island
ACORD 38VA - Virginia
ACORD 38WA - Washington

Not all states require a notice. Check with an experienced agent at your agency or with your underwriter.

In the bottom left hand corner of the first section of the Signature section there is a place to get your insured to initial. Don't forget this.




At the very bottom of the 4th page is a place for the Applicant's Signature and next to it a space to have the insured date their signature.

Next to that is a spot for your - the agent's - signature.

Finally there is a box for your National Producer Number if your agency has one.

If you are using our Cap Dat ACORD services we have an electronic, or e-signature, feature available to you. You can add this to the signature box and email a link to the form to your insured. They can then review and sign the form on a tablet, smart phone or most current browsers. This gives you an extra level of legal documentation on the time and date of the signature. It can also save time.

I hope this group of posts have been helpful in your learning more about how to complete the ACORD 130 workers compensation application.

We offer a daily and weekly email tutorial for ACORD forms. You can sign up for these below if you wish.

Sign Up for Daily ACORD Forms Tutorial Email

Sign Up for Weekly ACORD Forms Tutorial Emails

No comments:

Post a Comment