ACORD 75 Binder Coverage Part 3 Excess, Work Comp and Special Conditions

Instructions for ACORD 75 Binder

EXCESS LIABILITY

Instructions for ACORD 75 Binder of Insurance

TYPE OF INSURANCE - Check the box to indicate whether this is an UMBRELLA FORM or OTHER THAN UMBRELLA FORM.

COVERAGE / FORMS - list all coverage forms names, numbers and edition dates which will be present on the final policy.

RETRO DATE FOR CLAIMS MADE: - If this is a Claims Made form it will normally have a retro-active date prior to which claims will not be covered. Enter that date here.

If there is no Retro active date enter the word NONE.

LIMITS - Enter a limit for each of the following...

• EACH OCCURRENCE
• AGGREGATE
• SELF-INSURED RETENTION

WORKER'S COMPENSATION

Insurance Binder Workers Compensation Instructions

TYPE OF INSURANCE - There is nothing to put in this column.

COVERAGE / FORMS - list all coverage forms names, numbers and edition dates which will be present on the final policy.

LIMITS

In almost all cases you will check the check box next to the words PER STATUTE.

E.L. EACH ACCIDENT - E. L. stands for Employer's Liability Limits.

E. L DISEASE - EA EMPLOYEE - This stands for Employer's Liability for Disease - Each Employee

E.L. DISEASE - POLICY LIMIT - Stands for Employer's Liability for Disease - Policy Limit



SPECIAL CONDITIONS / OTHER COVERAGES  

ACORD 75 Insurance Binder Instructions

Add any additional description of coverage provided that has no specific mention in the rest of the form.

You can also use this space to reference other Binders, acknowledge payment receipt, etc.

LIMITS - Enter any fees, taxes or the estimated total premium if you know this information.



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