Instructions ACORD 163 Commercial Auto Driver Information Schedule

Instructions ACORD 163 Commercial Auto Driver Information Schedule

The ACORD 163 Commercial Auto Driver Information Schedule is used to list additional drivers with the following other ACORD forms when these forms no longer have room for the list of insured drivers:


ACORD 127 Business Auto
ACORD 128 Garage and Dealers
ACORD 132 Truckers / Motor Carriers


BASIC INFORMATION

Instructions ACORD 163 Commercial Auto Driver Schedule

AGENCY CUSTOMER ID

As with all ACORD forms with more than one page enter your agency customer ID so this page will be able to find the rest of this application if somewhere, somehow in that thing we call the business cycle they get separated from each other.

DATE

This is the date you are completing this application. Enter the date as Day Day / Month Month / Year Year Year. This means you would enter Jan 1st 2015 as 01/01/2015.

Instructions ACORD 163

AGENCY CUSTOMER ID

As with all ACORD forms with more than one page enter your agency customer ID so this page will be able to find the rest of this application if somewhere, somehow in that thing we call the business cycle they get separated from each other.

DATE

This is the date you are completing this application. Enter the date as Day Day / Month Month / Year Year Year. This means you would enter Jan 1st 2015 as 01/01/2015.

AGENCY

Enter your agency's name here.

CARRIER

The insurance company underwriting this policy. This is the company listed on the DEC page of the policy.

NAIC NUMBER

NAIC stands for the National Association of Insurance Commissioners.

Here is their website home page...

http://www.naic.org/index.htm

They assign each insurance company a five digit code. You can search for any insurance company by name on their website at this page...

https://eapps.naic.org/cis/

POLICY NUMBER

Enter the policy number if one exists. If no policy number has been assigned yet enter TBD for to be determined. If you have a binder number enter that here.

EFFECTIVE DATE

This is the date this policy begins coverage.

NAMED INSURED

Enter the same as the Name on the preceding documents in this application. This is also the name which appears on the issued policy's declarations page.



DRIVER INFORMATION

Instructions ACORD 163 Driver Information

DRIVER# You should just list these in a 1,2,3 sequential order.

NAME CITY, STATE, and ZIP CODE The driver's name and address. This should be an exact match to the information on their driver's license.

SEX M for male, F for female.

MAR STAT Marital status is usually shown as M for married, S for single, D for divorced, W for widow or widower, etc. The note at the bottom of this section states "MARTIAL STATUS / CIVIL UNION (if applicable)". I do not know the indicator for civil union. I suggest a C.

DATE OF BIRTH It will be appreciated if you enter this in the DD/MM/YYYY format. Again, match the driver's license.

YRS EXP - Years of driving experience for this driver.

Here is a secret. You and I both know that if you subtract Year Licensed from this year, you will get the answer to Driver's YRS EXP. But sometimes we apparently have to help others with this type of math. Just do so in a kind way so you do not hurt your underwriter's feelings.

YR LIC - This is the year the license was issued.

DRIVERS LICENSE NUMBER/ SOCIAL SECURITY NUMBER Enter the complete driver's license number. If this is not available enter this person's social security number.

STATE LIC Enter the two character ID for the state which has issued this driver's license.

DATE HIRED This is the date this driver was originally hired by this business. It is fine to say month and year.

BROADENED NO FAULT This is a yes or no answer. Use Y or N.

DOC This stands for Driver Other Car coverage. This is a yes or no question, Use a Y or an N.

USE VEH # Enter the vehicle number from this application of the vehicle that this driver operates most often.

% USE Enter the percentage of the time this driver is the operator of the USE VEH you entered in the previous question. Example, if this driver uses vehicle 1 all the time enter 100%.

Repeat these entries for each additional driver. If you need more room use additional ACORD 163 forms until you have completed listing your drivers.

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Instructions ACORD 129 Vehicle Schedule Part 2

Instructions ACORD 129 Vehicle Schedule Part 2

DESCRIPTION CONTINUED AND PHYSICAL DAMAGE COVERAGE

Instructions ACORD 129 Vehicle Schedule

USE

Select one and only one.

PLEASURE - Private passenger vehicles or pickups/vans not used for business purposes
FARM - Private passenger vehicles or pickups/vans principally garaged and used on a farm or ranch
DRIVE TO WORK / SCHOOL - check either the < 15 miles (less than) or 15 miles + box
COMM'L - transportation of property in vehicles other than those defined as retail or service
RETAIL - Pick up or delivery of property to individual households
SERVICE - Transportation of personnel, tools, equipment or supplies to or from a job site
FOR HIRE - taxi's, etc
OTHER - you describe

CHECK COVERAGES

Check all that apply. The checked boxes should match the coverage selected in the state specific ACORD 137 form attached to this application.

LIAB - liability
NO-FAULT - liability no-fault
ADD'L NO-FAULT - additional liability no- fault
MED PAY - medical payments
UNINS MOTOR - uninsured motorists liability
UNDRINS MOTOR - under-insured motorists liability
TOWING & LABOR

SPEC C of L - Specified Cause of Loss - these are all physical damage coverages
F - Specified Cause of Loss by Fire
FT - Specified Causes of Loss by Fire and Theft
FTW - Specified Causes of Loss by Fire, Theft and Windstorm
LSP - Limited Specified Peril
COMP/OTC - Comprehensive / Other Than Collision physical damage coverages
COLL - Collision
RENT REIMB - rental reimbursement
FG - Full Glass Coverage
OTHER - you enter

DEDUCTIBLES

Check one in this first section you have...

ACV - actual cash value
AA - agreed amount
ST AMT - stated amount

These are types of physical damage valuation methods normally used on older vehicles.

If you check one of these, enter the dollar amount of the value on the line in the bottom of this box where you see the $ sign.


Check either Comp / OTC or SPEC C of L if either apply. You cannot have both, but you can have neither. If you have either, enter the dollar amount of the deductible on the next line after the $ sign.

If you have collision coverage enter the dollar amount of the deductible on the line to the left of COLL after the $ sign.

NET VEH DR/CR - This is the total of all the credits or debit factors to be applied in the rating of this vehicle. You will almost always leave this blank. This is for the raters to do.

TOTAL PREMIUM: $ - You will almost always leave this blank. This is a rating field.


I hope this has helped you learn how to complete the ACORD 127 vehicle description section.

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Instructions ACORD 129 Vehicle Schedule Part 1

Instructions ACORD 129 Vehicle Schedule

The ACORD 129 Vehicle Schedule is used to list additional vehicles with the following other ACORD forms when these forms no longer have room for the list of insured vehicles:

• ACORD 127 Business Auto
• ACORD 128 Garage and Dealers
• ACORD 132 Truckers / Motor Carriers
• ACORD 143 Transportation

BASIC INFORMATION

Instructions ACORD 129 Vehicle Schedule

AGENCY CUSTOMER ID

As with all ACORD forms with more than one page enter your agency customer ID so this page will be able to find the rest of this application if somewhere, somehow in that thing we call the business cycle they get separated from each other.

DATE

This is the date you are completing this application. Enter the date as Day Day / Month Month / Year Year Year. This means you would enter Jan 1st 2015 as 01/01/2015.

AGENCY

Enter your agency's name here.

CARRIER

The insurance company underwriting this policy. This is the company listed on the DEC page of the policy.

NAIC NUMBER

NAIC stands for the National Association of Insurance Commissioners.

Here is their website home page...

http://www.naic.org/index.htm

They assign each insurance company a five digit code. You can search for any insurance company by name on their website at this page...

https://eapps.naic.org/cis/

POLICY NUMBER

Enter the policy number if one exists. If no policy number has been assigned yet enter TBD for to be determined. If you have a binder number enter that here.

EFFECTIVE DATE

This is the date this policy begins coverage.

NAMED INSURED

Enter the same as the Name on the preceding documents in this application. This is also the name which appears on the issued policy's declarations page.


VEHICLE DESCRIPTION PART 1

Instructions ACORD 129 Vehicle Schedule

VEH# - Vehicle number. Enter the numbers in sequence starting with 1.

YEAR - The model year of the vehicle. 2010, 2011, etc.

MAKE - The manufacturer's name. Chevrolet, Ford, etc.

MODEL - The model of the vehicle. F-3500 or Dodge Step Van are examples.

BODY TYPE - Examples - Dump truck, Van, Sedan

V.I.N. - Vehicle identification number. This is the serial number for the vehicle. It is on the registration card and on the vehicle dashboard in front of the steering wheel.

VEHICLE TYPE - Only one can apply. PP is private passenger. SPEC is Special - which I assume is anything not the other two options. COML is commercial.

SYM / AGE - Only private passenger vehicles have a symbol. If it is not a private passenger vehicle you will leave this blank and answer the "Cost New" question two line down.

Age is more than a little obvious and embarrassing. You have already told them the year built. But age is a cross reference point in some rating manuals. So to avoid mistakes have pity and enter the age. (This year minus the model year)

COMP / OTC SYM - Comprehensive / Other Than Collision Symbol. Only private passenger vehicles will have this.It can be an ISO symbol or some companies publish their own symbols. A symbol is a two digit numeric value used as a cross reference point in manual rating.

COLL SYM - Collision symbol. Only private passenger vehicles will have this.It can be an ISO symbol or some companies publish their own symbols. A symbol is a two digit numeric value used as a cross reference point in manual rating.

GARAGING ADDRESS

STREET (Required in KY) - the actual street address where this vehicle is normally kept overnight. In auto insurance terms "garaging" does not mean an actual building or physical garage. It only means where the car is normally kept when not in use.

CITY - The city of the garaging address.

COUNTY - The county of the garaging address.

STATE - The 2 character abbreviation for the state in which the vehicle is garaged.

ZIP - The 5 digit post office ZIP code for the where the vehicle is kept. Have I mentioned before that ZIP stands for Zone Improvement Plan? Now you can win another bar bet.

LIC STATE - The two digit abbreviation of the state in which this vehicle is licensed. Not always the same as the garaging location.

TERR - The rating Territory. While most states use ZIP codes for private passenger rating, commercial rating still has maps with territories. You will need to reference the tables of cities and counties, or a map for this information. Your agency or carrier will have access to this.

GVW / GCW - This is the gross vehicle weight or the gross combined weight - also defined as the total weight of the vehicle itself and the load it is designed to carry. This will be listed on the vehicle registration. The second item - combined weight - is the total of the GVW for a tractor unit and the trailer to which it is attached.

Private passenger vehicles do not have a GVW.

CLASS - I quote exactly the ACORD FIG form here...This is the primary industry classification code found in rating manuals for commercial vehicles as determined by: *If this is a fleet or non-fleet policy *Commercial autos by size, business use, radius of operation and whether truck or trailer type *Public autos by type of vehicle, radius or seating capacity.

A private passenger vehicle insured on a business auto policy that is not a fleet - 5 or more vehicles are needed to be a fleet - normally uses the private passenger rates and classification code, not the business auto classification code.

SIC - The secondary special industry class. This will be available to you in manuals from your agency or carrier. Or in your commercial rating software.

Class and SIC are two of those things that make agents new to commercial lines uncomfortable. But here is the nice thing about them - you set them on a vehicle and they stay there. With personal lines these are often sorted and assigned to another vehicle based on driver and rating sorting. Commercial is much more straight forward.

FACTOR - This is a rating factor. You will normally leave this blank. The Class and SIC tables carry factors. This would be the sum of those factors.

SEAT CP - This only applies to Public or Livery vehicles - cabs and buses. It stands for seating capacity.

RADIUS - These do not apply to private passenger vehicles. Enter the code from the following list...

L - Local. Up to 50 miles. Not frequently operated beyond a 50-mile radius from the point of principal garaging.

I - Intermediate. Operation beyond 50 miles, but not regularly operated beyond a 200-mile radius from the point of principal garaging.

LH - Long Haul. Regularly and frequently operated beyond a radius of 200 miles.

FARTHEST TERMINAL - Long distance, or long haul vehicles are ZONE Rated. You can find these Zones in business auto manuals or in your rating software. For long haul vehicles enter the physical address for the garaging location farthest from the normal garaging location.

COST NEW $ - This is for vehicles which do not have a symbol. This is not what was paid for this vehicle used, but what would have been paid for it new.

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Required ACORD Forms for a Workers Compensation Application in California

Required ACORD Forms for a Workers Compensation Application in California

We are often asked which forms are required for a specific coverage and state.

If you are using our Simply Easier ACORD Forms service we provide our Knowledge Base tools to answer these questions.

But in this post we will answer that question for an application for a new or renewal workers compensation policy in California.

Your specific carrier may have additional forms they require. We do not have a list of those requirements. For ACORD forms, however, this is the list.

Below each form is a link to a Table of Contents for all our tutorials on how to complete the form correctly.

Workers Compensation is one of the few commercial lines coverages which does not use the ACROD 125 Commercial Insurance Application.

You begin with the ACORD 130 Workers Compensation Application

http://simply-easier-acord-forms.blogspot.com/2014/05/acord-130-workers-compensation_14.html


ACORD 63 Fraud Statements

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-63-fraud-statements.html

ACORD 64 US - Supplement for Terrorism Coverage

http://simply-easier-acord-forms.blogspot.com/2014/12/instructions-acord-64us-insurance.html

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Instructions ACORD 64US Insurance Supplement for Workers Compensation

Instructions ACORD 64US Insurance Supplement for Workers Compensation

The ACORD 64 US is the Workers Compensation supplement for the Federal Terrorism Risk Insurance Act. It should be used in all states with any workers compensation insurance application.


BASIC INFORMATION

Instructions ACORD 64 US Terrorism Coverage Supplement

AGENCY CUSTOMER ID

As with all ACORD forms with more than one page enter your agency customer ID so this page will be able to find the rest of this application if somewhere, somehow in that thing we call the business cycle they get separated from each other.

AGENCY

Enter your agency's name here.

APPLICANT / NAMED INSURED

Enter the same as the Name on the preceding documents in this application.

POLICY NUMBER

Enter the policy number if one exists. If no policy number has been assigned yet enter TBD for to be determined. If you have a binder number enter that here.

CARRIER

The insurance company underwriting this policy. This is the company listed on the DEC page of the policy.

NAIC NUMBER

NAIC stands for the National Association of Insurance Commissioners.

Here is their website home page...

http://www.naic.org/index.htm

They assign each insurance company a five digit code. You can search for any insurance company by name on their website at this page...

https://eapps.naic.org/cis/


POLICY HOLDER DISCLOSURE - NOTICE OF TERRORISM INSURANCE COVERAGE

Policy Holder Disclosure Terrorism Insurance Coverage

This section contains the actual coverage details. It references the Terrorism Risk Insurance ACT.

Here is a selection of very good, informative links about this act...

http://www.naic.org/cipr_topics/topic_tria.htm

http://www.treasury.gov/resource-center/fin-mkts/Pages/program.aspx

http://en.wikipedia.org/wiki/Terrorism_Risk_Insurance_Act

https://www.ncci.com/nccimain/industryinformation/terrorismwc/pages/tria-faq.aspx


PREMIUM

Enter the portion of this policy premium which is attributable to this coverage. If you do not know ask you underwriter.



ACKNOWLEDGEMENT and SIGNATURES

Instructions ACORD 64 US

Policyholder/Applicant's Signature - have the authorized representative or representatives sign.

Print Name - have the person who signed print their name.

Date - enter the date the person signed. It is best to have the signee enter the date.

Effective Date - enter the effective date of this coverage - it will normally be the same as the policy effective date.

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ACORD Forms Required for a California Business Auto Application

ACORD Forms Required for a California Business Auto Application

You almost always need more than one ACORD form to complete an application for new or renewal business.

Supplemental forms commonly required have to do with Terrorism coverage, Fraud Statements, etc.

These forms typically require the insured's signature and become a part of the legal documentation you need to protect your insured, your carrier, your agency and yourself in the event of certain losses.

This post list all the required ACORD forms for a Business Auto Policy application in the state of California.

This list would differ in other states, but this is a good idea of forms in every state. A specific carrier may have some forms of their own which they require. We do not have a list of non ACORD forms required by specific carriers.

As with all commercial lines except workers comp you start with the ACORD 125 Commercial Insurance Application.

http://simply-easier-acord-forms.blogspot.com/2014/06/table-of-contents-overview-how-to.html


Next is the ACORD 127 Business Auto Section

http://simply-easier-acord-forms.blogspot.com/2014/08/table-of-contents-for-acord-127.html

The the state specific ACORD 137CA California Commercial Auto form. Each state has their own 137 form.

http://simply-easier-acord-forms.blogspot.com/2014/12/instructions-acord-137-ca-overview-and.html

The ACORD 60 US Terrorism Insurance Coverage

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-60us-terrorism.html

The ACORD 61 CA California Auto Supplement. This is the mandatory offer of uninsured motorist coverage. Most states have their own version of this form.

http://simply-easier-acord-forms.blogspot.com/2014/12/instructions-acord-61-ca-overview-and.html

Finally the ACORD 63 US Fraud Statement form.

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-63-fraud-statements.html

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Instructions ACORD 61 CA Overview and Table of Contents

Instructions ACORD 61 CA Overview and Table of Contents

This post is a table of Contents for the post on instructions for the ACORD CA 61 Uninsured Motorists form.


ACORD 61 CA California Auto Supplement Mandatory Offer of Uninsured Motorist Bodily Injury Coverage

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-61ca-california-auto.html


ACORD 61 CA California Auto Supplement Mandatory Offer of Uninsured Motorist Property Damage Coverage

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-61-ca-uninsured.html

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Instructions ACORD 137 CA Overview and Table of Contents

Instructions ACORD 137 CA Overview and Table of Contents

This post is a table of contents and link to each of the tutorials on the ACORD 137 CA.

ACORD 137CA Policy/ Agency/ Carrier Information

http://simply-easier-acord-forms.blogspot.com/2014/10/acord-137-ca-california-commercial-auto.html

ACORD 137 CA Business Auto Section

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-137ca-california.html

ACORD 137 CA Endorsements, Remarks, and Signatures

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-137-ca-commercial.html

ACORD 137CA  Truckers Liability Section

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-137ca-truckers.html

ACORD 137 CA Truckers Physical Damage Section

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-137ca-truckers_10.html

ACORD 137 CA Truckers Trailer Interchange Section

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-137-ca-trailer.html

ACORD 137 CA Truckers Endorsements and Remarks

http://simply-easier-acord-forms.blogspot.com/2014/11/acord-137ca-instructions-for.html

ACORD 137 CA Motor Carrier Liability Section

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-137ca-motor-carrier.html

ACORD 137 CA Motor Carrier Physical Damage Section

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-137-motor-carrier.html

ACORD 137 CA Motor Carrier Trailer Interchange Section

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-137ca-motor-carrier_12.html

ACORD 137 CA Motor Carrier Endorsement / Remarks / Signatures Section

http://simply-easier-acord-forms.blogspot.com/2014/11/instructions-acord-137ca-endorsements.html

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Instructions ACORD 63 Fraud Statements

Instructions ACORD 63 Fraud Statements

BASIC INFORMATION

Instructions ACORD 63 Fraud Statements

AGENCY CUSTOMER ID

As with all ACORD forms with more than one page enter your agency customer ID so this page will be able to find the rest of this application if somewhere, somehow in that thing we call the business cycle they get separated from each other.

AGENCY

Enter your agency's name here.

CARRIER

The insurance company underwriting this policy. This is the company listed on the DEC page of the policy.

NAIC NUMBER

NAIC stands for the National Association of Insurance Commissioners.

Here is their website home page...

http://www.naic.org/index.htm


They assign each insurance company a five digit code. You can search for any insurance company by name on their website at this page...

https://eapps.naic.org/cis/


POLICY NUMBER

Enter the policy number if one exists. If no policy number has been assigned yet enter TBD for to be determined. If you have a binder number enter that here.

EFFECTIVE DATE

This is the effective date of the policy to which this form is attached.


APPLICANT / NAMED INSURED

Enter the same as the Name on the preceding documents in this application.


FRAUD WARNINGS

Instructions ACORD 63

Familiarize yourself with each of these warnings - including the ones for states other than your home state.

If you have an insured with locations in more than one state the applicable law may be the law for that state.

You do not use this form with Loss Notices or with Workers Compensation applications.


SIGN AND DATE

How to complete the ACORD 63 Fraud Statements

APPLICANT'S SIGNATURE

Have you applicant or their legally authorized representative sign here.

DATE ( MM/DD/YYYY)

Enter the date this form is signed. Use the format month month / day day / year year year year - which looks like this for Oct first two thousand fourteen...

10/01/2014

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Instructions ACORD 61 CA Uninsured Motorists Property Damage Coverage Offer

Instructions ACORD 61 CA Uninsured Motorists Property Damage Coverage Offer

MANDATORY OFFER

Instructions ACORD 61 CA Uninsured Motorists Property Damage Coverage Offer

AGENCY CUSTOMER ID

As with all ACORD forms with more than one page enter your agency customer ID so this page will be able to find the rest of this application if somewhere, somehow in that thing we call the business cycle they get separated from each other.

MANDATORY UNINSURED MOTORISTS PROPERTY DAMAGE COVERAGE OFFER

The wording in this section provides a description of this coverage.

Note this coverage is only available...

1 - If you have not rejected Uninsured Motorists Bodily Injury Coverage, and

2 - For autos for which you have not purchased Collision Coverage.

If you already have Collision coverage on an auto, then Uninsured Motorists Property Damage Coverage is considered to be redundant. I do not quite agree with that because I am not aware if collision coverage would pay for loss of resale value to a repaired auto which has been in an accident, but that is because I do not know the answer to that.

SELECTION / REJECTION

Select or reject ACORD 61CA

Regardless of whether you are selecting or rejecting coverage, you need to have the applicant indicate that decision on this form.

If the coverage is being selected check the line to the left of that statement and then list the vehicles for which coverage is selected. If you have more than three vehicles, use another form.

If coverage is being completely rejected, check the line to the left of that statement.

If coverage is being rejected when specifically named individuals are operating the vehicle check the line to the left of that statement and list the named individuals being excluded.

SIGNATURES

APPLICANT's SIGNATURE

Have your applicant sign here.

DATE

Have the applicant enter the date of the signing.

EFFECTIVE DATE

Enter the effective date of this coverage. Normally this will be the policy effective date, however, this can be done by endorsement during a policy period. In that case the effective date would be the date of the endorsement.

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Instructions ACORD 61CA California Auto Supplement

Instructions ACORD 61CA California Auto Supplement

BASIC INFORMATION

Instructions ACORD 61CA California Auto Supplement

AGENCY CUSTOMER ID

As with all ACORD forms with more than one page enter your agency customer ID so this page will be able to find the rest of this application if somewhere, somehow in that thing we call the business cycle they get separated from each other.

AGENCY

Enter your agency's name here.

APPLICANT / NAMED INSURED

Enter the same as the Name on the preceding documents in this application.

POLICY NUMBER

Enter the policy number if one exists. If no policy number has been assigned yet enter TBD for to be determined. If you have a binder number enter that here.

CARRIER

The insurance company underwriting this policy. This is the company listed on the DEC page of the policy.

NAIC NUMBER

NAIC stands for the National Association of Insurance Commissioners.

Here is their website home page...

http://www.naic.org/index.htm


They assign each insurance company a five digit code. You can search for any insurance company by name on their website at this page...

https://eapps.naic.org/cis/

MANDATORY UNINSURED MOTORISTS BODILY INJURY COVERAGE OFFER

Instructions ACORD 61 CA

The offer states that the insured may reject coverage completely or accept lower limits.

This statement also defines Uninsured and Underinsured Motorists Coverage.

REJECTION OF UNINSURED MOTORISTS BODILY INJURY COVERAGE

Rejection of Uninsured Motorists Coverage

This section allows the insurer or the applicant (the insured) to...

Completely Reject Coverage, or
Reject Coverage for specially named drivers when operating a vehicle insured under this policy.

Check the line to the left of the choice that is being made.

If you are not rejecting coverage, do not check anything here.

If you are rejecting coverage for specifically named drivers, enter the names of the excluded drivers here.


LOWER LIMITS for UNINSURED MOTORISTS BODILY INJURY COVERAGE

Accept Lower Limits for Uninsured Motorists Bodily Injury Coverage

The insurer and the insured may decide to accept a lower limit for Bodily Injury Uninsured Motorist.

If that is the decision, check the line to the left of the text stating that decision. Just after the dollar sign ($) enter the lower limits which have been accepted.

APPLICANT's SIGNATURE

Have your applicant sign here.

DATE

Have the applicant enter the date of the signing.

EFFECTIVE DATE

Enter the effective date of this coverage. Normally this will be the policy effective date, however, this can be done by endorsement during a policy period. In that case the effective date would be the date of the endorsement.


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Instructions ACORD 60US Terrorism Insurance Coverage

Instructions ACORD 60US Terrorism Insurance Coverage

BASIC INFORMATION

This form is attached to the ACORD 125 and/or many other forms depending on the type of insurance for which this applicant is applying.

Instructions ACORD 60 US Terrorism Insurance Coverage

AGENCY CUSTOMER ID

As with all ACORD forms with more than one page enter your agency customer ID so this page will be able to find the rest of this application if somewhere, somehow in that thing we call the business cycle they get separated from each other.

AGENCY

Enter your agency's name here.

APPLICANT / NAMED INSURED

Enter the same as the Name on the preceding documents in this application.

POLICY NUMBER

Enter the policy number if one exists. If no policy number has been assigned yet enter TBD for to be determined. If you have a binder number enter that here.

CARRIER

The insurance company underwriting this policy. This is the company listed on the DEC page of the policy.

NAIC NUMBER

NAIC stands for the National Association of Insurance Commissioners.

Here is their website home page...

http://www.naic.org/index.htm


They assign each insurance company a five digit code. You can search for any insurance company by name on their website at this page...

https://eapps.naic.org/cis/


POLICYHOLDER DISCLOSURE

How to complete the ACORD 60 US

This section contains the actual coverage details. It references the Terrorism Risk Insurance ACT.

Here is a selection of very good, informative links about this act...

http://www.naic.org/cipr_topics/topic_tria.htm

http://www.treasury.gov/resource-center/fin-mkts/Pages/program.aspx

http://en.wikipedia.org/wiki/Terrorism_Risk_Insurance_Act

https://www.ncci.com/nccimain/industryinformation/terrorismwc/pages/tria-faq.aspx

You need to be familiar with this ACT. Notice the ACT does not cover all loses, only a percentage. The ACT also has a cap for all loses from a unique event. Once this cap is paid out your insured may have even more uncovered loses.


ACCEPTANCE OR REJECTION

Instructions ACORD 60US Terrorism Insurance Coverage

Check the first box to accept coverage.

Enter the premium amount for the policy period.

Check the second box to reject coverage.


SIGNATURES

ACORD 60US

Policyholder/Applicant's Signature - have the authorized representative or representatives sign.

Print Name - have the person who signed print their name.

Date - enter the date the person signed. It is best to have the signee enter the date.

Effective Date - enter the effective date of this coverage - it will normally be the same as the policy effective date.

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Instructions ACORD 137CA Endorsements, Remarks and Signatures Section

Instructions ACORD 137CA Endorsements, Remarks and Signatures Section

ENDORSEMENTS / REMARKS

Instructions ACORD 137CA Endorsements, Remarks and Signatures Section

ENDORSEMENTS

Use this space to enter any endorsements which are part of this policy. Include forms numbers and edition dates.

REMARKS

Use the space to add any remarks. If you need more space use the ACORD 101 Additional Remarks Section.



SIGNATURE

Instructions ACORD 137CA Endorsements, Remarks and Signatures Section

The very first box in the Signature section states that if an Insurer is not going to provide cover to a "GOOD DRIVER", the insurer must provide a written statement to the insured explaining why.

A "GOOD DRIVER" is a person with no more than one violation point or more than one at-fault accident resulting in only property damage in the past three years.

The second section speaks to Un-insured motorist coverage being offered.

The final section reminds the insured that the choices made in this application are permanent until actively changed.

APPLICANTS SIGNATURE - have your customer sign here.

DATE - The date the Applicant signs.

PRODUCER's SIGNATURE - The licensed producer - the agent writing this account - should sign here.

NATIONAL PRODUCER NUMBER - Enter your national producer number.

The National Insurance Producer Registry states "The National Producer Number is a unique NAIC identifier assigned through the licensing application process or the NAIC reporting systems to individuals and business entities (including, but not limited to producers, adjusters, and navigators) engaged in insurance related activities regulated by a state insurance department."

Here is a link to their web site...

http://www.nipr.com/

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Instructions ACORD 137CA Motor Carrier Trailer Interchange Section

Instructions ACORD 137CA Motor Carrier Trailer Interchange Section

TRAILER INTERCHANGE

The following discussion is taken directly from the JM Wilson Blog.

"The definition of trailer interchange is an agreement among common carriers whereby one trucker will transfer a trailer containing a shipment to a second trucker to transport the trailer to its destination or to a point of interchange with yet another trucker.  The arrangement continues until the cargo reaches its destination.  The effect of such an arrangement, which must be in writing, is that the trucker will be hauling trailers of others. (Northland Insurance Product News T-27R March 2007)

What this means is that trailer interchange is truly third party liability coverage, not first-party physical damage coverage.   Trailer interchange does not provide coverage to the average trucker who may be using a third party trailer while transporting goods."

"The main thing I try to point out to agents is that if no written agreement is in place, then non-owned trailer coverage is what the insured needs.  If the situation arises when the shipper is asking for non-owned trailer coverage and they do not have a written agreement in place, the situation can usually be handled by receiving a copy of the contract the insured has with the shipper and working it out with the company."

Thanks to Leon Hilaski for this article.

Instructions ACORD 137CA Motor Carrier Section Trailer Interchange

COMP / OTC

COMP means comprehensive coverage. Comprehensive insurance provides protection for your vehicle if it is damaged by something other than a collision with a vehicle or object, or if your vehicle is stolen.

OTC means other than collision coverage.

COVERED AUTO SYMBOLS - Look at the very last block in the Motor Carrier Section. On the far left it is titled "COVERED AUTO SYMBOLS.

These correspond to the check boxes in the Liability Section under Covered Auto Symbols. You will check any and all which apply for this policy.

The options are...

69 - Trailers in your possession  under a trailer interchange agreement.
70 - Your trailers in the possession of another trucker under a trailer interchange agreement.

# TRAILERS - Enter the maximum number of trailers operated by the insured under a trailer interchange agreement during this policy term.

FARTH ZONE - Farthest Zone where the trailer interchange agreement applies. Remember Zones from the ACORD 127

# DAYS - Enter the number of days during this policy period in which the insured will be pulling trailers under a trailer interchange agreement.

Radius - Enter the actual mileage radius - a number of miles - in which the insured will be pulling trailers under a trailer interchange agreement.


SPECIFIED CAUSES OF LOSS

This is an alternative to comprehensive coverage. Comprehensive coverage is more an All -Risk coverage. Losses are coverage unless specifically excluded. Specified Causes of Loss only covers losses caused by things specifically listed.

COVERED AUTO SYMBOLS - Look at the very last block in the Truckers Section. On the far left it is titled "COVERED AUTO SYMBOLS.

These correspond to the check boxes in the Liability Section under Covered Auto Symbols. You will check any and all which apply for this policy.

The options are...

69 - Trailers in your possession  under a trailer interchange agreement.
70 - Your trailers in the possession of another trucker under a trailer interchange agreement.

# TRAILERS - Enter the maximum number of trailers operated by the insured under a trailer interchange agreement during this policy term.

FARTH ZONE - Farthest Zone where the trailer interchange agreement applies. Remember Zones from the ACORD 127

# DAYS - Enter the number of days during this policy period in which the insured will be pulling trailers under a trailer interchange agreement.

Radius - Enter the actual mileage radius - a number of miles - in which the insured will be pulling trailers under a trailer interchange agreement.

COLLISION

Collision insurance provides protection for your vehicle if it is damaged in an accident. Collision insurance pays to repair or replace your vehicle if it collides with another object or overturns or rolls.

COVERED AUTO SYMBOLS - Look at the very last block in the Truckers Section. On the far left it is titled "COVERED AUTO SYMBOLS.

These correspond to the check boxes in the Liability Section under Covered Auto Symbols. You will check any and all which apply for this policy.

The options are...

69 - Trailers in your possession  under a trailer interchange agreement.
70 - Your trailers in the possession of another trucker under a trailer interchange agreement.

# TRAILERS - Enter the maximum number of trailers operated by the insured under a trailer interchange agreement during this policy term.

FARTH ZONE - Farthest Zone where the trailer interchange agreement applies. Remember Zones from the ACORD 127

# DAYS - Enter the number of days during this policy period in which the insured will be pulling trailers under a trailer interchange agreement.

Radius - Enter the actual mileage radius - a number of miles - in which the insured will be pulling trailers under a trailer interchange agreement.

WAIVER OF DEDUCTIBLE - check this box if your insured has selected this option.

A collision deductible waiver is a clause added as an option to some auto policies, which already include collision coverage, as a means of protecting the policyholder against under insured drivers.

DEDUCTIBLE - Enter the comprehensive or OTC deductible.

TRAILER VALUE - Enter the value assigned to the trailer in the trailer interchange agreement.


HIRED PHYSICAL DAMAGE

STATES - Enter the state codes - ex: NY for New York - for the states covered by the trailer interchange agreement.

# DAYS - This is used to rate this coverage. Enter the number of days during the policy period units will be pulled under the trailer interchange agreement.

# VEH - number of vehicles. This is also used for pricing this coverage. Enter the number of units which will be pulled under the trailer interchange agreement during this policy period.

COVERAGE IS: - check the box fro Primary or Secondary based on how you are having this policy set up.

PRIMARY - this coverage will pay damages before any other coverage.

SECONDARY - this coverage will pay only after other coverage has been completed used.


OTHER - Enter any other coverage description, Covered Auto Symbols and limits fro coverage provided under this policy.

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Instructions ACORD 137 Motor Carrier Physical Damage Section

Instructions ACORD 137 Motor Carrier Physical Damage Section

MOTOR CARRIERS PHYSICAL DAMAGE

Instructions ACORD 137 Motor Carriers Physical Section

COMP / OTC

COMP means comprehensive coverage. Comprehensive insurance provides protection for your vehicle if it is damaged by something other than a collision with a vehicle or object, or if your vehicle is stolen.

OTC means other than collision coverage.

COVERED AUTO SYMBOLS - Look at the very last block in the Motor Carriers Section. On the far left it is titled "COVERED AUTO SYMBOLS.

These correspond to the check boxes in the Liability Section under Covered Auto Symbols. You will check any and all which apply for this policy.

The options are...

62 - Owned Autos Only - does not cover non-owned or hired
63 - Owned Private Passenger Autos Only - Does not cover Hired or Non-Owned Autos or Commercial Vehicles
64 - Owned Commercial Autos Only - Does not cover private passenger autos or hired or non-owned autos
67 - Specifically Described Autos - only autos listed in schedule as part of the policy
68 - Hired Autos Only - covers neither owned or non-owned autos

The check box without a number lets you manuscript your own symbol. Be sure you add a text description or no one other than you will understand what you mean.

You do not enter a limit for this row.

DEDUCTIBLE - Enter the comprehensive or OTC deductible.


SPECIFIED CAUSES OF LOSS

This is an alternative to comprehensive coverage. Comprehensive coverage is more an All -Risk coverage. Losses are coverage unless specifically excluded. Specified Causes of Loss only covers losses caused by things specifically listed.

COVERED AUTO SYMBOLS - Look at the very last block in the Truckers Section. On the far left it is titled "COVERED AUTO SYMBOLS.

These correspond to the check boxes in the Liability Section under Covered Auto Symbols. You will check any and all which apply for this policy.

The options are...

62 - Owned Autos Only - does not cover non-owned or hired
63 - Owned Private Passenger Autos Only - Does not cover Hired or Non-Owned Autos or Commercial Vehicles
64 - Owned Commercial Autos Only - Does not cover private passenger autos or hired or non-owned autos
67 - Specifically Described Autos - only autos listed in schedule as part of the policy
68 - Hired Autos Only - covers neither owned or non-owned autos

The check box without a number lets you manuscript your own symbol. Be sure you add a text description or no one other than you will understand what you mean.

Under Limits check the box for the specific coverages which  are being requested under this policy.

SCL - stands for Specified Cause of Loss
F - stands for Fire as the cause of loss
FT - stands for Fire and Theft as the cause of loss
FTW - stands for Fire, Theft and Windstorm as the cause of loss
LSP - stands for Limited Specified Perils as the cause of loss


DEDUCTIBLE - Enter the comprehensive or OTC deductible.


COLLISION

Collision insurance provides protection for your vehicle if it is damaged in an accident. Collision insurance pays to repair or replace your vehicle if it collides with another object or overturns or rolls.

COVERED AUTO SYMBOLS - Look at the very last block in the Truckers Section. On the far left it is titled "COVERED AUTO SYMBOLS.

These correspond to the check boxes in the Liability Section under Covered Auto Symbols. You will check any and all which apply for this policy.

The options are...

62 - Owned Autos Only - does not cover non-owned or hired
63 - Owned Private Passenger Autos Only - Does not cover Hired or Non-Owned Autos or Commercial Vehicles
64 - Owned Commercial Autos Only - Does not cover private passenger autos or hired or non-owned autos
67 - Specifically Described Autos - only autos listed in schedule as part of the policy
68 - Hired Autos Only - covers neither owned or non-owned autos

The check box without a number lets you manuscript your own symbol. Be sure you add a text description or no one other than you will understand what you mean.

You do not enter a limit for this row.


WAIVER OF DEDUCTIBLE - check this box if your insured has selected this option.

A collision deductible waiver is a clause added as an option to some auto policies, which already include collision coverage, as a means of protecting the policyholder against under insured drivers.

DEDUCTIBLE - Enter the comprehensive or OTC deductible.


TOWING & LABOR

COVERED AUTO SYMBOLS - Look at the very last block in the Truckers Section. On the far left it is titled "COVERED AUTO SYMBOLS.

These correspond to the check boxes in the Liability Section under Covered Auto Symbols. You will check any and all which apply for this policy.

The options are...

46 - Specifically Described Autos - only covers listed vehicles

The check box without a number lets you manuscript your own symbol. Be sure you add a text description or no one other than you will understand what you mean.

LIMIT - enter the dollar limit available under this policy.

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Instructions ACORD 137CA Motor Carrier Section

Instructions ACORD 137CA Motor Carrier Section

Instructions ACORD 137CA Motor Carriers Section


AGENCY CUSTOMER ID

Instructions ACORD 137CA Motor Carrier Section

As with all ACORD forms with more than one page enter your agency customer ID so this page will be able to find the rest of this binder if somewhere, somehow in that thing we call the business cycle they get separated from each other.

MOTOR CARRIERS LIABILITY COVERAGE SECTION

Instructions ACORD Motor Carriers Section

LIABILITY

COVERED AUTO SYMBOLS - Look at the very last block in the Motor Carriers Section. On the far left it is titled "COVERED AUTO SYMBOLS.

These correspond to the check boxes in the Liability Section under Covered Auto Symbols. You will check any and all which apply for this policy.

The options are...

61 - Any Auto - covers all the rest of the symbols
62 - Owned Autos Only - does not cover non-owned or hired
63 - Owned Private Passenger Autos Only - Does not cover Hired or Non-Owned Autos or Commercial Vehicles
64 - Owned Commercial Autos Only - Does not cover private passenger autos or hired or non-owned autos
67 - Specifically Described Autos - only autos listed in schedule as part of the policy
68 - Hired Autos Only - covers neither owned or non-owned autos
71 - Non-Owned Autos Only - other peoples's cars used on behave of the insured. An example is a sales person driving her own car.


The check box without a number lets you manuscript your own symbol. Be sure you add a text description or no one other than you will understand what you mean.

LIMITS- check the boxes which describe the coverage limits used in this policy.

CSL means combined single limits. If you  check this box you cannot check the BI EA PER box. You will also only enter a single limit next to the top dollar sign.

Limits which are not combined single limits (CSL) are called split limits. That means you have a limit for Bodily Injury for each person and a aggregate bodily injury limit for each accident regardless of how may persons are injured.

You have a separate limit for Property Damage.


MEDICAL PAYMENTS

COVERED AUTO SYMBOLS - Look at the very last block in the Truckers Section. On the far left it is titled "COVERED AUTO SYMBOLS.

These correspond to the check boxes in the Liability Section under Covered Auto Symbols. You will check any and all which apply for this policy.

The options are...

62 - Owned Autos Only - does not cover non-owned or hired
63 - Owned Private Passenger Autos Only - Does not cover Hired or Non-Owned Autos or Commercial Vehicles
64 - Owned Commercial Autos Only - Does not cover private passenger autos or hired or non-owned autos
67 - Specifically Described Autos - only autos listed in schedule as part of the policy

The check box without a number lets you manuscript your own symbol. Be sure you add a text description or no one other than you will understand what you mean.

LIMITS - Enter the dollar limit of coverage for each person.


UNINSURED MOTORIST

COVERED AUTO SYMBOLS - Look at the very last block in the Truckers Section. On the far left it is titled "COVERED AUTO SYMBOLS.

These correspond to the check boxes in the Liability Section under Covered Auto Symbols. You will check any and all which apply for this policy.

The options are...

62 - Owned Autos Only - does not cover non-owned or hired
63 - Owned Private Passenger Autos Only - Does not cover Hired or Non-Owned Autos or Commercial Vehicles
64 - Owned Commercial Autos Only - Does not cover private passenger autos or hired or non-owned autos
66 - Owned Autos Subject to a Compulsory Uninsured Motorist Law
67 - Specifically Described Autos - only autos listed in schedule as part of the policy

The check box without a number lets you manuscript your own symbol. Be sure you add a text description or no one other than you will understand what you mean.

LIMITS - check the boxes which describe the coverage limits used in this policy.

CSL means combined single limits. If you  check this box you cannot check the BI EA PER box. You will also only enter a single limit next to the top dollar sign.

Limits which are not combined single limits (CSL) are called split limits. That means you have a limit for Bodily Injury for each person and a aggregate bodily injury limit for each accident regardless of how may persons are injured.

You have a separate limit for Property Damage.

NON-TRUCKERS HIRED / BORROWED

Check with your underwriter on this, but I believe this is referring to Bob-Tail use of the hired trucker vehicle. When the Truckers Hired coverage is added to the policy it covers the hired vehicle for use while it is being used exclusively in the named insured's trucking business and pursuant to operating rights granted to the named insured by a public authority. A truck owner who operates exclusively for hire with other trucking firms may therefore have no need for a truckers policy of his or her own. However, the owner will need to have insurance for non-trucking use, which is commonly called bobtail coverage.

(From http://nationalunderwriterpc.moss.nuco.com/sites/fcsonline/commlin/truc/truccov/pages/Truckers%20Endorsements.aspx )

Check the YES box if non-truckers hired / borrowed coverage applies.

If you check the YES Box enter the list of states in which coverage applies.

Check the NO box this coverage does not apply.

If non-truckers hired / borrowed coverage applies does apply enter the COST OF HIRE, or...

Check the box next to IF ANY if vehicles are only randomly and occasionally hired or borrowed instead of entering a COST of HIRE. The actual exposure will be determined by the policy audit.


TRUCKERS HIRED / BORROWED

Check the YES box if truckers hired / borrowed coverage applies.

If you check the YES Box enter the list of states in which coverage applies.

Check the NO box this coverage does not apply.

If truckers hired / borrowed coverage applies does apply enter the COST OF HIRE, or...

Check the box next to IF ANY if vehicles are only randomly and occasionally hired or borrowed instead of entering a COST of HIRE. The actual exposure will be determined by the policy audit.


NON-OWNED AUTO LIABILITY

If this coverage is provided by this policy check the YES check box. Otherwise, check the NO check box.

If this coverage is provided, list the states in which the coverage is provided. If you need more room use the remarks section.

GROUP TYPE

Check the box or boxes which best describe the vehicles used on behalf of this insured which are owned by others.

The Options are...

1 - EMPLOYEES
2 - VOLUNTEERS
3 - PARTNERS

Enter the number of vehicles in each group in the box to the right of the group.


OTHER

For liability coverage not listed use the OTHER columns to enter your Liability Coverage Name,  Covered Auto Symbols and Limits.

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ACORD 137CA Instructions for Endorsements, Remarks and Signatures

ACORD 137CA Instructions for Endorsements, Remarks and Signatures

ENDORSEMENTS / REMARKS

Instructions ACORD 137CA Endorsements and Remarks Section

ENDORSEMENTS

Use this space to enter any endorsements which are part of this policy. Include forms numbers and edition dates.

REMARKS

Use the space to add any remarks. If you need more space use the ACORD 101 Additional Remarks Section.



SIGNATURE

Instructions ACORD 137CA Signatures

The very first box in the Signature section states that if an Insurer is not going to provide cover to a "GOOD DRIVER", the insurer must provide a written statement to the insured explaining why.

A "GOOD DRIVER" is a person with no more than one violation point or more than one at-fault accident resulting in only property damage in the past three years.

The second section speaks to Un-insured motorist coverage being offered.

The final section reminds the insured that the choices made in this application are permanent until actively changed.

APPLICANTS SIGNATURE - have your customer sign here.

DATE - The date the Applicant signs.

PRODUCER's SIGNATURE - The licensed producer - the agent writing this account - should sign here.

NATIONAL PRODUCER NUMBER - Enter your national producer number.

The National Insurance Producer Registry states "The National Producer Number is a unique NAIC identifier assigned through the licensing application process or the NAIC reporting systems to individuals and business entities (including, but not limited to producers, adjusters, and navigators) engaged in insurance related activities regulated by a state insurance department."

Here is a link to their web site...

http://www.nipr.com/

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