ACORD 81 - Instructions for Binders, Information Practices, Fraud Warnings & Signatures

Instructions for Binders, Information Practices, Fraud Warnings & Signatures in the ACORD 81

BINDER & NOTICE OF INFORMATION PRACTICES

ACORD 81 INSTRUCTIONS Binder and Notice of Information Practices

The second half - bottom half - of the third page of the ACORD 81 form contains the wording for the Binder and the wording for the Notice of Information Practices.

INSURANCE BINDER

If you are not binding coverage you should not put any information in the binder box.

If you are binding this policy enter correct information into the following....

EFFECTIVE DATE

EXPIRATION DATE

TIME - If the binder will take effect after the time and date you are completing this form then check the box for either 12:01 AM or Noon,

If the binder will take effect immediately, enter the actual time you complete the form.


NOTICE OF INFORMATION PRACTICES

Your customer must initial the space in the bottom right hand corner of this document to acknowledge she has read the Information Practices statement.

If, at the time of this writing, your customer is in...

Arizona
California
Delaware
Kansas
Massachusetts
Minnesota
North Dakota
Oregon
Virginia
West Virginia

Then you need to use the state specific Notice of Information Practices ACORD document instead of this portion of this form.

Your producer must also check the check box stating a copy of this notice has been given to this customer.

FRAUD STATEMENTS / SIGNATURES -  Page 4

ACORD 81 Instructions for Agency ID

In the top right hand corner of teh page enter your agency's or agency management system's customer ID number.

FRAUD STATEMENT

ACORD 81 Fraud Statement Instructions

If you are selling this policy for a customer in any of the states listed in the Fraud Warning section you need to review that state's Fraud Warning statement with your customer. People can and have gone to jail over this issue. If you do not advise them of this fact, you will also be exposed.


SIGNATURES

ACORD 81 Signatures Instructions

PRODUCER'S SIGNATURE - The producer / agent should sign by hand or digitally.

PRODUCER"S NAME (Please Print) - Print the name of the producer / agent whose signature is on the space to the left.

STATE PRODUCER LICENSE NO (Required in Florida) - Enter you state producer number.

APPLICANT'S SIGNATURE - the authorized representative of the insured should sign by hand or digitally.

DATE - the date of the signature by the customer

NATIONAL PRODUCER NUMBER - enter 'em if you got 'em.



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ACORD 81 Attachments and Schedule of Property Instructions

ACORD 81 Attachments and Schedule of Property Section

AGENCY CUSTOMER ID

ACORD 81 ID Instructions

Enter your customers identification number assigned by your agency or agency management system.


ATTACHMENTS

ACORD 81 Attachments Instructions

Check any and all check boxes which describe documents, spreadsheet, pictures, etc which you are attaching to this ACORD 81 form.

• STATE SUPPLEMENTS
• PHOTOGRAPH
• APPRAISAL
• BILL OF  SALE
• PROTECTIVE DEVICE CERTIFICATION
• OTHER - three boxes left blank. Fill in your own description

SCHEDULE OF PROPERTY

ACORD 81 Schedule of Property Instructions

There are 24 rows on this page for entering specific items to be insured. You will repeat each of the following steps for each row you have an item in.

If you need more space than this I recommend you complete another ACORD 81 forms or set up a spreadsheet with exactly these columns and attache the spreadsheet to this master document.


SCHD #

Schedule number. Enter the number asssociated with the property class from page 1 of this form. For example, if this is a Fine Arts item look back at the PROPERTY CLASS listing on page one. You will see FINE ARTS listed as SCH# 3. In this instance you would enter a 3 in this box on page 3.


ITEM #

This is the item number you - the producer - assign to this item.

DESCRIPTION

Enter a full and complete descriptions including serial numbers. You are trying to give the claims folks something to work with in identifying this item.

FORMAL APPRAISAL ? (Y/N)

If you have a formal appraisal enter a Y for Yes and attach a copy of that appraisal to this document when you send it to your underwriter.

If not, enter N for No.

VALUATION DATE (Purchase or Appraisal)

Enter the most recent date of valuation or appraisal.

AMOUNT OF INSURANCE

Enter the amount of insurance you want on this specific item. Remember any co-insurance clauses. If you have an item valued at $100,000 and this policy requires 80% co-insurance, you certainly do not want to only insure the item for $5,000. Likewise if the Valuation is $100,000 the insurance carrier is unlikely to insure this item for $1,000,000.


I hope these instructions for the ACORD 81 have helped you learn how to complete an ACORD 81 form.


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ACORD 81 Loss History, Payment Plan, Additional Interest Instructions

How to Complete the ACORD 81 Loss History, Payment Plan and Additional Interest Sections

LOSS HISTORY

Instructions for ACORD 81 Loss History Section

Just to the right of the title LOSS HISTORY is the question...

ANY LOSSES, WHETHER OR NOT PAID BY INSURANCE, DURING THE LAST _ YEARS, AT THIS OR ANY LOCATION

Enter the number of years in the blank space.

To the right of the text is a check box. Enter "Y" for YES or "N" for NO in this box to answer the question.

If the answer if YES, then you will need to explain more detail by completing the information in the remainder of this section.

If the answer is NO, you will not have anything to add to this section.

APPLICANT'S INITIALS

Have you customer initial here to confirm the correctness of this information.

There are four rows, all with the same columns. The same actions should be taken for each row in which you have entered a loss date. If you need more room you can use the ACORD 101 Additional Remarks form.

LOSS DATE - enter the date of the occurrence, accident or incident occurred which created this loss.

LOSS TYPE - Enter the type of coverage this loss was filed under as a claim.

DESCRIPTION OF LOSS - enter a concise description of the loss event. Brevity is saintly here.

CAT # - This stands for Catastrophe Number. Sometimes ISO - Insurance Services Office - will assign a Catastrophe Number to major events such as a hurricanes, floods, earthquakes or other major events. You may not know this number.

AMOUNT PAID - Enter the amount actually paid. This does not include reserved amounts.

ENTERED BY (A)GENT (C)OMPANY - If this loss is being entered by the agent enter A, if it is being added to this form by the insurance company enter C.

IN DISPUTE (Y/N) - "Y" for YES, "N" for NO. Is this claim being disputed by the insurance company?


PAYMENT PLAN

Attach ACORD 610 Premium Payment Supplement if additional information is required.

ACORD 81 Instructions for Premium Payment Section

BILLING ACCOUNT #

Enter this customer's billing account number.

DEPOSIT AMOUNT

Enter the amount of the insured's deposit.

EST TOTAL PREMIUM

Enter your estimated annual premium for this account

BILLING - Three Options

DIRECT BILL - POLICY - Check if this specific policy is being billed directly by the insurance company.

DIRECT BILL - ACCOUNT - Check if this entire account - more than one policy - is being billed directly by the insurance company

AGENCY BILL - Check this box if this policy or account is billed by the agency.


PAYMENT PLAN

FULL PAY - check this box if the payment for the policy or account will be paid in full at the time of the policy issuance.

ANNUAL - Check if this will be billed once a year.

SEMI-ANNUAL - billed once every six months

QUARTERLY - billed once every three months

BI-MONTHLY - billed every other month

MONTHLY - billed each month

BLANK - enter any other plan. An example might be billed monthly for three months in a row.


PAYMENT METHOD

Check the check box next to the method of payment the insured will be using.

CASH

CHECK

CREDIT CARD - include debit cards

EFT - Electronic Funds Transfer. This is a pre-authorized form of drafting a bank account.

PAYROLL DEDUCTION

PRE-AUTHORIZED DRAFT / CHECK (PAC) - this would normally be an ACH pre-authorized billing. Normally ACH is for a set amount or an amount within a limited range. EFT has more flexibility.


MAIL POLICY TO:

AGENT - the agent would mail or deliver copy to the insured

INSURED

OTHER - sometimes this would be a lienholder, etc.


PAYOR

Check the box for who will be paying this bill.

INSURED

MORTGAGEE


ADDITIONAL INTEREST (Attach ACORD 45, Additional Interest Schedule if additional information is required)

Instructions ACORD 81 Additional Interest

INTEREST

Check the box which applies for this specific business entity.

ADDITIONAL INSURED - Good Definition HERE

LIENHOLDER - a person who retains legal possession of a piece of property until the person to whom he/she has advanced money for use of the property has satisfactorily repaid the debt.

LOSS PAYEE - Good Definition HERE

MORTGAGEE - Good Discussion HERE

TRUSTEE - a person or institution which manages property for the insured

OTHER - List your own here



NAME ADDRESS

Enter the full name and address as they need to be shown on a certificate of insurance.

RANK

Additional Interest can have a priority of rights. A rank of 1 would indicate this Additional Interest would receive protection from the policy prior to payments being made on behalf of lower ranked Additional Interests.

EVIDENCE

Check if this entity wants an Evidence of Insurance form.

CERTIFICATE

Check if this entity wants a certificate of insurance form.

SEND BILL

Check if this is to whom the bill should be sent.

REFERENCE  / LOAN #

Enter the loan number.


INTEREST IN ITEM NUMBER

SCHD#: - Schedule number

This is the number from the schedule on the third page of this form for the item this additional interest has an interest in.

ITEM#:

This is the number from the schedule on the third page of this form for the item this additional interest has an interest


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