ACORD 21 Form (2016/03) – Aircraft Insurance Certificate PDF

Certificate of Aircraft Insurance

ACORD 21 (2016/03)

Property & Casualty

March 2016

1 page

PDF, Fillable PDF


The adequate insurance of an aircraft protects the policyholder from financial loss and legal disputes due to an accident. An Acord 21 form is a standardized document and serves as proof that a specific aircraft has enough insurance coverage. It is not an insurance policy, but it summarises all insurance coverage and acts as a certificate of insurance. In the aviation industry, aircraft owners, pilots, lessors, and other staff require this certificate to get permission for operations. An insurance agent or broker issues this certificate under the terms and conditions of the Association of Cooperative Operations and Research Department (ACORD).


Insurance companies, airports, and the Federal Aviation Administration require this form to comply with legal requirements and avoid potential consequences.

The Acord certificate of aircraft insurance protects the owners, pilots, and other staff from financial loss after an unforeseen incident.

This certificate allows aircraft owners to perform operations without any barriers. It ensures quick access to agreements in the aviation industry.

If an accident occurs, the timely submission of this form helps facilitate the claim process for the loss. The insurer will only pay the deductible amount, while the insurance company will pay the remaining amount.


Includes the producer and policyholder information to understand the insurance policy.

Records for the insurance policy type and line of business to authorise the aviation operations.

Contains comprehensive details of insured aircraft, its coverage, and limitations of deductible amounts, with additional information.

Description of the aviation operation with additional remarks to make transparent communication.

Understand the cancellation clause before expiration and ensure the authorized representative’s signature is obtained.


  1. Write the date of issuance of the certificate.
  2. Write the name, address, and phone number of the insurance broker or agent.
  3. Name, address, contact number, and email address of the aircraft owner or pilot.
  4. Mention the insurance policy certificate number, revision number, policy type, and line of business’s subcode.
  5. Write the manufacturer year, make, model, serial, and registration number of an aircraft.
  6. Write the aircraft coverage details, including policy number, effective and expiration date, coverage types, and limitations.
  7. Communicate a description of aviation operations.
  8. Write down the policyholder’s name, address, and contact number.
  9. Mention the cancellation clause before the policy expires.
  10. Get the signature of an authorized representative.

No, this certificate serves as proof of insurance coverage. It does not amend or extend coverage in the policy.

You will need to obtain another certificate of aircraft insurance form from your new insurer.

Yes, under the cancellation clause, you can cancel the certificate at any time, and you must send a notice to the certificate holder.

They must contact the insurance company mentioned on the form for verification.

Yes, it ensures policy limits for all types of insurance listed on the form.

You should consult your insurance agent or broker and request a new or revised certificate.

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