ACORD 81 (2012/02) PDF – Personal Inland Marine Application

ACORD 81 (2012/02)

PERSONAL INLAND MARINE APPLICATION

Form Number:

ACORD 81 (2012/02)

Category:

Personal Lines

Last Updated:

February 2012

Page Count:

04 Pages

File Format:

PDF, Fillable PDF

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ACORD 81

The Acord 81, Personal Inland Marine Application, is a standardized document that is used to apply personal inland marine insurance coverage. Additionally, this form allows individuals who need to insure valuable personal property, such as jewelry, fine arts, firearms, cameras, electronic equipment, or collectibles, ensuring that the items are properly insured against theft, loss, or damage. By completing this form, applicants provide insurers with the necessary information required to assess risk, determine coverage options, and calculate accurate premiums. Access a fillable or downloadable copy of the form and start filling it today to secure your valuable assets.

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Benefits of the Acord Form 81

Risk Management

This form collects safety information, such as storage in vaults, protective devices, and fire protection classes, that helps reduce risks and get better premium rates.

Easier Verification

Attachments, such as photographs, bills of sales, appraisals, and protective device certificates, the form ensures that all submitted property values are documented and supported, making claims easier.

Accuracy

The Acord 81 form requires exact values, coverage type, and deductible selection, which helps insurers evaluate risks and determine insurance coverage and premiums accurately. Also, it prevents underinsurance or overpaying for coverage.

Key Sections of Acord 81 Fillable Form

Producer and Policy Information

This section contains the agent’s information, agency codes, carrier information, and effective date.

Insured Details

Describes the applicant’s personal information, including name, address, date of birth, marital status, occupation, and contact details.

Property Location Information

This section describes the insured property’s location, construction type, dwelling type, and fire protection.

Vault & Safe Information

Describe whether the valuables are stored in a residential or bank vault.

Schedule of Property

List classes of property, such as jewelry, cameras, fine arts, silverware, and collectibles with coverage type and values.

Coverage Qualifiers

This section indicates whether the property is used commercially, exhibited, or stored in a vault.

Loss History

It records claims from past years, the amount paid, and any disputes.

Payment Plan & Attachments

Choose the billing method and payment frequencies.

How To Complete The Acord 81 Inland Marine Application?

  1. Insurance Information: Provide the agency and carrier information, including agency name, contact details, agency code, subcode, customer ID, policy number, plan, facility code, and applicant’s information.
  2. Location Information: Provide the location details, including location number, property location, TERR code, construction type, dwelling type, fire district name, and PROT class.
  3. Coverage Information: Specify the property class, LOC number, loss settlements, professional/commercial, and property description. Also, answer the required Yes or No questions and select the coverage qualifiers.
  4. Safe/Vault Information: Describe whether the items are stored in a home vault or a bank vault. Describe the vault specifications to show secure storage.
  5. General Information: Answer all questions with Yes or No responses. Also, explain all responses.
  6. Loss History: Describe any previous losses or claims within the requested timeframe. Indicate the paid amount or whether disputes occurred.
  7. Payment Plan: Select a payment plan, such as EFT, credit card, or direct billing. Specify the billing account number, deposit amount, and estimated total premium. Attach the Acord 610, Premium Payment Supplement, for additional notes.
  8. Additional Interest: Describe any third party having a financial interest in the property, including their name and address. Attach the Acord 45, Additional Interest Schedule, for more space.
  9. Schedule of Property: Write the schedule number, item number, description, valuation date, and amount of insurance.
  10. Binder / Signature: The producer and applicant must sign and date the form. Mention the effective and expiration date.
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Frequently Asked Questions

Of course, many items require a bill of sale or an appraisal. You can attach an appraisal or photograph as proof of value.

The form requires past losses or claims within a given period. It helps insurers to evaluate risk and determine premium rates.

The coverage qualifiers identify special conditions, such as whether items are used for commercial purposes, kept in vaults, exhibited at shows, or require specific exclusions. Additionally, it helps insurers to calculate coverage that reflects the actual risks.

It is used to apply for Personal Inland Marine insurance coverage, allowing you to list valuable personal items, such as jewelry, cameras, laptops, furs, fine arts, and collectibles, so insurers can provide specific protection.