ACORD 84 (2016/11) Form – Dwelling Fire Insurance PDF
ACORD 84 (2016/11)
Dwelling Fire Insurance
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Form Number: |
ACORD 84 (2016/11) |
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Category: |
Personal Lines |
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Last Updated: |
November 2016 |
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Page Count: |
05 pages |
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File Format: |
PDF, Fillable PDF |
Acord 84 Dwelling Fire Application Form
An Acord 84 fillable form helps people apply for dwelling fire insurance to protect their properties against windstorms or fires. Dwelling fire insurance covers specific perils for properties, including seasonal homes, vacant dwellings, or rental units. Property owners, landlords, and property investors require the form for transparent communication to reduce claim disputes. The form covers the detailed information about the property, applicant, safety features, loss history, and coverage preference to help insurers underwrite the policy.
Form Preview
Benefits of Using the Acord 84 Fillable
Customized Coverage
The dwelling fire insurance application form ensures customized coverage to protect from fire, lightning, or windstorms.
Landlord Security
The Acord 84 PDF form protects the landlord’s investment from financial loss due to unforeseen accidents.
Calculate Premiums
Property details, loss history, safety features, and dwelling coverage allow insurers to assess the risk and calculate premiums.
Digital Accessibility
The fillable PDF form allows online completion and submission to reduce errors and approval time.
Key Sections of the Acord 84 (2016/11) Form
Applicant Information
Records the applicant’s identity for transparent communication to ensure accurate policy issuance.
Property Details
It includes property coverage to help insurers assess property risk and determine eligibility and premiums.
Coverage Options
The Acord 84 PDF form ensures customized insurance to protect the property values from risks.
Loss History
Records the past claims or losses to evaluate the risk history that impacts the premium calculations.
Rating/Underwriting
It contains the safety features, hazards, conditions, and pricing to inform insurers about assessing the risk for safety compliance and fair pricing.
Additional Interests
Ensure the involvement of mortgagees and lienholders meets lender requirements and protects financial stakeholders.
Signature
The producer and applicant’s signatures authorize the application and prevent rejection delays.
How to Fill Out the Acord 84 Dwelling Fire Application Form?
- Write the insurance agent’s name, phone number, fax number, email address, and customer ID.
- Mention the Carrier and write the NAIC number.
- Write the insured’s name, policy number, effective date, and expiry date.
- Write the applicant’s name, date of birth, social security number, marital status, contact details, and mailing address.
- Mention the limits and premiums of the coverage type.
- Write the location number, form’s name, number, ending date, and copyright owner code.
- Tick the boxes for the payment method.
- Mention the construction type, condition, heating, and foundation details.
- Mention the coverage type, information, limits, deductibles, and premiums.
- Tick the answers for general questions.
- Write the description of the loss history.
- Write the additional remarks.
- Get the producer and applicant signatures.
Frequently Asked Questions
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