ACORD Forms Notification Service
February 2008 Bulletin
ACORD P&C and Life Form Changes and Additions
The following pages include both a List of recently Revised and New ACORD forms and an Explanation of the Changes made. Copies of the forms mentioned in this announcement can be downloaded in the formats you need at either of these two web sites:
> www.acord.org > ACORD Forms > Download Forms, or > www.acordadvantage.org > Forms > Forms Search
To download forms, you will need to “sign-in” as an ACORD or ACORD Advantage member with your user name and password. If you need assistance, a sample of a form, or are an agent/broker who would like to join the Advantage Program, please call Member Services at (800) 444-3341, Option 2 or email us at
If you do not wish to receive this notification, please send an email to [email protected] requesting that we unsubscribe you to this Forms Notification Service.
Form Number Replaces Title REVISIONS
P&C - Countrywide
67 (2008/04) 2006/01 Illinois / Indiana / Kentucky / West Virginia Mine Subsidence 88 (2007/11) 2007/09 Personal Insurance Application
89 (2007/11) 2007/09 Residential Section
P&C - State Specific
* 50 FL (2008/02) 2007/12 Florida Personal Auto Insurance Identification Card
* 51 FL (2008/02) 2007/12 Florida Commercial Auto Insurance Identification Card
60 US (2008/02) 2006/04 Insurance Supplement – Notice – Offer of Terrorism Coverage 62 US (2008/02) 2006/04 Insurance Supplement – Standard Fire Policy Only
Notice – Offer of Terrorism Coverage
64 US (2008/02) 2006/04 Insurance Supplement – Workers’ Compensation Only Notice – Offer of Terrorism Coverage
Life/Annuity NONE
NEW
P&C - Countrywide NONE
P&C – State Specific
NONE
Life/Annuity
759 TX (2008/02) NEW Texas Important Notice: Replacement of Life Insurance or Annuities
WITHDRAWN
62 AZ (2003/05) Arizona Auto Supplement (Spanish Version)
FIG CHANGES ONLY
45 (2003/04) Additional Interest
401 (2007/09) Agriculture Application
62 GA (2008/01) Georgia Auto Supplement – Uninsured Motorists Optional Coverage Disclosure
* Due to their unique nature, printed versions of ACORD forms identified with an asterisk (*) will not be available for shipping for 10-15 business days. You can download forms from the ACORD Web site immediately.
Explanation of Changes 02-29-2008
1 of 5 ACORD Explanation of Changes 02-29-2008
P&C FORMS Countrywide – Revised
67 (2008/04)
Illinois / Indiana / Kentucky / West Virginia Mine Subsidence
Please note: Application text has been reformatted
1. Add field for AGENCY CUSTOMER ID: to upper right hand corner of page 2. Replace header with new standard header for a supplement/section
3. Retain EFFECTIVE DATE and EXPIRATION DATE fields 4. Reformat state list below fifth paragraph
5. Revise text pertaining to Illinois
6. Update ACORD copyright to new format with year as first item after copyright symbol 7. Add -2008 and All rights reserved. to copyright
8. Add The ACORD name and logo are registered marks of ACORD to footer
88 (2007/11)
Personal Insurance Application
Page 3
1. PAYMENT PLAN section, FOR CREDIT CARDS, add (Not applicable in North Carolina)
89 (2007/11) Residential Section
Page 2
1. COVERAGES / LIMITS OF LIABILITY section, DEDUCTIBLES, add an asterisk after NAMED HURRICANE and ANNUAL HURRICANE and add a footnote immediately below the section, * Not applicable in North Carolina
2 of 5 ACORD Explanation of Changes 02-29-2008 State Specific – Revised
50 FL (2008/02)
Florida Personal Auto Insurance Identification Card
Page 1
1. Add PERSONAL INJURY PROTECTION BENEFITS / to PROPERTY DAMAGE LIABILITY check box Page 2
2. Revise ACORD copyright, replacing 2007 with 2008 Page 3
3. Add PERSONAL INJURY PROTECTION BENEFITS / to PROPERTY DAMAGE LIABILITY check box (8 places)
Page 4
4. Revise ACORD copyright, replacing 2007 with 2008 (8 places)
51 FL (2008/02)
Florida Commercial Auto Insurance Identification Card
Page 1
1. Add PERSONAL INJURY PROTECTION BENEFITS / to PROPERTY DAMAGE LIABILITY check box Page 2
2. Revise ACORD copyright to 2007, 2008 Page 3
3. Add PERSONAL INJURY PROTECTION BENEFITS / to PROPERTY DAMAGE LIABILITY check box (8 places)
Page 4
4. Revise ACORD copyright to 2007, 2008
60 US (2008/02) Insurance Supplement Policyholder Disclosure
Notice of Terrorism Insurance Coverage
The Terrorism Risk Insurance Act, as amended in 2007, has resulted in a total revision of this form. Please treat it as a new form.
62 US (2008/02)
Insurance Supplement – Standard Fire Policy Only Policyholder Disclosure
Notice of Terrorism Insurance Coverage
The Terrorism Risk Insurance Act, as amended in 2007, has resulted in a total revision of this form. Please treat it as a new form.
Explanation of Changes 02-29-2008
3 of 5 ACORD Explanation of Changes 02-29-2008
64 US (2008/02)
Insurance Supplement – Workers’ Compensation Only Policyholder Disclosure
Notice of Terrorism Insurance Coverage
The Terrorism Risk Insurance Act, as amended in 2007, has resulted in a total revision of this form. Please treat it as a new form.
Countrywide – New NONE
State Specific – New NONE
LIFE & ANNUITY FORMS - NEW 759 TX (2008/02)
Texas Important Notice: Replacement of Life Insurance or Annuities
Use ACORD 759 TX, Texas Important Notice: Replacement of Life Insurance or Annuities, in the state of Texas, to inform the Carrier of the intent to replace a policy. The form is to be completed by the Producer and then sent to the new Carrier.
WITHDRAWN FORMS 62 AZ (2003/05)
Arizona Auto Supplement (Spanish Version)
4 of 5 ACORD Explanation of Changes 02-29-2008 FIG CHANGES ONLY
45 (2003/04) Additional Interest
ADDITIONAL INTERESTS/CERTIFICATE RECIPIENTS section, Field Name, Name and Address, Field Description now reads:
Enter the complete name and address of the additional interest, including the city, state and country. If the additional interest is the owner of a motor vehicle, and the owner is different from the Named Insured, show the owner's name here.
401 (2007/09)
Agriculture Application
1. PREMISES INFORMATION section, Field Name, Distance to Public Hydrant Ft, Field Description now reads:
Show the distance in feet to the nearest fire hydrant.
2. PREMISES INFORMATION section, Field Name, Distance to Fire Station Mi, Field Description now reads:
Show the distance in miles to the nearest fire station. 62 GA (2008/01)
Georgia Auto Supplement - Uninsured Motorists Optional Coverage Disclosure
TITLE section, Field Description now reads:
ACORD 62 GA, Uninsured Motorists Optional Coverage Disclosure, complies with Georgia law. Use this form with all applications for personal and commercial auto insurance as well as renewals. The language in this form has been provided by the Commissioner of Insurance.
Explanation of Changes 02-29-2008
5 of 5 ACORD Explanation of Changes 02-29-2008
STATE ACTIVITY
US Terrorism Risk Insurance Program Reauthorization Act of 2007 renews Federal backstop for losses due to terrorism. ACORD will revise disclosure forms.
The Terrorism Risk Insurance Program Reauthorization Act of 2007 has been passed and signed by the President. This act extends the federal backstop for losses due to terrorism until December 31, 2014. Several provisions of the initial Act (2002) have changed. As a result, ACORD will revise ACORD 60 US, Notice-Offer of Terrorism Coverage, ACORD 62 US, Standard Fire Policy Only, Notice- Offer of Terrorism Coverage, and ACORD 64 US, Notice -Terrorism Insurance Coverage, Workers Compensation Coverage Only, The revised forms will be released at the end of February.
IMPORTANT: MANY STATES ARE REQUIRING THAT INSURERS FILE THE DISCLOSURE FORMS THEY WILL USE AT THE TIME THEY FILE RATES FOR TERRORISM COVERAGE. ACORD CANNOT MAKE THESE FILINGS FOR INSURERS.
Arizona requires that ACORD Auto Uninsured and Underinsured Motorists coverage selection form must be filed by insurers
ACORD 61 AZ, Arizona Auto Supplement, Uninsured/Underinsured Motorists Coverage Selection Form, is an auto disclosure form that is required by Arizona law to be used in connection with all applications for auto insurance. The text of the form was developed by the Arizona Commissioner of Insurance.
The text of ACORD 61 AZ is an exact duplicate of the form developed by the commissioner. Nevertheless, auto insurers have been directed by the commissioner to file any UM/UIM coverage selection form that they use. Filing by ACORD is not acceptable. Individual insurers using ACORD 61 AZ must file the form on their behalf.
Amended Rhode Island rule requires change in auto ID card. ACORD has responded.
Rhode Island House Bill 5547, effective January 1, 2008, resulted in the amending of the statement on page 2 of the Auto ID card regarding selection of a car repairer. ACORD has subsequently revised and released the Rhode Island Auto ID card with the amended language.
