Content Overview
File Details
| Fact Name | Description |
|---|---|
| Form Purpose | The Acord 50 WM form is used for workers' compensation insurance applications. |
| Governing Law | This form is governed by the laws of the state in which the insurance is being applied for. |
| Required Information | Applicants must provide details about their business operations and employee classifications. |
| Submission Process | The completed form should be submitted to the insurance carrier for review and approval. |
| State-Specific Variations | Some states may have specific requirements or additional forms that accompany the Acord 50 WM. |
| Renewal Usage | Businesses may need to complete this form again during policy renewals to ensure updated information. |
| Importance of Accuracy | Providing accurate information on the form is crucial to avoid coverage issues or claims denials. |
Sample - Acord 50 WM Form
For use with ACORD 360 WM, four part perforated 32 lb. paper
INSURANCE IDENTIFICATION CARD
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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COMMERCIAL |
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PERSONAL |
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POLICY NUMBER |
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EFFECTIVE DATE |
EXPIRATION DATE |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
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AGENCY/COMPANY ISSUING CARD |
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INSURED
SEE IMPORTANT NOTICE ON REVERSE SIDE
INSURANCE IDENTIFICATION CARD
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(STATE) |
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COMPANY NUMBER |
COMPANY |
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COMMERCIAL |
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PERSONAL |
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POLICY NUMBER |
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EFFECTIVE DATE |
EXPIRATION DATE |
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YEAR |
MAKE/MODEL |
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VEHICLE IDENTIFICATION NUMBER |
||||
AGENCY/COMPANY ISSUING CARD |
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||
INSURED
SEE IMPORTANT NOTICE ON REVERSE SIDE
INSURANCE IDENTIFICATION CARD
|
(STATE) |
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|
|
|
|
COMPANY NUMBER |
COMPANY |
|
|
COMMERCIAL |
|
PERSONAL |
|
POLICY NUMBER |
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EFFECTIVE DATE |
EXPIRATION DATE |
|||
YEAR |
MAKE/MODEL |
|
VEHICLE IDENTIFICATION NUMBER |
||||
AGENCY/COMPANY ISSUING CARD |
|
|
|
|
|
||
INSURED
SEE IMPORTANT NOTICE ON REVERSE SIDE
INSURANCE IDENTIFICATION CARD
|
(STATE) |
|
|
|
|
|
|
COMPANY NUMBER |
COMPANY |
|
|
COMMERCIAL |
|
PERSONAL |
|
POLICY NUMBER |
|
|
EFFECTIVE DATE |
EXPIRATION DATE |
|||
YEAR |
MAKE/MODEL |
|
VEHICLE IDENTIFICATION NUMBER |
||||
AGENCY/COMPANY ISSUING CARD |
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|
|
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||
INSURED
SEE IMPORTANT NOTICE ON REVERSE SIDE
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW
ACORD 50 WM (2007/03) |
© ACORD CORPORATION |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW
ACORD 50 WM (2007/03) |
© ACORD CORPORATION |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW
ACORD 50 WM (2007/03) |
© ACORD CORPORATION |
THIS CARD MUST BE KEPT IN THE INSURED
VEHICLE AND PRESENTED UPON DEMAND
IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:
1.Name and address of each driver, passenger and witness.
2.Name of Insurance Company and policy number for each vehicle involved.
THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW
ACORD 50 WM (2007/03) |
© ACORD CORPORATION |
Common mistakes
When completing the Acord 50 WM form, individuals often overlook important details that can lead to complications. One common mistake is failing to provide accurate contact information. This includes not only the name and address but also the correct phone number and email address. Inaccuracies can delay communication and hinder the processing of the application.
Another frequent error is neglecting to specify the coverage limits. Applicants sometimes assume that the default limits will suffice, but this can result in insufficient coverage. It is essential to carefully review and select appropriate limits based on individual needs and circumstances.
In addition, many people forget to sign and date the form. A missing signature can render the entire application invalid. Always double-check that the form is signed in the designated areas and that the date reflects when the form was completed.
Providing incomplete information is also a significant issue. Some applicants may skip sections or leave fields blank, thinking they are not relevant. However, every section is designed to gather essential information. Leaving out details can lead to delays or even rejection of the application.
Another mistake involves misunderstanding the purpose of the form. Some individuals may confuse the Acord 50 WM with other forms, leading to incorrect information being provided. It’s crucial to understand what the form is for and to fill it out accordingly.
Lastly, not reviewing the form before submission can lead to avoidable errors. Taking the time to go over the completed form can help catch mistakes and ensure all information is accurate and complete. This simple step can save time and prevent future issues.
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