Blank Acord 50 WM Form
The Acord 50 WM form plays a crucial role in the insurance industry, particularly in the context of workers' compensation coverage. This standardized document serves as a comprehensive application for insurance agents and brokers, facilitating the collection of essential information about a business seeking coverage. It includes various sections that capture details about the employer, the nature of the business operations, and the workforce. Additionally, the form addresses the specific types of coverage requested, as well as any prior insurance history. By streamlining the application process, the Acord 50 WM form ensures that insurers can accurately assess risks and provide appropriate quotes. The clarity and organization of this form contribute to efficient communication between all parties involved, ultimately aiding in the timely issuance of policies. Understanding the components and requirements of the Acord 50 WM form is vital for those navigating the complexities of workers' compensation insurance.
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Dos and Don'ts
When filling out the Acord 50 WM form, attention to detail is crucial. Here’s a helpful list of dos and don’ts to guide you through the process.
- Do read the instructions carefully before starting. Understanding the requirements will save you time and effort.
- Do provide accurate and complete information. Ensure all details are correct to avoid delays in processing.
- Do use clear and legible handwriting if filling out the form by hand. If possible, consider typing the information.
- Do double-check your entries for any errors. A quick review can catch mistakes that might otherwise lead to complications.
- Don’t leave any required fields blank. Missing information can result in your form being returned.
- Don’t use abbreviations unless specified. Clarity is key, and full words help avoid confusion.
- Don’t submit the form without a thorough review. Take the time to ensure everything is in order.
- Don’t forget to keep a copy for your records. Having a backup can be invaluable for future reference.
Following these guidelines will help ensure that your Acord 50 WM form is completed correctly and efficiently.
Acord 50 WM Sample
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 |
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|
COMMERCIAL |
|
PERSONAL |
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POLICY NUMBER |
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EFFECTIVE DATE |
EXPIRATION DATE |
|||
YEAR |
MAKE/MODEL |
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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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||
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 |
Listed Questions and Answers
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What is the Acord 50 WM form?
The Acord 50 WM form is a standard document used in the insurance industry. It serves as a summary of coverage and is typically used for workers' compensation insurance. This form provides essential information regarding the insured party, including details about their business operations, the types of coverage they are seeking, and any additional information necessary for underwriting purposes.
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Who needs to fill out the Acord 50 WM form?
Businesses that require workers' compensation insurance must complete the Acord 50 WM form. This includes employers in various industries who have employees and are mandated by state laws to provide coverage. The form is essential for insurers to assess risk and determine appropriate premiums.
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What information is required on the Acord 50 WM form?
The form typically requires the following information:
- Name and address of the business
- Type of business operations
- Number of employees
- Payroll estimates
- Previous workers' compensation insurance history
Providing accurate information is crucial, as it directly affects coverage options and premium calculations.
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How is the Acord 50 WM form submitted?
The Acord 50 WM form can be submitted to an insurance agent or broker, who will then forward it to the appropriate insurance company. Some insurers may also accept electronic submissions through their online platforms. Ensure that all required fields are completed to avoid delays in processing.
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What happens after submitting the Acord 50 WM form?
Once submitted, the insurance company will review the information provided. They may request additional details or clarification if necessary. After the review, the insurer will determine the eligibility for coverage and provide a quote. If the terms are acceptable, the business can proceed with purchasing the workers' compensation policy.
Form Overview
| Fact Name | Description |
|---|---|
| Purpose | The Acord 50 WM form is used for workers' compensation insurance applications, providing essential information about the applicant's business and coverage needs. |
| Standardization | This form is standardized across many states, facilitating a consistent approach to workers' compensation applications and ensuring that all necessary information is collected. |
| State-Specific Requirements | Some states may have additional requirements or specific versions of the Acord 50 WM form, governed by local workers' compensation laws. |
| Submission | The completed form must be submitted to the insurance provider for processing, and it is crucial for obtaining the appropriate coverage for employees. |