Acord 50 WM Template

Acord 50 WM Template

The Acord 50 WM form is a document used in the insurance industry to provide a comprehensive overview of a worker's compensation policy. This form serves as a crucial tool for insurers and policyholders alike, facilitating clear communication and understanding of coverage details. By outlining essential information, the Acord 50 WM form helps streamline the underwriting process and ensures that all parties are informed about the terms of the policy.

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The Acord 50 WM form serves as a crucial document in the realm of commercial insurance, particularly for businesses seeking to streamline their coverage for workers' compensation. This form provides a comprehensive overview of the insurance requirements, ensuring that employers meet both state and federal regulations. It includes essential information such as the type of coverage being requested, details about the insured entity, and the nature of the business operations. By utilizing the Acord 50 WM form, businesses can effectively communicate their insurance needs to providers, facilitating a smoother underwriting process. Additionally, the form helps to clarify the specific risks associated with various job functions, allowing insurers to assess coverage options more accurately. This document is not only vital for compliance but also plays a significant role in protecting employees and employers alike, establishing a foundation for workplace safety and financial security. Understanding the nuances of this form can empower businesses to make informed decisions regarding their insurance policies, ultimately contributing to their long-term success and stability.

Acord 50 WM Sample

For use with ACORD 360 WM, four part perforated 32 lb. paper

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

 

 

 

 

 

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

 

 

 

 

 

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

 

 

 

 

 

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

 

 

 

 

 

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 1993-2007. All rights reserved.

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 1993-2007. All rights reserved.

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 1993-2007. All rights reserved.

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 1993-2007. All rights reserved.

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Key takeaways

  • The Acord 50 WM form is essential for documenting workers' compensation insurance needs. It serves as a standardized tool to communicate coverage details between businesses and insurers.

  • Accurate completion of the form is crucial. Errors or omissions can lead to coverage gaps or delays in processing. Double-check all entries before submission.

  • Ensure that all relevant business information is included. This includes the name, address, and contact details of the business, as well as the nature of its operations.

  • The form requires detailed information about the employees covered. This includes job classifications and payroll estimates, which help determine the appropriate premium rates.

  • Review the specific requirements of your state. Workers' compensation laws vary, and understanding local regulations can help in accurately filling out the form.

  • Keep a copy of the completed form for your records. This can be useful for future reference and can help in addressing any disputes that may arise regarding coverage.