ACORD 82 InstructionsACORD 82 - Watercraft Application The underwriting process for any personal lines policy begins with the submission of a completed application. The following will provide assistance in completing ACORD 82, Watercraft Application.
If coverage will
be provided under a yacht policy, do not use this form. Use ACORD 210, Yacht
Section." IDENTIFICATION SECTION Date Month/day/year
(MM/DD/YYYY) on which the form is completed. Agency Producer's name
and address. Phone No. Producer's telephone
number. (Include area code and extension if applicable) Fax No. Producer's fax
number. (Include area code) Code Identification
code assigned to the agency or brokerage firm by the insurance company receiving
this form. Sub Code If the agency
or brokerage uses a sub-code identification system with the company, enter the
appropriate code. Agency Customer ID Customer's identification
number assigned by the agency or brokerage. Applicant's Name and Address Full name of the applicant as it should appear on the policy. The First Named Insured is given certain rights and responsibilities by the policy contract language. If more than one insured is named, be sure the one intended to receive these rights and responsibilities is named first and any additional insureds identified as such. If joint ownership, the name used may include both names (e.g., John and Mary Smith). Provide the physical address, not a P.O. Box, at which the first named insured is to receive all mail.
NAIC Code The identification
code assigned to the company by the NAIC. Policy Number The number assigned
by the insurance company for the policy. In general, policy numbers will not
appear on new business applications since they are not known at that point in
time. CO/Plan Name of the insurance
company (or residual market plan) that will receive the application. Do not
use group names, use the actual name of the company within the group in which
you wish to have the policy issued. Also, if applicable, indicate the type of
plan or policy program (example: Preferred) that you wish to use when issuing
the policy. Use the specific plan name that is unique to that company. Home Phone # Home telephone
number at which the applicant may be reached. Include area code. Effective Date Date (MM/DD/YYYY)
on which the terms and conditions of the policy will commence. Expiration Date Date (MM/DD/YYYY)
on which the terms and conditions of the policy will terminate unless renewed. Business Phone # Business telephone
number at which the applicant may be reached. Include area code and extension,
if applicable. BOAT HULL Provide hull number
if more than one hull is to be insured. Power Indicate the method
of propulsion. Sailboats can be powered by an auxiliary engine, therefore, please
check SAIL in addition to the auxiliary type of propulsion for sailboats. Type of Hull Indicate the
type of watercraft to be insured. "Personal WC" refers to "personal
watercraft". Hull Material If the hull material
is not fiberglass, metal or wood, please indicate the material type in the remarks
area. Hull Design Indicate the
type of hull to be insured. Fuel Tank Indicate whether
the fuel tank is made of fiberglass or metal. Year Model year of
the unit in YYYY format. If built at home, enter the year built. Manufacturer/Mode
Name of the manufacturer and the model (e.g., Chris Craft Tournament
Fisherman, Pacemaker Runabout). Length Overall length
measured in feet from bow to stern. Max Speed Enter the maximum
speed of the craft. State if measured in knots or miles per hour. Date Purchased Date the watercraft
was purchased by the insured in MM/YYYY format. Cost New Cost of the boat
when it was purchased new, in whole dollar amounts. Present Value Boat's present
value, stated or agreed, in whole dollar amounts. Name of Boat Name in which
the watercraft is registered. Registration Number/Hull Identification Number Enter
the registration number and the serial number of the watercraft. Waters Navigated Identify the
primary area of operation (e.g., San Francisco Bay Area, Hudson River). Territory This is typically
the navigation territory. However, use company manuals to determine territory. Berth/Storage Location Physical
address where the boat is stored; no P.O. boxes. Lay-Up Period Specify the period
when the boat is not in operation (e.g., October through March). Also, state
if the boat is stored afloat or in a dry dock. If the boat is stored afloat,
indicate the devices used to prevent ice damage (e.g., bubble system). ENGINE/MOTOR Use this section
to provide information about all engines and motors used to propel the boat.
For Outboard Motors Only, provide the date purchased, cost when new and present
value. Year Model year of
the engine/outboard motor in YYYY format. Manufacturer/Model Enter the name
of the manufacturer, the model (e.g., Mercury Mark 50, Evinrude 200). Serial Number Enter the serial
number. Horsepower Enter the horsepower.
There is a method for determining the maximum safe horsepower for a specific
boat based on length and width. If the company employs this formula, it may
be helpful to make note of the width in the space labeled "other". Fuel Indicate the fuel
used to power the engine. Date Purchased Date the engine
or motor was purchased by the insured in MM/YYYY format. (For Outboard Motors
Only) Cost New Cost of the engine
or motor when it was purchased new, in whole dollar amounts. (For Outboard Motors
Only) Present Value Engine or motor's
present value, stated or agreed, in whole dollar amounts. (For Outboard Motors
Only) Other Enter any other
pertinent information to assist in underwriting the policy. TRAILER If boat trailer
insurance is to be included on the watercraft policy (usually only available
for stand-alone watercraft policies), enter all pertinent information regarding
the boat trailer: year, manufacturer, serial number, number of axles, capacity,
date purchased, cost. Year Model year of
the boat trailer in YYYY format. Manufacturer/Model Enter the name
of the manufacturer and the model of the trailer. Serial Number Enter the serial
number. # Axles Indicate the number
of axles on the boat trailer. Capacity Indicate the capacity
of the boat trailer. Date Purchased Date
the boat trailer was purchased by the insured in MM/YYYY format. Cost Cost of the boat trailer when it was purchased, in whole dollar amounts.
Indicate the limit
of insurance, deductible and coverage premium for each applicable coverage.
List any additional coverages, including their limit and premium in the other
coverage section. Hull Amount of coverage
for boat damage; this may include collision liability. Outboard Motor Amount of coverage
for damage to the outboard motor. Limits may be entered for three motors. *
Coverage for inboard motors is included in the hull coverage. Portable Accessories Coverage amount for those items not permanently attached to the boat. Examples: * Oars Trailer Amount of coverage
for damage to the trailer. Liability Coverage amount
for bodily injury and property damage. May be called protection and indemnity. Medical Payments Amount of coverage
for medical expenses for bodily injury to occupants of the boat. Uninsured Boaters Liability Coverage amount
for bodily injury and property damage C74caused by an uninsured boat operator.
Some companies offer this coverage. Total Estimated total
premium. Other Coverages and Endorsements Use this space
to indicate any other coverages and endorsements to apply. Describe all Credits to Apply to each Boat List all credit
amounts and names for each boat. Credit Total credit amount
for the watercraft portion of the policy. PAYMENT PLAN Indicate whether
the agency or the company (direct) will bill the insured or other payee for
the policy. If direct bill, also indicate who is to be billed, and the plan
to be used for payment. ADDITIONAL INTEREST Provide the following
information for each entity having an interest in the motors or the watercraft
to be insured: the interest number or rank (1st, 2nd), whether the additional
interest is the lienholder (e.g., bank in which the loan is held) or other interest,
the name and address of the interest (e.g., Loans Are Us Bank, 123 Main St,
Anytown, NY 10010) and loan number. RATING/UNDERWRITING Provide a description
of the equipment on the boat that is of particular interest to the underwriter.
Indicate the number present on the boat and an appropriate description of each
piece of equipment. Bilge Pumps A bilge pump is
a manually operated or automatically activated device used for pumping water
from the inner part of the ship's hull. Using the same principle as the manual
pump, the automatic pump is activated by the rise of water within the hull.
Specify the manufacturer and the model (e.g., Dynaflow Pump 304). Cooking Stove Indicate the manufacturer,
model and fuel type. Also indicate if there is more than one stove. Fume Detector A device used
for detecting the presence of fuel vapors below deck. Specify the manufacturer
and model (e.g., Sniffer 203). CO2/ Chemical System A built-in fire
extinguishing device. Indicate if it is manual or automatic and identify the
spaces protected. Include the manufacturer and model. Use the Remarks section
if necessary. Fire Extinguishers Indicate the
number of fire extinguishers on the boat. Specify the type, size, and the date
last weighed, if available. Depth Sounder An electronic
device for determining the depth of the water beneath the boat. Indicate the
manufacturer and model (e.g., Moran 6" - 150/SV-300). Radar A device for detecting
distant objects and determining their position. Specify the manufacturer and
model. Radio Direction Finder A navigational
aid employing a radio signal. Enter the manufacturer and model (e.g., Loran,
GSP). Ship to Shore Radio Indicate the type of radio. Examples:
Special locks,
burglar alarms or engine cut-out devices may be employed by the applicant. Marina
security may be noted as well. Heating Describe heating
system, if any. Other Use the blank
spaces to list additional equipment. Attach a separate list if necessary. PORTABLE ACCESSORIES Equipment List the portable
accessories that are to be insured. Include the name of the equipment. Year List the portable
accessories that are to be insured. Include the year of manufacture. Manufacturer List the portable
accessories that are to be insured. Include the name of manufacturer. Model List the portable
accessories that are to be insured. Include the model. Serial Number List the portable
accessories that are to be insured. Include the serial number if applicable. Limit Provide the limit(s)
of insurance required. OPERATORS # Number each household
member and any other frequent operator. Name List the name
for each household member and any other frequent operators. Sex List the sex for
each household member and any other frequent operators. Marital Status List the marital
status (S-Single, M-Married, D-Divorced, SEP-Separated, W-Widowed) for each
household member and any other frequent operators. Date of Birth List the date
of birth (MM/DD/YYYY) for each household member and any other frequent operators. Auto Driver's License Number List the auto
drivers license number for each household member and any other frequent operators. Licensed State List the licensed
state if applicable, for each household member and any other frequent operators. Social Security List the social
security # for each household member and any other frequent operators. # Number
of each household member and any other frequent operator as defined in the OPERATORS
section.. Indicate
if any operator completed courses offered by the United States Coast
Guard Auxiliary, the Power Squadron or other recognized training. The underwriter
will also be interested in the number of years of boating experience and the
type of boats operated or owned. Some companies require the percentage of use
for each operator. HULL INFORMATION Use the Remarks
section to provide additional information for any questions answered with a
"Yes" response. 1. Is the boat chartered to others? If the vessel
is chartered, describe the type of arrangements, destination, length of time
and frequency. Indicate if it is a bare boat charter where no crew or supervision
is furnished, a voyage charter, a time charter, etc. Include the purpose of
the charter (sight-seeing, fishing) and whether alcohol is served. 2. Is the boat used commercially or for business purposes? Describe the
commercial or business use of the vessel. Indicate if the vessel is used for
demonstrations, promotions, fishing, sight-seeing trips, etc. 3. Is the boat used for racing? If the vessel
is used for racing, indicate the frequency of such races during the year, the
extent of the race, the waters navigated, etc. 4. Is the boat used for waterskiing? Indicate how
frequently the vessel is used for waterskiing. 5. Does the applicant employ a paid crew? Specify the number
of crew members, and whether they are full or part time. Be sure to list the
crew members in the Operator section of the application. 6. Any sleeping facilities? Provide number
of beds. 7. Any existing damage to the boat? If "Yes",
describe in detail in remarks. GENERAL INFORMATION Use the Remarks
section to provide additional information for any question answered with a "yes"
response. 1. Has the applicant lived at current address for less than 3 years? Indicate the previous
address of the applicant. 2. Any operator have physical/mental impairment? Answer "yes"
only if the impairment impedes the use of the watercraft. Indicate the impairment
and any applicable medical treatment being used. 3.Any drivers license suspended/revoked during the last 3 years? Indicate if the
drivers license of any operator was suspended or revoked and explain the circumstances. 4. Has any operator had an accident/conviction during the last 3 years? Indicate accidents/convictions
for both driving and boating records. 5. Any other insurance with this company? Indicate if other
insurance is currently written for this applicant by the company. If a submission
was mailed to another department recently, note it in the remarks section along
with any policy numbers available. 6. Any losses occur during the last 3 years? Describe in detail, all losses during the last three years. Include data on the operator, the type of loss, the amount of the loss, the date and the disposition.
Provide the circumstances surrounding this situation. This question cannot be asked in Missouri.
In RI, failure
to disclose the existence of an arson conviction is a misdemeanor punishable
by a sentence of up to one year of imprisonment. Remarks Use the Remarks
section to provide additional information for any questions answered with a
"Yes" response. Attachments Check any applicable
attachments. BINDER/SIGNATURE This section is to be used by producers with the permission of the company underwriter or when the producer has binding authority for this line of business. Effective Date Month/day/year
(MM/DD/YYYY) on which the insurance applied for is bound. This insurance is
subject to the terms, conditions, and limitations of the company. Expiration Date Month/day/year
(MM/DD/YYYY) on which the binder terminates. Time Time the provisions
of the binder become effective. 12:01/ Noon Indicate the time
on which the binder terminates. Notice of Information Practices Check this box
if a copy of the Notice of Information Practices has been given to the applicant. Applicant's Signature The applicant
should read and understand the Fair Credit Reporting Act, the Privacy Act (where
applicable), the Applicant's Statement, and any other disclosure information
on the form before personally signing the application. Date Date the form
was signed. Producer's Signature The producer should
sign the application. This is required in most states. National Producer Number The National
Producer Number assigned by the NAIC should be shown. Sign up for Free Access to all ACORD forms. Return to Simply Easier ACORD Forms home page from ACORD 24 Instructions page.
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