ACORD 1 Instructions


Section Name Field Name Field and/or Section Description
TITLE ACORD 1 (2009/02) PROPERTY LOSS NOTICE The title of the form. ACORD 1, Property Loss Notice, is used for reporting commercial and personal lines property losses including Homeowners, Dwelling Fire, Inland Marine, Commercial Property, Flood, Wind and others.
IDENTIFICATION SECTION Date Enter date: The month/day/year on which the form is completed. (MM/DD/YYYY)
IDENTIFICATION SECTION Agency Enter text: The full name of the producer/agency.
IDENTIFICATION SECTION Enter text: The mailing address line one of the producer/agency.
IDENTIFICATION SECTION Enter text: The mailing address line two of the producer/agency.
IDENTIFICATION SECTION Enter text: The mailing address city name of the producer/agency.
IDENTIFICATION SECTION Enter code: The mailing address state or province code of the producer/agency.
IDENTIFICATION SECTION Enter code: The mailing address postal code of the producer/agency.
IDENTIFICATION SECTION Contact Name Enter text: The name of the individual at the producer’s establishment that is the primary contact.
IDENTIFICATION SECTION Phone (A/C, No, Ext) Enter number: The producer’s contact person’s phone number. If applicable, include the area code and extension.
IDENTIFICATION SECTION FAX Enter number: The fax number of the producer/agency.
IDENTIFICATION SECTION E-Mail Address Enter text: The producer’s contact person e-mail address.
IDENTIFICATION SECTION Code Enter code: The identification code assigned to the producer (e.g. agency or brokerage firm) by the insurer.
IDENTIFICATION SECTION Subcode Enter code: The identification code assigned by the insurer to the sub-producer (e.g. person) within a producer’s office (e.g. agency or brokerage).
IDENTIFICATION SECTION Agency Customer ID Enter identifier: The customer’s identification number assigned by the producer (e.g. agency or brokerage).
Section Name Field Name Field and/or Section Description
IDENTIFICATION SECTION Insured Location Code Enter code: The code the policyholder defines that is used to allocate loss experience to cost centers. For example, if a grocery store chain is insured and the entire chain was under one policy, the grocery store chain might choose to allocate the losses for each store. To do this they would provide a store number or store code (something the insured defines) when they report a claim. The insured would include that store number in the “Insured Location Code” field so that the carrier can record the code in their claim system and then the right store is assessed the loss experience.
IDENTIFICATION SECTION Date of Loss Enter date: The date that the loss occurred.
IDENTIFICATION SECTION Time of Loss Enter time: The approximate time that the loss occurred.
IDENTIFICATION SECTION AM Check the box (if applicable): Indicates the loss occurred in the morning.
IDENTIFICATION SECTION PM Check the box (if applicable): Indicates the loss occurred in the afternoon or evening.
IDENTIFICATION SECTION Property/Home Company Enter text: The insurer’s full legal company name(s) as found in the file copy of the policy. Use the actual name of the company within the group to which the policy has been issued. This is not the insurer’s group name or trade name.
IDENTIFICATION SECTION NAIC Code Enter code: The identification code assigned to the insurer by the NAIC.
IDENTIFICATION SECTION Policy Number Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number.
IDENTIFICATION SECTION Flood Company Enter text: The insurer’s full legal company name(s) as found in the file copy of the policy. Use the actual name of the company within the group to which the policy has been issued. This is not the insurer’s group name or trade name.
IDENTIFICATION SECTION NAIC Code Enter code: The identification code assigned to the insurer by the NAIC.
IDENTIFICATION SECTION Policy Number Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number.
IDENTIFICATION SECTION Wind Company Enter text: The insurer’s full legal company name(s) as found in the file copy of the policy. Use the actual name of the company within the group to which the policy has been issued. This is not the insurer’s group name or trade name.
Section Name Field Name Field and/or Section Description
IDENTIFICATION SECTION NAIC Code Enter code: The identification code assigned to the insurer by the NAIC.
IDENTIFICATION SECTION Policy Number Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number.
INSURED Name of Insured Enter text: The named insured(s) as it/they will appear on the policy declarations page.
INSURED Date of Birth Enter date: The date of birth of the insured.
INSURED FEIN (if applicable) Enter identifier: The tax identifier of the named insured. As used here, this is the Federal Employer’s Identification Number, if applicable.
INSURED Marital Status Enter code: The insured’s marital status. The applicable codes are: * S Single * M Married * D Divorced * P Separated * W Widowed * C Domestic Partner (unmarried) * V Civil Union * U Unknown * O Other
INSURED Primary Phone Number Enter number: The named insured’s primary phone number.
INSURED Home Check the box (if applicable): Indicates the primary phone number is for a home phone.
INSURED Business Check the box (if applicable): Indicates the primary phone number is for a business phone.
INSURED Cell Check the box (if applicable): Indicates the primary phone number is for a cell phone.
INSURED Secondary Phone Enter number: The named insured’s secondary phone number.
INSURED Home Check the box (if applicable): Indicates the secondary phone number is for a home phone.
INSURED Business Check the box (if applicable): Indicates the secondary phone number is for a business phone.
INSURED Cell Check the box (if applicable): Indicates the phone number is for a cell phone.
INSURED Insured’s Mailing Address Enter text: The named insured’s mailing address line one.
INSURED Enter text: The named insured’s mailing address line two.
Section Name Field Name Field and/or Section Description
INSURED Enter text: The named insured’s mailing address city name.
INSURED Enter code: The named insured’s mailing address state or province code.
INSURED Enter code: The named insured’s mailing address postal code.
INSURED Primary E-Mail Address Enter text: The named insured’s primary e-mail address.
INSURED Secondary E-Mail Address Enter text: The named insured’s secondary e-mail address.
INSURED Name of Spouse Enter text: The named insured(s) as it/they will appear on the policy declarations page.
INSURED Date of Birth Enter date: The date of birth of the insured.
INSURED FEIN (if applicable) Enter identifier: The tax identifier of the named insured. As used here, this is the Federal Employer’s Identification Number, if applicable.
INSURED Marital Status Enter code: The insured’s marital status. The applicable codes are: * S Single * M Married * D Divorced * P Separated * W Widowed * C Domestic Partner (unmarried) * V Civil Union * U Unknown * O Other
INSURED Primary Phone Number Enter number: The named insured’s primary phone number.
INSURED Home Check the box (if applicable): Indicates the primary phone number is for a home phone.
INSURED Business Check the box (if applicable): Indicates the primary phone number is for a business phone.
INSURED Cell Check the box (if applicable): Indicates the primary phone number is for a cell phone.
INSURED Secondary Phone Enter number: The named insured’s secondary phone number.
INSURED Home Check the box (if applicable): Indicates the secondary phone number is for a home phone.
INSURED Business Check the box (if applicable): Indicates the secondary phone number is for a business phone.
INSURED Cell Check the box (if applicable): Indicates the phone number is for a cell phone.
INSURED Spouse’s Mailing Address Enter text: The named insured’s mailing address line one.
INSURED Enter text: The named insured’s mailing address line two.
Section Name Field Name Field and/or Section Description
INSURED Enter text: The named insured’s mailing address city name.
INSURED Enter code: The named insured’s mailing address state or province code.
INSURED Enter code: The named insured’s mailing address postal code.
INSURED Primary E-Mail Address Enter text: The named insured’s primary e-mail address.
INSURED Secondary E-Mail Address Enter text: The named insured’s secondary e-mail address.
CONTACT Contact Insured Check the box (if applicable): Indicates If the individual to contact is the same as the insured, check this box and leave blank the areas for contact name, address and phone numbers.
CONTACT Name of Contact Enter text: The full name (First, Middle, Last) of the individual to be contacted as a representative of the insured on all subsequent business relating to this incident. No entry is needed if the ‘Contact Insured’ option is checked.
CONTACT Primary Phone Number Enter number: The loss contact’s primary telephone number including area code.
CONTACT Home Check the box (if applicable): Indicates the primary phone number is for a home phone.
CONTACT Business Check the box (if applicable): Indicates the primary phone number is for a business phone.
CONTACT Cell Check the box (if applicable): Indicates the primary phone number is for a cell phone.
CONTACT Secondary Phone Enter number: The loss contact’s secondary telephone number including area code.
CONTACT Home Check the box (if applicable): Indicates the secondary phone number is for a home phone.
CONTACT Business Check the box (if applicable): Indicates the secondary phone number is for a business phone.
CONTACT Cell Check the box (if applicable): Indicates the secondary phone number is for a cell phone.
CONTACT When to Contact Enter text: The best time of the day to contact this individual (e.g., evenings, days, noon to 3:00 P.M.).
CONTACT Contact’s Mailing Address Enter text: The loss contact’s first address line.
CONTACT Enter text: The loss contact’s second address line.
CONTACT Enter text: The loss contact’s city.
CONTACT Enter code: The loss contact’s state.
CONTACT Enter code: The loss contact’s postal code.
CONTACT Primary E-Mail Address Enter text: The loss contact’s primary e-mail address.
CONTACT Secondary E-Mail Address Enter text: The loss contact’s secondary e-mail address.
LOSS Location of Loss Street Enter text: The loss location’s physical street address.
Section Name Field Name Field and/or Section Description
LOSS Location of Loss City, State, Zip Enter text: The loss location’s city.
LOSS Enter code: The loss location’s state or province code.
LOSS Enter code: The loss location’s postal code.
LOSS Location of Loss Country Enter code: The loss location’s country code.
LOSS Describe Location of Loss if not at Specific Street Address Enter text: The description of the location of loss if not at a specific street address.
LOSS Police or Fire Department Contacted Enter text: The name of the municipal, county or other police department, fire department or other authority to which the accident was reported, including any precinct or station number, if available.
LOSS Report Number Enter identifier: The report number assigned by the authority contacted. For example, the number of the vehicle incident report filed by the police after an automobile accident.
LOSS Kind of Loss Check the box (if applicable): Indicates the loss was due to fire.
LOSS Kind of Loss Check the box (if applicable): Indicates the loss was due to theft.
LOSS Kind of Loss Check the box (if applicable): Indicates the loss was due to lightning.
LOSS Kind of Loss Check the box (if applicable): Indicates the loss was due to hail.
LOSS Kind of Loss Check the box (if applicable): Indicates the loss was due to flooding.
LOSS Kind of Loss Check the box (if applicable): Indicates the loss was due to wind.
LOSS Kind of Loss Check the box (if applicable): Indicates the loss was due to other that those types listed.
LOSS Kind of Loss Enter text: The description of the cause of the loss.
LOSS Probable Amount Entire Loss Enter amount: The estimated dollar amount which may be paid on all claims arising from this incident. If no dollar estimate is available, provide a description such as “small” or “substantial”.
LOSS Description of Loss & Damage Enter text: The description of the cause of the loss and resulting damage, including the areas of buildings which were damaged. Note: If the loss resulted in bodily injury to individuals or damage to the property of others, indicate in the Remarks Section and complete the appropriate additional claim form.
LOSS Reported By Enter text: The name of the individual that reported the loss.
LOSS Reported To Enter text: The name of the individual within the agency or company to whom this loss was reported.
IDENTIFICATION SECTION Agency Customer ID Enter identifier: The customer’s identification number assigned by the producer (e.g. agency or brokerage).
Section Name Field Name Field and/or Section Description
IDENTIFICATION SECTION Agency Customer ID Enter identifier: The customer’s identification number assigned by the producer (e.g. agency or brokerage).
Edition Date The edition identifier of the form including the form number and edition (the date is typically formatted YYYY/MM).