ACORD 137NY Instructions

ACORD 137 NY (2003/11) – New York Commercial Auto, Coverages/Limits Section

Use this form to collect the coverage, limits and premium information necessary to write Business Auto, Truckers or Motor Carrier insurance in this state.

Use this form with ACORD 127, Business Auto Section, or ACORD 132, Truckers/Motor Carrier Section.

The specific differences in this state are:

  • Personal Injury Protection coverages are revised to reflect New York’s unique coverages and options. Refer to your state Manual.
  • A question is included regarding any applicant covered by a wage continuation plan. If coverage applies, the name of the plan and the person(s) covered must be shown in the application. New York State law requires a reduction in work loss payment under Personal Injury Protection coverage and a PIP premium reduction, if an insured is covered by a qualified wage continuance plan.
  • Uninsured and Underinsured Motorists coverages are replaced by “Statutory UM/UIM” and “Supplemental UM (SUM)”. Refer to your State Manual.
  • Fraud statement text is specific to this state.
  • Statement added to the back of the form referencing the availability of Statutory Uninsured Motorists and Supplementary Uninsured Motorists coverages and options.


For further instructions refer to the generic ACORD 137 Instruction here.