ACORD 65NC Instructions


Section Name Field Name Field and/or Section Description
TITLE ACORD 65 NC (2010/02) North Carolina Auto Supplement, Notice of Right to Purchase Higher Limits ofUninsured Motorist(UM) and Underinsured Motorist (UIM) Coverage The title of the form. ACORD 65 NC, North Carolina Auto Supplement, Notice of Right to Purchase Higher Limits of Uninsured Motorist (UM) and Underinsured Motorist (UIM) Coverage, is used to comply with the statutory requirement that current policyholders and new applicants must be notified that they have the right to purchase Uninsured MotoristBodily Injury coverage with limits up to one million dollars ($1,000,000) per person and one million dollars ($1,000,000) per accident. This requirement does not apply to (1) fleet policies, or (2) policies issued oncommercial vehicles as defined by NC General Statute 20-4.01(d).
IDENTIFICATION SECTION Agency Customer ID Enter identifier: The customer’s identification number assigned by the producer (e.g. agency or brokerage).
IDENTIFICATION SECTION Agency Enter text: The full name of the producer/agency.
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 Effective Date Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence.
IDENTIFICATION SECTION Named Insured(s) Enter text: The named insured(s) as it/they will appear on the policy declarations page.
IDENTIFICATION SECTION Carrier Enter text: The insurer’s full legal company name(s) as found in thefile 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.
Edition Date The edition identifier of the form including the form number and edition (the date is typically formatted YYYY/MM).