ACORD 78 (2003/04) – Jewelry Insurance Appraisal – Single Item
This form is identical to ACORD 79, Jewelry Insurance Appraisal, in all
ACORD 79 allows for up to two jewelry items per page, and up to two stone groupings.
ACORD 78 contains a single jewelry item, and the jewelry descriptive content is expanded to eight stone groupings. This form may be used alone or in combination with ACORD 79 by jewelers to provide appraisal information about jewelry. If submitted at the time insurance is applied for, this form should be used with Personal Lines Applications, such as ACORD 80, Homeowners, or ACORD 81, Personal Inland Marine Application.
Month/day/year the appraisal was prepared.
Blank Area (next to and above NAME AND ADDRESS)
This area is reserved for the optional imprinting of a logo, name and address and other information of the jeweler/appraiser providing the appraisal.
Name and Address
Name and mailing address of the person whose item(s) are appraisedhere within.
Item number of the total items appraised within this appraisal as of the stated date.
Class Code #
These fields allow for the systematic tracking by general jewelry CLASS codes. This coding facilitates in the determination of actual loss experience within major jewelry groups thereby creating a mechanism for more effective exposure rating and the capability of utilizing different rates for jewelry (gold items, diamond jewelry, etc.).
The short class jewelry description aids in locating specific jewelry items on large schedules.
Est Replacement Value
Appraised values (based on retail selling price – see form for additional information) are isolated and stand out for quick evaluation.
All key information necessary for valuation of items made with precious metal (gold, silver, platinum) is contained in the described fields. This enables underwriting to determine insurance to value and assists adjusters in calculating replacement/actual cash value.
This is similar in scope to the above mounting format, except that it provides necessary stone specifics for determination of value. Multiple stone entries are allowed so like kind stones can be grouped together.
This area is reserved for other information the appraiser feels is necessary to fully describe the item.
Color Photograph Attached
Provides a visual representation of the item and indicates that a color photo exists.
Item Sales Receipt Attached
Identifies sales receipt information which should include the seller’s name, address, receipt # and date (indicated after check box).
The back of this form includes information relating to credentials, definitions of a jewelry appraisal, the purpose of a jewelry appraisal, minimum descriptive information that should be included on all appraised items, gem lab and testing information, appraisers’ warranties, and information on the “four c’s” of diamonds.
Also available is ACORD 805, Jewelry Sales Receipt For Insurance Purposes. This form can be used to provide descriptive information about jewelry containing diamonds or colored stones and documenting the price paid for the item. This is not an appraisal.