ACORD 90RI Instructions


ACORD 90 RI (2003/05)Rhode Island Personal Auto Application


Following are the differences from ACORD 90, the generic Personal Auto Application. For instructions on completing the balance of this form, refer to ACORD 90, the generic Personal Auto Application Instructions, on thiswebsite.

  • Personal Injury Protection coverages are not available; this is not a “no-fault” state.
  • Uninsured and Underinsured Motorists coverages are combined.
  • Notice of Information Practices (Privacy) is specific to this state.
  • Statements are added to the back of the form that:

1. Allow the applicant to acknowledge the offer of Medical Payments coverage, and the options selected;
2. Reference the state supplement, ACORD 61 RI, which must be signed by the applicant if Uninsured/Underinsured Motorists Bodily Injury coverage is rejected;
3. Allow the applicant to acknowledge the offer of Uninsured/Underinsured Motorists Property Damage coverage, and the options selected. The applicant must initial the options selected.