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Content Overview

The Acord 50 WM form plays a crucial role in the world of insurance, specifically in the realm of workers' compensation. This standardized document is designed to facilitate the process of reporting and managing claims related to workplace injuries and illnesses. It serves as a communication tool between employers, insurance carriers, and state agencies, ensuring that all parties have access to essential information. The form captures vital details such as the nature of the injury, the circumstances surrounding the incident, and the medical treatment received. Additionally, it includes sections for both employer and employee information, which helps streamline the claims process. By utilizing the Acord 50 WM form, employers can fulfill their reporting obligations while also providing necessary support to injured employees. Understanding how to properly complete and submit this form is essential for ensuring compliance with state regulations and for facilitating timely claims processing.

Similar forms

The ACORD 50 WM form is a document commonly used in the insurance industry, particularly for workers' compensation. It serves as a way to provide essential information about a business's insurance coverage. There are several other documents that share similarities with the ACORD 50 WM form. Here’s a list of those documents:

  • ACORD 25: This is the Certificate of Liability Insurance. Like the ACORD 50 WM, it provides proof of insurance coverage and details about the policyholder's insurance, including limits and effective dates.
  • ACORD 27: This is the Certificate of Property Insurance. Similar to the ACORD 50 WM, it outlines property coverage details and serves as verification for lenders or other interested parties.
  • ACORD 130: This is the Commercial General Liability Application. It collects information about a business's operations, similar to how the ACORD 50 WM gathers details relevant to workers' compensation coverage.
  • ACORD 131: This is the Commercial General Liability Coverage Form. Like the ACORD 50 WM, it specifies coverage terms and conditions, helping businesses understand their liability protections.
  • Hold Harmless Agreement: This legal document, such as the Hold Harmless Agreement, is vital for protection against liability for injuries or damages during specified activities, paralleling the Acord 50 WM's focus on liability considerations.
  • ACORD 140: This is the Business Auto Application. It shares similarities in that it collects information about a business's vehicle insurance needs, just as the ACORD 50 WM does for workers' compensation.
  • ACORD 151: This is the Workers' Compensation Application. It is similar to the ACORD 50 WM as it also focuses on workers' compensation coverage, gathering necessary information to evaluate risks.
  • ACORD 100: This is the Commercial Insurance Application. It serves a broader purpose but, like the ACORD 50 WM, it collects vital information to help insurers assess coverage needs for businesses.

Document Specifics

Fact Name Description
Purpose The Acord 50 WM form is used for reporting workers' compensation insurance information in various states.
Governing Laws This form is governed by state-specific workers' compensation laws, which can vary significantly across jurisdictions.
Usage Insurance agents and brokers typically complete this form to provide essential details about coverage and claims.
Required Information The form requires information such as policy numbers, coverage limits, and the names of insured parties.
Submission Completed forms must be submitted to the appropriate state agency or insurance carrier for processing.

Things You Should Know About This Form

  1. What is the Acord 50 WM form?

    The Acord 50 WM form is a document used in the insurance industry, specifically for workers' compensation. It serves as a way for employers to provide essential information about their business and employees to their insurance provider. This helps in determining the appropriate coverage and premiums for workers' compensation insurance.

  2. Who needs to fill out the Acord 50 WM form?

    Any business that employs workers and requires workers' compensation insurance should complete the Acord 50 WM form. This includes small businesses, large corporations, and even sole proprietors with employees. Filling out the form accurately ensures that the insurance company has the necessary information to assess risk and provide coverage.

  3. What information is required on the Acord 50 WM form?

    The form typically asks for details such as:

    • Business name and address
    • Type of business and industry
    • Number of employees
    • Payroll information
    • History of workers' compensation claims

    Providing accurate and complete information helps ensure that you receive the correct coverage and premium rates.

  4. How do I submit the Acord 50 WM form?

    Once you have completed the Acord 50 WM form, you can submit it to your insurance agent or directly to the insurance company. Many companies allow electronic submissions, while others may require a physical copy. Check with your insurer for their preferred submission method to ensure a smooth process.

Documents used along the form

The Acord 50 WM form is a vital document in the insurance industry, particularly for workers' compensation. However, it is often used in conjunction with other forms and documents to ensure comprehensive coverage and compliance. Below is a list of commonly associated documents that you might encounter.

  • Acord 25: This is the Certificate of Liability Insurance. It provides proof of insurance coverage and details the types of coverage and limits available to the insured party.
  • Acord 130: This is the Commercial General Liability Application. It collects essential information about the business seeking coverage, helping insurers assess risk and determine appropriate premiums.
  • Acord 126: Known as the Commercial Property Application, this document gathers information about the property to be insured, including its location, value, and any existing coverage.
  • Colorado ATV Bill of Sale: This essential document records the transfer of ownership of an all-terrain vehicle, laying out the transaction details such as price and involved parties. For further information, visit Colorado PDF Forms.
  • Acord 2: This is the General Information Form. It provides background information about the insured and is often used to streamline the application process for various types of insurance.
  • Acord 27: The Additional Insured Endorsement is used to add another party to an existing insurance policy, offering them protection under the terms of the policy.
  • Acord 40: This form is a Workers' Compensation Application that helps insurers evaluate the risk associated with providing workers' compensation coverage to a business.
  • Acord 51: The Workers' Compensation Experience Modification Rate (EMR) Application assesses a business's safety record and helps determine their insurance premium based on past claims.
  • Acord 855: This form is used for submitting changes to existing policies, such as updates to coverage or changes in business operations that may affect insurance needs.

Understanding these documents and their purposes can significantly enhance your experience in navigating the insurance landscape. Always ensure that you have the right forms completed and submitted to facilitate a smooth insurance process.

Acord 50 WM Preview

For use with ACORD 360 WM, four part perforated 32 lb. paper

INSURANCE IDENTIFICATION CARD

 

(STATE)

 

 

 

 

 

 

COMPANY NUMBER

COMPANY

 

 

COMMERCIAL

 

PERSONAL

POLICY NUMBER

 

 

EFFECTIVE DATE

EXPIRATION DATE

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AGENCY/COMPANY ISSUING CARD

 

 

 

 

 

INSURED

SEE IMPORTANT NOTICE ON REVERSE SIDE

INSURANCE IDENTIFICATION CARD

 

(STATE)

 

 

 

 

 

 

COMPANY NUMBER

COMPANY

 

 

COMMERCIAL

 

PERSONAL

POLICY NUMBER

 

 

EFFECTIVE DATE

EXPIRATION DATE

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AGENCY/COMPANY ISSUING CARD

 

 

 

 

 

INSURED

SEE IMPORTANT NOTICE ON REVERSE SIDE

INSURANCE IDENTIFICATION CARD

 

(STATE)

 

 

 

 

 

 

COMPANY NUMBER

COMPANY

 

 

COMMERCIAL

 

PERSONAL

POLICY NUMBER

 

 

EFFECTIVE DATE

EXPIRATION DATE

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AGENCY/COMPANY ISSUING CARD

 

 

 

 

 

INSURED

SEE IMPORTANT NOTICE ON REVERSE SIDE

INSURANCE IDENTIFICATION CARD

 

(STATE)

 

 

 

 

 

 

COMPANY NUMBER

COMPANY

 

 

COMMERCIAL

 

PERSONAL

POLICY NUMBER

 

 

EFFECTIVE DATE

EXPIRATION DATE

YEAR

MAKE/MODEL

 

VEHICLE IDENTIFICATION NUMBER

AGENCY/COMPANY ISSUING CARD

 

 

 

 

 

INSURED

SEE IMPORTANT NOTICE ON REVERSE SIDE

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW

ACORD 50 WM (2007/03)

© ACORD CORPORATION 1993-2007. All rights reserved.

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW

ACORD 50 WM (2007/03)

© ACORD CORPORATION 1993-2007. All rights reserved.

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW

ACORD 50 WM (2007/03)

© ACORD CORPORATION 1993-2007. All rights reserved.

THIS CARD MUST BE KEPT IN THE INSURED

VEHICLE AND PRESENTED UPON DEMAND

IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information:

1.Name and address of each driver, passenger and witness.

2.Name of Insurance Company and policy number for each vehicle involved.

THE FRONT OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK - HOLD AT AN ANGLE TO VIEW

ACORD 50 WM (2007/03)

© ACORD CORPORATION 1993-2007. All rights reserved.