ACORD 83 Fillable | Personal Umbrella Application

A lawsuit after a bad accident can be bigger than the liability limits on your car and home policies. A personal umbrella policy sits on top of those policies and pays the rest, up to its own limit. The ACORD 83 form is how an agent applies for one.

This personal umbrella ACORD form runs six pages. Most of it copies details from your current policies and your household. The rest is a set of risk questions.

Your agent usually fills it in with you. Signing it doesn’t give you coverage by itself, so wait for a binder or a policy.

Four situations push people toward an umbrella.

Your net worth is bigger than your limits

If a judgment tops your auto or home limits, the rest can come out of your savings. An umbrella adds a layer above them.

You own a pool, a boat, or an RV

Each one adds liability, and the form asks about every one of them.

Your household has teen drivers or pets

The form asks about every driver and every animal, so expect questions.

You rent out a property

A rental home or a duplex adds liability. It goes in the property section and in your primary policy list.

Six pages, in this order.

1. 1

   Page 1: Applicant and umbrella details

   Page 1 starts with the agency, the carrier, and your name, address, phone numbers, and email. Then it covers the umbrella itself. You pick the policy amount, the retention, and any optional coverages. The form shows the premium for each part.

2. 2

   Page 1: Your current policies

   The primary policy section lists your auto, home, rental dwelling, boat, recreational vehicle, and employers liability policies. For each one, write the company, the policy number, the dates, and the liability limits. The umbrella sits on top of these.

3. 3

   Page 1: Payment plan

   Pick how you’ll pay, either in full or in installments, and by check, card, or bank draft. Say who gets the bill and whether a lender finances the premium. Attach ACORD 610 if you need more room.

4. 4

   Page 2: People and things you own

   List everyone in your household and everyone who drives your vehicles or boats. Then list your cars, boats, and properties. The form also asks about your prior coverage, or whether you had none.

5. 5

   Page 3: Risk questions and driving record

   Six yes/no questions cover pools, employees, animals, trampolines, aircraft, and business use. Another set asks about accidents, tickets, and drivers with health problems that affect driving. Explain every yes, and attach ACORD 101 if a box fills up.

6. 6

   Page 4: More questions

   Nine more questions cover farming, unpaid positions, other people’s property, business activities, and lawsuits. They also ask if any insurer declined, canceled, or didn’t renew your coverage in the last five years.

7. 7

   Pages 5 and 6: Disclosures, binder, and signatures

   The last two pages of the ACORD 83 cover your uninsured motorist choices, a privacy notice, and state supplements. A binder box lets the company start coverage right away. Page 6 carries each state’s fraud warning and the signatures.

The umbrella box on the ACORD 83 uses a few terms that sound alike. This is what they mean.

Policy amount

How much extra liability coverage you want. Many people start at $1 million.

Retention

The amount you pay yourself when the umbrella covers something your other policies don’t. It works like a deductible.

Underlying policies

Your auto, home, and boat policies. The umbrella sits on top of them, and you have to keep them in place.

Uninsured and underinsured motorist

Optional coverage for injuries caused by a driver with no insurance or too little. Your state decides if it’s offered.

Estimated total premium

The price of the whole umbrella package, with the deposit included.

These questions on the ACORD 83 cause the most confusion. This is how to handle each one.

Accidents, even when it wasn’t your fault

The accident question says “regardless of fault.” Count every auto accident or liability loss on a primary or excess policy. Use the number of years the form lists.

Who counts in your household

List everyone who lives with you and everyone who drives your vehicles or boats. Don’t leave out a teen driver.

Unpaid positions

Question 9 asks about non-compensated positions, like serving on a nonprofit board. Say yes if you do.

Other people’s property

Question 10 asks about property that isn’t yours but is in your care and worth more than $1,000, like a borrowed trailer.

Gaps in your current policies

Question 12 asks if any primary policy has reduced limits or leaves out coverage for something specific, like a dog breed. Say yes if so. The umbrella may not fill a gap the carrier never knew about.

Business use

Question 6 asks if you use any property or vehicle for business. A personal umbrella generally leaves out business activity, so a yes may mean you need other coverage.

Missouri and Kansas

Missouri applicants skip the question about declined or canceled coverage. Kansas law lets you leave out small speeding tickets. That means up to 6 mph over in a 30 to 54 mph zone. It also means up to 10 mph over in a 55 to 75 mph zone.