|
Section Name |
Field Name |
Field and/or Section Description |
|
TITLE ACORD 38 DE (2008/04) |
Delaware Personal Insurance Supplement - Notice of Information Practices (Privacy) |
Use ACORD 38 DE, Delaware Personal Insurance Supplement, with all applications for personal insurance. The form complies with the requirements of DE Regulation 906 (formerly Reg. 87), pertaining to insurance scoring. |
|
IDENTIFICATION SECTION |
Agency Customer ID |
Customer's identification number assigned by the agency or brokerage. |
|
IDENTIFICATION SECTION |
Agency |
Producer's name. |
|
IDENTIFICATION SECTION |
Applicant / First Name Insured |
Full name of the applicant as it should appear on the policy. The First Named Insured is given certain rights and responsibilities by the policy contract language. If more than one insured is named, be sure the one intended to receive these rights and responsibilities is named first and any additional insureds identified as such. If joint ownership, the name used may include both names (e.g., John and Mary Smith). |
|
|
The number assigned by the insurance company for the policy. In general, policy numbers |
|
IDENTIFICATION SECTION |
Policy Number |
will not appear on new business applications since they are not known at that point in time. |
|
|
Name of the insurance company (or residual market plan) that will receive the application. |
|
|
Do not use group names, use the actual name of the company within the group in which |
|
IDENTIFICATION SECTION |
Carrier |
you wish to have the policy issued. |
|
IDENTIFICATION SECTION |
NAIC Code |
The identification code assigned to the company by the NAIC. |
|
APPLICANT / NAMED |
Applicant / Named Insured's |
|
|
INSURED'S SIGNATURE |
Signature |
All applicants / named insureds must sign this form. |
|
APPLICANT / NAMED |
|
|
|
INSURED'S SIGNATURE |
Date (MM/DD/YYYY) |
Enter the date the form was signed by the applicant / named insureds. (MM/DD/YYYY) |