ACORD cancellation form. How to fill form 35 with examples

Apr 17, 2024by Axel Hardy

ACORD Cancellation form. Your document guide

ACORD Cancellation Form 35 is your essential tool when you need to terminate an insurance policy. This form, widely used across the insurance industry, requires precise information to avoid processing delays and potential disputes.

Whether you're an insurer, agent, or policyholder, understanding how to correctly fill out and submit this document is crucial. Our guide will walk you through each section, ensuring you complete it accurately and efficiently, with tips to make the process smoother.

Also read how to write an effective insurance cancellation letter

How to fill out acord cancellation form

Accord cancellation form 35
  1. Agency Name and Address: At the top of the form, fill in the name and address of the insurance agency handling the cancellation.
  2. Insurer: Enter the insurer's name from whom the insurance policy is being canceled.
  3. NAIC Code: The National Association of Insurance Commissioners (NAIC) code for the insurer should be included if known. This code is unique to each insurance company and can usually be found on your policy documents. The NAICS code for ACCORD is 624190
  4. Insured: Fill in the name and address of the policyholder whose policy is being cancelled.
  5. Policy Number: Enter the policy number as it appears on the insurance policy documents.
  6. Effective Date of Cancellation: Specify the date the cancellation should be adequate. Make sure this date is in agreement with any required notice periods and the terms of the policy.
  7. Cancellation Method: Check the appropriate box to indicate whether the cancellation is requested by the insured or initiated by the insurer.
  8. Reason for Cancellation: Provide a clear and concise reason for the cancellation. This might be due to non-payment of premium, change in risk profile, or policyholder's request for cancellation, among other reasons.
  9. Authorized Signature: The form must be signed by an authorized representative of the insurance agency or the insured, depending on who is initiating the cancellation. The signature certifies that all information provided is accurate and that the requisite notice period has been observed.
  10. Date: Include the date on which the form is signed.
  11. Witness: If required, a witness may need to sign the form to validate the cancellation.

Additional details to consider while filling out the cancellation form

Beyond the primary entries and the reason for cancellation, filling out an ACORD cancellation form typically requires attention to a few additional details to ensure completeness and compliance. Here are further considerations:

  1. Date Notice Given: Depending on the policy and state regulations, you need to specify when the notice of cancellation was provided to the insured or insurer to comply with legal requirements about notification periods.
  2. Premium Due/Return Premium: Indicate if there is an outstanding premium due from the insured or a return premium owed to the insured. This is important for financial reconciliation and clarity between the insurer and the insured.
  3. Policy Type: Specify the type of insurance policy being cancelled (e.g., commercial property, auto, liability). This helps in processing the cancellation correctly within the insurer's systems.
  4. Agent Contact Information: Provide contact information for the agent or broker handling the cancellation. This can include a phone number, email address, and any relevant agent identification number.
  5. Document Submission: Depending on the insurer’s procedures, additional documents might be required to process the cancellation, such as written consent from the insured or proof of new insurance coverage.
  6. Verification of Coverage: If the policy is being replaced by another policy, details of the new insurance policy (insurer, policy number, effective dates) should be included to ensure there is no lapse in coverage.
  7. Instructions for Future Communications: Specify how the insured wishes to receive any final documents or communications (e.g., email, postal mail).
  8. Cancellation Fee: If applicable, note any cancellation fee the insurer charges. This fee can vary depending on the timing of the cancellation and the type of policy.
  9. Copy Distribution: Indicate where copies of the cancellation notice should be sent, which could include the insured, the mortgagee, or other interested parties.
  10. Compliance Check: Ensure all entries comply with state insurance laws and regulations regarding policy cancellations, which vary widely.

Examples of Reasons of cancellation for ACORD form

Here are ten examples of reasons you might write in the "Reason for Cancellation" section on an ACORD cancellation form:

  • Non-payment of Premiums: The insured must make the required premium payments stipulated in the policy terms.
  • Policyholder Request: The insured has requested cancellation of the policy voluntarily, possibly due to no longer needing the coverage.
  • Sale of Insured Property: The property or vehicle covered by the policy has been sold, and coverage is no longer required.
  • Change in Risk Profile: Changes in the insured's situation or the risk profile make the existing policy unsuitable or unnecessary.
  • Replacement of Policy: The insured has obtained alternative or more suitable coverage elsewhere.
  • Business Closure: The business covered by the policy has ceased operations permanently.
  • Risk Reduction Measures: Risk improvements or changes at the insured's property reduce the need for the current level of coverage.
  • Non-renewal by Insurer: The insurer has decided not to renew the policy based on a review of the risk or other underwriting criteria.
  • Regulatory Changes: Changes in legal or regulatory requirements render the existing insurance coverage inadequate or excessive.
  • Dispute Over Claims Handling or Service Issues: Dissatisfaction with the insurer's service, mainly how claims have been handled, prompts a cancellation.

Download the ACORD 35 Cancellation form as a pdf here

Pls download and print the same. Link to download form 35

Closing comments

Each field should be completed carefully to ensure the policy cancellation's accuracy and legality. Always double-check with the insurer's specific requirements and any relevant regulations to avoid issues. If you need more details, it's advisable to contact the insurance company or consult with a legal advisor. This will help prevent potential misunderstandings or legal complications.

It is essential to review the completed form for accuracy and ensure all necessary information is included. The process may vary slightly depending on the insurance company's specific requirements or state regulations. Always check with your insurer or legal advisor if you need clarification on completing the form.


1 comment

  • Avenue 17 April 26, 2024 at 8:00 am

    Clearly, many thanks for the help in this question.

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