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This is Example 2 from our Blogpost “How To Read An Automobile Insurance Policy Declaration Sheet”

However, the term “Declaration Sheet” may differ depending on your insurance company.

*Disclaimer: The following is only applicable to PRIVATE PASSENGER MOTOR VEHICLES insured by a natural person (i.e. not a corporation) for policies issued in Pennsylvania subject to the Pennsylvania Motor Vehicle Financial Responsibility Law.*

Tort Status:

  • This is an example where the “Tort” status is embedded within the document, rather than found at the end.


Liability Protection:

  • This is a the amount of coverage limit that each category will cover the policyholder in the event of injury or damage.


First Party Benefits:

  • This is the amount of coverage that beneficiaries would receive for medical expenses, funeral expenses, income loss and accidental death. 


Underinsured/Uninsured Motorist Benefits:

  • You’ll note that there is no mention of “stacked” on this example, even though there are two (2) vehicles listed on the policy. This is when your attorney would typically ask your insurance company for a copy of your “Rejection of Stacking” form, which must have been signed by the Named Insured on the policy. If they cannot produce this form, you are deemed to have elected “Stacked” benefits. The same would be true if the policy read “non-stacked.”
  • If your insurance company can produce a signed “Rejection of Stacking” form, then you would not be entitled to stacked benefits under your policy, no matter how many cars you have on the policy. (An example of this form to follow).


If you’d like to learn more, or you know someone who has been injured in an auto crash, please do not hesitate to contact our offices by phone, email or text messaging, and one of our experienced staff members/attorneys will be happy to help you.

Snyder Law Group