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This is Example 3 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 final example is actually an “Estimate.” You may receive something similar when shopping for new or increased insurance benefits.
  • In this example, the “Tort Status” is not listed on the form. If the “Tort Status” is not listed, be sure to clarify with your insurance agent that you wish to elect “Full Tort,” signing the “Tort Election” form on the line for “Full Tort.” (An example of this form to follow).

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:

  • In this example, the words “Medical Expense” do not appear on the Estimate, but this $5,000.00 still applies to your Medical Expense.
  • Work loss benefits are the same as the “Income loss” benefits referred to in the other examples.


Underinsured/Uninsured Motorist Benefits: 

  • This is an example where the UIM/UM benefits have not been “Signed-Down,” so they are equal to the Liability Protection available under the proposed policy.


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