Auto Policy Declaration Example “Tort Election Form”

This is the Example “Tort Election Form” 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:

• Above, we have an example of the “Tort Election” form we referenced in the previous examples. Here, you can see we have highlighted the policy number, and the signature lines for either “limited tort” or “full tort.” Your insurance agent will present you with a similar form for signing when selling you new insurance, or when changing your tort status on an existing policy. In this example, the named insured signed, for “limited tort” insurance, scratching out the line for “full tort.” AS A REMINDER, OUR RECOMMENDATION IS TO ALWAYS ELECT “FULL TORT.”

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 
(610)265-8050