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Insurance Tort Option

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INSURANCE TORT OPTION

Applicant / Insured Information

Applicant Name:

Policy Details

Election of Tort Option

The undersigned insured affirms the election or declination of the Tort Option as described below. By selecting the Tort Option, the insured elects to retain the right to initiate legal action for non-economic damages arising from covered incidents that meet the jurisdictional and contractual standards for suit. This election is effective as specified in the policy and may affect premium, deductibles, and recovery of non-economic damages.

Selecting this box affirms my election to preserve the right to sue for non-economic damages under the insured policy.

Selecting this box affirms my election to accept limits on the right to recover non-economic damages as set forth by the insurer and applicable law.

I acknowledge that I have read and understand the material differences between electing and declining the Tort Option, including the potential effect on recovery of non-economic damages, and the potential for adjustment to premiums and policy terms. I further acknowledge that inaccurate or omitted information may result in rescission, denial of coverage, or other remedies provided by law and the policy.

Coverage Present on Policy

Indicate coverages included in the policy by checking all that apply below:

Exclusions and Limitations

The following standard exclusions and limitations may apply to the Tort Option election. This list is illustrative and not exhaustive. Specific policy language controls.

Typical exclusions may include: punitive damages, damages for intentionally caused injury, losses arising from excluded vehicles or drivers, loss arising from non-covered uses, and limits where statutory or contractual caps apply. Election of the Tort Option does not expand coverage beyond the policy limits and terms.

Beneficiary Designation (If Applicable)

Designate any beneficiary or payee entitled to proceeds related to this policy election or settlement proceeds. Allocations should total 100% if multiple beneficiaries are named.

Certification and Acknowledgement

By signing below, I certify under penalty of perjury that the information provided on this form is true and correct to the best of my knowledge. I acknowledge that my election or declination of the Tort Option is binding as described in the policy and applicable law, and that this election may affect my rights and remedies following an incident. I further acknowledge that the insurer has provided policy language governing this election and that I have read and understand those provisions.

I understand that if I am electing the Tort Option, this may preserve my ability to recover non-economic damages in a civil action subject to policy limits and statutory requirements. If I decline the Tort Option, I may be limited in my ability to recover non-economic damages under the policy and applicable law.

Applicant Name:

Signature:

Date:

Enter text✕

What the Insurance Tort Option Is

The Insurance Tort Option is a formal election in certain U.S. auto-insurance systems that preserves an insured party's right to pursue tort litigation for bodily injury rather than relying solely on no-fault benefits. States differ on whether and how the option must be offered, when the election may be made, and whether the election requires a signed form or special acknowledgements.

Why choosing the Insurance Tort Option matters

Electing the Tort Option affects your ability to sue for pain and suffering and can change available benefits and premium levels. A clear, signed election documents intent, reduces disputes with insurers, and preserves legal rights where state law permits litigation instead of exclusive no-fault recovery.

Why choosing the Insurance Tort Option matters

Who commonly completes Insurance Tort Option forms

These forms are completed by parties who must record an election about litigation rights under their auto policy; several stakeholders also handle, review, or store the signed form.

  • Drivers and policyholders who must elect tort or no-fault coverage choice for their auto policy.
  • Insurance agents and company representatives who present the election and retain the signed record.
  • Attorneys and claims adjusters who rely on the signed election during dispute or litigation.

Accurate completion matters for both consumer protection and insurer compliance; keep a dated copy and confirm the insurer's acceptance to avoid later disputes.

Step-by-step: completing an Insurance Tort Option form

Follow these sequential steps to document an election cleanly and reduce processing delays.

  • 01
    Review policy: Confirm whether your state offers a Tort Option and the implications.
  • 02
    Select option: Mark the Tort Option box exactly as the form instructs.
  • 03
    Complete details: Enter policyholder, policy number, vehicle, and effective date.
  • 04
    Sign and retain: Sign, date, and provide copy to insurer; store a saved record.

Core components to include in a professional Tort Option form

A compliant form clearly identifies parties, states the election, documents dates, and provides acknowledgements to reduce later disputes.

Parties

Full legal names for insured and insurer, plus policy number and contact details so the election ties to the correct contract.

Clear election language

Unambiguous wording that the signatory elects the Tort Option and understands the right to pursue or waive certain claims.

Coverage limits

Reference to bodily injury limits and any threshold for suit so the election's legal effect is clear.

Waivers and notices

Any statutory consumer disclosures, waiver language, or references to rights under state law should appear on the form.

Effective date

Date when the election takes effect and whether it applies to renewal periods or only new incidents.

Acknowledgement

A signature block plus printed name, date, and a brief consent statement acknowledging understanding of the election.

Essential fields and why they matter

Insured Name: Identifies the signer.
Policy Number: Links election to policy.
Vehicle VIN: Verifies covered vehicle.
Election Box: Records the choice.
Signature: Shows intent to sign.
Effective Date: Determines legal start.

Where to send a completed Tort Option form

After signing, deliver the completed form to the insurer and retain a copy for your records; routing depends on company procedures.

  • Agent Portal: Upload via the insurer's agent or producer portal for immediate attachment to the policy.
  • Insurer Email: Send to the insurer's designated intake address if the company accepts electronic submissions.
  • Mail or Fax: Some carriers require a mailed or faxed signed original depending on internal policy.
  • Regulatory Filing: In rare cases, submit to state Department of Insurance if statute requires recorded acknowledgement.

Digital signing and file-format considerations

Use PDF or DOCX when submitting electronically; include the signed copy and a certificate of completion when available.

  • File types: PDF or DOCX recommended.
  • Authentication: Use email link or multi-factor when required.
  • Audit trail: Capture IP, timestamp, and signer email.

Platforms that meet ESIGN and UETA standards preserve intent and retention; when HIPAA or other regulated data is present, ensure the vendor supports required compliance workflows and any needed Business Associate Agreement.

Timing considerations and common deadlines

Timing rules for electing or recording a Tort Option vary by state and carrier; follow insurer instructions and retain evidence of submission.

At purchase:

Many elections must be made when the policy is issued or first offered.

At renewal:

Some insurers permit election changes only at renewal; check policy terms.

Post-accident:

Changing election after a loss is often restricted or ineffective for that incident.

Insurer request:

Provide a signed form promptly if the insurer asks for documentation.

Record retention:

Keep signed copy for the life of the policy and beyond per retention rules.

Common risks and potential consequences of errors

Loss of rights: Waives or limits litigation rights.
Claim denial: Incorrect forms can delay or deny coverage.
Void election: Ambiguous marks may be treated as no election.
Premium changes: Elections can affect rate calculations.
Regulatory review: State DOI may investigate repeated errors.
Administrative burden: Re-submissions and legal disputes increase costs.

eSignature vendor pricing and capability snapshot for Tort Option workflows

Common eSignature capabilities affect how you capture, store, and authenticate Tort Option elections; below is a pricing and feature comparison with signNow listed first.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day trial Varies Varies Varies Varies
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies Varies Varies

Frequently asked questions about the Insurance Tort Option

Answers to common procedural and legal questions when completing, submitting, or changing a Tort Option election.


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