Insured claimants must make a detailed disclosure of their insurance coverage by stating:

1. (a) Their name and address.
2. (b) Kind, amount, and dates of coverage of insurance.
3. (c) Insurance policy number.
4. (d) Whether a claim was presented to the insurer and, if so, in what amount.
5. (e) Whether the insurer paid or is expected to pay the claim.
6. (f) The amount of any payment made or promised.