Affidavit Of No Health Insurance Form Nc

Affidavit pdf 173 kb.

Affidavit of no health insurance form nc. Form number form name fs 45 liability insurance power of attorney mvr 18a plate return verification form. Aoc cr 158 criminal forms cr affidavit. I certify that the foregoing statements made by me are true. Because an affidavit is a legal statement it verifies your personal information for identification purposes.

Insurance carrier for coverage of medical services. By north carolina judicial branch. Most insurance adjusters have been trained on how to apply rule 414 and he or she will use it as liberally as possible to reduce the value of your claim. On the date the accident occurred i personally did not own an automobile with liability insurance coverage that would afford me personal injury protection no fault benefits.

Microsoft word affidavit of no insurance 032008 doc author. Search statewide judicial forms by keyword general statute form number form title and more. County of appearing before the undersigned notary and being duly name of principal. However this only happens if no objection is made to its use and if it is subject to cross examination.

3 26 2008 2 25 30 am. North carolina judicial branch search menu search. To the extent permitted by law this affidavit will be kept confidential by the north carolina department of insurance. During the claims process the insurance adjuster will likely request itemized billing in order to determine what your health insurance provider paid to satisfy your medical expenses.

Brian french created date. An affidavit form may also be used as evidence in administrative and quasi judicial proceedings. If an accident victim claims to have no health insurance the insurance adjuster will likely demand an affidavit of no health insurance. These files may not be suitable for users of assistive technology.

Raleigh nc 27699 1203. Fax 919 807 6635. One year affidavit to clear driving privilege na. Form c 101 08 2014 1.

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