Any person whose license has been suspended, is about to be suspended, or becomes subject to suspension pursuant to this article, may relieve himself from the suspension by filing with the director an affidavit which states all of following:
(a) That at the time of the incident upon which the judgment was rendered he was insured.
(b) That the insurer is liable to pay the judgment.
(c) The reason, if known, why the insurance company has not paid the judgment.