So, this is a question I have seen asked on here a few times, and some responding that it's not worth bothering with.

here is my recent experience.

We (me the wife and 8 year old daughter) entered Ukraine late weds night from Romania over a minor Border at Sighetu.

We were given a bit of a hard time by the Ukrainian Border Police who would not let us in as we didn't have insurance. I explained that it was my intention to buy insurance once over the border. He advised this was not possible and we should have bought it in Romania. I argued the point that there wasn't anywhere to do this, but he wouldn't have it, but advised that a small 'gift' would see us right, I hate this sort of bullshit, fair do's if you've done something wrong, but I hadn't, but my wife (who is a native russian speaker from belarus so who tends to do the talking) advised there was no way he was going to let us through without and we would be stuck at the border all night. I reluctantly agreed, but without any foreign currency we were a bit stuffed, eventually we settled on a bottle of whisky from the duty free where I could pay with my Monzo card. I managed to find a bottle for 6 euros and, job done, we crossed the border and found, as i expected, a kiosk 1/4 mile up the road selling insurance. It was closed but there was a number to ring, which the wife did, and after about 10 minutes a very lovely lady appeared who sorted out 1 months insurance for about £10.
We found a cheap (but rubbish!) hotel for the night and settled down. Next day we set off for our intended destination, L'viv.

Although not far we took the 'scenic' route over mountain tracks before going onto tarmac where the going was even slower, the roads were terrible, lorries going at walking pace and us only averaging 20mph. We arrived in L'viv at about20:30 and started looking for our overnight accommodation.

It was pouring with rain, absolutely tipping down, as we made our way through the traffic.

As I came up to one junction on the inside lane, my path was blocked by a bus. I waited for the car in lane 2 to pass before pulling out to go round the bus and cross the junction. I was about half way across as the lights changed from green.
I cleared the junction and then there was a horrendous crash, followed by my wife screaming. To my horror I saw an umbrella flying up the left side of the bonnet and behind it a pair of legs sticking out horizontally and rolling up the bonnet.

I slammed on the brakes and skidded to a halt, the body flew off the bonnet and into the road about 10 feet ahead and to the right in lane 1.

She lay slightly curled up, back to me, and motionless.

My wife was still screaming as I jumped out of the truck. I've been a nurse for 30 years, most of it in the emergency department, and was a trauma nurse in the military, so I know, when a casualty is quite and still, it's bad, very bad. She was quiet and still.

I got to the girl, as she turned out to be, who looked in her early 20s, slight and blond. I knelt down next to her in the wet and started to talk to her, telling her not to move, she was able to answer, and tell me her name, but was very quiet and still. I moved her hood back a little to see her face, there was a trickle of blood from her nose. She had earphones in and was still holding her phone.

My wife was out of the car now, asking if she was dead. I shouted t her to get the bus driver to call an ambulance and to get my coat out of the vehicle. I covered the girl in my coat, and another from a bystander. I used the girls umbrella to try and shelter her some more. Although she spoke English a little, given the language difficulties, the fact she was conscious and breathing, and the environmental difficulties, I decided against instigating any treatment.

The passers by were wonderful, one girl who spoke good English (she's an English teacher) especially, offering to help with translation and giving advice about the police etc.

I continued talking to the girl gently, reassuring her. She told me she had been running to catch the bus. The bus moved off so I was concerned about oncoming traffic hitting us, so I explained to someone I was going to move my vehicle to protect us. He said that would be a very bad thing to do and we must wait for the police, so instead I got my warning triangle out and asked someone to put that in the road in the lane we were in.

eventually the medics arrived. They were rough. They pulled off everything that was covering her and carelessly rolled her onto a spinal board, with no spinal control, no collar and no examination, oh and no straps to keep her on it. She was unceremoniously bundled into the back of the meat wagon, because thats all it was, and they drove around the corner, then stopped to park.

We started to ask about the police, if anyone had called them. No one had. Fleetingly it crossed my mind just to bugger off at that point, my trust of foreign police not being that high, but to do that would be an admission of guilt and if later caught, having avoided an alcohol test (0 limit here) there would be assumptions of guilt. I was sure this wasn't my fault and the best thing to do was to sit tight and face the music.

While we were waiting, one of the ambulance crew arrived, some shabby looking old bloke, and started shouting. My wife explained he was being a dick, saying the girl had crossed on a green light and it was our fault. It's none of his business and he needed to pay more attention to doing his job and leave the investigations to the police.

Eventually the police turned up, a man and a woman. The man spoke a little English but mostly my wife translated. They were actually very nice, measured, non judgemental and fair. They went through my documentation and said we would have to wait for the accident investigator to arrive.

some 2 hours after the initial accident the investigator arrived. He was also a very nice chap. very professional and polite, very understanding. He went through my documents again, including the insurance I had bought at the border. He advised me we needed to wait for the report from the hospital, if she had any fractures they would need to impound my vehicle for a technical inspection. he also advised he would need to speak to the consulate, as a procedure.

I was sure the girl would have fractured, maybe a hip, Right leg and/or arm. You get hit by 3 tons of landcruiser, even at 20mph, and get thrown 10 feet down the road your going to be damaged. Thats without the possibility of a serious head injury or internal injuries.

Finally word came back from the hospital. She had been discharged with no significant injuries.

I cannot even begin to tell you the relief!!

We were now too late to check into our accommodation. Despite the fact he had another accident to go to that night, and that he was on duty the next day, the investigator then proceeded to ring a number of hotels to find us somewhere affordable for the night.

Once that was arranged he advised we should follow the other 2 officers to the Hospital, where I would need to have a blood test for alcohol. Once that was done they would then take us to our hotel.

So, here we are, 2 days later. The alcohol test takes 3 days. I know I had none, but it's still nerve racking to wait. tomorrow we have to go and see the accident investigator to sign statements and file a report.

The police were lovely, very professional, but I am absolutely certain, had my paperwork not been in order, things would be very very different.

You may not be intending to have an accident, no one ever is, but they happen, no matter how careful or good a driver you are.

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1990 Landcruiser H60. Full rebuild completed 2014

Once at a Central America border crossing, rainy night, I met a fellow traveler who had just hit a local crossing the road. He had no insurance. The police had seized his bike-and him- and were waiting for an update from the hospital. The local was okay, so Mr Lucky continued on his way. I met him down the road--he still didn't have insurance. I assume everyone is out to get me, I am always over insured.

Trouble is, driving without insurance in countries which allow (or tolerate) it works out just fine 99%+ of the time. I did this as a youngster for many years in the USA--usually illegally--and always got away with it. I've done it more recently in South America, Africa, and a few other places, and I've still gotten away with it.

So I've accumulated all these data points which tell me it's ok and that I've been making the right decision. But sooner or later that infinitesimally-small chance of an accident manifests itself, and in some small percentage of those accidents there are serious consequences. That's what makes it worthwhile to carry insurance all those other times, when nothing happens. It's a tough case to make precisely because serious situations like the one the OP describes are so rare.

To me, the real point is that I've come very close to accidents--some my own fault and some not--a great many times. There was a pedestrian I nudged gently in France, and one I didn't see who jumped out of my way here at home; the bus that nudged me to the ground from behind in Morocco, fortunately just as he braked to a stop; the large truck tire which came bounding toward me out of the chaos of oncoming traffic once in Ghana; the times oncoming trucks and buses have shunted me right off the road in various countries, including at night when I've had no advance knowledge of whether there was a empty shoulder, someone walking a water buffalo or carrying an infant, or even whether I'd be heading off a cliff. Then there are a whole slew of times when I did something stupid and other people were kind enough to avoid hitting me--sometimes by mere centimeters.

Again, if I take this to mean that the world is basically safe, I'm missing the underlying truth, which is that disaster is seldom more than a split second away. The fact that I usually evade it doesn't alter the fact that it's right there, waiting for me, and that eventually I'm likely to fall into that fractional percentage and get slammed. It's taken me 45 years of driving to figure that out, and I'm still tempted sometimes.

Mark

The question to ask yourself is, for the sake of 10 quid, is it worth it?
It's not just having an accident either. IN a lot of these countries the Rozzers just love to pull foreigners. At best it's going to cost you a bribe thats possibly more than the insurance, at worst, well, how bad can it get.
I have also been asked (In Africa) at the border when leaving a country to provide evidence I had insurance whilst I was there.

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1990 Landcruiser H60. Full rebuild completed 2014