Preneed Insurance forms

You will need to submit forms in order to allow us to perform an array of tasks on your Preneed Funeral insurance policies through Great Western Insurance Company. If a form you need is not listed below, please call 866-689-1401.

Authorization for the use and disclosure of information

Use this form to grant permission to release information to individuals.

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Preneed death claim form

This form should be used for Preneed Funeral insurance claims in all states except Indiana, Tennessee, Kentucky, and Texas.

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Preneed death claim form for Indiana

This form should be used for Preneed Funeral insurance claims in Indiana.

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Preneed death claim form for Kentucky

This form should be used for Preneed Funeral insurance claims in Kentucky.

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Preneed death claim form for Tennessee

This form should be used for Preneed Funeral insurance claims in Tennessee.

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Preneed death claim form for Texas

This form should be used for Preneed Funeral insurance claims in Texas.

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Texas preneed funeral contract brochure

This brochure is for Texas residents who purchase Preneed insurance.

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Preneed policyholder service request

Use this form to update your name, address, and beneficiary or request a duplicate policy. 

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Automatic premium withdrawal

Use this form to authorize premium payments through bank draft and update your account.

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