Forms

You will need to submit forms in order to allow us to perform an array of tasks on your Preneed Funeral or Final Expense 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 Forms

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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Preneed Policyholder Service Request for Policies Submitted on Nov. 1, 2019, or After

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

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Preneed Policyholder Service Request for Policies Submitted Prior to Nov. 1, 2019

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

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Preneed Automatic Premium Withdrawal for Policies Submitted Prior to Nov. 1, 2019

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

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Preneed Automatic Premium Withdrawal for Policies Submitted on Nov. 1, 2019, or After

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

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Final Expense Forms

Final Expense Claim Form — Proof of Death

Use this form to disclose a covered person's death. Contact Customer Care for claim information.

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Final Expense Absolute Assignment

Use this form to change the ownership of your policy. Do NOT use it to assign benefits to others.

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Final Expense Beneficiary Designation

Use this form to designate or change the beneficiaries on your Final Expense policy.

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Final Expense Accelerated Benefit Request

Use this form to request the Accelerated Death Benefit for your Final Expense policy.

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Final Expense Request for Service

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

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Final Expense Cash Surrender Value Request

Use this form if you'd like to cancel or surrender your policy in exchange for its cash value.

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Final Expense Policy Loan Agreement

Use this form if you would like to request a loan against the value of your policy.

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Our Funeral Expenses Calculator can help estimate your burial and end-of-life expenses and show how those costs could be affected by inflation over time. The data can help you determine whether Final Expense or Preneed Funeral insurance will meet your needs.


Calculate Your Expenses