Get Great West Life Claim

Submitting a claim with Great West Life can be a straightforward process if you have the right guidance. This guide will provide you with step-by-step instructions on how to fill out the Great West Life Claim form online, ensuring you complete each section accurately.

Follow the steps to fill out your Great West Life Claim form.

1. Click ‘Get Form’ button to access the Great West Life Claim form and open it in your preferred editor.
2. Begin by completing pages 1 and 2 of the form thoroughly. Make sure all information is accurate and legible.
3. Attach receipts for all services or expenses being claimed, and keep copies for your records, as original receipts will not be returned.
4. In Part 1, confirm all information is correct, authorize Great West Life to process your claim, and provide your signature along with the date.
5. Complete Part 2 by filling in your plan member information, including your name, address, date of birth, and language preference.
6. In Part 3, indicate your coordination of benefits. Specify if you or any family member has benefits coverage under another plan, and provide details if applicable.
7. Fill out Part 4 with patient information for each expense claimed, providing their relationship to you and date of birth.
8. For Part 5, list the claim details for each expense, ensuring to provide all requested information.
9. In Part 6 through Part 9, enter specific information based on the type of expenses being claimed, ensuring you attach the necessary receipts for verification.
10. Finally, submit your completed claim to the appropriate Benefit Payment Office as indicated in Part 10. Ensure you keep a copy for your records.

Begin your claim process online today by completing the Great West Life Claim form.