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Other Names: Death Notice Death Notification Death Announcement Death Notification Letter Notification of Death Notice of Death to an Insurance Company
Notice of Death to an Insurance Company document preview

What is a Notice of Death to an Insurance Company?

This notice is used to advise an insurance company that an auto or homeowners policy can be terminated because of the death of the policy owner.

When to use a Notice of Death to an Insurance Company:

  • You need to provide notice of the death of a policy owner.
  • You want to obtain a refund of any unused premium amount.

Sample Notice of Death

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Notice of Death










Type of Policy:

Policy Number:

Date of Cancellation:


You are hereby notified that died on . Please cancel the polic(ies) as of the cancellation date(s) shown above. The unused premium(s) should be sent to my attention at the address shown above.


Enclosed is a copy of which shows my authority to make this request.


You may contact me if you have any questions or need additional information. or


Thank you for your prompt attention to this matter.







Notice of Death to an Insurance Company document preview

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