3 Verifications

A Final Itemized Funeral Home Billing Statement with Payment Sources is required with the WFCAP application. In addition, the Final Itemized Funeral Home Billing Statement with Payment Sources must be signed by the executor or family representative.

Note: WFCAP no longer accepts the Statement of Funeral Goods and Services Selected as a verification for total funeral expenses. Applications submitted without the Final Itemized Funeral Home Billing Statement with Payment Sources will be denied.

3.1.2 Verification of Cemetery/Crematory Expenses

A Final Itemized Cemetery and/or Crematory Statement with Payment Sources indicating all goods and services provided and identifying the corresponding expense is required with the WFCAP application. In addition, the Final Itemized Cemetery and/or Crematory Statement must be signed by the executor or the family representative.

Note: If a burial space is not accounted for on the Itemized Cemetery Statement with Payment Sources, the application will be denied. If the plot has a monetary value, it should also be accounted for on the WFCAP application in section 8. If the plot was donated, or has no charge, a written statement with explanation is required.

3.2 Verification of Cash Advances

3.2.1 Third Party Cash Advances

A receipt from the third party vendor is the required method of verification. If a receipt is not available, a written statement from the third party vendor will be acceptable. The written statement must include: the third party’s name, phone number, and amount, along with the purchase date. In addition, the third party must sign and date the statement.

Note: Applications submitted without receipts or proper documentation will be delayed.

3.2.2 Cemetery Cash Advances (Provider to Provider)

A Final Itemized Cemetery Statement with Payment Sources from the cemetery is required. The statement must include the following:

The cemetery's name, address, and telephone number
The purchase date
The amount of the cash advance
Verification that the goods and services have been paid in full and that services have been rendered
The cemetery service provider's signature
The executor or family representative's signature

3.2.3 Crematory Cash Advances (Provider to Provider)

A Final Itemized Crematory Statement with Payment Sources from the crematory is required. The statement must include the following:

The crematory's name, address, and telephone number
The purchase date
The amount of the cash advance
Verification that the goods and services have been paid in full and that services have been rendered
The crematory service provider's signature
The executor or family representative's signature

3.2.4 Required but Not Provided

A receipt from the third party vendor showing payment has been made is the required method of verification. A written statement in place of a receipt will no longer be accepted.

3.2.5 Required and Provided

A Final Itemized Cemetery Statement with Payment Sources is the required method of verification. The statement must include the following:

The cemetery’s name, address, and telephone number
The purchase date and amount
A description of the good(s) and service(s) provided
The cemetery service provider's signature and date
The executor or family representative's signature and date
Verification that the good(s) or service(s) has occured

Note: The provider is required to submit a joint WFCAP application.

3.3 Verification of Life Insurance

Adequate verifying documentation for all life insurance policies insuring the decedent’s life is required.

Applications will be denied when life insurance policies insuring the decedent’s life are identified, but adequate verifying documentation is not provided.

Documentation must include a copy of the life insurance policy that states the following:

Face value
Verifying documentation showing the death benefit amount payment
Insurance company name
Issue date
Policy number

Service providers should work with the decedent’s executor or family representative to obtain the required verifying documentation.

Note: WFCAP will accept a copy of check(s), or letter from the insurance company(s) verifying the amount(s) received.

Note: Life insurance funds received must be accounted for in section 8 of the WFCAP application.

3.3.1 Verification of Burial Trusts/Burial Insurance

Adequate verifying documentation for all burial trusts/burial insurance for the decedent is required.

Applications will be denied when burial trusts/burial insurance are identified, but adequate verifying documentation is not provided.

Documentation must include a copy of the following:

The pre-need
A copy of the check or verification showing the amount received from the burial trust/burial insurance

Note: Burial trust/burial insurance funds received must be accounted for in section 8 of the WFCAP application.

3.4 Certifying Signatures

3.4.1 Executor or Family Representative

In signing the application, the executor or family representative certifies that the amount available from estate and amount available from other sources represent the total funds available from the estate and other funding sources to cover funeral, cemetery, and crematory expenses.

The amount available from estate and amount available from other sources must include the following:

Burial trusts
Burial insurance
Life insurance funded burial contracts
Burial funds designated as exempt burial assets during the Medicaid application process
Any other payment sources (including but not limited to: bank accounts, refunds to the estate, sale of personal belongings, or fundraisers)

In addition, if the decedent is named as the insured on a life insurance policy with a death benefit of more than $3,000, the amount exceeding $3,000 must be used to pay for the decedent’s unmet funeral and cemetery/crematory expenses.

The executor or family representative must sign for each category of services the provider(s) have applied for on the WFCAP application. The executor or family representative must also sign any modifications to the application. Further, if any modifications are made to the Final Itemized Funeral Home Bill Statement with Payment Sources, or the Final Itemized Cemetery and/or Crematory statement with Payment Sources, the executor or family representative must sign the modified statement(s).

The application must be signed by the person representing the decedent with whom the funeral home, cemetery, or crematory is working to arrange the funeral and burial. If the service provider is working with an out-of-state person to make the arrangements, then the out-of-state family member is the person who must sign the form. If there is no one to represent the decedent, the application should be submitted with a written statement indicating there is no one representing the decedent.

3.4.2 Service Provider

In signing the application form, the service provider certifies both of the following:

The expenses indicated represent the total actual expenses for goods and services provided, including cash advances and service fees, if applicable.

Funds to which the service provider is entitled — including but not limited to burial trusts, burial insurance, life insurance funded burial contracts, burial funds, life insurance exceeding $3,000, and any other payment sources — are included in the amount available from estate and amount available from other sources.

3.4.3 Life Insurance Declaration

3.4.3.1 Service Provider

By signing the life insurance declaration section of the WFCAP application, the service provider certifies an inquiry was made of the executor or family representative of any life insurance policies, created on or after October 3, 2016, insuring the life of the decedent.

3.4.3.2 Executor or Family Representative

By signing the life insurance declaration section of the WFCAP application, the executor or family representative certifies that an inquiry was made by the service provider as to the existence of any life insurance policies, created on or after October 3, 2016, insuring the life of the decedent and has disclosed all known policies on the application.

This page last updated in Release Number: 22-01

Release Date: 05/02/2022

Effective Date: 05/02/2022