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Toll Free: 866-792-4515

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Claim Information
Policyholder Name:
Date of Accident:
Driver:
Vehicle Involved:
Location of Accident:
Names of other Parties in Accident:
Insurance Carrier for other parties:
Describe the Incident (what happened):
Best Contact Number:
Email Address:
Witnesses:

 
 

1911 Lakin Avenue
Great Bend, KS 67530

Phone: 620-792-4515
Fax: 620-793-3311

Email Goss Insurance

 

 

Phone: 620-792-4515
Toll Free: 866-792-4915
Fax: 620-793-3311

1911 Lakin Avenue
P.O. Box 1910
Great Bend, KS 67530-1910

www.gossins.com
Email Goss Insurance

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