Earthquake Insurance Quote

We would prefer to talk to you and walk through the application process over the phone.  Submitting the application below will enable our team to process the information prior to a conversation.  We will call you and review the options.   If you prefer, just give us a call at Toll Free:1-85-JustHome (1-855-878-463) or 678-648-1900.

NOTE: We no longer provide stand-alone earthquake coverage. Earthquake coverage in Georgia is bundled with the homeowner policy.

NOTE: Ga Earthquake Insurance.com is provided by an insurance agency and not a call center or a company selling leads. Your information is processed by our staff in Johns Creek Georgia and you are not added to any e-mail lists.

Online Quote

1. First Owner's First & Last Name(required)
2. Please Choose Choose Male Female
3. First Owner's Birth Date
4. Email(valid email required)
5. Phone Number
6. Second Owner's First Name & Last Name
7. Please Choose Choose Male Female
8. Second Owner's Birth Date
9. Relationship Married Parent/Child Friend Domestic Partner Other
10. Current Mailing Address
11. Current City
12. Current State
13. Current Zip
14. Do You Currently have Property Insurance? Renters Insurance Home Insurance Condo Insurance Mobile Home Insurance Other NONE

Information on the Home to be Insured

1. Address to be Insured
2. City
3. State
4. Zip
5. County
6. What type of Occupancy? Primary Residence Secondary Residence Tenant Occupied Vacant Home Vacation Short Term Rental Other
7. Type of home Single Family Cluster Home Condo Duplex Triplex Quadraplex Townhome
8. Exterior Construction Wood Exterior Vinyl/Aluminum Brick Veneer Stucco Log Hardi Plank Solid Brick or Concrete Walls Rock
9. Type of Foundation Slab Crawl Space Basement- 0% Complete Basement- 25% Complete Basement- 50% Complete Basement- 75% Complete Basement- 100% Complete
10. Garage Type Attached to Home Detached from Home In Basement Carport Driveway Only
11. Garage/Carport Size 1 Car 2 Car 3 Car 4 Car None
12. Is There Heated Living Space Above the Garage?
13. Yes
    No
14. How Many Stories is the Home (not including basement) Please Choose Ranch-1 story Two Story Three Story Bi-Level Tri-Level Split Level
15. Approximate Number of Square Feet (not including basement)
16. Year Built
17. Fire Places NONE 1 2 3 4 5 6
18. How Many Full Bathrooms? 1 2 3 4 5 6 7 8 9 10
19. How Many Half Bathrooms? 0 1 2 3 4 5

Current or Competative Coverage

1. Dwelling Coverage
2. Personal Property
3. Liability Coverage $100,000 $200,000 $300,000 $500,000 $1,000,000
4. Medical Coverage $1,000 $3,000 $5,000

Discounts

1. Deadbolt Locks, Smoke Detectors, Fire Extinguisher?
2. Yes
   No
3. Monitored Security System/Fire Alarm? None Monitored Alarm/Fire Non-Monitored Alarm/Fire
4. Interior Fire Sprinkler System
5. Yes
   No

Other

1. Does your Subdivision have a Mandated Homeowner Association?
2. Yes
   No
3. Re-Key Coverage Desired? (Lost/Stolen Keys)
4. Yes
   No
5. Identity Theft Coverage Desired?
6. Yes
   No
7. Business Computers/Equipment Coverage
8. Yes
   No
9. Comments
10. What color is snow?
11. As part of the application process, we may collect personal information from persons other than you or other individuals proposed for coverage, including credit reports and loss information reports. This information, as well as other personal or privileged information subsequently collected by us, may in certain circumstances be disclosed to third parties without your authorization. You have a right of access and correction with respect to all personal information we collect. If you would like more detailed information in writing about our information collection practices, please let us know. NOTE: In regard to the statement above, we are required to post this as a process of obtaining Loss Information History and final quoting criteria. Submitting this form approves the collection of data. We have not asked for and do not require a social security number in this process.
12. I Agree

 

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