Home
Get A Quote
Automobile
Auto Insurance Quote
Mexico Travel Insurance Quote
Auto Quote Form (short)
Get Instant Auto Insurance Quote Now Click here
Business & Commercial
Commercial Auto Insurance Quote
General Liability Quote Form
Business Owners (BOP) Quote Form
Builders Risk
Liquor Liability Quote Form
Workers Compensation Quote
Master Condominium Associations & Apartment Buildings
Condominium
Construction
Dental
Earthquake
Employee Benefits
Group Health
Health
Health Insurance Quote
Long Term Care Insurance Quote
Affordable Health Insurance
Homeowners
Life
Life Insurance Quote
Term Life Insurance Quote
Motorcycle
Pet Insurance
Pet Insurance Quote
Pet Insurance Quote
Renters
Restaurant
Travel
Vision
Watercraft & Boat
Windstorm
Customer Service
Automobile
Request ID Card for Auto Policy
Send Declaration and Coverages Information to Lien Holder
Add Driver to Existing Auto Policy
Remove Driver from Existing Auto Policy
Business & Commercial
Remove Driver from Existing Commercial Auto Policy
Request General Liability Certificate of Insurance
Other
Claims
Automobile
Business & Commercial
Earthquake
Homeowners
Motorcycle
Renters
Watercraft & Boat
Windstorm
Blog
Make a Payment
Resources
Refer a Friend
Important Links
Calculators
Free Reports
Insurance Glossary
About Us
About Savin Jones Insurance Agency
Location Map
Partners
Privacy Policy
Contact
Contact Us
Join Our Newsletter
Home
>
Earthquake
>
Earthquake Property Loss Claim Form
Earthquake Property Loss Claim Form
Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.
Personal Information
First Name
Required
Last Name
Required
Street
Required
City
Required
State
Required
MA
ZIP / Postal Code
Required
Primary Phone Number
Required
Alternate Phone Number
Optional
E-Mail Address
Required
Policy Number
Required
Loss Overview
Loss Type
Required
Fire
Theft
Lightning
Hail
Flood
Wind
Act of God
What date did the incident take place?
Required
January
February
March
April
May
June
July
August
September
October
November
December
/
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
/
2029
2028
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
1907
1906
1905
1904
1903
1902
1901
1900
How severe was the damage?
Required
Minor
Moderate
Severe
Unknown
None
Describe the Loss
Required
Submission Validation
Required
Enter the Validation Code from above.
Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either Savin Jones Insurance, or your insurance company. If you have any questions, please feel free to
contact us
.
Per the terms of our
online privacy policy
we will not resell your information to any third-party.
Insurance Websites
Designed and Hosted by
Insurance Website Builder
867-C Dorchester Ave | Dorchester, MA 02125 | Ph: 617.474.9900 | Fx: 617.474.9901