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Property Loss Notice

NOTE: This service applies only to existing, current policy holders that have purchased their earthquake insurance through the Burke Insurance Agency.

Please provide the information requested below to initiate the claims process and one of our customer service representatives will begin working on your claim right away.

Name and Mailing Address of Insured
Zip Code*
Address of Property
City* (California Only)
Zip Code*
Contact Information
Home Phone*
Work Phone
Email Address*
Where to Contact
When to Contact
Earthquake Policy Information
Policy Provider*
Policy Number*
Policy Start Date*
Policy Exp. Date*
Property Loss Information
Date of Loss*
Estimate of Entire Loss*
Additional Information
*Required Information