Maraletos Insurance

714-323-5301

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714-276-8584

Dedicated Line
for Medicare calls only

Personal Auto Insurance

Road accidents can be traumatic. With Automobile Insurance, you help prepare yourself financially in the event of collision, theft, fire and other accidents involving your car.
* =Required Fields
Primary Insured
* First Name * Last Name
*Gender
 Age
 Occupation
* Street
 * City
State
 *Zip Code
*Home Phone
 *Business Phone
*Email Address
 Present Insurance Company
* Marital Status  
 *Yrs Licensed
 *Annual Mileage
Last 3 years
*Tickets
 *At fault accidents
 *Major Violations
DUI last 7 years
Additional Drivers
Driver 1
Name
 Gender
Age
 Occupation
Relationship To Primary
Marital Status
 Yrs Licensed
 Annual Mileage
LAST 3 YEARS
Tickets
 At fault accidents
 Major Violations
DUI last 7 years
Driver 2
Name
 Gender
Age
 Occupation
Relationship To Primary
Marital Status
 Yrs Licensed
 Annual Mileage
LAST 3 YEARS
Tickets
 At fault accidents
 Major Violations
DUI last 7 years
Driver 3
Name
 Gender
Age
 Occupation
Relationship To Primary
Marital Status
 Yrs Licensed
 Annual Mileage
LAST 3 YEARS
Tickets
 At fault accidents
 Major Violations
DUI last 7 years
Driver 4
Name
 Gender
Age
 Occupation
Relationship To Primary
Marital Status
 Yrs Licensed
 Annual Mileage
LAST 3 YEARS
Tickets
 At fault accidents
 Major Violations
DUI last 7 years
 
About The Cars
Vehicle 1
*Year

 *Make
 *Model
*Miles To Work (one way)
 Anti-Lock Brakes No Yes
*Protective Devices 
 VIN
Primary Driver
 Annual Mileage
Vehicle 2
Year

 Make
 Model
Miles To Work (one way)
 Anti-Lock Brakes No Yes
Protective Devices 
 VIN
Primary Driver
 Annual Mileage
Vehicle 3
Year

 Make
 Model
Miles To Work (one way)
 Anti-Lock Brakes No Yes
Protective Devices 
 VIN
Primary Driver
 Annual Mileage
Vehicle 4
Year

 Make
 Model
Miles To Work (one way)
 Anti-Lock Brakes No Yes
Protective Devices 
 VIN
Primary Driver
 Annual Mileage
 
Limits of Liability
Vehicle 1
*Bodily Injury  
 *Property Damage  
*UM Bodily Injury  
 *UM Property Damage
 Medical Payments  
>Vehicle 2
Bodily Injury  
 Property Damage  
UM Bodily Injury  
 UM Property Damage
 Medical Payments  
Vehicle 3
Bodily Injury  
 Property Damage  
UM Bodily Injury  
 UM Property Damage
 Medical Payments  
Vehicle 4
Bodily Injury  
 Property Damage  
UM Bodily Injury  
 UM Property Damage
 Medical Payments  
Deductibles
Vehicle 1
*Comprehensive  *Collision 
Vehicle 2
Comprehensive    Collision 
Vehicle 3
Comprehensive    Collision 
Vehicle 4
Comprehensive    Collision 
 
Additional Endorsements

Towing

Loss of Use (Rental Car)
Glass Buyback
($100 Deductible)

SR-22 Filing Needed
 
Comments
 

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When you fill out our form, you will receive health insurance quotes from Aetna, Anthem Blue Cross, Blue Shield of California, Health Net, PacifiCare & United Health Care. We'll help you find individual, family or small business health insurance and the best medical insurance plans for your needs and budget.