MAIF Insurance - Maryland Automobile Insurance Fund (MD)

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MAIF Price Quote and Locations
To receive a free MAIF price quotation for car insurance, please select an office or complete the form at the bottom of the page.  For more information about each office, please click on the agency name to go to their web site. 
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Beltway Insurance Agency
9105 Central Ave
Capitol Heights, Maryland (MD)  20743

301-324-0300 Office
301-324-0302 Fax
Beltwayins@allstate.com email

Norken Insurance Agency
615 S Frederick Ave
Gaithersburg, Maryland (MD)  20877

240-243-9900 Office
240-243-9901 Fax
maifinsurance@gmail.com email

Ramirez Insurance Agency
3601 Hamilton Street
Hyattsville, Maryland (MD)  20782

301-277-4000 Office
301-277-0392 Fax
Ramirezins@allstate.com email
 MAIF Car Insurance Price Quote

To receive a quick price quote, please complete the following information.  Please complete as much as possible for the most accurate price estimate.
Applicant / Driver#1 Name - First Middle Last:
Street Address:
City:
State:
Zip Code: (5 digits)
Have you lived at this address over 2 years?:
If less than 2 years, then please list previous address:
Do you own or rent?:
Phone number:
Email:
Applicant - Date of birth: (MM DD YYYY)
Applicant - Sex:
Applicant - Marital status:
Applicant - Driver's License number:
Applicant - Driver's License State:
Applicant - Social Security # (optional):
Applicant - Number of Accidents in last 3 years:
Applicant - Number of tickets in last 3 years:
Please briefly describe Accidents and Tickets for applicant:
Driver #2 - (If none, then skip to Vehicle #1)
First Middle Last:
Driver #2 - Date of birth: (MM DD YYYY)
Driver #2 - Sex:
Driver #2 - Driver's License number:
Driver #2 - Driver's license State:
Driver #2 - Social Security # (optional):
Driver #2 - Number of Accidents in last 3 years:
Driver #2 - Number of tickets in last 3 years:
Please briefly describe Accidents and Tickets for Driver #2:
Do you have insurance?:
If yes, with what insurance company and for how long?:
Vehicle #1 - Year/Make/Model:
Vehicle #1 - Vin Number (optional):
Bodily Injury and Property Damage Liability Limits (All cars will be the same):
Uninsured Motorist - Bodily Injury and Property Damage Liability Limits (All cars will be the same):
Personal Injury Protection (All cars will be the same):
Vehicle #1 Comprehensive:
Vehicle #1 Collision:
Vehicle #1 Rental Reimbursement:
Vehicle #1 Towing and Labor:
Vehicle #2 - Year/Make/Model (if only one vehicle, then type none):
Vehicle #2 - VIN Number (optional):
Vehicle #2 Comprehensive:
Vehicle #2 Collision:
Vehicle #2 Rental Reimbursement:
Vehicle #2 Towing and Labor:
 Please tell us where you heard about our agency. Yellow pages
  Google/Yahoo etc.
  Referred by a Friend or Relative
  Craigslist
  Other
Comments - Please list any additional cars or drivers here:

Just so you are aware of our procedures, we will order consumer reports including credit, motor vehicle, loss information and prior insurance reports.  This information will be used to evaluate your application.  By pressing "Submit", I agree to these terms.
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