In the last two decades, less than one-third of the losses caused by natural disasters were insured. High-income countries cover on average 30% of their losses, while low-income countries insured only 1% of their losses. Notably, in most parts of the Middle East, insurance and other disaster risk financing instruments are rarely used. We developed an earthquake loss model covering the residential building stock of 12 countries in the Middle East. Then, we explored different strategies to diversify the risk, and potentially decrease the cost of insurance policies. We demonstrate that aggregating earthquake risk from several countries in the same pool can decrease considerably the cost of insurance in the region, consequently improving affordability.