That would surely be the 2004 earthquake in Sumatra-Andaman, with over 275,000 deaths. That one is hard to top.

The October 8, 2005 magnitude 7.6 earthquake in Pakistan was not especially large, but the more than 40,000 victims has raised it to the level of a major catastrophe. Without doubt, however, the most devastating loss of life in recent years was the much larger 9.3 Sumatra-Andaman earthquake (the third largest ever recorded) / tsunami in late 2004 that is now estimated to have claimed 275,000 lives. The tsunami was responsible for the bulk of the damage and casualties. The total costs of these events are still to early to measure, but probably won't exceed the property damage caused by the 1995 Kobe earthquake, now estimated at more than $150 billion. Within the US (excluding earthquake-prone Alaska), neither the Los Angeles Quake (1994) nor even the great San Francisco event of 1906, were nearly as damaging.
Source(s):
http://www.eas.slu.edu/hazards.html

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