@extends('reachassuree_agent/layouts.main')
@section('title', $data['title'])
@section('content')

<style>
    .select2-container .select2-selection--multiple .select2-search__field{
        width: 205px !important;
    }

    @media only screen and (max-width:421px) {
        .actions li:first-child a{
            margin-bottom: .5rem!important;
        }
    }

    @media only screen and (max-width:767px) {
        .form-check .col-md-2 .form-control{
            width:267%!important;
        }
    }

    @media only screen and (max-width: 1400px){
        #intimated_by_id .text-center {
            text-align: initial !important;
        }

        #intimated_by_id .justify-content-center {
            justify-content: initial !important;
        }
    }
    
    @media only screen and (max-width: 1795px) {
        #add_new_row .col-xxl-3,
        #add_new_row .col-xxl-2,
        .row-item .col-xxl-3,
        .row-item .col-xxl-2 {
            width: 50% !important;
        }

        #add_new_row .col-xxl-1,
        .row-item .col-xxl-1 {
            width: 100% !important;
        }
    }

    button#btnSave {
        width: 105px;
        height: 39px;
        line-height: 14px;
    }

    button#send_email {
        width: 105px;
        margin-left: 15px;
    }

    button#download {
        width: 160px;
        margin-right: 15px;
    }

    .form-check-inline{
        margin-right: 0.5rem;
    }

    .list-unstyled.dropdownlist {
        position: absolute;
        border: 1px solid #ced4da;
        width: 90%;
        background: #fff;
        z-index: 999999999;
        margin-left :12px;
    }

    .list-unstyled.dropdownlist li {
        padding: 8px 12px;
        cursor: pointer;
        border: 1px solid #ced4da;
    }

    .p_number,
    .p_number_1,
    .p_number_2 {
        color: black;
    }

    .p_number:hover,
    .p_number_1:hover,
    .p_number_2:hover{
        background: var(--bs-blue);
        color: white;
    }

    .disabled-link {
        opacity: .65;
        pointer-events: none;
        cursor: not-allowed;
    }

    @media only screen and (min-width: 1401px) and (max-width: 1682px){
        #intimated_by_id .d-flex {
            display: inline-table !important;
        }
    }
</style>

<div class="page-content">
    <div class="container-fluid">
        <!-- start page title -->
            @include('../reachassuree_agent/master/comman/header')
        <!-- end page title -->

        <div class="row justify-content-end">
            <a href="javascript:void(0);" onclick="return learningVideo()" class="btn-youtube-pulse btn-youtube-pulse-border">
                <i class="mdi mdi-youtube"></i>
            </a>
        </div>

        <div class="row">
            <div class="col-lg-12">
                <div class="card">
                    <div class="card-body">
                        <form id="addIntimation"  method="POST" accept-charset="utf-8" class="needs-validation" enctype="multipart/form-data" novalidate>
                            @csrf
                            <input type="hidden" id="id" name="id" value="">
                            <input type="hidden" id="parent_id" name="parent_id" value="">
                            <input type="hidden" id="multiple_reasons" name="multiple_reasons" value="">
                            <input type="hidden" id="url_type" name="url_type" value="">

                            <div id="basic-example">
                                <!-- step 1 -->
                                <h3>Step 1</h3>
                                <section class="wizard-step">
                                    <div class="row">
                                        <div class="col-md-12">
                                            <div class="mb-3">
                                                <label class="form-label" for="non_cash_1">Choose Claim Type<span class="text-danger">*</span></label>
                                                <div class="form-check">
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="radio" name="claim_type_1" id="non_cash_1" value="Non Cash" checked>
                                                        <label class="form-check-label me-5" for="non_cash_1">Non Cash</label>
                                                    </div>
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="radio" name="claim_type_1" id="cashless_1" value="Cashless">
                                                        <label class="form-check-label me-5" for="cashless_1">Cashless</label>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                    
                                    <div class="row">
                                        <div class="col-md-12">
                                            <div class="mb-3">
                                                <label class="form-label" for="mediclaim_1">Choose Claim Intimation Type<span class="text-danger">*</span></label>
                                                <div class="form-check">
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="radio" name="type_1" id="mediclaim_1" value="Mediclaim" checked>
                                                        <label class="form-check-label me-5" for="mediclaim_1">Mediclaim</label>
                                                    </div>
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="radio" name="type_1" id="vehicle_claim_1" value="Vehicle Claim">
                                                        <label class="form-check-label me-5" for="vehicle_claim_1">Vehicle Claim</label>
                                                    </div>
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="radio" name="type_1" id="death_claim_1" value="Death Claim">
                                                        <label class="form-check-label me-5" for="death_claim_1">Death Claim</label>
                                                    </div>
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="radio" name="type_1" id="disability_claim_1" value="Disability Claim">
                                                        <label class="form-check-label me-5" for="disability_claim_1">Disability Claim</label>
                                                    </div>
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="radio" name="type_1" id="other_claim_1" value="Other Claim">
                                                        <label class="form-check-label me-5" for="other_claim_1">Other Claim</label>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                    </div>

                                    <div class="row" id="vehicle_ins_1">
                                        <div class="col-md-12">
                                            <div class="mb-3">
                                                <label class="form-label" for="own_vehicle_claim_1">Vehicle Claim Owner Type<span class="text-danger">*</span></label>
                                                <div class="form-check">
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="radio" name="vehicle_owner_1" id="own_vehicle_claim_1" value="Own Vehicle Claim" checked>
                                                        <label class="form-check-label me-5" for="own_vehicle_claim_1">Own Vehicle Claim</label>
                                                    </div>
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="radio" name="vehicle_owner_1" id="third_party_vehicle_claim_1" value="Third Party Vehicle Claim">
                                                        <label class="form-check-label me-5" for="third_party_vehicle_claim_1">Third Party Vehicle Claim</label>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                    </div>

                                    <div class="row" id="death_claim_agency_1">
                                        <div class="col-md-12">
                                            <div class="mb-3">
                                                <label class="form-label" for="self_agency">Select Agency<span class="text-danger">*</span></label>
                                                <div class="form-check">
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="radio" name="agency_name" id="self_agency" value="Self Agency" checked>
                                                        <label class="form-check-label me-5" for="self_agency">Self Agency</label>
                                                    </div>
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="radio" name="agency_name" id="others_agency" value="Others Agency">
                                                        <label class="form-check-label me-5" for="others_agency">Others Agency</label>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                    </div>

                                    <div class="row">
                                        <div class="col-xxl-6" id="main_claim_type_id">
                                            <div class="mb-3">
                                                <label for="claim_type_id_1" class="form-label">Select Claim Type<span class="text-danger">*</span></label>
                                                <select class="form-control select2-ajax" id="claim_type_id_1" name="claim_type_id_1" required></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>
                                        <div class="col-xxl-2" id="death_claim_type_id">
                                            <div class="mb-3">
                                                <label for="death_claim_type" class="form-label">Select Death Claim Type<span class="text-danger">*</span></label>
                                                {{-- <select class="form-control select2-ajax" id="death_claim_type" name="death_claim_type[]" required multiple></select> --}}
                                                <select class="form-control select2-ajax" id="death_claim_type" name="death_claim_type" required></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>
                                        <div class="col-xxl-3" id="client_type_id">
                                            <div class="mb-3">
                                                <label for="client_type" class="form-label">Client Type<span class="text-danger">*</span></label>
                                                <select class="form-control select2-ajax" id="client_type" name="client_type" required>
                                                    <option value=""></option>
                                                    <option value="0">Registered Client</option>
                                                    <option value="1">Non-Registered Client</option>
                                                </select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>
                                        <div class="col-xxl-3" id="select_policy_holder_name_id">
                                            <div class="mb-3">
                                                <label for="select_policy_holder_name" class="form-label">Select Policy Holder Name<span class="text-danger">*</span></label>
                                                <select class="form-control select2-ajax" id="select_policy_holder_name" name="select_policy_holder_name" required></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>
                                        <div class="col-xxl-3" id="enter_policy_holder_name_id">
                                            <div class="mb-3">
                                                <label for="enter_policy_holder_name" class="form-label">Policy Holder Name<span class="text-danger">*</span></label>
                                                <input type="text" class="form-control" id="enter_policy_holder_name" name="enter_policy_holder_name" placeholder="Enter policy holder name" autocomplete="off" required>
                                            </div>
                                        </div>
                                        <div class="col-xxl-2" id="select_ins_company_id">
                                            <div class="mb-3">
                                                <label for="select_ins_company" class="form-label">Select Insurance Company<span class="text-danger">*</span></label>
                                                <select class="form-control select2-ajax" id="select_ins_company" name="select_ins_company" required></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>
                                        {{-- <div class="col-xxl-2" id="select_branch_id">
                                            <div class="mb-3">
                                                <label for="select_branch" class="form-label">Select Branch<span class="text-danger">*</span></label>
                                                <select class="form-control select2-ajax" id="select_branch" name="select_branch" required></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div> --}}
                                        <div class="col-xxl-4" id="select_vehicle_num_id">
                                            <div class="mb-3">
                                                <label for="select_vehicle_number" class="form-label">Select Vehicle Number<span class="text-danger">*</span></label>
                                                <select class="form-control select2-ajax" name="select_vehicle_number" id="select_vehicle_number" required></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>
                                        <div class="col-xxl-6" id="main_policy_id">
                                            <div class="mb-3">
                                                <label for="policy_number_1" class="form-label">Select Policy Number<span class="text-danger">*</span></label>
                                                <select class="form-control select2-ajax" id="policy_number_1" name="policy_number_1" required></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>
                                        <div class="col-xxl-3" id="policy_num_2_id">
                                            <div class="mb-3">
                                                <label for="policy_num_2" class="form-label">Policy Number<span class="text-danger">*</span></label>
                                                <input type="text" class="form-control" id="policy_num_2" name="policy_num_2" placeholder="Enter policy number" autocomplete="off" required maxlength="30">
                                            </div>
                                        </div>
                                        <div class="col-xxl-1" id="claim_count_id">
                                            <label for="claim_count" class="form-label">Claim Count</label>
                                            <input type="text" class="form-control" name="claim_count" id="claim_count" disabled value="" autocomplete="off">
                                        </div>
                                        <div class="col-xxl-3" id="policy_type_id">
                                            <label for="policy_type" class="form-label">Policy Type<span class="text-danger">*</span></label>
                                            <select class="form-control select2-ajax" name="policy_type" id="policy_type" required>
                                                <option value=""></option>
                                                <option value="0">Group</option>
                                                <option value="1">Other</option>
                                            </select>
                                            <div class="invalid-feedback">This value is required.</div>
                                        </div>
                                    </div>
                                </section>

                                <!-- Step 2 -->
                                <h3>Step 2</h3>
                                <section class="wizard-step">
                                    <div class="row">
                                        <div class="col-md-12 mt-4">
                                            <div class="card text-white bg-dark mb-3">
                                            <div class="card-header text-center font-size-13" id="claim_type_value_1">Mediclaim</div>
                                            </div>
                                        </div>
                                    </div>

                                    <div class="row">
                                        <div class="col-md-12 mt-4">
                                            <div class="card text-white bg-secondary mb-3" style="background-color: #c1dbff !important;color: var(--bs-blue) !important">
                                            <div class="card-header text-center font-size-13">POLICY DETAIL</div>
                                            </div>
                                        </div>
                                    </div>

                                    <div id="step_2_claim">
                                        <div class="row">
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="policy_number_1_1" class="form-label">Policy Number</label>
                                                    <input type="text" class="form-control" name="policy_number_1_1" id="policy_number_1_1" disabled value="">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <input type="hidden" name="policy_holder_name_id_hidden" id="policy_holder_name_id_hidden">
                                                    <label for="policy_holder_name_1" class="form-label">Policy Holder Name</label>
                                                    <input type="text" class="form-control" name="policy_holder_name_1" id="policy_holder_name_1" disabled value="">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="insurance_company_name_1" class="form-label">Insurance Company Name</label>
                                                    <input type="text" class="form-control" name="insurance_company_name_1" id="insurance_company_name_1" disabled value="">
                                                </div>
                                            </div>
                                        </div>
                
                                        <div class="row" id="death_policy_details">
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="nominee_name_1" class="form-label">Nominee Name</label>
                                                    <input type="text" class="form-control" name="nominee_name_1" id="nominee_name_1" disabled value="" placeholder="Nominee Name">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="nominee_contact_num" class="form-label">Nominee Contact No.</label>
                                                    <input type="text" class="form-control" name="nominee_contact_num" id="nominee_contact_num" disabled value="" placeholder="Nominee Contact No.">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="branch_name" class="form-label">Branch Name</label>
                                                    <input type="text" class="form-control" name="branch_name" id="branch_name" disabled value="" placeholder="Branch Name">
                                                </div>
                                            </div>
                                        </div>

                                        <div id="general_mediclaim">
                                            <div class="row">
                                                <div class="col-xxl-4" id="branch_name_id">
                                                    <div class="mb-3">
                                                        <label for="branch_name_1" class="form-label">Branch Name</label>
                                                        <input type="text" class="form-control" name="branch_name_1" id="branch_name_1" disabled value="" placeholder="Branch Name">
                                                    </div>
                                                </div>
                                                <div class="col-xxl-2" id="vehicle_data_name">
                                                    <div class="mb-3">
                                                        <label for="vehicle_name" class="form-label">Vehicle Name</label>
                                                        <input type="text" class="form-control" name="vehicle_name" id="vehicle_name" disabled value="">
                                                    </div>
                                                </div>
                                                <div class="col-xxl-2" id="vehicle_data_number">
                                                    <div class="mb-3">
                                                        <label for="vehicle_number" class="form-label">Vehicle Number</label>
                                                        <input type="text" class="form-control" name="vehicle_number" id="vehicle_number" disabled value="">
                                                    </div>
                                                </div>
                                                <div class="col-xxl-3" id="seg_1">
                                                    <div class="mb-3">
                                                        <label for="segment_1" class="form-label">Segment</label>
                                                        <input type="text" class="form-control" name="segment_1" id="segment_1" disabled value="">
                                                    </div>
                                                </div>
                                                <div class="col-xxl-3" id="brok_1">
                                                    <div class="mb-3">
                                                        <label for="broker_1" class="form-label">Broker</label>
                                                        <input type="text" class="form-control" name="broker_1" id="broker_1" disabled value="">
                                                    </div>
                                                </div>
                                                <div class="col-xxl-3" id="sub_agent_id">
                                                    <div class="mb-3">
                                                        <label for="sub_agent_1" class="form-label">Sub Agent</label>
                                                        <input type="text" class="form-control" name="sub_agent_1" id="sub_agent_1" disabled placeholder="Sub agent" value="">
                                                    </div>
                                                </div>
                                                <div class="col-xxl-3" id="agency_id">
                                                    <div class="mb-3">
                                                        <label for="agency_1" class="form-label">Agency</label>
                                                        <input type="text" class="form-control" name="agency_1" id="agency_1" disabled value="" placeholder="Agency">
                                                    </div>
                                                </div>
                                            </div>
                                        </div>

                                        <div id="life_health_claim">
                                            <div class="row">
                                                <div class="col-xxl-4">
                                                    <div class="mb-3">
                                                        <label for="plan_number_term_1" class="form-label">Plan No./Term/Prem.Term</label>
                                                        <input type="text" class="form-control" name="plan_number_term_1" id="plan_number_term_1" disabled value="">
                                                    </div>
                                                </div>
                                                <div class="col-xxl-4">
                                                    <div class="mb-3">
                                                        <label for="plan_name_1" class="form-label">Plan Name</label>
                                                        <input type="text" class="form-control" name="plan_name_1" id="plan_name_1" disabled value="">
                                                    </div>
                                                </div>
                                                <div class="col-xxl-4">
                                                    <div class="mb-3">
                                                        <label for="prem_due_date_1" class="form-label">Premium Due Date</label>
                                                        <input type="text" class="form-control" name="prem_due_date_1" id="prem_due_date_1" disabled placeholder="dd-mm-yyyy" value="">
                                                    </div>
                                                </div>
                                            </div>
                                        </div>

                                        <div class="row">
                                            <div class="col-xxl-2">
                                                <div class="mb-3">
                                                    <label for="risk_from_date_1" class="form-label">Risk From Date</label>
                                                    <input type="text" class="form-control" name="risk_from_date_1" id="risk_from_date_1" disabled value="">
                                                </div>
                                            </div>
                                            <div class="col-xxl-2">
                                                <div class="mb-3">
                                                    <label for="risk_to_date_1" class="form-label">Risk To Date</label>
                                                    <input type="text" class="form-control" name="risk_to_date_1" id="risk_to_date_1" disabled placeholder="dd-mm-yyyy" value="">
                                                </div>
                                            </div>
                                            <div class="col-xxl-2" id="sum_assu_amt_id">
                                                <div class="mb-3">
                                                    <label for="sum_assured_1" class="form-label">Sum Assured</label>
                                                    <input type="hidden" name="sum_assu_amt" id="sum_assu_amt_2">
                                                    <input type="text" class="form-control" name="sum_assured_1" id="sum_assured_1" disabled value="">
                                                </div>
                                            </div>
                                            <div class="col-xxl-2">
                                                <div class="mb-3">
                                                    <label for="remaining_assured_1" class="form-label">Remaining Assured Amt</label>
                                                    <input type="text" class="form-control" name="remaining_assured_1" id="remaining_assured_1" disabled value="">
                                                </div>
                                            </div>
                                            <div class="col-xxl-2" id="TPL_Due_date"></div>
                                            <div class="col-xxl-2" id="person_covered">
                                                <div class="mb-3">
                                                    <label for="person_covered_1" class="form-label">Person Covered</label>
                                                    <input type="text" class="form-control" name="person_covered_1" id="person_covered_1" disabled value="">
                                                </div>
                                            </div>
                                            <div class="col-xxl-2" id="premium_amt_id">
                                                <div class="mb-3">
                                                    <label for="premium_amount_1" class="form-label">Premium Amount</label>
                                                    <input type="text" class="form-control" name="premium_amount_1" id="premium_amount_1" disabled value="">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4" id="bank_name_id">
                                                <div class="mb-3">
                                                    <label for="bank_name" class="form-label">Bank Name</label>
                                                    <input type="text" class="form-control" name="bank_name" id="bank_name" disabled value="" placeholder="Bank Name">
                                                </div>
                                            </div>
                                            <div class="col-xxl-2" id="model_id">
                                                <div class="mb-3">
                                                    <label for="model_year" class="form-label">Model</label>
                                                    <input type="text" class="form-control" name="model_year" id="model_year" disabled placeholder="Model" value="">
                                                </div>
                                            </div>
                                            <div class="col-xxl-2" id="rto_id">
                                                <div class="mb-3">
                                                    <label for="rto_name" class="form-label">RTO</label>
                                                    <input type="text" class="form-control" name="rto_name" id="rto_name" disabled value="" placeholder="RTO">
                                                </div>
                                            </div>
                                            <div class="col-xxl-6" id="policy_address_id">
                                                <div class="mb-3">
                                                    <label for="policy_address" class="form-label">Policy Holder Address</label>
                                                    <input type="text" class="form-control" name="policy_address" id="policy_address" disabled value="">
                                                </div>
                                            </div>
                                        </div>
                                    </div>

                                    <div id="step_2_death_claim">
                                        <div class="row">
                                            <div class="col-xl-4">
                                                <div class="mb-3">
                                                    <input type="hidden" name="policy_holder_name_id_hidden" id="policy_holder_name_id_hidden">
                                                    <label for="policy_holder_name_death" class="form-label">Policy Holder Name</label>
                                                    <input type="text" class="form-control" name="policy_holder_name_death" id="policy_holder_name_death" disabled value="">
                                                </div>
                                            </div>
                                            <div class="col-xl-4">
                                                <div class="mb-3">
                                                    <label for="insurance_company_name_death" class="form-label">Insurance Company Name</label>
                                                    <input type="text" class="form-control" name="insurance_company_name_death" id="insurance_company_name_death" disabled value="">
                                                </div>
                                            </div>
                                            {{-- <div class="col-xl-4">
                                                <div class="mb-3">
                                                    <label for="branch_name_death" class="form-label">Branch Name</label>
                                                    <input type="text" class="form-control" name="branch_name_death" id="branch_name_death" disabled value="">
                                                </div>
                                            </div>                                                                                      --}}
                                            <div class="col-xl-4" id="select_branch_id">
                                                {{-- <div class="row">
                                                    <div class="col-xl-10"> --}}
                                                        <div class="mb-3">
                                                            <label for="claim_branch" class="form-label">Claim Intimated Branch<span class="text-danger">*</span></label>
                                                            <input type="text" class="form-control" id="claim_branch" name="claim_branch" placeholder="Enter branch name" autocomplete="off" required>
                                                            {{-- <select class="form-control select2-ajax" id="select_branch" name="select_branch" required></select>
                                                            <div class="invalid-feedback">This value is required.</div> --}}
                                                        </div>
                                                    </div>
                                                    {{-- <div class="col-xl-2">
                                                        <div class="mb-3">
                                                            <label class="form-label spaceRemove" for="addBranchBtn">&nbsp;&nbsp;&nbsp;&nbsp;</label>
                                                            <button class="btn btn-primary px-4 form-control" id="addBranchBtn" onclick="return addBranch();" type="button"><span>Add</span></button>
                                                        </div>
                                                    </div> --}}
                                                {{-- </div>
                                            </div> --}}
                                        </div>

                                        <div id="add_new_row_death"></div>
                                        <br>

                                        <div class="row mt-3" id="riders-lable">
                                            <div class="col-xl-3">
                                                <div class="card text-white bg-secondary mb-3">
                                                    <div class="card-header text-center font-size-14">Sum Assured<br>
                                                        <input type="hidden" name="sum_assu_amt" id="sum_assu_amt">
                                                        <div id="sum_assu_amt_1"></div>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                    </div>

                                    <div id="step_2_other_death_claim">
                                        <div class="row">
                                            <div class="col-xxl-3">
                                                <div class="mb-3">
                                                    <label for="enter_ins_comp" class="form-label">Insurance Company<span class="text-danger">*</span></label>                                                    
                                                    <select class="form-control select2-ajax" name="enter_ins_comp" id="enter_ins_comp" required></select>
                                                    <div class="invalid-feedback">This value is required.</div>
                                                </div>
                                            </div>
                                            <div class="col-xxl-3">
                                                <div class="mb-3">
                                                    <label for="enter_add_city_pin" class="form-label">Address / City / Pin<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="enter_add_city_pin" id="enter_add_city_pin" placeholder="Enter address / city / pin" autocomplete="off" required>
                                                </div>
                                            </div>
                                            <div class="col-xxl-3">
                                                <div class="mb-3">
                                                    <label for="enter_risk_from_date" class="form-label">Risk From Date<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="enter_risk_from_date" id="enter_risk_from_date" placeholder="dd-mm-yyyy" autocomplete="off" required>
                                                </div>
                                            </div>
                                            <div class="col-xxl-3">
                                                <div class="mb-3">
                                                    <label for="enter_risk_to_date" class="form-label">Risk To Date<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="enter_risk_to_date" id="enter_risk_to_date" placeholder="dd-mm-yyyy" autocomplete="off" required>
                                                </div>
                                            </div>                                                                                                                              
                                        </div>

                                        <div class="row">
                                            <div class="col-xxl-3">
                                                <div class="mb-3">
                                                    <label for="enter_segment_name" class="form-label">Segment Name<span class="text-danger">*</span></label>                                                    
                                                    <select class="form-control select2-ajax" name="enter_segment_name" id="enter_segment_name" required></select>
                                                    <div class="invalid-feedback">This value is required.</div>
                                                </div>
                                            </div>
                                            <div class="col-xxl-3">
                                                <div class="mb-3">
                                                    <label for="enter_sum_assured" class="form-label">Policy Sum Assured<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control isNumber" name="enter_sum_assured" id="enter_sum_assured" placeholder="Enter amount" autocomplete="off" required maxlength="9">
                                                </div>
                                            </div>
                                            <div class="col-xxl-3">
                                                <div class="mb-3">
                                                    <label for="enter_agency_name" class="form-label">Agency<span class="text-danger">*</span></label>                                                    
                                                    <select class="form-control select2-ajax" name="enter_agency_name" id="enter_agency_name" required></select>
                                                    <div class="invalid-feedback">This value is required.</div>
                                                </div>
                                            </div>
                                            <div class="col-xxl-3">
                                                <div class="mb-3">
                                                    <label for="enter_broker_name" class="form-label">Broker<span class="text-danger">*</span></label>                                                    
                                                    <select class="form-control select2-ajax" name="enter_broker_name" id="enter_broker_name" required></select>
                                                    <div class="invalid-feedback">This value is required.</div>
                                                </div>
                                            </div>
                                        </div>
                                   
                                        <div class="row">
                                            <div class="col-xxl-3">
                                                <div class="mb-3">
                                                    <label for="enter_sub_agent_name" class="form-label">Sub Agent<span class="text-danger">*</span></label>                                                    
                                                    <select class="form-control select2-ajax" name="enter_sub_agent_name" id="enter_sub_agent_name" required></select>
                                                    <div class="invalid-feedback">This value is required.</div>
                                                </div>
                                            </div>
                                            <div class="col-xxl-3">
                                                <div class="mb-3">
                                                    <label for="enter_mobile_num" class="form-label">Mobile No.<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control isNumber" name="enter_mobile_num" id="enter_mobile_num" placeholder="Enter mobile number" autocomplete="off" minlength="10" maxlength="10" required>
                                                </div>
                                            </div>
                                            <div class="col-xxl-3">
                                                <div class="mb-3">
                                                    <label for="enter_whatsapp_num" class="form-label">Whatsapp No.<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control isNumber" name="enter_whatsapp_num" id="enter_whatsapp_num" placeholder="Enter whatsapp number" autocomplete="off" minlength="10" maxlength="10" required>
                                                </div>
                                            </div>
                                            <div class="col-xxl-3">
                                                <div class="mb-3">
                                                    <label for="enter_contact_person" class="form-label">Contact Person Name<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="enter_contact_person" id="enter_contact_person" placeholder="Enter name" autocomplete="off" required>
                                                </div>
                                            </div>
                                        </div>
    
                                        <div class="row">
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="enter_policy_address" class="form-label">Policy Address<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="enter_policy_address" id="enter_policy_address" placeholder="Enter policy address" autocomplete="off" required>
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="enter_present_address" class="form-label">Present Address<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="enter_present_address" id="enter_present_address" placeholder="Enter present address" autocomplete="off" required>
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="enter_email_id" class="form-label">Email Id<span class="text-danger">*</span></label>
                                                    <input type="email" class="form-control" name="enter_email_id" id="enter_email_id" placeholder="Enter email" autocomplete="off" required>
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                </section>

                                <!-- Step 3 -->
                                <h3>Step 3</h3>
                                <section class="wizard-step">
                                    <div class="row">
                                        <div class="col-md-12 mt-4">
                                            <div class="card text-white bg-dark mb-3">
                                                <div class="card-header text-center font-size-13" id="claim_type_value_1_1">Mediclaim</div>
                                            </div>
                                        </div>
                                    </div>

                                    <div class="row">
                                        <div class="col-md-12 mt-4">
                                            <div class="card text-white bg-secondary mb-3" style="background-color: #c1dbff !important;color: var(--bs-blue) !important">
                                                <div class="card-header text-center font-size-13">CLAIM INTIMATION ENTRY</div>
                                            </div>
                                        </div>
                                    </div>
            
                                    <div class="row">
                                        <div class="col-xxl-6">
                                            <div class="mb-3">
                                                <label for="transaction_date" class="form-label">Transaction Date<span class="text-danger">*</span></label>
                                                <input type="text" class="form-control" name="transaction_date" id="transaction_date" value="{{date('d-m-Y')}}" required autocomplete="off">
                                            </div>
                                        </div>
                                        <div class="col-xxl-6">
                                            <div class="mb-3">
                                                <label for="claim_document_number" class="form-label">Document Number<span class="text-danger">*</span></label>
                                                <input type="text" class="form-control" name="claim_document_number" id="claim_document_number" readonly value="@php echo date('dmy'); echo mt_rand(10000,99999); @endphp" required>
                                            </div>
                                        </div>                                      
                                    </div> 

                                    <div class="row">
                                        <div class="col-xxl-4" id="holder_name">
                                            <div class="mb-3">
                                                <label for="policy_holder_name_1_1" class="form-label">Policy Holder Name</label>
                                                <input type="text" class="form-control" id="policy_holder_name_1_1" name="policy_holder_name_1_1" disabled>
                                            </div>
                                        </div>
                                        <div class="col-xxl-4" id="patient_name">
                                            <div class="mb-3">
                                                <label for="name_of_patient" class="form-label">Patient Name<span class="text-danger">*</span></label>
                                                <select class="form-control select2-ajax" id="name_of_patient" name="name_of_patient" required></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                                <div class='alert alert-info my-1 px-2 py-0 text-center' role='alert' id='general_single_mode_msg'> Selected members in policy are displayed here.</div>
                                            </div>                                                
                                        </div>
                                        <div class="col-xxl-4" id="patient_name_1">
                                            <div class="mb-3">
                                                <label for="enter_patient_name" class="form-label">Patient Name<span class="text-danger">*</span></label>
                                                <input type="text" class="form-control" name="enter_patient_name" id="enter_patient_name" placeholder="Enter patient name" autocomplete="off" required>
                                            </div>
                                            </div>
                                        <div class="col-xxl-4" id="admit_date">
                                            <div class="mb-3">
                                                <label for="date_of_admission" class="form-label">Admission Date<span class="text-danger">*</span></label>
                                                <input type="text" class="form-control" name="date_of_admission" id="date_of_admission" placeholder="dd-mm-yyyy" value="" required autocomplete="off" required>
                                            </div>
                                        </div>
                                        <div class="col-xxl-4" id="date_of_incident">
                                            <div class="mb-3">
                                                <label for="date_of_incident_1" class="form-label">Incident Date<span class="text-danger">*</span></label>
                                                <input type="text" class="form-control" name="date_of_incident_1" id="date_of_incident_1" placeholder="dd-mm-yyyy" value="" required autocomplete="off">
                                            </div>
                                        </div>
                                        <div class="col-xxl-4" id="incident_time_id_1">
                                            <div class="mb-3">
                                                <label for="incident_time_1" class="form-label">Incident Time<span class="text-danger">*</span></label>
                                                {{-- <input type="time" class="form-control" id="incident_time_1" name="incident_time_1" placeholder="hh:mm" autocomplete="off" required onclick="this.showPicker()"> --}}
                                                <input type="text" class="form-control" id="incident_time_1" name="incident_time_1" placeholder="Enter time" autocomplete="off" required>
                                            </div>
                                        </div>
                                        <div class="col-xxl-3" id="death_person_name_id">
                                            <div class="mb-3">
                                                <label for="death_person_name" class="form-label">Death Person Name<span class="text-danger">*</span></label>
                                                <input type="text" class="form-control" name="death_person_name" id="death_person_name" placeholder="Enter name" value="" required autocomplete="off">
                                            </div>
                                        </div>
                                        <div class="col-xxl-3" id="nominee_name_id">
                                            <div class="mb-3">
                                                <label for="nominee_name" class="form-label">Nominee Name<span class="text-danger">*</span></label>
                                                <select class="form-control select2-ajax" id="nominee_name" name="nominee_name" required></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>
                                        <div class="col-xxl-2" id="contact_num_id">
                                            <div class="mb-3">
                                                <label for="contact_number" class="form-label">Contact Number<span class="text-danger">*</span></label>
                                                <input type="text" class="form-control isNumber" name="contact_number" id="contact_number" placeholder="Enter contact number" value="" required maxlength="10" autocomplete="off" maxlength="10">
                                            </div>
                                        </div>
                                        <div class="col-xxl-4">
                                            <div class="mb-3">
                                                <label for="intimation_date" class="form-label">Intimation Date<span class="text-danger">*</span></label>
                                                <input type="text" class="form-control" name="intimation_date" id="intimation_date" placeholder="dd-mm-yyyy" value="" required autocomplete="off">
                                            </div>
                                        </div>
                                        <div class="col-xxl-4" id="estimated_loss_amt_id">
                                            <div class="mb-3">
                                                <label for="estimated_loss_amt" class="form-label">Estimated Loss Amount<span class="text-danger">*</span></label>
                                                <input type="text" class="form-control isNumber" name="estimated_loss_amt" id="estimated_loss_amt" placeholder="Enter amount" value="" required autocomplete="off" maxlength="9">
                                            </div>
                                        </div>                                       
                                    </div>

                                    <div id="wc_health_id">
                                        <div class="row">
                                            <div class="col-xxl-2">
                                                <div class="mb-3">
                                                    <label for="date_of_birth" class="form-label">Date Of Birth</label>
                                                    <input type="text" class="form-control" name="date_of_birth" id="date_of_birth" placeholder="dd-mm-yyyy" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-2">
                                                <div class="mb-3">
                                                    <label for="age" class="form-label">Age</label>
                                                    <input type="text" class="form-control" name="age" id="age" placeholder="Enter age" autocomplete="off" maxlength="15">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="gender" class="form-label">Gender<span class="text-danger">*</span></label>
                                                    <select class="form-control select2-ajax" name="gender" id="gender" required></select>
                                                    <div class="invalid-feedback">This value is required.</div>
                                                </div>
                                            </div>                                            
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="postal_address" class="form-label">Full Postal Address</label>
                                                    <input type="text" class="form-control" name="postal_address" id="postal_address" placeholder="Enter full address" autocomplete="off">
                                                </div>
                                            </div>
                                        </div>
                                        
                                        <div class="row">
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="job_joining_date" class="form-label">Job Joining On</label>
                                                    <input type="text" class="form-control" id="job_joining_date" name="job_joining_date" placeholder="Enter date / description" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                               <div class="mb-3">
                                                   <label for="job_description" class="form-label">Job Description</label>
                                                   <input type="text" class="form-control" id="job_description" name="job_description" placeholder="Enter description" autocomplete="off">
                                               </div>
                                           </div>                                          
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="approx_salary" class="form-label">Approx Salary</label>
                                                    <input type="text" class="form-control" id="approx_salary" name="approx_salary" placeholder="Enter salary" autocomplete="off" maxlength="10">
                                                </div>
                                            </div>
                                        </div>
                                    </div>

                                    <div id="death_details">
                                        <div class="row">
                                            <div class="col-xxl-3" id="death_date_id">
                                                <div class="mb-3">
                                                    <label for="death_date" class="form-label">Death Date<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="death_date" id="death_date" placeholder="dd-mm-yyyy" value="" required autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-3" id="death_type_id">
                                                <div class="mb-3">
                                                    <label for="death_type" class="form-label">Death Type<span class="text-danger">*</span></label>
                                                    <select class="form-control select2-ajax" id="death_type" name="death_type" required></select>
                                                    <div class="invalid-feedback">This value is required.</div>
                                                </div>
                                            </div>
                                            <div class="col-xxl-3" id="death_reason_id">
                                                <div class="mb-3">
                                                    <label for="death_reason" class="form-label">Reason Of Death<span class="text-danger">*</span></label>
                                                    <select class="form-control select2-ajax" id="death_reason" name="death_reason" required></select>
                                                    <div class="invalid-feedback">This value is required.</div>
                                                </div>
                                            </div>
                                            <div class="col-xxl-4" id="acci_place_id">
                                                <div class="mb-3">
                                                    <label class="form-label desti_incident" for="destination_of_accident">Destination Of Accident</label>
                                                    <input type="text" class="form-control" id="destination_of_accident" name="destination_of_accident" placeholder="Enter detail (address + city with pincode)" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-3" id="illness_id">
                                                <div class="mb-3">
                                                    <label for="illness_name" class="form-label">Illness Name</label>
                                                    <input type="text" class="form-control" name="illness_name" id="illness_name" placeholder="Enter name" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-3" id="dsd_id">
                                                <div class="mb-3">
                                                    <label for="death_short_detail" class="form-label short-detail">Death Short Detail</label>
                                                    <input type="text" class="form-control" name="death_short_detail" id="death_short_detail" placeholder="Enter details" maxlength="160" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4" id="intimated_to_id">
                                                <div class="mb-3">
                                                    <label for="intimated_to" class="form-label">Intimated To</label>
                                                    <select class="form-control select2-ajax" name="intimated_to[]" id="intimated_to" multiple>
                                                        <option value="">Search</option>
                                                        <option value="Police_station">Police Station</option>
                                                        <option value="Fire Station">Fire Station</option>
                                                    </select>
                                                </div>
                                            </div>
                                            <div class="col-xxl-3" id="fp_name_id">
                                                <div class="mb-3">
                                                    <label for="firm_person_name" class="form-label">Firm / Person Name</label>
                                                    <input type="text" name="firm_person_name" id="firm_person_name" class="form-control" placeholder="Enter name" autocomplete="off" disabled>
                                                </div>
                                            </div>
                                            <div class="col-xxl-3" id="hospital_name_add_id">
                                                <div class="mb-3">
                                                    <label for="hospital_name_address" class="form-label">Hospital Name / Address</label>
                                                    <input type="text" class="form-control" name="hospital_name_address" id="hospital_name_address" placeholder="Enter detail (if hospitalise)" value="" maxlength="160" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-3" id="dod_id">
                                                <div class="mb-3">
                                                    <label for="death_destination" class="form-label">Destination Of Death</label>
                                                    <input type="text" class="form-control" name="death_destination" id="death_destination" placeholder="Enter detail (address + city with pincode)" value="" maxlength="160" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-3" id="ps_name_id">
                                                <div class="mb-3">
                                                    <label for="police_station_name" class="form-label">Police Station Name</label>
                                                    <input type="text" class="form-control" name="police_station_name" id="police_station_name" placeholder="Enter detail (address + city with pincode)" value="" maxlength="160" autocomplete="off">
                                                </div>
                                            </div>
                                        </div>

                                        <div id="add_multiple_death_row"></div>
                                    </div>
            
                                    <div id="general_1">
                                        <div id="general_hospital_detail_id">
                                            <div class="row">
                                                <div class="col-xxl-4">
                                                    <div class="mb-3">
                                                        <label for="hospital_name" class="form-label">Hospital Name<span class="text-danger">*</span></label>
                                                        <input type="text" class="form-control" name="hospital_name" id="hospital_name" placeholder="Enter hospital name" value="" required autocomplete="off">
                                                        <div id="hospitalNameList">
                                                            <ul id="hospitalNameListId" class="list-unstyled dropdownlist"></ul>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="col-xxl-4">
                                                    <div class="row">
                                                        <div class="col-xxl-6">
                                                            <div class="mb-3">
                                                                <label for="hospital_contact_number" class="form-label">Hospital Contact No.</label>
                                                                <input type="text" class="form-control isNumber" name="hospital_contact_number" id="hospital_contact_number" placeholder="Enter contact number" value="" minlength="10" maxlength="10" autocomplete="off">
                                                            </div>
                                                        </div>   
                                                        <div class="col-xxl-6">
                                                            <div class="mb-3">
                                                                <label for="landline_number" class="form-label">Land Line / Toll Free No.</label>
                                                                <input type="text" class="form-control" name="landline_number" id="landline_number" placeholder="Enter number" value="" minlength="7" maxlength="20" autocomplete="off">
                                                            </div>
                                                        </div>   
                                                    </div>
                                                </div>
                                                <div class="col-xxl-4">
                                                    <div class="mb-3">
                                                        <label for="reason_for_hosptalise" class="form-label">Hospitalized Reason<span class="text-danger">*</span></label>
                                                        <input type="text" class="form-control" name="reason_for_hosptalise" id="reason_for_hosptalise" placeholder="Enter reason for hospitalized" value="" required maxlength="250" autocomplete="off">
                                                        <div id="hospitaliseReasonList">
                                                            <ul id="hospitaliseReasonListId" class="list-unstyled dropdownlist"></ul>
                                                        </div>
                                                    </div>
                                                </div>                                                                           
                                            </div>
                    
                                            <div class="row">
                                                <div class="col-xxl-4">
                                                    <div class="mb-3">
                                                        <label for="hospital_address" class="form-label">Hospital Address<span class="text-danger">*</span></label>
                                                        <input type="text" class="form-control" name="hospital_address" id="hospital_address" placeholder="Enter hospital address" value="" required autocomplete="off">
                                                        <div id="hospitalAddressList">
                                                            <ul id="hospitalAddressListId" class="list-unstyled dropdownlist"></ul>
                                                        </div>
                                                    </div>
                                                </div>
                                                <div class="col-xxl-4">
                                                    <div class="mb-3">
                                                        <label for="estimated_stay_days" class="form-label">Estimated Stay Days</label>
                                                        <input type="text" class="form-control isNumber" name="estimated_stay_days" id="estimated_stay_days" placeholder="Enter estimated days" value="" autocomplete="off" maxlength="3">
                                                    </div>
                                                </div>
                                                <div class="col-xxl-4">
                                                    <div class="mb-3">
                                                        <label for="estimated_expense" class="form-label">Estimated Expense</label>
                                                        <input type="text" class="form-control isNumber" name="estimated_expense" id="estimated_expense" placeholder="Enter estimated expense" value="" autocomplete="off" maxlength="7">
                                                    </div>
                                                </div>                                                    
                                            </div>
                                        </div>
                                    
                                        <div class="row" id="life_health_claim_1">
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="mediclaim_ins_comp_name" class="form-label">Mediclaim Insurance Company Name</label>
                                                    <input type="text" class="form-control" name="mediclaim_ins_comp_name" id="mediclaim_ins_comp_name" placeholder="Enter mediclaim insurance company name" value="" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="mediclaim_policy_number" class="form-label">Mediclaim Policy Number</label>
                                                    <input type="text" class="form-control" name="mediclaim_policy_number" id="mediclaim_policy_number" placeholder="Enter mediclaim policy number" value="" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="mediclaim_sum_assured" class="form-label">Mediclaim Sum Assured</label>
                                                    <input type="text" class="form-control isNumber" name="mediclaim_sum_assured" id="mediclaim_sum_assured" placeholder="Enter mediclaim sum assured" value="" autocomplete="off" maxlength="7">
                                                </div>
                                            </div>      
                                        </div>      

                                        <div class="row" id="wc_medi_claim_1">
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="detail_of_incident" class="form-label">Short Detail Of Incident<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="detail_of_incident" id="detail_of_incident" required placeholder="Enter detail" maxlength="160" value="" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="incident_address" class="form-label">Incident Address<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="incident_address" id="incident_address" required placeholder="Enter incident address" value="" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4" id="incident_contact_num_id">
                                                <div class="mb-3">
                                                    <label for="incident_contact_num" class="form-label">Incident Contact No.<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control isNumber" name="incident_contact_num" id="incident_contact_num" maxlength="10" required placeholder="Enter incident contact number" value="" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-2" id="incident_date_id">
                                                <div class="mb-3">
                                                    <label for="incident_date" class="form-label">Incident Date<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="incident_date" id="incident_date" required placeholder="dd-mm-yyyy" value="" autocomplete="off">
                                                </div>
                                            </div>     
                                            <div class="col-xxl-2" id="incident_time_id">
                                                <div class="mb-3">
                                                    <label for="incident_time" class="form-label">Incident Time</label>
                                                    {{-- <input type="time" class="form-control" name="incident_time" id="incident_time" required placeholder="H:I:S" value="" autocomplete="off" onclick="this.showPicker()"> --}}
                                                    <input type="text" class="form-control" id="incident_time" name="incident_time" placeholder="Enter time" autocomplete="off">
                                                </div>
                                            </div>     
                                        </div>
                                    </div>

                                    <div class="row" id="others_claim_incident_fields">
                                        <div class="col-xxl-4">
                                            <div class="mb-3">
                                                <label for="reason_of_incident" class="form-label">Reason Of Incident<span class="text-danger">*</span></label>
                                                <select class="form-control select2-ajax" name="reason_of_incident" id="reason_of_incident" required>
                                                    <option value=""></option>
                                                    <option value="Short Circuit">Short Circuit</option>
                                                    <option value="Accident">Accident</option>
                                                    <option value="Fire">Fire</option>
                                                    <option value="Earthquake">Earthquake</option>
                                                    <option value="Flood">Flood</option>
                                                    <option value="Calastial Lightning">Calastial Lightning</option>
                                                    <option value="Riot">Riot</option>
                                                    <option value="Fall From Above">Fall From Above</option>
                                                    <option value="To Fall Upon Oneself">To Fall Upon Oneself</option>
                                                    <option value="Others">Others</option>
                                                </select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>
                                        <div class="col-xxl-4">
                                            <div class="mb-3">
                                                <label for="intimated_to_police" class="form-label">Intimation To Police Station<span class="text-danger">*</span></label>
                                                <select class="form-control select2-ajax" name="intimated_to_police" id="intimated_to_police" required>
                                                    <option value=""></option>
                                                    <option value="Short Circuit">Yes</option>
                                                    <option value="Accident">No</option>
                                                    <option value="Fire">Not Need</option>
                                                    <option value="Earthquake">On Site</option>
                                                </select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>
                                        <div class="col-xxl-4">
                                            <div class="mb-3">
                                                <label for="intimated_to_fire" class="form-label">Intimation To Fire Station<span class="text-danger">*</span></label>
                                                <select class="form-control select2-ajax" name="intimated_to_fire" id="intimated_to_fire" required>
                                                    <option value=""></option>
                                                    <option value="Short Circuit">Yes</option>
                                                    <option value="Accident">No</option>
                                                    <option value="Fire">Not Need</option>
                                                    <option value="Earthquake">On Site</option>
                                                </select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>
                                    </div>

                                    <div id="general_vehicle">
                                        <div class="row" id="general_vehicle_1">
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="garage_name" class="form-label">Garage Name</label>
                                                    <input type="text" class="form-control" name="garage_name" id="garage_name" placeholder="Enter garage name" value="" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="garage_address" class="form-label">Garage Address</label>
                                                    <input type="text" class="form-control" name="garage_address" id="garage_address" placeholder="Enter garage address" value="" maxlength="250" autocomplete="off">
                                                </div>
                                            </div>  
                                            <div class="col-xxl-2">
                                                <div class="mb-3">
                                                    <label for="garage_contact_number" class="form-label">Garage Contact Number</label>
                                                    <input type="text" class="form-control isNumber" name="garage_contact_number" id="garage_contact_number" placeholder="Enter contact number" value="" minlength="10" maxlength="10" autocomplete="off">
                                                </div>
                                            </div>   
                                            <div class="col-xxl-2">
                                                <div class="mb-3">
                                                    <label for="estimated_expense_1" class="form-label">Estimated Expense</label>
                                                    <input type="text" class="form-control isNumber" name="estimated_expense_1" id="estimated_expense_1" placeholder="Enter expense" value="" maxlength="7" autocomplete="off">
                                                </div>
                                            </div>                                                                           
                                        </div>

                                        <div class="row" id="general_vehicle_2">
                                            <div class="col-xxl-2">
                                                <div class="mb-3">
                                                    <label for="driving_by" class="form-label">Vehicle Driving By<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="driving_by" id="driving_by" placeholder="Enter driver name" required value="" autocomplete="off">
                                                </div>
                                            </div>
                                            <div class="col-xxl-2">
                                                <div class="mb-3">
                                                    <label for="relation" class="form-label">Relation<span class="text-danger">*</span></label>
                                                    <select class="form-control select2-ajax" id="relation" name="relation" required></select>
                                                    <div class="invalid-feedback">This value is required.</div>
                                                </div>
                                            </div>
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="incident_short_detail" class="form-label">Incident Short Detail<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="incident_short_detail" id="incident_short_detail" required placeholder="Enter detail" value="" maxlength="160" autocomplete="off">
                                                </div>
                                            </div>   
                                            <div class="col-xxl-4">
                                                <div class="mb-3">
                                                    <label for="damage_short_details" class="form-label">Damage Short Detail<span class="text-danger">*</span></label>
                                                    <input type="text" class="form-control" name="damage_short_details" id="damage_short_details" required placeholder="Enter detail" value="" maxlength="160" autocomplete="off">
                                                </div>
                                            </div>  
                                        </div>
                                    </div>

                                    @if($data['multiple_claim'] == 1 || $data['data']['claim_parent_id'] != 0)
                                        <div class="row">
                                            <div class="col-xl-4 text-center">
                                                <div class="mb-3">
                                                    <label for="yes" class="form-label">Claim Settled</label>
                                                    <div class="form-check d-flex justify-content-center">
                                                        <div class="form-check-inline">
                                                            <input class="form-check-inline form-check-input" type="radio" name="claim_settled" id="yes" value="Yes" checked>
                                                            <label for="yes" class="form-check-label me-5">Yes</label>
                                                        </div>
                                                        
                                                        <div class="form-check-inline">
                                                            <input class="form-check-inline form-check-input" type="radio" name="claim_settled" id="no" value="No">
                                                            <label for="no" class="form-check-label">No</label>
                                                        </div>
                                                    </div>
                                                </div>
                                            </div>

                                            <div class="col-xl-4">
                                                <div class="mb-3">
                                                    <label for="claim_settled_date" class="form-label">Claim Settled Date<span class="text-danger claim-settled">*</span></label>
                                                    <input type="text" class="form-control" name="claim_settled_date" id="claim_settled_date" placeholder="dd-mm-yyyy" autocomplete="off" required>
                                                </div>
                                            </div>
                                            
                                            <div class="col-xl-4">
                                                <div class="mb-3">
                                                    <label for="claim_settled_amt" class="form-label">Claim Settled Amount<span class="text-danger claim-settled">*</span></label>
                                                    <input type="text" class="form-control isNumber" name="claim_settled_amt" id="claim_settled_amt" placeholder="Enter amount" autocomplete="off" required maxlength="12">
                                                </div>
                                            </div>
                                        </div>

                                    @endif

                                    <div class="row">
                                        <div class="col-xxl-12">
                                            <div class="mb-3">
                                                <label class="form-label" for="call">Intimated Through<span class="text-danger claim-settled">*</span></label>
                                                <div class="form-check">
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="checkbox" name="intimated_through[]" id="email" value="Email" checked>
                                                        <label class="form-check-label me-5" for="email">Email</label>
                                                    </div>
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="checkbox" name="intimated_through[]" id="online" value="Online">
                                                        <label class="form-check-label me-5" for="online">Online</label>
                                                    </div>
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="checkbox" name="intimated_through[]" id="call" value="Call">
                                                        <label class="form-check-label me-5" for="call">Call Center</label>
                                                    </div>
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="checkbox" name="intimated_through[]" id="whatsapp" value="Whatsapp">
                                                        <label class="form-check-label me-5" for="whatsapp">Whatsapp</label>
                                                    </div>
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="checkbox" name="intimated_through[]" id="others" value="Others">
                                                        <label class="form-check-label me-5" for="others">Others</label>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                    </div>

                                    <div class="row email-require">
                                        <div class="col-xxl-2">
                                            <div class="mb-3">
                                                <label class="form-label" for="direct_company">Intimation To…</label>
                                                <div class="form-check">
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="checkbox" name="intimation_to[]" id="direct_company" value="Direct Company" checked required>
                                                        <label class="form-check-label" for="direct_company">Direct Company</label>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="col-xxl-4">
                                            <div class="mb-3" style="margin-top: 0.6rem!important;">
                                                <select class="form-control select2-ajax" id="direct_company_name" name="direct_company_name"></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>  
                                        <div class="col-xxl-4">
                                            <div class="mb-3" style="margin-top: 0.6rem!important;">
                                                <select class="form-control select2-ajax" id="direct_company_email" name="direct_company_email[]" multiple></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>   
                                        <div class="col-xxl-2">
                                            <div class="mb-3">
                                                <a href="javascript:void(0);" onclick="return addEmail(1);" class="btn btn-primary px-4 form-control mt-2"><span>Add Email</span></a>
                                            </div>
                                        </div>
                                    </div>

                                    <div class="row" id="tpaHide">
                                        <div class="col-xxl-2">
                                            <div class="mb-3">
                                                <div class="form-check">
                                                    <div class="form-check-inline">
                                                        <input class="form-check-inline form-check-input" type="checkbox" name="intimation_to[]" id="tpa_company" value="TPA Company" required>
                                                        <label class="form-check-label" for="tpa_company">TPA Company</label>
                                                        <div class="invalid-feedback">Please select atleast one of this checkbox.</div>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>  
                                        <div class="col-xxl-4">
                                            <div class="mb-3" >
                                                <select class="form-control select2-ajax" id="tpa_company_name" name="tpa_company_name"></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>  
                                        <div class="col-xxl-4">
                                            <div class="mb-3" >
                                                <select class="form-control select2-ajax" id="tpa_company_email" name="tpa_company_email[]" multiple></select>
                                                <div class="invalid-feedback">This value is required.</div>
                                            </div>
                                        </div>   
                                        <div class="col-xxl-2">
                                            <div class="mb-3">
                                                <a href="javascript:void(0);" onclick="return addEmail(2);" class="btn btn-primary px-4 form-control"><span>Add Email</span></a>
                                            </div>
                                        </div>
                                    </div>
                                    
                                    <div class="row">
                                        <div class="col-xxl-4">
                                            <div class="mb-3">
                                                <label for="intimated_by_name" class="form-label">Intimated By</label>
                                                <input type="text" class="form-control" name="intimated_by_name" id="intimated_by_name" placeholder="Enter name" value="" autocomplete="off">
                                            </div>
                                        </div>
                                        <div class="col-xxl-4" id="intimated_by_id">
                                            <div class="mb-3 text-center">
                                                <label class="form-label" for="intimated_agent" style="margin-bottom: 15px;">&nbsp;&nbsp;&nbsp;</label>
                                                <div class="form-check d-flex justify-content-center">
                                                    <div class="form-check-inline me-3">
                                                        <input class="form-check-inline form-check-input" type="radio" name="intimated_by_relation" id="intimated_agent" value="Agent" checked>
                                                        <label class="form-check-label me-3" for="intimated_agent">Agent</label>
                                                    </div>
                                                    <div class="form-check-inline me-3">
                                                        <input class="form-check-inline form-check-input" type="radio" name="intimated_by_relation" id="office_staff" value="Office Staff">
                                                        <label class="form-check-label me-3" for="office_staff">Office Staff</label>
                                                    </div>
                                                    <div class="form-check-inline me-3">
                                                        <input class="form-check-inline form-check-input" type="radio" name="intimated_by_relation" id="intimated_policy_holder" value="Policy Holder">
                                                        <label class="form-check-label me-3" for="intimated_policy_holder">Policy Holder</label>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>
                                        <div class="col-xxl-4">
                                            <div class="mb-3">
                                                <label for="policy_holder_contact_number" class="form-label">Policy Holder Contact Number</label>
                                                <input type="text" class="form-control" name="policy_holder_contact_number" id="policy_holder_contact_number" disabled value="" placeholder="Contact number" autocomplete="off">
                                            </div>
                                        </div>                                        
                                    </div>

                                    <div class="row">
                                        <div class="col-xxl-12">
                                            <div class="mb-3">
                                                <label for="remarks" class="form-label">Remarks</label>
                                                <input type="text" class="form-control" name="remarks" id="remarks" value="" placeholder="Enter remarks" maxlength="160" autocomplete="off">
                                            </div>
                                        </div>
                                    </div>                                
                                </section>

                                <!-- Step 4 -->
                                <h3>Step 4</h3>
                                <section class="wizard-step">

                                    <div class="row mb-3 ">
                                        <div class="col d-flex justify-content-end">
                                            <button type="button"
                                                class="btn btn-primary" style="padding-inline : 1.5rem !important"
                                                id="add_doc_row"
                                                onclick="AddNewRowDocumentUpload()">
                                                Add Row
                                            </button>
                                        </div>
                                    </div>

                                    <div id="add_new_row"></div>
                                </section>
                            </div>
                        </form>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>

<div class="modal fade" id="modalAddEmail" data-bs-backdrop="static" data-bs-keyboard="false" tabindex="-1" role="dialog" aria-labelledby="modalAddEmailLabel" aria-hidden="true">
    <div class="modal-dialog modal-dialog-centered modal-lg" role="document">
        <div class="modal-content">
            <div class="modal-header">
                <h5 class="modal-title" id="modalAddEmailLabel">Insurance Company Email</h5>
                <button type="button" class="btn-close" data-bs-dismiss="modal" aria-label="Close"></button>
            </div>

            <form id="formAddEmail" method="POST" class="needs-validation" novalidate>
                <div class="modal-body pb-1">
                    @csrf
                    <input type="hidden" class="form-control" id="company_id" name="company_id">

                    <div class="row">
                        <div class="col-md-6">
                            <div class="mb-3">
                                <label for="email_status" class="form-label">Status<span class="text-danger">*</span></label>
                                <select class="form-control select2-ajax" id="email_status" name="email_status" required>
                                    <option value=""></option>
                                    <option value="Inquiry">Inquiry</option>
                                    <option value="Claim Inquiry">Claim Inquiry</option>
                                    <option value="Claim Intimation">Claim Intimation</option>
                                </select>
                                <div class="invalid-feedback">This value is required.</div>
                            </div>
                        </div>
                        <div class="col-md-6">
                            <div class="mb-3">
                                <label for="insurance_company_email" class="form-label">Company Email<span class="text-danger">*</span></label>
                                <input type="text" class="form-control" id="insurance_company_email" name="insurance_company_email" placeholder="Enter company email" value="" required autocomplete="off">
                            </div>
                        </div>
                    </div>
                </div>

                <div class="modal-footer">
                    <button type="button" class="btn btn-light" data-bs-dismiss="modal">Close</button>
                    <button type="button" class="btn btn-primary px-3" id="ins_comp_email_id" onClick='return SaveComEmail();'>Save</button>
                </div>
            </form>
        </div>
    </div>
</div>

<!-- Send Mail Modal -->
<div class="modal fade" id="sendMailModal" data-bs-backdrop="static" data-bs-keyboard="false" tabindex="-1" role="dialog" aria-labelledby="sendMailModalLable" aria-hidden="true">
    <div class="modal-dialog modal-dialog-centered modal-xl mx-auto" role="document">
        <div class="modal-content">
            <div class="modal-header">
                <h5 class="modal-title" id="sendMailModalLable">E-Mail Contain</h5>
                <button type="button" class="btn-close" data-bs-dismiss="modal" aria-label="Close"></button>
            </div>

            <div class="modal-body">
                <div class="row">
                    <div id="sendMailContain"></div>
                </div>
            </div>

            <div class="modal-footer">
                <button type="button" class="btn btn-light" data-bs-dismiss="modal">Close</button>
                <button type="button" id="btnevent" class="btn btn-primary px-4" onclick="return sendMail();">Send Email</button>
            </div>
        </div>
    </div>
</div>
<!-- End modal -->

<!-- add branch -->
<div class="modal fade" id="modalBranch" data-bs-backdrop="static" data-bs-keyboard="false" tabindex="-1" role="dialog" aria-labelledby="modalBranchLabel" aria-hidden="true">
    <div class="modal-dialog modal-dialog-centered modal-lg" role="document">
        <div class="modal-content">
            <div class="modal-header">
                <h5 class="modal-title" id="modalBranchLabel">Branch</h5>
                <button type="button" class="btn-close" data-bs-dismiss="modal" aria-label="Close"></button>
            </div>

            <form id="formBranch" action="{{ route('master.branch.save') }}" method="POST" class="needs-validation" novalidate>
                <div class="modal-body pb-1">
                    @csrf
                    <div class="row">
                        <div class="col-md-12">
                            <div class="mb-3">
                                <label for="branch_name" class="form-label">Branch Name<span class="text-danger">*</span></label>
                                <input type="text" class="form-control" id="branch_name" name="branch_name" placeholder="Branch name" value="" required autocomplete="off">
                            </div>
                        </div>
                    </div>
                </div>

                <div class="modal-footer">
                    @if(getActualExpirationDate() >= date('Y-m-d H:i:s'))
                        <button type="button" class="btn btn-light" data-bs-dismiss="modal">Close</button>
                        <button type="submit" class="btn btn-primary px-3">Save</button>
                    @else
                        <p class="text-center text-danger font-size-14 fw-bold m-0 ">Your current plan has expired. To resume disabled operations, you have the option to renew your existing plan or upgrade to a new one. Simply visit our 'Renew' or 'Upgrade' tab to proceed.</p>
                    @endif
                </div>
            </form>
        </div>
    </div>
</div>
<!-- add branch end-->

@include('../reachassuree_agent/client/document_upload/restore_doc_modal')
@endsection


@section('custom-scripts')

<script src="{{ asset('assets/libs/moment/min/moment.min.js')}}"></script>
<script src="{{ asset('assets/libs/parsleyjs/parsley.min.js') }}"></script>
<script src="{{ asset('assets/js/pages/kendo.all.min.js') }}"></script>
<script src="{{ asset('assets/js/pages/form-validation.init.js') }}?v=2"></script>
<script src="{{ asset('assets/js/pages/jquery.form.js') }}"></script>

<!-- jquery step -->
<script src="{{ asset('assets/libs/jquery-steps/build/jquery.steps.min.js') }}"></script>
<!-- form wizard init -->
<script src="{{ asset('assets/js/pages/form-wizard.init.js') }}"></script>

<script type="text/javascript">
    var saveIntimation = "{{route('intimation.save')}}";
    var saveCompanyEmail = "{{route('master.insurance.company.email.save')}}";
    var ajaxSearchClaimTypes = "{{route('master.search.claim.types')}}";    
    var ajaxSearchDeathClaimTypes = "{{route('master.search.death.claim.types')}}";
    var ajaxSearchPolicyHolderName="{{route('search.policy.holder.name')}}";
    var ajaxSearchPolicyNumber = "{{route('search.policy.number')}}";
    var ajaxClientDetail = "{{route('client.policy.detail')}}"; 
    var ajaxPolicyDetails = "{{route('client.policy.detail.death')}}";       
    var ajaxSearchPatientName="{{route('search.patient.name')}}";
    var ajaxSearchRelation="{{route('search.relation')}}";
    var ajaxSearchInsCompanyName="{{route('search.insurance.company')}}";
    var ajaxSearchInsCompanyEmail="{{route('search.insurance.company.email')}}";
    var ajaxSearchBranch = "{{route('search.branch')}}";
    var ajaxSearchVehicleNum = "{{route('search.vehicle.number')}}";
    var ajaxSearchFamilyMember = "{{ route('search.nominee') }}";
    var ajaxSearchDeathType = "{{route('search.death.type')}}";
    var ajaxSearchDeathReason = "{{route('search.death.reason')}}";
    var ajaxSearchSegment = "{{route('search.segment')}}";
    var ajaxSearchBroker = "{{route('search.broker')}}";
    var ajaxSearchAgency = "{{route('search.agency')}}";
    var ajaxSearchSubAgent = "{{route('search.sub.agent')}}";
    var ajaxSearchDocumentType = "{{route('search.document.type')}}";
    var ajaxSearchDocumentName = "{{route('search.document.name')}}";
    var ajaxSearchGender = "{{route('search.gender')}}";
    var downloadIntimationPdf = "{{route('download.intimation.pdf')}}";
    var canEdit = "{{$data['can_edit']}}";
    var multipleClaim = "{{$data['multiple_claim']}}";
    var currentDate = new Date();
    var Counter = 1;
    var rowCounter = 1;
    var risk_from_date , risk_to_date;
    var authType = "{{ Auth::user()->type }}";
    var accumulatedAmounts = {};  
    var ajaxCheckDeletedDocument = "{{ route('check.deleted.document') }}";
    var ajaxPermanentlyDeleteDocument = "{{ route('permanent.delete.document') }}";
    var downloadRouteTemplate = "{{ route('download.client.document') }}";
    var ajaxRestoreDocument = "{{ route('restore.document') }}";

    var CURRENT_DEPARTMENT = 'ClaimIntimation';
    var ajaxCheckDeletedClaimDocument = "{{ route('check.deleted.claim.document') }}";
    var ajaxPermanentlyDeleteClaimDocument = "{{ route('permanent.delete.claim.document') }}";
    var ajaxRestoreClaimDocument = "{{ route('restore.claim.document') }}";
    var ajaxDeleteClaimDocument = "{{ route('delete.claim.document') }}";
    var clientDocuments = [];  // Documents from client
    var claimDocuments = [];   // Documents from existing claim


    // Configuration
    const CONFIG = {
        maxRows: 29,
        alwaysHiddenTypeIds: [], // Always hidden
        conditionalHiddenTypeIds: [6],
        container: '#add_new_row',
        addButton: '#add_doc_row'
    };

    // Check if row should be hidden
    function shouldHideRow(doc) {
        if (!doc) return false;
        if (doc.is_deleted) return true;
        
        const typeId = doc.document_type_id;
        
        // Always hide type 3
        if (CONFIG.alwaysHiddenTypeIds.includes(typeId)) return true;

        // Type 6 (Vehicle docs): hide unless it's a vehicle claim
        if (CONFIG.conditionalHiddenTypeIds.includes(typeId)) {
            const claimType = $("input[type=radio][name=type_1]:checked").val();
            return claimType !== 'Vehicle Claim';
        }
        
        return false;
    }

    function shouldHideByVehicle(doc, currentVehicleNo) {
        if (!doc) return false;
        const typeId = doc.document_type_id;
        const isVehicleDoc = CONFIG.conditionalHiddenTypeIds.includes(typeId);
        
        if (!isVehicleDoc) return false;
        
        // If document has no vehicle_no, hide it
        if (!doc.vehicle_no || doc.vehicle_no.toString().trim() === '') {
            return true;
        }
        
        // No vehicle selected in form → hide all vehicle docs
        if (!currentVehicleNo || currentVehicleNo.trim() === '') {
            return true;
        }
        
        // Compare vehicle numbers (normalized)
        const docVehicle = String(doc.vehicle_no)
            .replace(/[\s\-]/g, '')
            .toUpperCase()
            .trim();
        
        const currentVehicle = String(currentVehicleNo)
            .replace(/[\s\-]/g, '')
            .toUpperCase()
            .trim();
        
        // Hide if vehicle numbers don't match
        return docVehicle !== currentVehicle;
    }

    // Row template
    function rowTemplate(i, doc = null) {
        const isHidden = shouldHideRow(doc) ? 'd-none' : '';

        // Determine document type for new rows
        let docType = '';
        if (doc) {
            docType = doc.type; // Use existing type if available
        } else {
            // For new rows, we'll determine this dynamically when user selects
            docType = 'client_doc'; // Default
        }
        
        const downloadLink = doc?.name ? 
            `<a href="javascript:void(0)" data-document-name="${doc.name}" data-doc-type="${doc.type}" data-client-id="${doc.type == "client_doc" ? doc.client_id : null }" data-claim-number="${doc.type == "claim_doc" ? doc.id : null}" data-download-doc-num="${doc.type == "claim_doc" ? doc.download_document_number : null}"
                class="download-client-document-btn text text-primary ms-2">Download</a>` : '';

        return `
            <div class="row row-item-document ${isHidden}" data-row-index="${i}" data-doc-type="${docType}">
                ${doc ? `
                    <input type="hidden" name="hidden_doc_id_${i}" value="${doc.id}">
                    <input type="hidden" name="original_claim_id_${i}" value="${doc.original_claim_id || doc.claim_intimation_id}">
                    <input type="hidden" name="department_${i}" value="${doc.department ?? null}">
                ` : `
                    <input type="hidden" name="department_${i}" value="${CURRENT_DEPARTMENT}">
                `}
                
                <div class="col-xxl-3 col-xl-6">
                    <div class="mb-3">
                        <label class="form-label">Document Type</label>
                        <select class="form-control select2-ajax" id="claim_document_type_${i}" name="claim_document_type_${i}"></select>
                    </div>
                </div>
                <div class="col-xxl-3 col-xl-6">
                    <div class="mb-3">
                        <label class="form-label">Document Name</label>
                        <select class="form-control select2-ajax document_name_row" id="claim_document_name_${i}" name="claim_document_name_${i}"></select>
                    </div>
                </div>
                <div class="col-xxl-3 col-xl-6">
                    <div class="mb-3">
                        <label class="form-label">
                            Upload Document
                            <span style="font-size:12px;color:#808080bd;">(JPG, PNG, JPEG or PDF)</span>
                        </label>
                        ${downloadLink}
                        <input type="file" class="form-control" name="document_name_${i}[]" multiple
                            id="document_name_${i}" accept="image/jpeg,image/png,application/pdf">
                    </div>
                </div>
                <div class="col-xxl-2 col-xl-6">
                    <div class="mb-3">
                        <label class="form-label">Nos</label>
                        <input type="text" class="form-control" name="nos_${i}" id="nos_${i}"
                            value="${doc?.document_number ?? ''}" placeholder="Enter nos">
                    </div>
                </div>
                <div class="col-xxl-1 justify-content-md-end">
                    <div class="mt-2">
                        <label class="form-label"></label>
                        <button type="button" class="btn btn-danger form-control docRemove" 
                            onclick="removeRowDocs(this)" data-document-id="${doc?.id ?? ''}" data-doc-type="${docType}">
                            Remove
                        </button>
                    </div>
                </div>
            </div>
        `;
    }

    // Get visible rows helper
    function getVisibleRows() {
        return $(`${CONFIG.container} .row-item-document`).not('.d-none');
    }

    // Get next row index
    function getNextRowIndex() {
        let maxIndex = 0;
        $(`${CONFIG.container} .row-item-document`).each(function() {
            const idx = parseInt($(this).attr('data-row-index')) || 0;
            if (idx > maxIndex) maxIndex = idx;
        });
        return maxIndex + 1;
    }

    // Initialize row (select2, events)
    function initializeRow(index, doc = null) {
        const clientId = $("#policy_holder_name_id_hidden").val();
        const claimId = $("#id").val();
        const $row = $(`div.row-item-document[data-row-index="${index}"]`);

        $row.data('doc', doc);
        
        // Set select2 values if doc exists
        if (doc) {
            $(`#claim_document_type_${index}`)
                .append(new Option(doc.document_type, doc.document_type_id, true, true))
                .trigger('change');
            $(`#claim_document_name_${index}`)
                .append(new Option(doc.document_name, doc.document_name_id, true, true))
                .trigger('change');
            
            // ⭐ CRITICAL: Store original values as data attributes
            $row.data({
                originalType: String(doc.document_type_id), // Convert to string for comparison
                originalName: String(doc.document_name_id)  // Convert to string for comparison
            });
        }

        // Add event listener to update doc-type when document type changes
        $(`#claim_document_type_${index}`).on('change', function() {
            const selectedTypeId = $(this).val();
            const isClaimDoc = (selectedTypeId == 3);
            const docType = isClaimDoc ? 'claim_doc' : 'client_doc';
            
            // Update the data attribute on the row
            $row.data('doc-type', docType);
            
            // Update the remove button's data attribute
            $row.find('.firstRemove').data('doc-type', docType);
        });
        
        DocumentSelect2(index, clientId, 'claim_document_', claimId);
            
        // Capitalize nos field
        $(`#nos_${index}`).on('input', function() {
            $(this).val(capitalizeString($(this).val()));
        });
    }

    // Add row
    function addRow(doc = null) {
        if (getVisibleRows().length >= CONFIG.maxRows) {
            $(CONFIG.addButton).prop('disabled', true);
            return;
        }
        
        rowCounter = getNextRowIndex();
        $(CONFIG.container).append(rowTemplate(rowCounter, doc));
        initializeRow(rowCounter, doc);
        updateRowControls();
    }

    // Alias for backward compatibility
    function AddNewRowDocumentUpload() {
        addRow();
    }

    // Remove row
    function removeRowDocs(button) {
        const $row = $(button).closest(".row-item-document");
        const docId = $(button).data('document-id');
        const type = $(button).data('doc-type');

        // Helper to handle removal
        const performRemoval = () => {
            $row.addClass("d-none").attr("data-deleted", "1");
            if (getVisibleRows().length === 0) addRow();
            else updateRowControls();
        };

        // If existing document, confirm deletion via AJAX
        if (docId) {
            Swal.fire({
                title: "Are you sure want to delete this?",
                text: "It will be moved to Trash and can be restored later.",
                showCancelButton: true,
                confirmButtonColor: "#526BDF",
                cancelButtonColor: "#EC6767",
                confirmButtonText: "Yes, delete it!",
                cancelButtonText: "No, cancel it!"
            }).then((result) => {
                if (!result.isConfirmed) return;
                
                showLoader();
                ajaxUrl = type == "client_doc" ? "{{ route('delete.client.document') }}" : ajaxDeleteClaimDocument;

                $.ajax({
                    url: ajaxUrl,
                    method: "GET",
                    data: { 
                        _token: "{{ csrf_token() }}",
                        id: docId,
                        department: CURRENT_DEPARTMENT
                    },
                    success: (res) => {
                        hideLoader();
                        if (res.status === 1) {
                            toastr["success"](res.msg);
                            performRemoval();
                        } else {
                            toastr["error"](res.msg || "Failed to delete record.");
                        }
                    },
                    error: (xhr) => {
                        hideLoader();
                        toastr["error"](xhr.responseJSON?.message || "Error deleting record.");
                    }
                });
            });
        } else {
            // New row - just remove
            $row.remove();
            if (getVisibleRows().length === 0) addRow();
            else updateRowControls();
        }
    }

    // Update controls (add/remove button states)
    function updateRowControls() {
        const prefix = 'claim_document_';

        var visibleRows = getVisibleRows();
        var visibleCount = visibleRows.length;

         // Check for incomplete rows
        let hasIncomplete = false;
        visibleRows.each(function(index) {
            const $row = $(this);
            const rowId = $row.data('row-index');
            const complete = isRowComplete($row, prefix);
                    
            if (!complete) {
                hasIncomplete = true;
                return false; // break loop
            }
        });

        $(CONFIG.addButton).prop('disabled',  visibleCount >= CONFIG.maxRows || hasIncomplete);

        if (visibleCount <= 1) {
            visibleRows.each(function () {
                const removeBtn = $(this).find(".docRemove");
                removeBtn.prop('disabled', !removeBtn.data('document-id'));
            });
        } else {
            visibleRows.find(".docRemove").prop('disabled', false);
        }
    }

    // Load existing documents
    function loadExistingDocuments(documents) {
        $(CONFIG.container).empty();
        rowCounter = 0;

        if (!documents?.length) {
            addRow();
            updateType6RowsVisibility();
            return;
        }

        let hasVisible = false;
        documents.forEach((doc, i) => {
            rowCounter++;
            // if (!shouldHideRow(doc)) hasVisible = true;
            
            $(CONFIG.container).append(rowTemplate(rowCounter, doc));
            initializeRow(rowCounter, doc);
        });

        recalcRowVisibility();
        // if (!hasVisible) addRow();
        updateRowControls(); // important: run after rows exist
    }

    // Update recalcRowVisibility to include vehicle filtering
    function recalcRowVisibility() {
        const claimType = $("input[type=radio][name=type_1]:checked").val();
        const currentVehicleNo = $('#select_vehicle_number option:selected').text()?.trim();
        
        let visibleRowCount = 0;

        $(`${CONFIG.container} .row-item-document`).each(function () {
            const $row = $(this);
            const doc = $row.data('doc') || null;
            
            let hidden = false;

            // Original rules
            if (shouldHideRow(doc)) hidden = true;

            // Vehicle-based rule (only if it's a vehicle claim)
            if (!hidden && claimType === 'Vehicle Claim') {
                hidden = shouldHideByVehicle(doc, currentVehicleNo);
            }

            $row.toggleClass('d-none', hidden);

            if (!hidden) {
                visibleRowCount++;
            }
        });

        if (visibleRowCount === 0) addRow();
        updateRowControls();
    }
    

    $(document).ready(function() {  

        $("input[type=radio][name=type_1]").on('change', function() {
            recalcRowVisibility();
        });

        // When vehicle number is selected/changed
        $('#select_vehicle_number').on('change', function() {
            recalcRowVisibility();
        });

        // When policy number changes (which might affect vehicle selection)
        $('#policy_number_1').on('change', function() {
            // Add slight delay to ensure vehicle dropdown is populated
            setTimeout(function() {
                recalcRowVisibility();
            }, 500);
        });

        var options = {
            beforeSubmit: showRequest,
            success: showResponse
        };

        $('#formBranch').submit(function() {
            $(this).ajaxSubmit(options);
            return false;
        });

        $("#life_health_claim_1 , #vehicle_ins_1 , #TPL_Due_date , #vehicle_data_name , #vehicle_data_number , #life_health_claim , #holder_name , #date_of_incident , #general_vehicle , #wc_medi_claim_1").hide();
        $("#estimated_loss_amt_id , #others_claim_incident_fields , #death_claim_agency_1 , #death_claim_type_id , #client_type_id , #enter_policy_holder_name_id , #policy_num_2_id").hide();
        $("#select_policy_holder_name_id , #select_ins_company_id , #select_branch_id , #step_2_death_claim , #step_2_other_death_claim , #claim_count_id , #policy_type_id").hide();

        $('#incident_time_1, #hospital_name, #reason_for_hosptalise, #hospital_address, #intimated_by_name, #remarks, #nos_1, #mediclaim_ins_comp_name, #enter_patient_name, #age, #postal_address, #job_joining_date, #job_description, #detail_of_incident, #incident_address, #incident_time, #garage_name, #garage_address, #driving_by, #incident_short_detail, #damage_short_details, #destination_of_accident, #death_short_detail, #firm_person_name, #hospital_name_address, #death_destination, #police_station_name, #death_person_name_1, #nominee_person_name_1, #death_person_name, #illness_name, #death_short_detail, #enter_policy_holder_name, #enter_add_city_pin, #enter_contact_person, #enter_policy_address, #enter_present_address, #claim_branch').on('input', function() {
            var inputValue = $(this).val();
            var capitalizedValue = capitalizeString(inputValue);
            $(this).val(capitalizedValue);
        });

        $("input[type=radio][name=vehicle_owner_1]").on('change',function(){
            $("#claim_type_id_1").empty();
        });

        $("#estimated_expense, #estimated_expense_1, #mediclaim_sum_assured, #hospital_contact_number, #landline_number, #approx_salary, #age, #garage_contact_number, #contact_number, #enter_sum_assured, #enter_mobile_num, #enter_whatsapp_num, #incident_contact_num, #estimated_loss_amt, #claim_settled_amt").on('input paste', function(){
            let value = $(this).val();

            // Remove leading zeros but keep "0" if it's the only digit
            value = notAllZeroAmt(value);

            // Set the cleaned value back to the input field
            $(this).val(value);            
        });
        
        // basic-example 
        // step-1
        DeathClaimType(0);

        $("#claim_type_id_1").select2({
            ajax: {
                url: ajaxSearchClaimTypes,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "type": function() {return $("input[type=radio][name=type_1]:checked").val();},
                        "sub_type": function() {return $("input[type=radio][name=vehicle_owner_1]:checked").val();},
                        search_value: params.term, // search term
                        page: params.page
                    };
                },
                error: function(xhr, status, error) {
                    console.error(error); 
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        },
                    };
                },
                cache: false
            },
            placeholder: 'Search claim type',
        }).on('change',function(){
            var value = $(this).val();

            if(value == 12 || value == 13){
                if ($('#death_claim_type').hasClass('select2-hidden-accessible')) {
                    $('#death_claim_type').select2('destroy'); // Destroy the existing Select2 instance
                } 
                $('#death_claim_type').attr('multiple', 'multiple').attr('name', 'death_claim_type[]'); // Add the attributes
                DeathClaimType(1); // Reinitialize Select2

            }else{
                if ($('#death_claim_type').hasClass('select2-hidden-accessible')) {
                    $('#death_claim_type').select2('destroy');
                } 
                $("#death_claim_type").removeAttr('multiple').attr('name', 'death_claim_type');
                DeathClaimType(0);
            }
        });

        $("#death_claim_type, #select_policy_holder_name, #policy_number_1, #select_ins_company").on("select2:open", function(e) {
            if (!$("#claim_type_id_1 option:selected").length) {
                toastr.error("Please select a claim type first.");
            }
        });

        function DeathClaimType(id){
            if(id == 0){
                var close = true;
            }else{
                var close = false;
            }

            $("#death_claim_type").select2({
                ajax: {
                    url: ajaxSearchDeathClaimTypes,
                    dataType: 'json',
                    delay: 0,
                    data: function(params) {
                        return {
                            "id": function() {return $("#claim_type_id_1").val();},
                            search_value: params.term,
                            page: params.page
                        };
                    },
                    error: function(xhr, status, error) {
                        console.error(error); 
                    },
                    processResults: function(data, params) {
                       
                        params.page = params.page || 1;
    
                        return {
                            results: data.results,
                            pagination: {
                                more: (params.page * 30) < data.total_count
                            },
                        };
                    },
                    cache: false
                },
                placeholder: 'Search death claim type',
                closeOnSelect: close,
            });
        }

        $("#death_claim_type").on('change',function(){
            $("#select_policy_holder_name, #policy_number_1").empty();
        });

        $("#client_type, #policy_type").select2({placeholder:"Select type"});

        $("#select_policy_holder_name").select2({
            ajax: {
                url: ajaxSearchPolicyHolderName,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "id": function() {return $("#claim_type_id_1").val();},
                        "death_claim_id": function(){return $("#death_claim_type").val();},
                        search_value: params.term,
                        page: params.page
                    };
                },
                error: function(xhr, status, error) {
                    console.error(error);
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        },
                    };
                },
                cache: false
            },
            placeholder: 'Search policy holder name',
        });

        $("#select_ins_company").select2({
            ajax: {
                url: ajaxSearchInsCompanyName,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "company_type": function() { return companyType(); },
                        "policy_holder_id": function() {return $("#select_policy_holder_name").val()},
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        },
                    };
                },
                cache: false
            },
            placeholder: 'Search company',
        });

        $("#select_vehicle_number").on("select2:open", function(e) {
            if (!$("#select_policy_holder_name option:selected").length) {
                toastr.error("Please select a policy holder first.");
            }
        }).select2({
            ajax: {
                url: ajaxSearchVehicleNum,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "policy_holder_id":function(){return  $("#select_policy_holder_name").val();},                        
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        },
                    };
                },
                cache: false
            },
            placeholder: 'Search vehicle number',
        }).on('change',function(){
            $("#policy_number_1").empty();
        });

        $("#policy_number_1").select2({
            ajax: {
                url: ajaxSearchPolicyNumber,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    var requestData = {
                        "claim_type": function () { return $("#claim_type_id_1").val(); },
                        "policy_holder_id": function () { return $("#select_policy_holder_name").val(); },
                        "death_claim_id": function () { return $("#death_claim_type").val(); },
                        "vehicle_num_id": function () {
                            // Default value if no conditions are met
                            return null;
                        },
                        search_value: params.term,
                        page: params.page
                    };
                    if ($("input[type=radio][name=type_1]:checked").val() == "Vehicle Claim" || $("#claim_type_id_1").val() == 13) {
                        requestData.vehicle_num_id = function () {
                            return $("#select_vehicle_number").val();
                        };
                    }

                    return requestData;
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        },
                    };
                },
                cache: false
            },
            placeholder: 'Search policy number',
        });

        $("#gender").select2({
            ajax: {
                url: ajaxSearchGender,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        }
                    };
                },
                cache: false
            },
            placeholder: 'Search for gender',
        });

        var value = $("input[type=radio][name=type_1]:checked").val();
        ClaimIntimationView(value);

        $("input[type=radio][name=type_1]").on('change',function(){
            Counter = 1;

            value = $("input[type=radio][name=type_1]:checked").val();
        
            ClaimIntimationView(value);

            $("#claim_type_id_1").empty();
            $("#claim_count").val('');
            $(".actions ul li:contains('Next') a").removeClass("disabled-link");
        });
        
        var claimType = 0;

        $("#claim_type_id_1").on('change',function(){
            Counter = 1;

            $("#add_multiple_death_row").empty();
            $("#claim_count").val('');
            $(".actions ul li:contains('Next') a").removeClass("disabled-link");
            $("#policy_number_1").attr('disabled',false);

            claimType = $("#claim_type_id_1").val();
            var value = $("#claim_type_id_1 option:selected").html();
            
            $("#claim_type_value_1 , #claim_type_value_1_1").html(value);
            
            $("#main_policy_id , #patient_name").show().find('input select').removeClass('is-invalid');
            $("#select_policy_holder_name_id , #select_vehicle_num_id , #patient_name_1 , #wc_health_id").hide();

            setTimeout(function(){
                $(".email-require").find("input, select").prop("disabled", false).removeClass('is-invalid');
            }, 500);

            PatientName();        

            if(claimType == 1){
                $("#general_mediclaim").show();
                
                $("#life_health_claim , #life_health_claim_1 , #wc_medi_claim_1 , #general_vehicle").hide();

            }else if(claimType == 2){
                $("#general_mediclaim , #wc_medi_claim_1 , #patient_name_1 , #wc_health_id").show();
               
                $("#life_health_claim , #life_health_claim_1 , #general_vehicle , #incident_contact_num_id , #patient_name").hide().find('input select').removeClass('is-invalid');

            }else if(claimType == 3){
                $("#general_mediclaim , #wc_medi_claim_1").show();

                $("#life_health_claim , #life_health_claim_1 , #general_vehicle , #incident_contact_num_id").hide();

            }else if(claimType == 4){
                $("#general_vehicle").hide();

                $(".actions ul li:contains('Next') a").addClass("disabled-link");
                toastr["info"]("Coming Soon");
                $("#policy_number_1").attr('disabled',true);

            }else if(claimType == 5){
                $("#life_health_claim , #life_health_claim_1").show();
                $("#name_of_patient").select2('destroy');
                
                setTimeout(function() {
                    $("#general_mediclaim , #wc_medi_claim_1 , #general_vehicle").hide();
                }, 500);

            }else if(claimType == 6 || claimType == 7 || claimType == 8 || claimType == 9 || claimType == 10 || claimType == 11){
                $("#life_health_claim , #life_health_claim_1 , #patient_name").hide().find('input select').removeClass('is-invalid');

                $("#select_policy_holder_name_id , #select_vehicle_num_id").show().addClass('col-xxl-3').removeClass('col-xxl-4');                

            }else if(claimType == 12){  
                $("#select_ins_company_id , #select_branch_id , #step_2_death_claim , #nominee_name_id , #death_person_name_id , #contact_num_id , #death_date_id , #death_type_id , #illness_id , #select_policy_holder_name_id, #tpaHide").show();
                $("#death_claim_agency_1").show().find("input").prop("disabled",false).removeClass('is-invalid');
               
                $("#main_policy_id , #claim_count_id , #step_2_claim , #date_of_incident , #incident_time_id_1 , #acci_place_id , #intimated_to_id , #fp_name_id , #policy_type_id , #step_2_other_death_claim , #patient_name").hide().find('input select').removeClass('is-invalid');
                $("#client_type_id , #enter_policy_holder_name_id , #policy_num_2_id").hide().find("input , select").prop("disabled",true).removeClass('is-invalid , is-valid');       
                $(".short-detail").html('Death Short Detail');

                $("#death_reason_id , #dsd_id , #hospital_name_add_id , #dod_id , #ps_name_id").addClass('col-xxl-3').removeClass('col-xxl-4 , col-xxl-6');
                $("#main_claim_type_id , #select_policy_holder_name_id").addClass('col-xxl-3').removeClass('col-xxl-2');
           
            }else if(claimType == 13){               
                $("#main_policy_id , #date_of_incident , #incident_time_id_1 , #death_claim_agency_1 , #select_vehicle_num_id").show().find("input, select").prop("disabled", false).removeClass('is-invalid');
                $("#select_policy_holder_name_id , #claim_count_id , #step_2_claim , #death_policy_details , #rto_id , #model_id , #vehicle_data_name , #vehicle_data_number , #acci_place_id").show();
                
                $("#select_ins_company_id , #select_branch_id , #step_2_death_claim , #step_2_other_death_claim , #policy_address_id , #branch_name_id , #death_person_name_id , #nominee_name_id , #contact_num_id , #death_date_id , #death_type_id , #illness_id , #intimated_to_id , #fp_name_id , #policy_type_id , #patient_name, #tpaHide").hide().find('input select').removeClass('is-invalid');
                $("#client_type_id , #enter_policy_holder_name_id , #policy_num_2_id").hide().find("input , select").prop("disabled",true).removeClass('is-invalid , is-valid');

                $(".short-detail").html('Incident Short Detail');
                $(".desti_incident").html("Destination Of Accident");

                $("#death_reason_id , #dsd_id , #hospital_name_add_id , #dod_id , #ps_name_id").addClass('col-xxl-4').removeClass('col-xxl-3, col-xxl-6');
                $("#main_claim_type_id , #main_policy_id , #select_policy_holder_name_id , #death_claim_type_id").addClass('col-xxl-3').removeClass('col-xxl-2');
                $("#select_vehicle_num_id").removeClass('col-xxl-4').addClass('col-xxl-3');
                $("#claim_count_id").removeClass('col-xxl-1 ,col-xxl-3').addClass('col-xxl-2');
                $("#main_policy_id").removeClass('col-xxl-6 , col-xxl-4');

                $("#intimated_to option[value='By Us'] , #intimated_to option[value='By Authority'] ").remove();

                addMultipleRowsDeath();

            }else if(claimType == 14){                
                $("#main_policy_id , #date_of_incident , #incident_time_id_1 , #death_claim_agency_1").show().find("input, select").prop("disabled", false).removeClass('is-invalid');
                $("#select_policy_holder_name_id , #claim_count_id , #step_2_claim , #branch_name_id , #policy_address_id , #intimated_to_id , #fp_name_id , #acci_place_id, #tpaHide").show();
                
                $("#select_ins_company_id , #select_branch_id , #step_2_death_claim , #step_2_other_death_claim , #death_policy_details , #vehicle_data_name , #vehicle_data_number , #model_id , #rto_id , #death_person_name_id , #nominee_name_id , #contact_num_id , #death_date_id , #death_type_id , #illness_id , #policy_type_id , #patient_name").hide().find('input select').removeClass('is-invalid');
                $("#client_type_id , #enter_policy_holder_name_id , #policy_num_2_id").hide().find("input , select").prop("disabled",true).removeClass('is-invalid , is-valid');

                $(".short-detail").html('Incident Short Detail');
                $(".desti_incident").html("Destination Of Accident");

                $("#dod_id , #ps_name_id").addClass('col-xxl-6').removeClass('col-xxl-4 , col-xxl-3');
                $("#death_reason_id , #dsd_id , #fp_name_id , #hospital_name_add_id").addClass('col-xxl-4').removeClass('col-xxl-3');
                $("#main_claim_type_id , #select_policy_holder_name_id , #death_claim_type_id").addClass('col-xxl-3').removeClass('col-xxl-2');
                $("#claim_count_id").removeClass('col-xxl-1 ,col-xxl-2').addClass('col-xxl-3');
                
                $("#main_policy_id").addClass('col-xxl-3').removeClass('col-xxl-6 , col-xxl-2 , col-xxl-4');

                $("#date_of_incident , #incident_time_id_1").removeClass('col-xxl-2').addClass('col-xxl-4');
                
                $("#intimated_to option[value='By Us'] , #intimated_to option[value='By Authority'] ").remove();

                addMultipleRowsDeath();

            }else if(claimType == 15){
                $("#main_policy_id , #date_of_incident , #incident_time_id_1 , #client_type_id").show().find("input, select").prop("disabled", false).removeClass('is-invalid');
                $("#policy_address_id , #branch_name_id , #policy_type_id , #acci_place_id , #intimated_to_id , #fp_name_id , #select_policy_holder_name_id , #step_2_other_death_claim, #tpaHide").show();

                $("#enter_policy_holder_name_id , #policy_num_2_id , #death_claim_agency_1").hide().find("input").prop("disabled",false).removeClass('is-invalid'); 
                $("#select_ins_company_id , #select_branch_id , #claim_count_id , #step_2_death_claim , #step_2_claim , #death_policy_details , #vehicle_data_name , #vehicle_data_number , #model_id , #rto_id , #death_person_name_id , #nominee_name_id , #contact_num_id , #death_date_id , #death_type_id , #illness_id , #patient_name").hide().find('input select').removeClass('is-invalid');

                $(".short-detail").html('Incident Short Detail');
                $(".desti_incident").html("Destination Of Incident");

                $("#dod_id , #ps_name_id").addClass('col-xxl-6').removeClass('col-xxl-4 , col-xxl-3');
                $("#death_reason_id , #dsd_id , #fp_name_id , #hospital_name_add_id").addClass('col-xxl-4').removeClass('col-xxl-3');
                $("#main_claim_type_id, #select_policy_holder_name_id").addClass('col-xxl-3').removeClass('col-xxl-2');
                $("#main_policy_id").addClass('col-xxl-3').removeClass('col-xxl-6 , col-xxl-4 , col-xxl-2');
                $("#date_of_incident , #incident_time_id_1").removeClass('col-xxl-2').addClass('col-xxl-4');

                var html = '';
                html += '<option value="By Authority">By Authority</option>';
                html +='<option value="By Us">By Us</option>';

                $("#intimated_to").append(html);

                addMultipleRowsDeath();

            }else if(claimType == 16){

            }else if(claimType == 17){

            }else if(claimType == 18){

            }else if(claimType == 19){

            }else if(claimType == 20){

            }else if(claimType == 21){

            }else if(claimType == 22 ||  claimType == 23 || claimType == 24 || claimType == 25 || claimType == 26 || claimType == 27){
                $("#patient_name").hide().find('input select').removeClass('is-invalid');
            }else if(claimType == 28){

            }else if(claimType == 29){

            }else if(claimType == 30){

            }else {
                $("#claim_type_value_1 , #claim_type_value_1_1").html('');
            }

            $("#policy_number_1 , #death_claim_type , #select_policy_holder_name , #select_ins_company , #select_branch , #select_vehicle_number").empty().removeClass('is-invalid');
        });

        $("#client_type").on('change',function(){
            if("{{$data['can_edit']}}" == 0) {
                $("#step_2_other_death_claim").find("select , input").val('');
            }

            var value = $(this).val();
            var value2 = $("#claim_type_id_1").val();

            isNonRegisterdClientView(value , value2);

            $("#select_policy_holder_name , #policy_number_1 , #enter_ins_comp , #enter_segment_name , #enter_agency_name , #enter_broker_name , #enter_sub_agent_name").empty().removeClass('is-invalid');

            $("#enter_policy_holder_name , #policy_num_2").removeClass('is-valid , is-invalid');

            $("#enter_add_city_pin , #enter_contact_person").prop('disabled', false).removeClass('is-invalid');
        });

        $("#select_policy_holder_name").on('change',function(){
            $("#policy_number_1, #select_ins_company").empty();
            $("#claim_count").val('');
        });

        $("input[type=radio][name=claim_type_1]").on('change',function(){
            var value = $("input[type=radio][name=claim_type_1]:checked").val();

            if(value == "Cashless"){
                window.location = "{{route('add.cashless.claim.data')}}";
            }
        });    
        
        $("#enter_policy_holder_name").on('change',function() {
            var name = $(this).val();

            $.ajax({
                type: "GET",
                url: "{{ route('client.exists') }}",
                data: {
                    name: name
                },
                success: function(resultData) {
                    if (resultData['status'] == 0) {
                        toastr["error"](resultData['msg']);

                        $("#enter_policy_holder_name").val('').removeClass('is-valid').addClass('is-invalid');
                    } else {
                        $("#enter_policy_holder_name").removeClass('is-invalid').addClass('is-valid');
                    }
                }
            });
        });

        $("#policy_num_2").on('change',function() {
            var policy = $(this).val();

            $.ajax({
                type: "GET",
                url: "{{ route('check.policy.exits') }}",
                data: {
                    policy: policy
                },
                success: function(resultData) {
                    if (resultData['status'] == 0) {
                        toastr["error"](resultData['msg']);

                        $("#policy_num_2").val('').removeClass('is-valid').addClass('is-invalid');
                    } else {
                        $("#policy_num_2").removeClass('is-invalid').addClass('is-valid');
                    }
                }
            });
        });

        // step-2  
        $("#enter_risk_from_date , #enter_risk_to_date").datepicker({
            format: "dd-mm-yyyy",
        }).on('changeDate', function() {
            $('.datepicker').hide();
            $(this).trigger('change');
        });

        $('#enter_policy_holder_name').bind('keyup blur', function() {
            var node = $(this);
            node.val(node.val().replace(/[^a-zA-Z ]/g, ''));
        });

        $("#enter_segment_name").select2({
            ajax: {
                url: ajaxSearchSegment,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "claim": true,
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        }
                    };
                },
                cache: false
            },
            placeholder: 'Search for segment',
        });

        $("#enter_broker_name").select2({
            ajax: {
                url: ajaxSearchBroker,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        }
                    };
                },
                cache: false
            },
            placeholder: 'Search for broker',
        });

        $("#enter_agency_name").select2({
            ajax: {
                url: ajaxSearchAgency,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        }
                    };
                },
                cache: false
            },
            placeholder: 'Search for agency',
        });

        $("#enter_sub_agent_name").select2({
            ajax: {
                url: ajaxSearchSubAgent,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        }
                    };
                },
                cache: false
            },
            placeholder: 'Search for sub agent',
        });
          
        $("#policy_number_1").on('change',function(){
            $("#name_of_patient").empty().trigger("change").removeClass('is-invalid');

            $("#policy_holder_name_1_1").val('');
            var claim_type = $("#claim_type_id_1").val();
            var id = $(this).val();
            
            if (id != 0 && id != null) {
                $.ajax({
                    type: 'GET',
                    url: ajaxClientDetail + "?id=" + id + "&claim_type=" + claim_type,
                    success: function(resultData) {
                        if (resultData['status'] == 1) {
                            
                            if("{{$data['can_edit']}}" == 0){
                                if(resultData['already_claim'] == 1){
                                    swal.fire({
                                        title: "Claim already added!",
                                        text: "Do you want to add another claim for this policy?",
                                        icon: "warning",
                                        showCancelButton: true,
                                        confirmButtonColor: "#526BDF",
                                        cancelButtonColor: "#EC6767",
                                        confirmButtonText: "Add",
                                        cancelButtonText: "Cancel",
                                    }).then((result) => {
                                         if (result.isDismissed) {
                                            
                                            $("#addIntimation").trigger('reset');
                                            $("#claim_type_id_1, #death_claim_type, #select_policy_holder_name, #select_vehicle_number, #policy_number_1").empty();
                                            $("input[type=radio][name=type_1]").trigger('change');
                                        }
                                    });
                                }
                            }

                            $(".actions ul li:contains('Next') a").removeClass("disabled-link");

                            risk_from_date = resultData['record']['risk_from_date'];
                            risk_to_date = resultData['record']['risk_to_date'];
                            tp_due_date = resultData['record']['tp_due_date'];

                            var riskToDate = moment(risk_to_date, "DD-MM-YYYY" ,true);
                            if(riskToDate.isValid()){
                                riskToDate.toDate();
                            }
    
                            var currentDate = new Date();
                            var tp_risk_date = currentDate;
                            if (riskToDate > currentDate) {
                                tp_risk_date = risk_to_date;
                            }else{
                                tp_risk_date = tp_due_date;
                            }

                            initializeDatepicker(risk_from_date ,tp_risk_date);
                            $("#claim_count").val("" + resultData['record']['claim_count'] + "");
                            $("#branch_name, #branch_name_1").val("" + resultData['record']['branch_name'] + "");
                            $("#nominee_name_1").val("" + resultData['record']['nominee_name'] + "");
                            $("#nominee_contact_num").val("" + resultData['record']['nominee_contact'] + "");
                            $("#rto_name").val("" + resultData['record']['rto'] + "");
                            $("#bank_name").val("" + resultData['record']['bank_name'] + "");
                            $("#model_year").val("" + resultData['record']['vehicle_manufacture_year'] + "");
                            $("#policy_number_1_1").val("" + resultData['record']['policy_number'] + "");
                            $("#policy_holder_name_1 , #policy_holder_name_1_1").val("" + resultData['record']['policy_holder_name'] + "");
                            $("#policy_holder_name_id_hidden").val("" + resultData['record']['client_id'] + "");
                            $("#insurance_company_name_1").val("" + resultData['record']['insurance_company'] + "");
                            $("#vehicle_name").val("" + resultData['record']['vehicle_name'] + "");
                            $("#vehicle_number").val("" + resultData['record']['vehicle_no'] + "");
                            $("#segment_1").val("" + resultData['record']['segment_name'] + "");
                            $("#broker_1").val("" + resultData['record']['broker_name'] + "");
                            $("#sub_agent_1").val("" + resultData['record']['sub_agent_name'] + "");
                            $("#agency_1").val("" + resultData['record']['agency_name'] + "");
                            $("#risk_from_date_1").val(risk_from_date);
                            $("#risk_to_date_1").val(risk_to_date);
                            $("#sum_assu_amt_2").val("" + resultData['record']['sum_assured'] + "").prop('disabled',false).removeClass('is-invalid');
                            $("#sum_assured_1").val("" + resultData['record']['sum_assured'] + "");
                            $("#remaining_assured_1").val("" + resultData['record']['remaining_sum_assured'] + "");
                            $("#person_covered_1").val("" + resultData['record']['person_covered'] + "");
                            $("#tpl_due_date_1").val("" + resultData['record']['tp_due_date'] + "");
                            $("#premium_amount_1").val("" + resultData['record']['total_amount'] + "");
                            $("#plan_number_term_1").val("" + resultData['record']['plan_number'] +"/"+ resultData['record']['risk_term'] +"/"+resultData['record']['premium_paying_term']+ "");
                            $("#plan_name_1").val("" + resultData['record']['plan_name'] + "");
                            $("#prem_due_date_1").val("" + resultData['record']['last_payment_date'] + "");
                            $("#policy_address").val("" + resultData['record']['address1'] + "");

                            if(claim_type == 5){
                                $("#name_of_patient").empty();
                                var newOption = new Option(resultData['record']['policy_holder_name'], resultData['record']['client_id'], true, true);
                                $("#name_of_patient").append(newOption).trigger('change').attr('readonly',true);
                            }else{
                                PatientName();
                            }

                            var newOption = new Option(resultData['record']['insurance_company'], resultData['record']['insurance_company_id'], true, true);
                            $("#enter_ins_comp").append(newOption).trigger('change');

                            var newOption = new Option(resultData['record']['segment_name'], resultData['record']['segment_id'], true, true);
                            $("#enter_segment_name").append(newOption).trigger('change').removeClass('is-invalid');

                            var newOption = new Option(resultData['record']['agency_name'], resultData['record']['agency_id'], true, true);
                            $("#enter_agency_name").append(newOption).trigger('change').removeClass('is-invalid');

                            var newOption = new Option(resultData['record']['broker_name'], resultData['record']['broker_id'], true, true);
                            $("#enter_broker_name").append(newOption).trigger('change').removeClass('is-invalid');

                            var newOption = new Option(resultData['record']['sub_agent_name'], resultData['record']['sub_agent_id'], true, true);
                            $("#enter_sub_agent_name").append(newOption).trigger('change').removeClass('is-invalid');
                            
                            $("#enter_risk_from_date").val("" + resultData['record']['risk_from_date'] + "");
                            $("#enter_risk_to_date").val("" + resultData['record']['risk_to_date'] + "");
                            $("#enter_sum_assured").val("" + resultData['record']['sum_assured'] + "");
                            $("#enter_mobile_num").val("" + resultData['record']['mobile_number'] + "");
                            $("#enter_whatsapp_num").val("" + resultData['record']['whatsapp_number'] + "");
                            $("#enter_contact_person").val();
                            $("#enter_policy_address").val("" + resultData['record']['address1'] + "");
                            $("#enter_present_address").val("" + resultData['record']['address1'] + "");
                            $("#enter_email_id").val("" + resultData['record']['email']);

                            $("#policy_holder_contact_number").val("" + resultData['record']['mobile_number'] + "");

                            if("{{$data['can_edit']}}" == 0) { 
                                $("#direct_company_name, #direct_company_email").empty().removeClass('is-valid , is-invalid');
                                
                                var policyInsComp = resultData['record']['insurance_company'];
                                var policyInsCompId = resultData['record']['insurance_company_id'];
                                
                                // Append the option to Select2's underlying data
                                var newOption = new Option(policyInsComp, policyInsCompId, true, true);
                                $("#direct_company_name").append(newOption).trigger('change');
                            }

                            var client_documents = resultData['record']['client_documents'];

                            clientDocuments = [];
                            client_documents.forEach(el => {
                                clientDocuments.push(el);
                            });

                            var allDocuments = [...clientDocuments, ...claimDocuments];
                            loadExistingDocuments(allDocuments);
                            
                        } else {
                            $(".actions ul li:contains('Next') a").addClass("disabled-link");
                            toastr["error"](resultData['msg']);
                        }
                    }
                });
            }
        });
        
        $("#select_policy_holder_name, #select_ins_company").on('change',function(){
            $("#add_new_row_death").empty();

            var policyHolderName = $("#select_policy_holder_name").val();
            var insCompany = $("#select_ins_company").val();
            var claimType =  $("#claim_type_id_1").val();

            $("#policy_holder_name_death").val($("#select2-select_policy_holder_name-container").html());
            $("#insurance_company_name_death").val($("#select2-select_ins_company-container").html());
            
            if (policyHolderName && insCompany) {
                $.ajax({
                    type: 'GET',
                    url: ajaxPolicyDetails + "?policy_holder_name=" + policyHolderName +"&ins_company_name=" + insCompany  + "&claim_type_id=" + claimType,
                    success: function(resultData) {                        
                        if (resultData['data']['status'] == 1) {

                            if("{{$data['can_edit']}}" == 0){
                                if(resultData['already_claim'] == 1){
                                    swal.fire({
                                        title: "Claim already added!",
                                        text: "Do you want to add another claim for this policy holder?",
                                        icon: "warning",
                                        showCancelButton: true,
                                        confirmButtonColor: "#526BDF",
                                        cancelButtonColor: "#EC6767",
                                        confirmButtonText: "Add",
                                        cancelButtonText: "Cancel",
                                    }).then((result) => {
                                        if (result.isDismissed) {
                                            
                                            $("#addIntimation").trigger('reset');
                                            $("#claim_type_id_1, #death_claim_type, #select_policy_holder_name, #select_ins_company").empty();
                                            $("input[type=radio][name=type_1]").trigger('change');
                                        }
                                    });
                                }
                            }

                            $(".actions ul li:contains('Next') a").removeClass("disabled-link");
                        
                            var index = 0; 
                            var newRowHtml = '';
                            var TotalSumAssured = 0 ;
                            var mobile_number = '';
                            var deathPersonName = '';

                            for(var i=1; i<=resultData['total_policy']; i++){
                                 mobile_number = resultData.record[index].mobile_number;
                                 deathPersonName = resultData.record[index].policy_holder_name;

                                if (resultData['record'][index]['status'] == 0) {
                                    const allStatusZero = resultData.record.every(record => record.status === 0);
                                    if (allStatusZero) {    
                                        $(".actions ul li:contains('Next') a").addClass("disabled-link");
                                    }
                                    
                                    toastr["error"](resultData['record'][index]['msg']);
                                    index = index+ 1;

                                }else{
                                    var policy_number = resultData.record[index].policy_number;
                                    var branch_name = resultData.record[index].branch_name;
                                    var nominee_name = resultData.record[index].nominee_name;
                                    var agancy_name = resultData.record[index].agancy_name;
                                    var mode_name = resultData.record[index].mode_name;
                                    var plan_name = resultData.record[index].plan_name;
                                    var plan_number = resultData.record[index].plan_number;
                                    var risk_term = resultData.record[index].risk_term;
                                    var sub_agent_name = resultData.record[index].sub_agent_name;
                                    var broker_name = resultData.record[index].broker_name;
                                    var risk_from_date = resultData.record[index].risk_from_date;
                                    var risk_to_date = resultData.record[index].risk_to_date;
                                    var policy_status_name = resultData.record[index].policy_status_name;
                                    var basic_amount = resultData.record[index].basic_amount;
                                    var sum_assured = resultData.record[index].sum_assured;
                                    var maturity_date = resultData.record[index].maturity_date;
                                    let riders = resultData.record[i - 1].riders;
                                    var riders_sum_assured = resultData.record[i - 1].riders_sum_assured.split(',');
                                    var riders_risk_term = resultData.record[i - 1].riders_risk_term.split(',');
                                    var riders_premium_paying_term = resultData.record[i - 1].riders_premium_paying_term.split(',');
                                    var planNumberName = plan_number + ' - ' + plan_name;

                                    if("{{$data['can_edit']}}" == 0 || "{{$data['data']['death_claim_policy_num']}}".includes(policy_number)) {
                                        newRowHtml =`<div class="multiple_policies">
                                            <hr>
                                            <div class="row">
                                                <div class="col-xl-1">
                                                    <div class="mb-3">
                                                        <label for="sr_no_${i}" class="form-label">Sr. No.</label>
                                                        <input type="text" class="form-control" name="sr_no_${i}" id="sr_no_${i}" value="${i}" readonly maxlength="3" autocomplete="off">
                                                    </div>
                                                </div>
                                                <div class="col-xl-3">
                                                    <div class="mb-3">
                                                        <label for="policy_num_death_${i}" class="form-label">Policy Number</label>
                                                        <input type="hidden" class="form-control" name="death_claim_policy_num${i}" id="death_claim_policy_num${i}" value="${policy_number}">
                                                        <input type="text" class="form-control" name="policy_num_death_${i}" id="policy_num_death_${i}" disabled value="${policy_number}">
                                                    </div>
                                                </div>
                                                <div class="col-xl-3">
                                                    <div class="mb-3">
                                                        <label for="nominee_name_${i}" class="form-label">Nominee Name</label>
                                                        <input type="text" class="form-control" name="nominee_name_${i}" id="nominee_name_${i}" disabled value="${nominee_name}" placeholder="Nominee Name">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="assignee_name_${i}" class="form-label">Assignee Name</label>
                                                        <input type="text" class="form-control" name="assignee_name_${i}" id="assignee_name_${i}" disabled value="" placeholder="Assignee Name">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="policy_status_death_${i}" class="form-label">Policy Status</label>
                                                        <input type="text" class="form-control" name="policy_status_death_${i}" id="policy_status_death_${i}" disabled value="${policy_status_name}">
                                                    </div>
                                                </div>
                                                 <div class="col-xl-1">
                                                    <div class="mb-3">
                                                        <label for="term_death_${i}" class="form-label">Term</label>
                                                        <input type="text" class="form-control" name="term_death_${i}" id="term_death_${i}" disabled value="${risk_term}">
                                                    </div>
                                                </div>
                                            </div>
                                            
                                            <div class="row">
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="policy_branch_${i}" class="form-label">Branch Name</label>
                                                        <input type="text" class="form-control" name="policy_branch_${i}" id="policy_branch_${i}" disabled value="${branch_name}" placeholder="Branch Name">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="plan_name_death_${i}" class="form-label">Plan Number & Name</label>
                                                        <input type="text" class="form-control" name="plan_name_death_${i}" id="plan_name_death_${i}" disabled value="${planNumberName}">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="mode_name_death_${i}" class="form-label">Mode Name</label>
                                                        <input type="text" class="form-control" name="mode_name_death_${i}" id="mode_name_death_${i}" disabled value="${mode_name}">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="risk_from_death_${i}" class="form-label">Risk From Date</label>
                                                        <input type="text" class="form-control" name="risk_from_death_${i}" id="risk_from_death_${i}" disabled value="${risk_from_date}">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="risk_to_death_${i}" class="form-label">Risk To Date</label>
                                                        <input type="text" class="form-control" name="risk_to_death_${i}" id="risk_to_death_${i}" disabled value="${risk_to_date}">
                                                    </div>
                                                </div>
                                                 <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="maturity_date_${i}" class="form-label">Maturity Date</label>
                                                        <input type="text" class="form-control" name="maturity_date_${i}" id="maturity_date_${i}" disabled value="${maturity_date}">
                                                    </div>
                                                </div>
                                            </div>

                                            <div class="row">
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="agency_name_death_${i}" class="form-label">Agency Name</label>
                                                        <input type="text" class="form-control" name="agency_name_death_${i}" id="agency_name_death_${i}" disabled value="${agancy_name}" placeholder="Agency Name">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="other_agency_name_death_${i}" class="form-label">Other Agency</label>
                                                        <input type="text" class="form-control" name="other_agency_name_death_${i}" id="other_agency_name_death_${i}" disabled value="" placeholder="Other Agency">
                                                    </div>
                                                </div>                                                
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="sub_agent_death_${i}" class="form-label">Sub Agent Name</label>
                                                        <input type="text" class="form-control" name="sub_agent_death_${i}" id="sub_agent_death_${i}" disabled value="${sub_agent_name}" placeholder="Sub Agent Name">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="broker_name_death_${i}" class="form-label">Broker Name</label>
                                                        <input type="text" class="form-control" name="broker_name_death_${i}" id="broker_name_death_${i}" disabled value="${broker_name}">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="prem_amt_death_${i}" class="form-label">Premium Amount</label>
                                                        <input type="text" class="form-control" name="prem_amt_death_${i}" id="prem_amt_death_${i}" disabled value="${basic_amount}">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="sum_assured_death_${i}" class="form-label">Policy Sum Assured</label>
                                                        <input type="text" class="form-control" name="sum_assured_death_${i}" id="sum_assured_death_${i}" disabled value="${sum_assured}">
                                                    </div>
                                                </div>
                                            </div>`;

                                            newRowHtml +=`
                                            <div class="row">
                                                <div class="col-xl-3 text-center">
                                                    <label class="form-label"><b>Riders</b></label>
                                                </div>
                                                <div class="col-xl-3">
                                                    <label class="form-label"><b>Sum Assured</b></label>
                                                </div>
                                                <div class="col-xl-3">
                                                    <label class="form-label"><b>Risk Term</b></label>
                                                </div>
                                                <div class="col-xl-3">
                                                    <label class="form-label"><b>Premium Paying Term</b></label>
                                                </div>
                                            </div>`;

                                            riders.forEach((rider, index) => {[index]
                                                newRowHtml += `<div class="row text-center">
                                                    <div class="col-xl-12">
                                                        <div class="row">
                                                            <div class="col-md-3 mt-2">
                                                                <div class="mb-3">
                                                                    <label class="form-check-label optional-cover-label" for="riders_${rider.id}">${rider.optional_covers}</label>
                                                                </div>
                                                            </div>
                                                            <div class="col-md-3">
                                                                <div class="mb-3">
                                                                    <input type="text" class="form-control rider_sum_assured_${rider.optional_covers.replace(/\s+/g, '_')}" name="rider_sum_assured[]" id="rider_sum_assured_${rider.id}" placeholder="Sum Assured" value="${riders_sum_assured[index]}" disabled>
                                                                </div>
                                                            </div>
                                                            <div class="col-md-3">
                                                                <div class="mb-3">
                                                                    <input type="text" class="form-control" name="rider_risk_term[]" id="rider_risk_term_${rider.id}" placeholder="Risk Term" value="${riders_risk_term[index]}" disabled>
                                                                </div>
                                                            </div>
                                                            <div class="col-md-3">
                                                                <div class="mb-3">
                                                                    <input type="text" class="form-control" name="rider_premium_paying_term[]" id="rider_premium_paying_term_${rider.id}" placeholder="Premium Paying Term" value="${riders_premium_paying_term[index]}" disabled>
                                                                </div>
                                                            </div>
                                                        </div>
                                                    </div>
                                                </div>`;
                                            
                                                if (accumulatedAmounts[rider.optional_covers]) {
                                                    accumulatedAmounts[rider.optional_covers] += parseFloat(riders_sum_assured[index] || 0);
                                                } else {
                                                    accumulatedAmounts[rider.optional_covers] = parseFloat(riders_sum_assured[index] || 0);
                                                }

                                            });
                                            // Clear the container before appending new cards (to avoid duplicates on rerun)
                                            $('.dynamic-riders').remove();

                                            // Generate and append the cards
                                            for (var title in accumulatedAmounts) {
                                                var cardHtml = `<div class="col-xl-3 dynamic-riders">
                                                    <div class="card text-white bg-secondary mb-3">
                                                        <div class="card-header text-center font-size-14">${title}<br>
                                                            <div class="optional-cover-amt" id="rider_sum_assured_${title.replace(/\s+/g, '_')}">${accumulatedAmounts[title]}</div>
                                                        </div>
                                                    </div>
                                                </div>`;

                                                // Append the generated card to the container
                                                $('#riders-lable').append(cardHtml);
                                            }
                                            newRowHtml +=`<div class="row">
                                                <div class="col-xxl-10"></div>
                                                <div class="col-xxl-2 justify-content-md-end mt-2">
                                                    <div class="mb-3 text-end">
                                                        <button type="button" class="btn btn-danger form-control" data-bs-dismiss="multiple_policies" aria-label="Remove" onclick="removeRow(this)" id="remove_btn_policy_${index}" value="Remove">Remove</button>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>`;

                                        TotalSumAssured += sum_assured;
                                    
                                    }else{
                                        newRowHtml =`<div class="multiple_policies">
                                            <hr>
                                             <div class="row">
                                                <div class="col-xl-1">
                                                    <div class="mb-3">
                                                        <label for="sr_no_${i}" class="form-label">Sr. No.</label>
                                                        <input type="text" class="form-control" name="sr_no_${i}" id="sr_no_${i}" value="${i}" readonly maxlength="3" autocomplete="off">
                                                    </div>
                                                </div>
                                                <div class="col-xl-3">
                                                    <div class="mb-3">
                                                        <label for="policy_num_death_${i}" class="form-label">Policy Number</label>
                                                        <input type="hidden" class="form-control" name="death_claim_policy_num${i}" id="death_claim_policy_num${i}" value="${policy_number}">
                                                        <input type="text" class="form-control" name="policy_num_death_${i}" id="policy_num_death_${i}" disabled value="${policy_number}">
                                                    </div>
                                                </div>
                                                <div class="col-xl-3">
                                                    <div class="mb-3">
                                                        <label for="nominee_name_${i}" class="form-label">Nominee Name</label>
                                                        <input type="text" class="form-control" name="nominee_name_${i}" id="nominee_name_${i}" disabled value="${nominee_name}" placeholder="Nominee Name">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="assignee_name_${i}" class="form-label">Assignee Name</label>
                                                        <input type="text" class="form-control" name="assignee_name_${i}" id="assignee_name_${i}" disabled value="" placeholder="Assignee Name">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="policy_status_death_${i}" class="form-label">Policy Status</label>
                                                        <input type="text" class="form-control" name="policy_status_death_${i}" id="policy_status_death_${i}" disabled value="${policy_status_name}">
                                                    </div>
                                                </div>
                                                 <div class="col-xl-1">
                                                    <div class="mb-3">
                                                        <label for="term_death_${i}" class="form-label">Term</label>
                                                        <input type="text" class="form-control" name="term_death_${i}" id="term_death_${i}" disabled value="${risk_term}">
                                                    </div>
                                                </div>
                                            </div>
                                            
                                            <div class="row">
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="policy_branch_${i}" class="form-label">Branch Name</label>
                                                        <input type="text" class="form-control" name="policy_branch_${i}" id="policy_branch_${i}" disabled value="${branch_name}" placeholder="Branch Name">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="plan_name_death_${i}" class="form-label">Plan Number & Name</label>
                                                        <input type="text" class="form-control" name="plan_name_death_${i}" id="plan_name_death_${i}" disabled value="${planNumberName}">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="mode_name_death_${i}" class="form-label">Mode Name</label>
                                                        <input type="text" class="form-control" name="mode_name_death_${i}" id="mode_name_death_${i}" disabled value="${mode_name}">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="risk_from_death_${i}" class="form-label">Risk From Date</label>
                                                        <input type="text" class="form-control" name="risk_from_death_${i}" id="risk_from_death_${i}" disabled value="${risk_from_date}">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="risk_to_death_${i}" class="form-label">Risk To Date</label>
                                                        <input type="text" class="form-control" name="risk_to_death_${i}" id="risk_to_death_${i}" disabled value="${risk_to_date}">
                                                    </div>
                                                </div>
                                                 <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="maturity_date_${i}" class="form-label">Maturity Date</label>
                                                        <input type="text" class="form-control" name="maturity_date_${i}" id="maturity_date_${i}" disabled value="${maturity_date}">
                                                    </div>
                                                </div>
                                            </div>

                                            <div class="row">
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="agency_name_death_${i}" class="form-label">Agency Name</label>
                                                        <input type="text" class="form-control" name="agency_name_death_${i}" id="agency_name_death_${i}" disabled value="${agancy_name}" placeholder="Agency Name">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="other_agency_name_death_${i}" class="form-label">Other Agency</label>
                                                        <input type="text" class="form-control" name="other_agency_name_death_${i}" id="other_agency_name_death_${i}" disabled value="" placeholder="Other Agency">
                                                    </div>
                                                </div>                                                
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="sub_agent_death_${i}" class="form-label">Sub Agent Name</label>
                                                        <input type="text" class="form-control" name="sub_agent_death_${i}" id="sub_agent_death_${i}" disabled value="${sub_agent_name}" placeholder="Sub Agent Name">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="broker_name_death_${i}" class="form-label">Broker Name</label>
                                                        <input type="text" class="form-control" name="broker_name_death_${i}" id="broker_name_death_${i}" disabled value="${broker_name}">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="prem_amt_death_${i}" class="form-label">Premium Amount</label>
                                                        <input type="text" class="form-control" name="prem_amt_death_${i}" id="prem_amt_death_${i}" disabled value="${basic_amount}">
                                                    </div>
                                                </div>
                                                <div class="col-xl-2">
                                                    <div class="mb-3">
                                                        <label for="sum_assured_death_${i}" class="form-label">Policy Sum Assured</label>
                                                        <input type="text" class="form-control" name="sum_assured_death_${i}" id="sum_assured_death_${i}" disabled value="${sum_assured}">
                                                    </div>
                                                </div>
                                            </div>`;
                                            
                                            riders.forEach((rider, index) => {[index]
                                                newRowHtml += `<div class="row text-center">
                                                    <div class="col-xl-12">
                                                        <div class="row">
                                                            <div class="col-md-3 mt-2">
                                                                <div class="mb-3">
                                                                    <label class="form-check-label optional-cover-label" for="riders_${rider.id}">${rider.optional_covers}</label>
                                                                </div>
                                                            </div>
                                                            <div class="col-md-3">
                                                                <div class="mb-3">
                                                                    <input type="text" class="form-control rider_sum_assured_${rider.optional_covers.replace(/\s+/g, '_')}" name="rider_sum_assured[]" id="rider_sum_assured_${rider.id}" placeholder="Sum Assured" value="${riders_sum_assured[index]}" disabled>
                                                                </div>
                                                            </div>
                                                            <div class="col-md-3">
                                                                <div class="mb-3">
                                                                    <input type="text" class="form-control" name="rider_risk_term[]" id="rider_risk_term_${rider.id}" placeholder="Risk Term" value="${riders_risk_term[index]}" disabled>
                                                                </div>
                                                            </div>
                                                            <div class="col-md-3">
                                                                <div class="mb-3">
                                                                    <input type="text" class="form-control" name="rider_premium_paying_term[]" id="rider_premium_paying_term_${rider.id}" placeholder="Premium Paying Term" value="${riders_premium_paying_term[index]}" disabled>
                                                                </div>
                                                            </div>
                                                        </div>
                                                    </div>
                                                </div>`;

                                                if (accumulatedAmounts[rider.optional_covers]) {
                                                    accumulatedAmounts[rider.optional_covers] += parseFloat(riders_sum_assured[index] || 0);
                                                } else {
                                                    accumulatedAmounts[rider.optional_covers] = parseFloat(riders_sum_assured[index] || 0);
                                                }

                                            });
                                            
                                            $('.dynamic-riders').remove();

                                            for (var title in accumulatedAmounts) {
                                                var cardHtml = `<div class="col-xl-3 dynamic-riders">
                                                    <div class="card text-white bg-secondary mb-3">
                                                        <div class="card-header text-center font-size-14">${title}<br>
                                                            <div class="optional-cover-amt" id="rider_sum_assured_${title.replace(/\s+/g, '_')}">${accumulatedAmounts[title]}</div>
                                                        </div>
                                                    </div>
                                                </div>`;

                                                $('#riders-lable').append(cardHtml);
                                            }                                              
                                                
                                            newRowHtml += `<div class="row">
                                                <div class="col-xxl-10"></div>
                                                <div class="col-xxl-2 justify-content-md-end mt-2">
                                                    <div class="mb-3 text-end">
                                                        <button type="button" class="btn btn-danger form-control" data-bs-dismiss="multiple_policies" aria-label="Remove" onclick="removeRow(this)" id="remove_btn_policy_${index}" value="Remove">Remove</button>
                                                    </div>
                                                </div>
                                            </div>
                                        </div>`;

                                        TotalSumAssured += sum_assured;
                                    }

                                    $("#add_new_row_death").append(newRowHtml);
                                    $("#policy_holder_name_id_hidden").val("" + resultData['record']['client_id'] + "");
                                    $("#sum_assu_amt_1").html(TotalSumAssured);
                                    $("#sum_assu_amt").val(TotalSumAssured).prop('disabled' , false);

                                    index = index+ 1;

                                    if("{{$data['can_edit']}}" == 1) {
                                        if(("{{$data['data']['death_claim_policy_num']}}").trim() == policy_number.trim()){
                                            break;
                                        }
                                    }
                                }
                                updateTotals();
                            }

                            $("#policy_holder_contact_number").val(mobile_number);
                            
                            if("{{$data['can_edit']}}" == 0) {   
                                var newOption = new Option($("#select2-select_ins_company-container").html(), $("#select_ins_company").val(), true, true);
                                $("#direct_company_name").append(newOption).trigger('change');

                                $("#death_person_name").val(deathPersonName);
                            }
                        } else {
                            $(".actions ul li:contains('Next') a").addClass("disabled-link");
                            
                            toastr["error"](resultData['data']['msg']);
                        }
                    }
                });
            }
        });     

        dateValidations($('#transaction_date, #date_of_admission, #intimation_date, #incident_date, #date_of_birth, #date_of_incident_1, #date_of_death_1, #dob_age_1, #death_date, #enter_risk_from_date, #enter_risk_to_date, #claim_settled_date'));

        $('#enter_mobile_num, #enter_whatsapp_num').on('keyup blur', function (e) {

            $("#addIntimation").removeClass('was-validated');

            var value = $(this).val();
            var isWhatsappNumber = e.target.id === 'enter_whatsapp_num';

            if (e.type === 'keyup') {
                var numericValue = parseFloat(value);

                if (isNaN(numericValue)) {
                    $('#enter_whatsapp_num').val('').removeClass("is-invalid");
                } else {
                    if (value.length === 10) {
                        $('#enter_whatsapp_num').removeClass("is-invalid").addClass('is-valid');
                    }else{
                        if (value.length !== ''){
                            $('#enter_whatsapp_num').addClass("is-invalid");
                        }
                    }
                    $('#enter_whatsapp_num , #policy_holder_contact_number').val(numericValue);
                }
            }

            if (value.length !== '' && value.length !== 0) {
                if (value.length === 10) {
                    if(e.target.id === 'enter_whatsapp_num'){
                        $('#enter_whatsapp_num').removeClass("is-invalid").addClass('is-valid');
                    }else{
                        $('#enter_mobile_num').removeClass("is-invalid");
                    }
                } else {
                    $(this).addClass("is-invalid").removeClass("is-valid");
                }
            } else {               
                $(this).removeClass("is-invalid");
            }
        });

        $('#enter_mobile_num, #enter_whatsapp_num').on('change',function(e) {
            var mobile = $(this).val();

            if (mobile.length > 10) {
                e.preventDefault();
            }

            if(mobile.length != ''){
                if (e.target.value.length === 10) {
                    $(this).removeClass("is-invalid");
                    $(".actions ul li:contains('Next') a").removeClass('disabled-link');
        
                }else{
                    $(this).addClass("is-invalid").removeClass("is-valid");

                    var errorMessage = (e.target.id === 'enter_mobile_num') ? "Mobile number length must be 10 digits" : "Whatsapp number length must be 10 digits";
                    toastr['error'](errorMessage);

                    $(".actions ul li:contains('Next') a").addClass('disabled-link');
                }
            }else{
                $(this).removeClass("is-invalid");
            }
        });

        var emailErrorShown = false;

        $("#enter_email_id").on("keyup blur", function() {
            var email = $(this).val();

            if (email.trim() === "") {
                $(this).prop('required', false).removeClass("is-invalid");
                $(".actions ul li:contains('Next') a").removeClass("disabled-link");
                emailErrorShown = false;
            } else {
                $(this).prop('required', true);

                if (validateEmail(email)) {
                    $(this).removeClass("is-invalid").addClass("is-valid");
                    $(".actions ul li:contains('Next') a").removeClass("disabled-link");
                    emailErrorShown = false;
                } else {
                    if (!emailErrorShown) {
                        $(".actions ul li:contains('Next') a").addClass("disabled-link");
                        $(this).addClass("is-invalid");                      
                        emailErrorShown = true;
                    }
                }
            }
        }).on('change',function(e) {
            var email = $(this).val();

            if(email.length != ''){
                if (!validateEmail(email)) {
                    $(this).addClass("is-invalid").removeClass("is-valid");
                    toastr['error']("Please enter a valid email address");
                    $(".actions ul li:contains('Next') a").addClass('disabled-link');
                }
            }else{
                $(this).removeClass("is-invalid").addClass('is-valid');
            }
        });

        $("#enter_ins_comp").select2({
            ajax: {
                url: ajaxSearchInsCompanyName,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "company_type": function() { return companyType(); },
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        },
                    };
                },
                cache: false
            },
            placeholder: 'Search for company name',
        });

        $("#email_status").select2({placeholder:"Select status"});

        // step 3
        $("#hospital_contact_number, #garage_contact_number, #contact_number").on('keyup blur', function (e) {
            var value = $(this).val();

            if (value.length !== '' && value.length !== 0) {
                if (value.length === 10) {
                    $(this).removeClass("is-invalid");
                } else {
                    $(this).addClass("is-invalid").removeClass("is-valid");
                }
            } else {               
                $(this).removeClass("is-invalid");
            }
        }).on('change',function(e) {
            var mobile = $(this).val();

            if (mobile.length > 10) {
                e.preventDefault();
            }

            if(mobile.length != ''){
                if (e.target.value.length === 10) {
                    $(this).removeClass("is-invalid");

                }else{
                    $(this).addClass("is-invalid").removeClass("is-valid");

                    toastr['error']("Contact number length must be 10 digits");
                }
            }else{
                $(this).removeClass("is-invalid");
            }
        });

        $("#name_of_patient").on("select2:open", function(e) {
            if (!$("#policy_number_1 option:selected").length) {
                toastr.error("Please select a policy number first.");
            }
        });

        function PatientName(){
            $("#name_of_patient").select2({
                ajax: {
                    url: ajaxSearchPatientName,
                    dataType: 'json',
                    delay: 0,
                    data: function(params) {
                        return {
                            "policy_number_id": function() { return $("#policy_number_1").val();},
                            "claim_type": function(){return $("#claim_type_id_1").val();},
                            search_value: params.term,
                            page: params.page
                        };
                    },
                    processResults: function(data, params) {
                        params.page = params.page || 1;
    
                        return {
                            results: data.results,
                            pagination: {
                                more: (params.page * 30) < data.total_count
                            },
                        };
                    },
                    cache: false
                },
                placeholder: 'Search patient name',
            });
        }

        $("#nominee_name").select2({
            ajax: {
                url: ajaxSearchFamilyMember,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "id": function() {return $("#select_policy_holder_name").val();},
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        }
                    };
                },
                cache: false
            },
            placeholder: 'Search nominee name',
        });
        
        $("#death_type").select2({
            ajax: {
                url: ajaxSearchDeathType,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "claim_type": function() {return $("#claim_type_id_1").val();},
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        }
                    };
                },
                cache: false
            },
            placeholder: 'Search Death Type',
        });

        $("#death_reason").select2({
            ajax: {
                url: ajaxSearchDeathReason,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {    
                        "claim_type": function() {return $("#claim_type_id_1").val();}, 
                        "death_claim_type": function() {return $("#death_claim_type").val();},                   
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        }
                    };
                },
                cache: false
            },
            placeholder:"Search Death Reason",
        });

        $("#intimated_to").select2({placeholder:'Select option'});

        $(".isNumber").bind("keyup",function(){
            var node = $(this);
            node.val(node.val().replace(/[^0-9]/g, ''));
        });

        $("#add_multiple_death_row").on('keyup', '.isNumber', function() {
            var node = $(this);
            node.val(node.val().replace(/[^0-9]/g, ''));
        });

        $("#landline_number").bind("keyup", function() {
            var node = $(this);
            // Allow numbers (0-9) and specific special characters (+, -, #, etc.)
            node.val(node.val().replace(/[^0-9\(\)\&\+\-]/g, ''));
        });

        $("#hospital_name").bind("keyup",function(){
            var node = $(this);
            node.val(node.val().replace(/[^a-zA-Z& ]/g, ''));
        });

        $("#death_person_name, #reason_for_hosptalise").bind("keyup",function(){
            var node = $(this);
            node.val(node.val().replace(/[^a-zA-Z ]/g, ''));
        });

        $("#relation").select2({
            ajax: {
                url: ajaxSearchRelation,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        }
                    };
                },
                cache: false
            },
            placeholder: 'Search relation',
        });              

        $('input[type="checkbox"][name="intimation_to[]"]').on("change",function(){
           intimationToCompanies();
        });       

        var selectedValues = [];
        
        $('input[type="checkbox"][name="intimated_through[]"]:checked').each(function() {
            selectedValues.push($(this).val());
        });

        $('input[type="checkbox"][name="intimated_through[]"]').on('change',function(){

              // 🔐 prevent unchecking the last one
            if (!this.checked && selectedValues.length === 1) {
                this.checked = true;
                toastr.error('At least one “Intimated Through” option must remain selected.');
                return;
            }

            var value = $(this).val();

            if (this.checked) {
                // Add the checked value to the array if not already present
                if (!selectedValues.includes(value)) {
                    selectedValues.push(value);
                }
            } else {
                // Remove the unchecked value from the array
                selectedValues = selectedValues.filter(function(item) {
                    return item !== value;
                });
            }

            IntimationThorughFields(selectedValues);            
            
            var value = $("input[type=radio][name=type_1]:checked").val();

            // ClaimIntimationView(value);
        });

        // for general and life company
        $("#direct_company_name").select2({
            ajax: {
                url: ajaxSearchInsCompanyName,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "company_type": function() { return companyType(); },
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        },
                    };
                },
                cache: false
            },
            placeholder: 'Search for company name',
        }).on("change", function() {
            $("#direct_company_email").val("").trigger("change").removeClass('is-invalid');
            insComapnyEmail();
        });

        $("#direct_company_email").on("select2:open", function(e) {
            if (!$("#direct_company_name option:selected").length) {
                toastr.error("Please select a direct company first.");
            }
        }).select2({
            ajax: {
                url: ajaxSearchInsCompanyEmail,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "company_id": function() { return insComapnyEmail(); },
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        },
                    };
                },
                cache: false
            },
            placeholder: 'Search for company email',
            allowClear: true,
            closeOnSelect: false
        }).on('select2:unselecting', function(e) {
            $(this).val(null).trigger('change');
            $(this).empty().trigger('change');

            intimationToCompanies();
        }).on('change',function(){
            var value = $(this).val();
            if(value.length != 0){
                $(this).addClass('is-valid').removeClass('is-invalid');
            }
        });

        // for tpa company
        $("#tpa_company_name").select2({
            ajax: {
                url: ajaxSearchInsCompanyName,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "company_type": "TPA",
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        },
                    };
                },
                cache: false
            },
            placeholder: 'Search for TPA company name',
        }).on("change", function() {
            $("#tpa_company_email").val("").trigger("change");
        });

        $("#tpa_company_email").on("select2:open", function(e) {
            if (!$("#tpa_company_name option:selected").length) {
                toastr.error("Please select a tpa company first.");
            }
        }).select2({
            ajax: {
                url: ajaxSearchInsCompanyEmail,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "company_id": function() { return $("#tpa_company_name").val(); },
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        },
                    };
                },
                cache: false
            },
            placeholder: 'Search for TPA company email',
            allowClear: true,
            closeOnSelect: false
        });

        function companyType(){
            var claim_type_value = $("#claim_type_value_1").html();
           
            if(claim_type_value == "Life-Health" || claim_type_value == "Life Insurance Death Claim" || claim_type_value == "Life-Disability Claim"){
                return "life";
            }else{
                return "general";
            }
        }

        function insComapnyEmail(){
            var value = $("#direct_company_name").val();
            return  value;
        }

        $("#insurance_company_email").on("keyup", function() {
            var email = $(this).val();

            if (!validateEmail(email)) {
                $(this).addClass("is-invalid");
                $("#ins_comp_email_id").attr("disabled", true);
            } else {
                $(this).removeClass("is-invalid");
                $("#ins_comp_email_id").attr("disabled", false);
            }
        });
        
        // bootstrap datepicker    
        if("{{$data['can_edit']}}" == 0) {               
            intimationToCompanies();
            initializeDatepicker();
        }

        var selectedDate = new Date();

        $("#transaction_date ,#incident_date_1 , #intimation_date , #death_date, #claim_settled_date").datepicker({
            format: "dd-mm-yyyy",
            endDate: currentDate,
        }).on('changeDate', function() {
            $('.datepicker').hide();
            $(this).trigger('change');
        });

        $("#incident_date, #date_of_incident_1").datepicker({
            format:"dd-mm-yyyy",
            endDate:currentDate,
        }).on('changeDate',function(){
            selectedDate = $(this).datepicker('getDate');

            $('.datepicker').hide();
            $(this).trigger('change');
        })

        $("#date_of_birth").datepicker({
            format:"dd-mm-yyyy",
            forceParse: false,
            endDate:currentDate,
        }).on('changeDate keyup',function(){
            const selectedDate = $(this).val();

            const dateParts = selectedDate.split('-');
            const day = parseInt(dateParts[0], 10);
            const month = parseInt(dateParts[1], 10);
            const year = parseInt(dateParts[2], 10);

            const birthdate = new Date(year, month - 1, day);
           
            if (!isNaN(birthdate)) {
                if (birthdate > currentDate) {
                    $("#date_of_birth , #age").val('');

                    $('.datepicker').show();
                } else {
                    const ageInMilliseconds = currentDate - birthdate;
                    const ageDate = new Date(ageInMilliseconds);

                    const years = ageDate.getUTCFullYear() - 1970;
                    const hasBirthdayOccurred = currentDate >= birthdate;
                    const age = hasBirthdayOccurred ? years : years - 1;

                    $("#age").val(age).prop('readonly',true);
                    $('.datepicker').hide();
                    $(this).trigger('change');
                }
            }else{
                $("#age").val('').prop('readonly',false);;
            }
        });               

        $("#incident_time_1").on("change", function() {
            const selectedTime =  $(this).val(); 
            const currentDateTime = new Date();
            const timeParts = selectedTime.split(":");
            const selectedHour = parseInt(timeParts[0], 10);
            const selectedMinute = parseInt(timeParts[1], 10);
            const providedTime = new Date();
            providedTime.setHours(selectedHour, selectedMinute);
      
            if (providedTime > currentDateTime && currentDateTime.toDateString() === selectedDate.toDateString()) {
                $(this).val('');
                toastr["error"]("Please select a time in the past.");
            }
        });

        // for hospital name suggetions
        var hospitalSuggest= "{{route('hospital.suggestions')}}";
       
        $('#hospitalNameList').hide();

        $('#hospital_name').keyup(function(){  
            var hospital_name = $(this).val();
            var trHTML1 = '';  
            
            if(hospital_name != ''){
                $('#hospitalNameList').show();
                $('#hospitalAddressList , #hospitaliseReasonList').hide();
                    
                $.ajax({  
                    type: "GET",
                    url: hospitalSuggest,  
                    mimeType : "multipart/form-data",
                    data:{"hospital_name": hospital_name,} ,  
                    success:function(data)  
                    {  
                        $('#hospitalNameListId').empty();

                        var response = jQuery.parseJSON(data);
                        
                        if(response != ''){
                            $('.list-unstyled').show();
                        }

                        $.each(response.data, function(id, name) {
                            trHTML1 +='<li class="p_number" value="'+ name +'">'+name+'</li>'; 
                        });

                        $('#hospitalNameList ul').append(trHTML1); 
                    }  
                }); 
            }else{
                $('#hospitalNameList').hide();
            } 
        });  

        $(document).on('click', '.p_number', function(){  
            $('#hospital_name').text($(this).text()).val($(this).text()); 
            $('#hospitalNameList ul').fadeOut();  
        }); 

        // for hospitalise reason suggetions    
        var hospitalReasonSuggest= "{{route('hospitalise.reason.suggestions')}}";
       
        $('#hospitaliseReasonList').hide();

        $('#reason_for_hosptalise').keyup(function(){  
            var reason = $(this).val();
            var trHTML1 = '';  
            
            if(reason != ''){
                $('#hospitaliseReasonList').show();
                $('#hospitalNameList , #hospitalAddressList').hide();
                    
                $.ajax({  
                    type: "GET",
                    url: hospitalReasonSuggest,  
                    mimeType : "multipart/form-data",
                    data:{"reason": reason,} ,  
                    success:function(data)  
                    {  
                        $('#hospitaliseReasonListId').empty();

                        var response = jQuery.parseJSON(data);

                        if(response != ''){
                            $('.list-unstyled').show();
                        }

                        $.each(response.data, function(id, name) {
                            trHTML1 +='<li class="p_number_1" value="'+ name +'">'+name+'</li>'; 
                        });

                        $('#hospitaliseReasonList ul').append(trHTML1); 
                    }  
                }); 
            }else{
                $('#hospitaliseReasonList').hide();
            } 
        });  

        $(document).on('click', '.p_number_1', function(){  
            $('#reason_for_hosptalise').text($(this).text()).val($(this).text()); 
            $('#hospitaliseReasonList ul').fadeOut(); 
        });

        // for hospitalise address suggetions    
        var hospitalAddressSuggest= "{{route('hospital.address.suggestions')}}";
       
        $('#hospitalAddressList').hide();

        $('#hospital_address').keyup(function(){  
           var address = $(this).val();
           var trHTML1 = '';  
           
           if(address != ''){
               $('#hospitalAddressList').show();
               $('#hospitaliseReasonList , #hospitalNameList').hide();
                   
               $.ajax({  
                   type: "GET",
                   url: hospitalAddressSuggest,  
                   mimeType : "multipart/form-data",
                   data:{"address": address,} ,  
                   success:function(data){  
                       $('#hospitalAddressListId').empty();

                       var response = jQuery.parseJSON(data);

                       if(response != ''){
                           $('.list-unstyled').show();
                       }

                       $.each(response.data, function(id, name) {
                           trHTML1 +='<li class="p_number_2" value="'+ name +'">'+name+'</li>'; 
                       });

                       $('#hospitalAddressList ul').append(trHTML1); 
                    }  
               }); 
           }else{
               $('#hospitalAddressList').hide();
           } 
        });  
       
        $(document).on('click', '.p_number_2', function(){  
            $('#hospital_address').text($(this).text()).val($(this).text()); 
            $('#hospitalAddressList ul').fadeOut(); 
        }); 

        // for hide suggetion list of hospital name ,reason and address
        $(document).on('click', 'body', function(){  
            $('#hospitalNameList ul , #hospitaliseReasonList ul , #hospitalAddressList ul').fadeOut();  
        }); 

        if(canEdit == 0){
            var newOption = new Option("Claim Documents", '3', false, false);
            $('#claim_document_type_1').append(newOption).trigger('change');
        }
       
        // for document upload      
        // claimDocumentSelect2(1);
       
        // form wizard
        $('a').click(function() {
            if ($('.actions li:eq(1)').hasClass('disabled')) {
                disabledFinish(selectedValues);
            }

            if ($('.actions li:eq(1)').attr('class') == '') {
                $('#btnSave , #send_email , #download').hide();
            }
        });

        // for responsive ui
        $('.actions li:first-child a').addClass('form-control');

        $("form input[type='text']:not([disabled]), form select:not([disabled]), form input[type='checkbox']:not([disabled])").on("keyup change", function() {
            var form = $(this).closest("form");            
            var elementId = $(this).attr('id');

            if (typeof $(this).attr('disabled') !== 'undefined' && (form.find("input.is-invalid").length > 0 || form.find("select.is-invalid").length > 0)) {                     
                $(".actions ul li:contains('Next') a").addClass("disabled-link");
                var lastDoneTab = document.querySelector('li.done.last');

                if (lastDoneTab) {
                    lastDoneTab.classList.remove('done');
                    lastDoneTab.classList.add('disabled');
                }
            } else {                
                $(".actions ul li:contains('Next') a").removeClass("disabled-link");
            }
        });

        // for form wizard step validation
        $(".actions ul li:contains('Next') a").on('click',function(){
            $(".wizard-step input:required, .wizard-step select:required").on("keyup change", function(e) {
                var fieldValue = $(this).val();
               
                if (!fieldValue || fieldValue === '') {
                    $(this).addClass("is-invalid").removeClass("is-valid");
               
                } else {
                    if(e.target.id == "enter_email_id"){
                        if (validateEmail(email)) {
                            $("#enter_email_id").addClass("is-valid").removeClass("is-invalid");
                        }else{
                            $(this).addClass("is-invalid").removeClass("is-valid");
                        }
                    }else{
                        $(this).addClass("is-valid").removeClass("is-invalid");
                    }
                }
            });
        });

        addMultipleRowsDeath();
    });

    function showRequest(formData, jqForm, options) {
        showLoader();

        var queryString = $.param(formData);
        return true;
    }

    function showResponse(responseText, statusText, xhr, $form) {
        hideLoader();

        if (responseText['status'] == 1) {
            toastr["success"](responseText['msg']);
            $("#" + $form[0].id + "").removeClass('was-validated');
        
            var modalName = $form[0].id.split('form');
            $("#modal" + modalName[1] + "").modal('hide');

            if ("#" + $form[0].id + "" == "#formBranch") {
                $('#select_branch').empty();

                var newOption = new Option("" + responseText['data']['text'] + "", "" + responseText['data']['id'] + "", false, false);
                $('#select_branch').append(newOption).trigger('change');
            }
        }else{
            if (typeof responseText['data'] !== "undefined") {
                var size = Object.keys(responseText['data']).length;
                if (size > 0) {
                    for (var [key, value] of Object.entries(responseText['data'])) {
                    toastr["error"](value);
                    }
                }
            } else {
                toastr["error"](responseText['msg']);
            }
        }
    }

    function intimationToCompanies(){
        var checkedValues = []; // Array to store checked values

        $('input[type="checkbox"][name="intimation_to[]"]:checked').each(function() {
            checkedValues.push($(this).val());
        });
        
        if (checkedValues.includes("Direct Company") && checkedValues.includes("TPA Company")) {
            $("#direct_company_name , #direct_company_email , #direct_company , #tpa_company_name , #tpa_company_email , #tpa_company").attr('required',true).prop('disabled',false).removeClass('is-invalid');

            $("#direct_company , #tpa_company").attr('required',true);
            $("#direct_company_name , #direct_company_email , #tpa_company_name , #tpa_company_email").prop('disabled',false).removeClass('is-invalid');

        }else{
            if(checkedValues.includes ("Direct Company")){
                $("#direct_company_name , #direct_company_email , #direct_company").attr('required',true).prop('disabled',false).removeClass('is-invalid');
                
                var directMail = $("#direct_company_email").val();

                if(directMail.length == 0 && $("#basic-example-t-2").parent().hasClass('current') == true){
                    $("#direct_company_email").addClass('is-invalid').removeClass('is-valid');
                }else{
                    $("#direct_company_email").addClass('is-valid').removeClass('is-invalid');
                }

                $("#tpa_company").attr('required',false).removeClass('is-invalid');
                $("#tpa_company_name , #tpa_company_email").prop('disabled',true).removeClass('is-invalid , is-valid');
            }else{
                $("#direct_company_name, #direct_company_email").attr('required',false).val("").trigger("change").removeClass('is-invalid');

                $("#tpa_company").attr('required',true);
                $("#direct_company").removeClass('is-valid');
                $("#tpa_company_name, #tpa_company_email").prop('disabled',false).removeClass('is-invalid');
            }

            if(checkedValues.includes ("TPA Company")){
                $("#tpa_company_name , #tpa_company_email , #tpa_company").attr('required',true).prop('disabled',false).removeClass('is-invalid').addClass('is-valid');

                $("#direct_company").attr('required',false).removeClass('is-invalid');
                $("#direct_company_name , #direct_company_email").prop('disabled',true).removeClass('is-invalid , is-valid');
            }else{
                $("#tpa_company_name , #tpa_company_email").attr('required',false).val("").trigger("change").removeClass('is-invalid');

                $("#direct_company").attr('required',true).removeClass('is-valid');
                $("#direct_company_name , #direct_company_email").prop('disabled',false).removeClass('is-invalid');
            }

            if(checkedValues.length == 0){
                $("#direct_company , #tpa_company").addClass('is-invalid').removeClass('is-valid').attr('checked',false);
                $("#direct_company_name , #direct_company_email , #tpa_company_name , #tpa_company_email").prop('disabled',true).removeClass('is-invalid , is-valid');
            }
        }
    }

    function initializeDatepicker() {

        if("{{$data['can_edit']}}" == 0) {
            $("#date_of_admission, #intimation_date, #date_of_incident_1").datepicker("destroy").val(''); // Destroy previous instance
        }

        $("#date_of_admission").datepicker({
            format: "dd-mm-yyyy",
            startDate: risk_from_date,
            endDate: risk_to_date,
        }).on('changeDate', function() {
            $('.datepicker').hide();
            $(this).trigger('change');
        });           
        
        $("#intimation_date").datepicker({
            format: "dd-mm-yyyy",
            endDate: currentDate,
        }).on('changeDate', function() {
            $('.datepicker').hide();
            $(this).trigger('change');
        });
        
        $("#date_of_admission").on('change',function(){
            selectedDate = $(this).datepicker('getDate');

            if(selectedDate != null){
                var thirtyDaysBefore = new Date(selectedDate);
                thirtyDaysBefore.setDate(selectedDate.getDate() - 30);

                var thirtyDaysAfter = new Date(selectedDate);
                thirtyDaysAfter.setDate(selectedDate.getDate() + 30);

                if("{{$data['can_edit']}}" == 0) {
                    $("#intimation_date").datepicker("destroy").val(''); 
                }

                $("#intimation_date").datepicker({
                    format: "dd-mm-yyyy",
                    startDate: thirtyDaysBefore,
                    endDate: thirtyDaysAfter,
                }).on('changeDate', function() {
                    $('.datepicker').hide();
                    $(this).trigger('change');
                });
            }
        });

        $("#date_of_incident_1").datepicker({
            format: "dd-mm-yyyy",
            startDate: risk_from_date,
            endDate: currentDate,
        }).on('changeDate', function() {
            selectedDate = $(this).datepicker('getDate');

            $("#incident_time_1").val('');

            $('.datepicker').hide();

            if("{{$data['can_edit']}}" == 0) {
                $(this).trigger('change');
            }
        });
        
        $("#date_of_incident_1").on('change',function(){
            selectedDate = $(this).datepicker('getDate');
            
            if(selectedDate != null){
                var thirtyDaysBefore = new Date(selectedDate);
                thirtyDaysBefore.setDate(selectedDate.getDate() - 30);

                var thirtyDaysAfter = new Date(selectedDate);
                thirtyDaysAfter.setDate(selectedDate.getDate() + 30);

                if("{{$data['can_edit']}}" == 0) {
                    $("#intimation_date").datepicker("destroy").val(''); 
                }

                $("#intimation_date").datepicker({
                    format: "dd-mm-yyyy",
                    startDate: thirtyDaysBefore,
                    endDate: thirtyDaysAfter,
                }).on('changeDate', function() {
                    $('.datepicker').hide();
                    $(this).trigger('change');
                });
            }
        });            
    }

    function addEmail(id){
        if(id == 1){
            var comp_id = $("#direct_company_name").val();
        }else if(id == 2){
            var comp_id = $("#tpa_company_name").val();
        }

        if(comp_id){
            $("#formAddEmail").trigger('reset').removeClass('was-validated');
            $("#modalAddEmail").modal('show');
            $("#insurance_company_email").removeClass('is-invalid');
            $("#ins_comp_email_id").attr('disabled',false);
            $('#email_status').val("Claim Intimation").trigger('change');
            $("#company_id").val(comp_id);
        }else{
            toastr['error']('Please select first company name');
        }
    }

    function addMultipleRowsDeath(){
        
        var removeButtons = document.querySelectorAll(".firstRemove");

        if (removeButtons.length >= 8) {
            $("#add_row_1").attr('disabled', true);
        }
        
        var html = `
        <div class="row row-item-death">
            <div class="col-xxl-1">
                <div class="mb-3">
                    <label for="sr_no_${Counter}" class="form-label">Sr No.<span class="text-danger">*</span></label>
                    <input type="text" class="form-control" name="sr_no_${Counter}" id="sr_no_${Counter}" placeholder="Enter sr. no" value="${Counter}" readonly maxlength="3">
                </div>
            </div>
            <div class="col-xxl-3">
                <div class="mb-3">
                    <label for="death_person_name_${Counter}" class="form-label">Death Person Name<span class="text-danger">*</span></label>
                    <input type="text" class="form-control" name="death_person_name_${Counter}" id="death_person_name_${Counter}" placeholder="Enter name" required autocomplete="off">
                </div>
            </div>
            <div class="col-xxl-3">
                <div class="mb-3">
                    <label for="nominee_person_name_${Counter}" class="form-label">Nominee Name</label>
                    <input type="text" class="form-control" name="nominee_person_name_${Counter}" id="nominee_person_name_${Counter}"  placeholder="Enter name" autocomplete="off">
                </div>
            </div>
            <div class="col-xxl-3">
                <div class="mb-3">
                    <label for="nominee_person_number_${Counter}" class="form-label">Nominee Contact No.</label>
                    <input type="text" class="form-control isNumber" name="nominee_person_number_${Counter}" id="nominee_person_number_${Counter}" maxlength="10"  placeholder="Enter contact number" autocomplete="off">
                </div>
            </div>
            <div class="col-xxl-2">
                <div class="mb-3">
                    <label for="date_of_death_${Counter}" class="form-label">Date Of Death <span class="text-danger">*</span></label>
                    <input type="text" class="form-control" name="date_of_death_${Counter}" id="date_of_death_${Counter}" placeholder="dd-mm-yyyy" required autocomplete="off">
                </div>
            </div>
            <div class="col-xxl-3">
                <div class="mb-3">
                    <label for="death_of_type_${Counter}" class="form-label">Death Type<span class="text-danger">*</span></label>
                    <select class="form-control select2-ajax" id="death_of_type_${Counter}" name="death_of_type_${Counter}" required></select>
                    <div class="invalid-feedback">This value is required.</div>
                </div>
            </div>
            <div class="col-xxl-2">
                <div class="mb-3">
                    <label for="dob_age_${Counter}" class="form-label">Birth Date<span class="text-danger">*</span> <span style="font-size: 12px;color: #808080bd;"  class="age_${Counter}"></span></label>
                    <input type="text" class="form-control" id="dob_age_${Counter}" name="dob_age_${Counter}" placeholder="dd-mm-yyyy" required autocomplete="off">
                </div>
            </div>
            <div class="col-xxl-2">
                <div class="mb-3">
                    <label for="is_policy_holder_${Counter}" class="form-label">Is Policy Holder<span class="text-danger">*</span></label>
                    <select class="form-control select2-ajax" id="is_policy_holder_${Counter}" name="is_policy_holder_${Counter}" required>
                        <option value=""></option>
                        <option value="1">Yes</option>
                        <option value="0">No</option>
                    </select>
                    <div class="invalid-feedback">This value is required.</div>
                </div>
            </div>
            <div class="col-xxl-2">
                <div class="mb-3">
                    <label for="is_third_party_${Counter}" class="form-label">Is Third Party<span class="text-danger">*</span></label>
                    <select class="form-control select2-ajax" id="is_third_party_${Counter}" name="is_third_party_${Counter}" required>
                        <option value=""></option>
                        <option value="1">Yes</option>
                        <option value="0">No</option>
                    </select>
                    <div class="invalid-feedback">This value is required.</div>
                </div>
            </div>
            <div class="col-xxl-2">
                <div class="mb-3">
                    <label for="is_hospitalised_${Counter}" class="form-label">Is Hospitalised<span class="text-danger">*</span></label>
                    <select class="form-control select2-ajax" id="is_hospitalised_${Counter}" name="is_hospitalised_${Counter}" required>
                        <option value=""></option>
                        <option value="1">Yes</option>
                        <option value="0">No</option>
                    </select>
                    <div class="invalid-feedback">This value is required.</div>
                </div>
            </div>`;

            if (Counter == 1) {
                html += `<div class="col-xxl-1 justify-content-md-end mt-4">
                    <div class="mb-3">
                        <input type="button" class="btn btn-primary form-control" name="add_row_${Counter}" id="add_row_${Counter}" value="Add Row" style="margin-top: 3px;" onclick="return addMultipleRowsDeath();">
                    </div>
                </div>`;
            } else {
                html += `<div class="col-xxl-1 justify-content-md-end mt-4">
                    <div class="mb-3">
                        <button type="button" class="btn btn-danger firstRemove form-control" data-bs-dismiss="row" aria-label="Remove" onclick="removeRow(this)" id="remove_btn_${Counter}" value="Remove">Remove</button>
                    </div>
                </div>`;
            }

        html += `<hr></div>`;

        $("#add_multiple_death_row").append(html);

        $("#death_of_type_" + Counter).select2({
            ajax: {
                url: ajaxSearchDeathType,
                dataType: 'json',
                delay: 0,
                data: function(params) {
                    return {
                        "claim_type": function() { return $("#claim_type_id_1").val(); },
                        search_value: params.term,
                        page: params.page
                    };
                },
                processResults: function(data, params) {
                    params.page = params.page || 1;

                    return {
                        results: data.results,
                        pagination: {
                            more: (params.page * 30) < data.total_count
                        }
                    };
                },
                cache: false
            },
            placeholder: 'Search death type',
        });

        $("#is_policy_holder_" + Counter + ", #is_third_party_" + Counter + ", #is_hospitalised_" + Counter).select2({placeholder :'Search'});
        
        $("#is_policy_holder_" + Counter).on('change',function(){
            var value = $(this).val();

            if(value == 1){
                $("#is_third_party_" + (Counter - 1)).val(0).trigger("change");
            }else{
                $("#is_third_party_" + (Counter - 1)).val(1).trigger("change");
            }
        });
        
        $("#date_of_death_" + Counter).datepicker({
            format: "dd-mm-yyyy",
            endDate: currentDate,
        }).on('changeDate', function() {
            $('.datepicker').hide();
            $(this).trigger('change');
        });

        $("#dob_age_" + Counter).datepicker({
            format: "dd-mm-yyyy",
            endDate: currentDate,
        }).on('changeDate keyup', function() {
            const selectedDate = $(this).val();
            
            const dateParts = selectedDate.split('-');
            const day = parseInt(dateParts[0], 10);
            const month = parseInt(dateParts[1], 10);
            const year = parseInt(dateParts[2], 10);
            
            const birthdate = new Date(year, month - 1, day);
            
            if (!isNaN(birthdate)) {
                const ageInMilliseconds = currentDate - birthdate;
                const ageDate = new Date(ageInMilliseconds);
                
                const years = ageDate.getUTCFullYear() - 1970;
                const hasBirthdayOccurred = currentDate >= birthdate;
                const age = hasBirthdayOccurred ? years : years - 1;
                
                $(`.age_${Counter-1}`).text(" (age : " + age + ")");
                
            }else{
                $(`.age_${Counter-1}`).text("");
            }

            $('.datepicker').hide();
            $(this).trigger('change');
        });

        dateValidations($('#date_of_death_' + Counter + ', #dob_age_'+ Counter));

        $('#death_person_name_' + Counter + ', #nominee_person_name_' + Counter).on('input', function() {
            var inputValue = $(this).val();
            var capitalizedValue = capitalizeString(inputValue);
            $(this).val(capitalizedValue);
        });

        $("#nominee_person_number_" + Counter).on('keyup blur', function (e) {
            var value = $(this).val();

            if (value.length !== '' && value.length !== 0) {
                if (value.length === 10) {
                    $(this).removeClass("is-invalid");
                    $(".actions ul li:contains('Next') a").removeClass("disabled-link");
                } else {
                    $(this).addClass("is-invalid").removeClass("is-valid");
                    
                    $(".actions ul li:contains('Next') a").addClass("disabled-link");
                    
                    var lastDoneTab = document.querySelector('li.done');

                    if (lastDoneTab) {
                        lastDoneTab.classList.remove('done');
                        lastDoneTab.classList.add('disabled');
                    }
                }
            } else {               
                $(this).removeClass("is-invalid");
                $(".actions ul li:contains('Next') a").removeClass("disabled-link");
            }
        });

        $("#nominee_person_number_" + Counter).on('change',function(e) {
            var mobile = $(this).val();

            if (mobile.length > 10) {
                e.preventDefault();
            }

            if(mobile.length != ''){
                if (e.target.value.length === 10) {
                    $(this).removeClass("is-invalid");
                    $(".actions ul li:contains('Next') a").removeClass("disabled-link");
                }else{
                    $(this).addClass("is-invalid").removeClass("is-valid");

                    toastr['error']("Contact number length must be 10 digits");

                    $(".actions ul li:contains('Next') a").addClass("disabled-link");
                    var lastDoneTab = document.querySelector('li.done');

                    if (lastDoneTab) {
                        lastDoneTab.classList.remove('done');
                        lastDoneTab.classList.add('disabled');
                    }
                }
            }else{
                $(this).removeClass("is-invalid");
                $(".actions ul li:contains('Next') a").removeClass("disabled-link");
            }
        });

        Counter ++;
    }      

    function updateTotals() {
        TotalSumAssured = 0;

        $(".multiple_policies").each(function (index) {
            var sum_assured = parseFloat($(this).find(`[name^="sum_assured_death"]`).val()) || 0;
          
            TotalSumAssured += sum_assured;
        });

        $("#sum_assu_amt_1").html(TotalSumAssured);
        $("#sum_assu_amt").val(TotalSumAssured).prop('disabled' , false);

        var sumByClass = {};

        $('input[name^="rider_sum_assured["]').each(function(index) {
            var amt = parseFloat($(this).val()) || 0;
            var className = $(this).attr('class');

            if (className.includes('rider_sum_assured_')) {
                var specificClass = className.match(/rider_sum_assured_[\w\s]+/)[0];

                if (sumByClass[specificClass]) {
                    sumByClass[specificClass] += amt;
                } else {
                    sumByClass[specificClass] = amt;
                }
            }
        });

        Object.entries(sumByClass).forEach(([key, value]) => {
            $(`#${key}`).html(value);
        });
        
        $('.optional-cover-amt').each(function() {
            var id = $(this).attr('id');
         
            if (!sumByClass.hasOwnProperty(id)) {
                $(this).html(0);
            }
        });
    }

    function isNonRegisterdClientView(value , value2){       
        if(value2 == 15){
            if(value == 0){
                $("#select_policy_holder_name_id , #main_policy_id").show();
    
                $("#enter_policy_holder_name_id , #policy_num_2_id").hide();
    
                $("#step_2_other_death_claim").find("input , select").prop('disabled',true).removeClass('is-invalid , is-valid');
    
            }else if(value == 1){
                
                $("#enter_policy_holder_name_id , #policy_num_2_id").show();
                
                $("#select_policy_holder_name_id , #main_policy_id").hide();
    
                $("#step_2_other_death_claim").find("input , select").prop('disabled',false).removeClass('is-invalid , is-valid');
            }
        }
    }

    function IntimationThorughFields(value){
        if(value.includes("Email")) {
            $(".email-require, #tpaHide").find("input, select").prop("disabled", false).removeClass('is-invalid');
        } else {
            $(".email-require, #tpaHide").find("input, select").prop("disabled", true).removeClass('is-valid , is-invalid');
        }

        intimationToCompanies();
    }

    function ClaimIntimationView(value,claimType){  
        $("#TPL_Due_date").html('');

        $("#add_multiple_death_row").empty();      

        $("#policy_type_id , #select_policy_holder_name_id , #select_vehicle_num_id").hide();

        $("#main_claim_type_id , #select_policy_holder_name_id").addClass('col-xxl-3').removeClass('col-xxl-2');
        $("#main_policy_id").removeClass('col-xxl-2');

        var html = '';

        if(value == "Vehicle Claim"){
            $("#step_2_claim , #general_mediclaim , #vehicle_data_name , #vehicle_data_number, #premium_amt_id ,#holder_name ,#select_vehicle_num_id").show();
            $("#tpaHide").hide();

            var fieldsToShowAndEnable = [
                "main_policy_id",
                "vehicle_ins_1",
                "TPL_Due_date",                
                "date_of_incident",
                "general_vehicle",
                "general_vehicle_1",
                "general_vehicle_2",
                "intimation_type_id",     
                "select_policy_holder_name_id",    
                "incident_time_id_1",        
            ];

            fieldsToShowAndEnable.forEach(function(fieldId) {
                $("#" + fieldId).show().find("input, select").prop("disabled", false).removeClass('is-invalid');
            });

            var fieldsToHideAndDisable = [
                "estimated_loss_amt_id",
                "person_covered",
                "patient_name",
                "admit_date",
                "general_1",
                "others_claim_incident_fields",
                "general_hospital_detail_id",
                "incident_contact_num_id",
                "death_claim_agency_1",
                "death_claim_type_id",
                "client_type_id",
                "enter_policy_holder_name_id",
                "policy_num_2_id",
                "select_ins_company_id",
                "step_2_death_claim",
                "step_2_other_death_claim",
                "select_branch_id",
                "death_person_name_id",
                "nominee_name_id",
                "contact_num_id",
                "death_details",
                "claim_count_id",
                "death_policy_details",
                "bank_name_id",
                "model_id",
                "rto_id",
                "branch_name_id",
                "policy_address_id",
            ];

            fieldsToHideAndDisable.forEach(function(fieldId) {
                $("#" + fieldId).hide().find("input, select").prop("disabled", true).removeClass('is-invalid , is-valid');
            });

            $("#main_claim_type_id , #main_policy_id , #select_vehicle_num_id").addClass('col-xxl-3').removeClass('col-xxl-4 , col-xxl-6');
            $("#seg_1 , #brok_1 , #sub_agent_id , #agency_id").addClass('col-xxl-2').removeClass('col-xxl-3');
            // $("#sum_assu_amt_id").addClass('col-xxl-4').removeClass('col-xxl-2');
            
            $("#date_of_incident, #incident_time_id_1").removeClass('col-xxl-4').addClass('col-xxl-2');

            html += '<div class="mb-3">'
            html += '<label for="tpl_due_date_1" class="form-label">TPL Due Date</label>'
            html += '<input type="text" class="form-control" name="tpl_due_date_1" id="tpl_due_date_1" disabled value="" placeholder="dd-mm-yyyy">'
            html += '</div>'
        
            $("#TPL_Due_date").append(html);

        }else if(value == 'Other Claim'){
            $("#step_2_claim , #general_mediclaim , #person_covered , #premium_amt_id, #tpaHide").show();

            var fieldsToShowAndEnable = [
                "main_policy_id",
                "date_of_incident",
                "estimated_loss_amt_id",
                "others_claim_incident_fields",
                "general_1",
                "wc_medi_claim_1",
                "incident_contact_num_id",
            ];

            fieldsToShowAndEnable.forEach(function(fieldId) {
                $("#" + fieldId).show().find("input, select").prop("disabled", false).removeClass('is-invalid');
            });

            var fieldsToHideAndDisable = [
                "patient_name",
                "holder_name",
                "admit_date",
                "general_vehicle",
                "vehicle_ins_1",
                "TPL_Due_date",
                "vehicle_data_name",
                "vehicle_data_number",
                "intimation_type_id",
                "general_hospital_detail_id",
                "incident_date_id",
                "incident_time_id",
                "death_claim_agency_1",
                "death_claim_type_id",
                "client_type_id",
                "enter_policy_holder_name_id",
                "policy_num_2_id",
                "select_ins_company_id",
                "select_policy_holder_name_id",
                "select_branch_id",
                "step_2_death_claim",
                "step_2_other_death_claim",
                "death_person_name_id",
                "nominee_name_id",
                "contact_num_id",
                "death_details",
                "claim_count_id",
                "death_policy_details",
                "bank_name_id",
                "model_id",
                "rto_id",
                "branch_name_id",
                "policy_address_id",
                "incident_time_id_1"
            ];

            fieldsToHideAndDisable.forEach(function(fieldSelector) {
                $("#" + fieldSelector).hide().find("input, select").prop("disabled", true).removeClass('is-invalid , is-valid');
            });

            $("#main_claim_type_id , #main_policy_id").addClass('col-xxl-6').removeClass('col-xxl-3');
            $("#seg_1 , #brok_1 , #sub_agent_id , #agency_id").addClass('col-xxl-3').removeClass('col-xxl-2');
            // $("#sum_assu_amt_id, #date_of_incident").addClass('col-xxl-4').removeClass('col-xxl-2');
            $("#date_of_incident").addClass('col-xxl-4').removeClass('col-xxl-2');

            $("#reason_of_incident").select2({placeholder:"Select reason"});
            $("#intimated_to_police , #intimated_to_fire").select2({placeholder:"Select option"});
            
        }else if(value == 'Death Claim'){
            $("#step_2_death_claim, #tpaHide").show();

            var fieldsToShowAndEnable = [
                "death_claim_agency_1",
                "death_claim_type_id",                
                "select_policy_holder_name_id",
                "death_person_name_id",
                "nominee_name_id",
                "contact_num_id",
                "death_details",
                "general_vehicle",
                "select_ins_company_id",
                "select_branch_id",
                "general_mediclaim",
                "death_policy_details",
                "vehicle_data_name",
                "vehicle_data_number",
                "bank_name_id",
                "model_id",
                "rto_id",                
            ];

            fieldsToShowAndEnable.forEach(function(fieldId) {
                $("#" + fieldId).show().find("input, select").prop("disabled", false).removeClass('is-invalid');
            });            
           
            var fieldsToHideAndDisable = [
                "client_type_id",
                "enter_policy_holder_name_id",
                "policy_num_2_id",
                "vehicle_ins_1",
                "main_policy_id",
                "step_2_claim",
                "intimation_type_id",
                "holder_name",
                "date_of_incident",
                "patient_name",
                "admit_date",
                "general_1",
                "general_vehicle_1",
                "general_vehicle_2",
                "estimated_loss_amt_id",
                "others_claim_incident_fields",
                "claim_count_id",
                "person_covered",
                "premium_amt_id",
                "TPL_Due_date",
                "branch_name_id",
                "incident_time_id_1",
                "life_health_claim"
            ];

            fieldsToHideAndDisable.forEach(function(fieldSelector) {
                $("#" + fieldSelector).hide().find("input, select").prop("disabled", true).removeClass('is-invalid , is-valid');
            });            

            $("#main_claim_type_id").addClass('col-xxl-3').removeClass('col-xxl-6 , col-xxl-4');
            $("#seg_1, #brok_1, #agency_id, #sub_agent_id").addClass('col-xxl-2').removeClass('col-xxl-3');
            // $("#sum_assu_amt_id").addClass('col-xxl-2').removeClass('col-xxl-4');
            $("#select_ins_company_id, #death_claim_type_id").addClass('col-xxl-3').removeClass('col-xxl-2');

            if("{{$data['can_edit']}}" == 1) {
                if(claimType == 12){  
                    $("#select_ins_company_id , #select_branch_id , #step_2_death_claim , #nominee_name_id , #death_person_name_id , #contact_num_id , #death_date_id , #death_type_id , #illness_id , #select_policy_holder_name_id").show();
                    $("#death_claim_agency_1").show().find("input").prop("disabled",false).removeClass('is-invalid');
                
                    $("#main_policy_id , #claim_count_id , #step_2_claim , #date_of_incident , #incident_time_id_1 , #acci_place_id , #intimated_to_id , #fp_name_id , #policy_type_id , #step_2_other_death_claim").hide();
                    $("#client_type_id , #enter_policy_holder_name_id , #policy_num_2_id").hide().find("input , select").prop("disabled",true).removeClass('is-invalid , is-valid');       
                    $(".short-detail").html('Death Short Detail');

                    $("#death_reason_id , #dsd_id , #hospital_name_add_id , #dod_id , #ps_name_id").addClass('col-xxl-3').removeClass('col-xxl-4');
                    $("#main_claim_type_id , #select_policy_holder_name_id").addClass('col-xxl-3').removeClass('col-xxl-2');
            
                }else if(claimType == 13){               
                    $("#main_policy_id , #date_of_incident , #incident_time_id_1 , #death_claim_agency_1 , #select_vehicle_num_id").show().find("input, select").prop("disabled", false).removeClass('is-invalid');
                    $("#select_policy_holder_name_id , #claim_count_id , #step_2_claim , #death_policy_details , #rto_id , #model_id , #vehicle_data_name , #vehicle_data_number , #acci_place_id").show();
                    
                    $("#select_ins_company_id , #select_branch_id , #step_2_death_claim , #step_2_other_death_claim , #policy_address_id , #branch_name_id , #death_person_name_id , #nominee_name_id , #contact_num_id , #death_date_id , #death_type_id , #illness_id , #intimated_to_id , #fp_name_id , #policy_type_id, #tpaHide").hide();
                    $("#client_type_id , #enter_policy_holder_name_id , #policy_num_2_id").hide().find("input , select").prop("disabled",true).removeClass('is-invalid , is-valid');

                    $(".short-detail").html('Incident Short Detail');
                    $(".desti_incident").html("Destination Of Accident");

                    $("#death_reason_id , #dsd_id , #hospital_name_add_id , #dod_id , #ps_name_id").addClass('col-xxl-4').removeClass('col-xxl-3');
                    $("#main_claim_type_id , #main_policy_id , #select_policy_holder_name_id , #death_claim_type_id").addClass('col-xxl-3').removeClass('col-xxl-2');
                    $("#select_vehicle_num_id").removeClass('col-xxl-4').addClass('col-xxl-3');
                    $("#claim_count_id").removeClass('col-xxl-1 ,col-xxl-3').addClass('col-xxl-2');
                    $("#main_policy_id").removeClass('col-xxl-6 , col-xxl-4');

                    $("#intimated_to option[value='By Us'] , #intimated_to option[value='By Authority'] ").remove();

                }else if(claimType == 14){                
                    $("#main_policy_id , #date_of_incident , #incident_time_id_1 , #death_claim_agency_1").show().find("input, select").prop("disabled", false).removeClass('is-invalid');
                    $("#select_policy_holder_name_id , #claim_count_id , #step_2_claim , #branch_name_id , #policy_address_id , #intimated_to_id , #fp_name_id , #acci_place_id").show();
                    
                    $("#select_ins_company_id , #select_branch_id , #step_2_death_claim , #step_2_other_death_claim , #death_policy_details , #vehicle_data_name , #vehicle_data_number , #model_id , #rto_id , #death_person_name_id , #nominee_name_id , #contact_num_id , #death_date_id , #death_type_id , #illness_id , #policy_type_id").hide();
                    $("#client_type_id , #enter_policy_holder_name_id , #policy_num_2_id").hide().find("input , select").prop("disabled",true).removeClass('is-invalid , is-valid');

                    $(".short-detail").html('Incident Short Detail');
                    $(".desti_incident").html("Destination Of Accident");

                    $("#dod_id , #ps_name_id").addClass('col-xxl-6').removeClass('col-xxl-4 , col-xxl-3');
                    $("#death_reason_id , #dsd_id , #fp_name_id , #hospital_name_add_id").addClass('col-xxl-4').removeClass('col-xxl-3');
                    $("#main_claim_type_id , #select_policy_holder_name_id , #death_claim_type_id").addClass('col-xxl-3').removeClass('col-xxl-2');
                    $("#claim_count_id").removeClass('col-xxl-1 ,col-xxl-2').addClass('col-xxl-3');
                    
                    $("#main_policy_id").addClass('col-xxl-3').removeClass('col-xxl-6 , col-xxl-2 , col-xxl-4');
                    
                    $("#intimated_to option[value='By Us'] , #intimated_to option[value='By Authority'] ").remove();

                }else if(claimType == 15){
                    $("#main_policy_id , #date_of_incident , #incident_time_id_1 , #client_type_id").show().find("input, select").prop("disabled", false).removeClass('is-invalid');
                    $("#policy_address_id , #branch_name_id , #policy_type_id , #acci_place_id , #intimated_to_id , #fp_name_id , #select_policy_holder_name_id , #step_2_other_death_claim").show();

                    $("#enter_policy_holder_name_id , #policy_num_2_id , #death_claim_agency_1").hide().find("input").prop("disabled",false).removeClass('is-invalid'); 
                    $("#select_ins_company_id , #select_branch_id , #claim_count_id , #step_2_death_claim , #step_2_claim , #death_policy_details , #vehicle_data_name , #vehicle_data_number , #model_id , #rto_id , #death_person_name_id , #nominee_name_id , #contact_num_id , #death_date_id , #death_type_id , #illness_id").hide();

                    $(".short-detail").html('Incident Short Detail');
                    $(".desti_incident").html("Destination Of Incident");

                    $("#dod_id , #ps_name_id").addClass('col-xxl-6').removeClass('col-xxl-4 , col-xxl-3');
                    $("#death_reason_id , #dsd_id , #fp_name_id , #hospital_name_add_id").addClass('col-xxl-4').removeClass('col-xxl-3');
                    $("#main_claim_type_id").addClass('col-xxl-3');
                    $("#main_policy_id").addClass('col-xxl-3').removeClass('col-xxl-6 , col-xxl-4 ,col-xxl-2');
                    $("#select_policy_holder_name_id").addClass('col-xxl-3').removeClass('col-xxl-2');

                    var html = '';
                    html += '<option value="By Authority">By Authority</option>';
                    html +='<option value="By Us">By Us</option>';

                    $("#intimated_to").append(html);
                }
            }

        }else{
            $("#step_2_claim , #general_mediclaim , #person_covered , #premium_amt_id, #tpaHide").show();

            var fieldsToShowAndEnable = [
                "main_policy_id",
                "patient_name",
                "admit_date",
                "general_1",
                "intimation_type_id",
                "general_hospital_detail_id",
                "incident_date_id",
                "incident_time_id",
            ];

            fieldsToShowAndEnable.forEach(function(fieldId) {
                $("#" + fieldId).show().find("input, select").prop("disabled", false).removeClass('is-invalid');
            });

            var fieldsToHideAndDisable = [
                "general_vehicle",
                "holder_name",
                "date_of_incident",
                "estimated_loss_amt_id",
                "vehicle_ins_1",
                "TPL_Due_date",
                "vehicle_data_name",
                "vehicle_data_number",
                "others_claim_incident_fields",
                "incident_contact_num_id",
                "death_claim_agency_1",
                "death_claim_type_id",
                "client_type_id",
                "enter_policy_holder_name_id",
                "policy_num_2_id",
                "select_ins_company_id",
                "select_policy_holder_name_id",
                "select_branch_id",
                "step_2_death_claim",
                "step_2_other_death_claim",
                "death_person_name_id",
                "nominee_name_id",
                "contact_num_id",
                "death_details",
                "claim_count_id",
                "death_policy_details",
                "bank_name_id",
                "model_id",
                "rto_id",
                "branch_name_id",
                "policy_address_id",
                "incident_time_id_1",
            ];

            fieldsToHideAndDisable.forEach(function(fieldId) {
                $("#" + fieldId).hide().find("input, select, textarea").prop("disabled", true).removeClass('is-invalid , is-valid');
            });

            var claim_type_value = $("#claim_type_id_1").val();

            if(claim_type_value == 2){
                $("#wc_health_id").show();
                $("#patient_name").hide().find('input select').removeClass('is-invalid');
            }

            $("#main_claim_type_id , #main_policy_id").addClass('col-xxl-6').removeClass('col-xxl-3');
            // $("#sum_assu_amt_id").addClass('col-xxl-4').removeClass('col-xxl-2');
            $("#seg_1, #brok_1, #sub_agent_id, #agency_id").addClass('col-xxl-3').removeClass('col-xxl-2');
        }
    }

    function disabledFinish(selectedValues){
        $('#btnSave , #send_email , #download').remove();
        $('.actions li:last-child').show();
        $('.actions li:last-child a').remove();
        
        var claim_type_value = $("#claim_type_id_1").val();
           
        var html ='';
        html+="<div class='d-flex'>";
        if(claim_type_value == 2){
            html+="<button type='button' class='btn btn-primary form-control btn-label' role='menuitem' id='download' onclick='return downloadIntimationPDF();'><i class='bx bx-download label-icon'></i> Intimation Pdf</button>";
        }
        html+="<button type='button' class='btn btn-primary form-control' role='menuitem' id='btnSave' onClick='return SaveIntimation();'>Save</button>";
        html+="<button type='button' class='btn btn-primary form-control send-mail' role='menuitem' id='send_email' onClick='return sendMailModal();'>Send Email</button>";
        html+="</div>";

        if(selectedValues.includes("Email")) {
            $(".send-mail").removeClass('d-none')
        } else {
            setTimeout(function() {
                $(".send-mail").addClass('d-none');
            }, 300);
        }

        $(".actions li:last-child").append(html);
    }


    function SaveIntimation(){
        var formData = new FormData($('#addIntimation')[0]);

        if (!validateDocumentsOnSubmit('claim_document_')) {
            return false; // ⛔ blocks ajaxSubmit HARD
        }

        $.ajax({
            type: 'POST',
            url: saveIntimation,
            data: formData,
            processData: false, // Don't process the data
            contentType: false, 
            beforeSend: function(){
                showLoader();
            },
            success: function(responseText) {
                hideLoader();
                
                if (responseText['status'] == 1) {

                    toastr["success"](responseText['msg']);

                    $("#addIntimation").removeClass('was-validated');

                    if(responseText['url_type'] == 'mediclaim' || responseText['url_type'] == 'Mediclaim'){
                        window.location = "{{route('manage.intimation.claim.data')}}"  + "?type=mediclaim";
                    }else if(responseText['url_type'] == 'vehicle-claim' || responseText['url_type'] == 'Vehicle Claim'){
                        window.location = "{{route('manage.intimation.claim.data')}}" + "?type=vehicle-claim";
                    }else if(responseText['url_type'] == 'death-claim' || responseText['url_type'] == 'Death Claim'){
                        window.location = "{{route('manage.intimation.claim.data')}}"  + "?type=death-claim";
                    }else if(responseText['url_type'] == 'disability_claim' || responseText['url_type'] == 'Disability Claim'){
                        window.location = "{{route('manage.intimation.claim.data')}}"  + "?type=disability-claim";
                    }else if(responseText['url_type'] == 'other-claim' || responseText['url_type'] == 'Other Claim'){
                        window.location = "{{route('manage.intimation.claim.data')}}"  + "?type=other-claim";
                    }else{
                        window.location = "{{route('manage.intimation.claim.data')}}"  + "?type=mediclaim";
                    }

                } else if (responseText['status'] == 0) {
                    $("#addIntimation").addClass('was-validated');
                    
                    if (typeof responseText['data'] !== "undefined") {
                        var size = Object.keys(responseText['data']).length;
                        if (size > 0) {
                            for (var [key, value] of Object.entries(responseText['data'])) {
                                toastr["error"](value);
                            }
                        }
                    } else {
                        toastr["error"](responseText['msg']);

                    }

                    if(authType == 1 && responseText['flag'] == "Document"){
                        $('#modelPlanName').text('');
                        $('#modelPlanName').text("Document");
                        $('.forPlanUpgrade').hide();
                        $('.forPlanPurchase').show();
                        $('#upgradePurchaseModal').modal('show');
                    }
                }
            }
        });
    }

    $("#insurance_company_email").on('keyup',function(event){
        if (event.keyCode === 13) {
            event.preventDefault();
            document.getElementById("ins_comp_email_id").click();
        }
    });

    function SaveComEmail(){
        var formData = new FormData($('#formAddEmail')[0]);

        $.ajax({
            type: 'POST',
            url: saveCompanyEmail,
            data: formData,
            processData: false, // Don't process the data
            contentType: false, 
            beforeSend: function(){
                showLoader();
            },
            success: function(responseText) {
                hideLoader();

                if (responseText['status'] == 1) {
                    toastr["success"](responseText['msg']);
                    $("#formAddEmail").removeClass('was-validated');          
                    $("#modalAddEmail").modal('hide');
                    
                    if(responseText['data']['comp_type'] == "TPA"){
                        var value = $('#tpa_company_email').val();
                        if(value.length == 0){
                            var optionsHTML = '';
                            optionsHTML += '<option value="' + responseText['data']['id'] + '" selected>' + responseText['data']['email'] + '</option>';
                            $('#tpa_company_email').html(optionsHTML);
                        }
                        
                    }else{
                        var value = $('#direct_company_email').val();
                        if(value.length == 0){
                            var optionsHTML = '';
                            optionsHTML += '<option value="' + responseText['data']['id'] + '" selected>' + responseText['data']['email'] + '</option>';
                            $('#direct_company_email').html(optionsHTML);
                        }
                    }

                } else if (responseText['status'] == 0) {
                    if (typeof responseText['data'] !== "undefined") {
                        var size = Object.keys(responseText['data']).length;
                        if (size > 0) {
                            for (var [key, value] of Object.entries(responseText['data'])) {
                                toastr["error"](value);
                            }
                        }
                    } else {
                        toastr["error"](responseText['msg']);
                    }

                    $("#formAddEmail").addClass('was-validated');
                }
            }
        });
    }

    function downloadIntimationPDF(){
        var formData = new FormData($('#addIntimation')[0]);
        var csrfToken = $("[name=_token").val();

        $.ajax({
            type: 'POST',
            url: downloadIntimationPdf,
            data: formData, // Pass the FormData directly
            contentType: false,
            processData: false, // Ensure FormData is not processed as a string
            headers: {
                'X-CSRF-TOKEN': csrfToken
            },
            beforeSend: function() {
                showLoader();
            },
            success: function(resultData) {
                hideLoader();
                
                path = resultData['path'];
                window.open(path, '_blank');
            }
        });
    }
    
    function getEmailValues() {
        var value = [];
        $("#direct_company_email option:selected").each(function() {
            value.push($(this).html());
        });

        var value_1 = [];
        $("#tpa_company_email option:selected").each(function() {
            value_1.push($(this).html());
        });

        var claim_intimation_type = $('input[type="radio"][name="type_1"]:checked').val();
        var claim_type = $("#select2-claim_type_id_1-container").html();
        var policy_number = $("#policy_number_1_1").val();
        var policy_holder = $("#policy_holder_name_1").val();
        var policy_holder_contact_number = $("#policy_holder_contact_number").val();
        var name_of_patient = $("#select2-name_of_patient-container").html();
       
        if(claim_type == "Life-Health"){
            name_of_patient = policy_holder;
        }
        
        var patient_name = $("#enter_patient_name").val();
        var date_of_admission = $("#date_of_admission").val();
        var hospital_name = $("#hospital_name").val();
        var hospital_address = $("#hospital_address").val();
        var hospital_contact_number = $("#hospital_contact_number").val();
        var reason_for_hospitalise = $("#reason_for_hosptalise").val();
        var estimated_stay_days = $("#estimated_stay_days").val();
        var estimated_expences_rs = $("#estimated_expense").val();        
        var estimated_expences_rs_1 = $("#estimated_expense_1").val();       
        var mediclaim_insurance_comp_Name = $("#mediclaim_ins_comp_name").val();
        var mediclaim_policy_number = $("#mediclaim_policy_number").val();
        var mediclaim_sum_assured = $("#mediclaim_sum_assured").val();
        var detail_of_incident = $("#detail_of_incident").val();
        var incident_address = $("#incident_address").val();
        var incident_date = $("#incident_date").val();
        var incident_time = $("#incident_time").val();
      
        // for vehicle 
        var vehicle_owner_type =$('input[type="radio"][name="vehicle_owner_1"]:checked').val();
        var vehicle_number=$("#vehicle_number").val();        
        var vehicle_name=$("#vehicle_name").val();
        var tpl_due_date_1=$("#tpl_due_date_1").val();
        var driving_by=$("#driving_by").val();
        var date_of_incident_1=$("#date_of_incident_1").val();
        var incident_short_detail=$("#incident_short_detail").val();
        var damage_short_details=$("#damage_short_details").val();
        var garage_name=$("#garage_name").val();
        var garage_address=$("#garage_address").val();
        var garage_contact_number=$("#garage_contact_number").val();

        // for other claim
        var intimationDate = $("#intimation_date").val();
        var estimatedLossAmt = $("#estimated_loss_amt").val();
        var incidentReason = $("#select2-reason_of_incident-container").html();
        var incidentContactNum = $("#incident_contact_num").val();
        var Police = $("#select2-intimated_to_police-container").html();
        var Fire = $("#select2-intimated_to_fire-container").html();
        var insComp = $("#insurance_company_name_1").val();
        var sagmentName = $("#segment_1").val();     

        // for death claim
        var death_claim_type = $("#select2-death_claim_type-container").html();
        
        if(typeof death_claim_type == 'undefined'){
            var selectedOptions = $('#death_claim_type option:selected');
            var death_claim_type = [];
            // Iterate over the selected options and get their text
            selectedOptions.each(function() {
                var optionText = $(this).text();
                death_claim_type.push(optionText);
                
                // You can store or manipulate the optionText as needed
            }); 
        }

        var policy_holder_death = $("#policy_holder_name_death").val();
        var nominee_name = $("#select2-nominee_name-container").html();
        var nominee_contact_num = $("#contact_number").val();
        var death_date = $("#death_date").val();
        var death_reason = $("#select2-death_reason-container").html();
        var death_short_detail = $("#death_short_detail").val();
        var hospital_name_address = $("#hospital_name_address").val();
        var death_deatination_name = $("#death_destination").val();
        var police_station_name = $("#police_station_name").val();
        var total_policy_sum_assur = $("#sum_assu_amt_1").html();
        var remarks = $("#remarks").val();
        var policy_sum_assur = $("#sum_assured_1").val();
        var branch_name = $("#branch_name").val();
        var firm_person_name = $("#firm_person_name").val();
        var destination_of_acci = $("#destination_of_accident").val();
        var enter_add_city_pin = $("#enter_add_city_pin").val();
        var client_type = $("#client_type").val();
        var non_policy_holder_name = $("#enter_policy_holder_name").val();
        var non_policy_num = $("#policy_num_2").val();
        var non_segment_name = $("#select2-enter_segment_name-container").html();
        var non_sum_assured = $("#enter_sum_assured").val();
        var non_ins_comp = $("#select2-enter_ins_comp-container").html();
        var non_mobile_num = $("#enter_mobile_num").val();

        // Get the unique values from the selectedOptions object
        var selectedValues = [];
        $('input[type="checkbox"][name="intimated_through[]"]:checked').each(function() {
            selectedValues.push($(this).val());
        });

        var uniqueValues = selectedValues;

        return {
            value : value,
            value_1 : value_1,
            claim_intimation_type : claim_intimation_type,            
            claim_type : claim_type,
            policy_number : policy_number,
            policy_holder : policy_holder,
            policy_holder_contact_number : policy_holder_contact_number,
            name_of_patient : name_of_patient,
            patient_name : patient_name,
            date_of_admission : date_of_admission,
            hospital_name : hospital_name,
            hospital_address : hospital_address,
            hospital_contact_number : hospital_contact_number,
            reason_for_hospitalise : reason_for_hospitalise,
            estimated_stay_days :estimated_stay_days,
            estimated_expences_rs : estimated_expences_rs,
            estimated_expences_rs_1 : estimated_expences_rs_1,
            mediclaim_insurance_comp_Name : mediclaim_insurance_comp_Name,
            mediclaim_policy_number : mediclaim_policy_number,
            mediclaim_sum_assured : mediclaim_sum_assured,
            detail_of_incident : detail_of_incident,
            incident_address : incident_address,
            incident_date : incident_date,
            incident_time : incident_time,
            vehicle_owner_type : vehicle_owner_type,
            vehicle_number : vehicle_number,
            vehicle_name : vehicle_name,
            tpl_due_date_1 : tpl_due_date_1, 
            driving_by : driving_by,
            date_of_incident_1 : date_of_incident_1,
            incident_short_detail : incident_short_detail,
            damage_short_details : damage_short_details,
            garage_name : garage_name,
            garage_address : garage_address,
            garage_contact_number : garage_contact_number,
            intimationDate : intimationDate,
            estimatedLossAmt : estimatedLossAmt,
            incidentReason : incidentReason,
            incidentContactNum : incidentContactNum,
            Police : Police,
            Fire : Fire,
            insComp : insComp,
            sagmentName : sagmentName,
            death_claim_type : death_claim_type,
            policy_holder_death : policy_holder_death,
            nominee_name : nominee_name,
            nominee_contact_num : nominee_contact_num,
            death_date : death_date,
            death_reason : death_reason,
            death_short_detail : death_short_detail,
            hospital_name_address : hospital_name_address,
            death_deatination_name : death_deatination_name,
            police_station_name : police_station_name,
            total_policy_sum_assur : total_policy_sum_assur,
            remarks : remarks,
            policy_sum_assur : policy_sum_assur,
            branch_name : branch_name,
            firm_person_name : firm_person_name,
            destination_of_acci : destination_of_acci,
            enter_add_city_pin : enter_add_city_pin,
            client_type : client_type,
            non_policy_holder_name : non_policy_holder_name,
            non_policy_num : non_policy_num,
            non_segment_name : non_segment_name,
            non_sum_assured : non_sum_assured,
            non_ins_comp : non_ins_comp,
            non_mobile_num : non_mobile_num,
            uniqueValues : uniqueValues,
        }
    }

    function sendMailModal(){
        $("#sendMailModal").modal('show');
        $("#sendMailContain").empty();

        var emailValues = getEmailValues();        

        var html = '';      

        if (emailValues.value.length > 0 && emailValues.value_1.length === 0) {
            html += "<b>To Email : </b>" + emailValues.value + "<br>";
        } else if (emailValues.value.length === 0 && emailValues.value_1.length > 0) {
            html += "<b>To Email : </b>" + emailValues.value_1 + "<br>";
        } else if (emailValues.value.length > 0 && emailValues.value_1.length > 0) {
            html += "<b>To Email : </b>" + emailValues.value + ',' + emailValues.value_1 + "<br>";
        } 

        if(emailValues.claim_type == "Mediclaim"){
                            
            html += "<b>Subject</b> : " + emailValues.claim_type + " Intimation Regarding Policy No. " + emailValues.policy_number + " of " + emailValues.name_of_patient + "<br>";
            html += "<b>Body</b> : <br>";
            html += "<table style='border-collapse: collapse;'>";
            html += "<tbody style='text-align: right;'>";
            html += "<tr><td style='padding-right:10px;'>01)</td><td>Claim Type</td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.claim_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>02)</td><td>Policy Number</td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>03)</td><td>Policy Holder Name</td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_holder + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>04)</td><td>Contact No. Of Policy Holder</td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_holder_contact_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>05)</td><td>Name of Patient</td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.name_of_patient + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>06)</td><td>Date Of Admission</td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.date_of_admission + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>07)</td><td>Hospital Name</td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.hospital_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>08)</td><td>Hospital Address</td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.hospital_address + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>09)</td><td>Hospital Contact Number</td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.hospital_contact_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>10)</td><td>Reason For Hospitalise</td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.reason_for_hospitalise + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>11)</td><td>Estimated Stay Days</td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.estimated_stay_days + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>12)</td><td>Estimated Expenses Rs.</td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.estimated_expences_rs + "</td></tr>";
            html += "</tbody></table>";

        }else if(emailValues.claim_type == "Life-Health"){

            html += "<b>Subject</b> : " + emailValues.claim_type + " Intimation Regarding  Policy No. " + emailValues.policy_number + " of " + emailValues.name_of_patient + "<br>";
            html += "<b>Body</b> : <br>";
            html += "<table style='border-collapse: collapse;'>";
            html += "<tbody style='text-align: right;'>";
            html += "<tr><td style='padding-right:10px;'>01)</td><td> Claim Type </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.claim_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>02)</td><td> Policy Number </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.policy_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>03)</td><td> Policy Holder Name </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.policy_holder + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>04)</td><td> Contact No. Of Policy Holder </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.policy_holder_contact_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>05)</td><td> Name of Patient </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.name_of_patient + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>06)</td><td> Date Of Admission </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.date_of_admission+ "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>07)</td><td> Hospital Name </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.hospital_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>08)</td><td> Hospital Address </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.hospital_address + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>09)</td><td> Hospital Contact Number </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.hospital_contact_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>10)</td><td> Reason For Hospitalise </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.reason_for_hospitalise + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>11)</td><td> Estimated Stay Days </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.estimated_stay_days + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>12)</td><td> Estimated Expenses Rs. </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.estimated_expences_rs + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>13)</td><td> Mediclaim Insurance Co. Name </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.mediclaim_insurance_comp_Name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>14)</td><td> Mediclaim Policy No. </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.mediclaim_policy_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>15)</td><td> Mediclaim Policy Sum Assured </td><td class='px-2'> : </td><td style='text-align: left;'>"  + emailValues.mediclaim_sum_assured + "</td></tr>";
            html += "</tbody></table>";

        }else if(emailValues.claim_type == "WC-Health" || emailValues.claim_type == "WC-Medical" || emailValues.claim_type == "PA-Health"){

            if(emailValues.claim_type == "WC-Health" || emailValues.claim_type == "WC-Medical"){
                var patientName = emailValues.patient_name;
            }else{
                var patientName = emailValues.name_of_patient;
            }
            
            html += "<b>Subject</b> : " + emailValues.claim_type + " Intimation Regarding Policy No. " + emailValues.policy_number + " of " + patientName + "<br>";
            html += "<b>Body</b> : <br>";
            html += "<table style='border-collapse: collapse;'>";
            html += "<tbody style='text-align: right;'>";
            html += "<tr><td style='padding-right:10px;'>01)</td><td> Claim Type </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.claim_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>02)</td><td> Policy Number </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>03)</td><td> Policy Holder Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_holder + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>04)</td><td> Contact No. Of Policy Holder </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_holder_contact_number + "</td></tr>";                   
            html += "<tr><td style='padding-right:10px;'>05)</td><td> Name of Patient </td><td class='px-2'> : </td><td style='text-align: left;'>" + patientName + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>06)</td><td> Date Of Admission </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.date_of_admission + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>07)</td><td> Hospital Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.hospital_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>08)</td><td> Hospital Address </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.hospital_address + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>09)</td><td> Hospital Contact Number </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.hospital_contact_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>10)</td><td> Reason For Hospitalise </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.reason_for_hospitalise + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>11)</td><td> Estimated Stay Days </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.estimated_stay_days + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>12)</td><td> Estimated Expenses Rs. </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.estimated_expences_rs + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>13)</td><td> Short Detail Of Incident </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.detail_of_incident + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>14)</td><td> Incident Address </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.incident_address + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>15)</td><td> Incident Date & Time </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.incident_date + " " + emailValues.incident_time + "</td></tr>";
            html += "</tbody></table>";

        }else if(emailValues.claim_intimation_type == "Vehicle Claim"){

            html += "<b>Subject</b> : " + emailValues.claim_type + " Intimation Regarding  Policy No. " + emailValues.policy_number + " of " + emailValues.policy_holder + "<br>";
            html += "<b>Body</b> : <br>";
            html += "<table style='border-collapse: collapse;'>";
            html += "<tbody style='text-align: right;'>";
            html += "<tr><td style='padding-right:10px;'>01)</td><td> Claim Type </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.claim_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>02)</td><td> Vehicle Claim Owner Type </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.vehicle_owner_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>03)</td><td> Vehicle Reg. No. / Vehicle Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.vehicle_number + " / " + emailValues.vehicle_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>04)</td><td> Policy Number / Risk To Date </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_number + " / " + emailValues.tpl_due_date_1 + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>05)</td><td> Policy Holder Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_holder + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>06)</td><td> Contact No. Of Policy Holder </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_holder_contact_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>07)</td><td> Vehicle Driving By </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.driving_by + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>08)</td><td> Date Of Incident </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.date_of_incident_1 + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>09)</td><td> Short Details Of Incident </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.incident_short_detail + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>10)</td><td> Short Details Of Damages </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.damage_short_details + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>11)</td><td> Garage Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.garage_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>12)</td><td> Garage Address </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.garage_address + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>13)</td><td> Garage Contact No. </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.garage_contact_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>14)</td><td> Intimation Through </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.uniqueValues + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>15)</td><td> Estimated Expenses Rs. </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.estimated_expences_rs_1 + "</td></tr>";
            html += "</tbody></table>";

        }else if(emailValues.claim_intimation_type == "Other Claim"){
            
            html += "<b>Subject</b> : " + emailValues.claim_type + " Intimation Regarding  Policy No. " + emailValues.policy_number + " of " + emailValues.policy_holder + "<br>";
            html += "<b>Body</b> : <br>";
            html += "<table style='border-collapse: collapse;'>";
            html += "<tbody style='text-align: right;'>";
            html += "<tr><td style='padding-right:10px;'>01)</td><td> Claim Type </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.claim_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>02)</td><td> Policy Number </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>03)</td><td> Policy Holder Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_holder + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>04)</td><td> Contact No. Of Policy Holder </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_holder_contact_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>05)</td><td> Name Of Insurance Company </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.insComp + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>06)</td><td> Segment </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.sagmentName + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>07)</td><td> Intimation Date </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.intimationDate + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>08)</td><td> Date Of Incident </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.date_of_incident_1 + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>09)</td><td> Estimated Loss Amount Rs. </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.estimatedLossAmt + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>10)</td><td> Reason for Incident </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.incidentReason + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>11)</td><td> Short Details Of Incident </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.incident_short_detail + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>12)</td><td> Insident Address / Insident Contact No. </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.incident_address + " / " + emailValues.incidentContactNum + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>13)</td><td> Intimated To Police Station ? </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.Police + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>14)</td><td> Intimated To Fire Station ? </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.Fire + "</td></tr>";
            html += "</tbody></table>";

        }else if(emailValues.claim_type == "Life Insurance Death Claim"){

            html += "<b>Subject</b> : " + emailValues.claim_type + " Of " + emailValues.death_claim_type + " Intimation <br>";
            html += "<b>Body</b> : <br>";
            html += "<table style='border-collapse: collapse;'>";
            html += "<tbody style='text-align: right;'>";
            html += "<tr><td style='padding-right:10px;'>01)</td><td> Death Claim Intimation Type </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.claim_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>02)</td><td> Death Claim Type </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_claim_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>03)</td><td> Policy Holder Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_holder_death + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>04)</td><td> Nominee Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.nominee_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>05)</td><td> Nominee Contact No. </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.nominee_contact_num + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>06)</td><td> Date Of Death </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_date + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>07)</td><td> Reason Of Death </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_reason + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>08)</td><td> Short Details Of Death </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_short_detail + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>09)</td><td> Hospital Name / Address </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.hospital_name_address + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>10)</td><td> Destination Of Death </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_deatination_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>11)</td><td> If Accident , Police Station Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.police_station_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>12)</td><td> Total Policy Sum Assured </td><td class='px-2'> : </td><td style='text-align: left;'> " + emailValues.total_policy_sum_assur + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>13)</td><td> Remarks </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.remarks + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>14)</td><td> Intimation Through </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.uniqueValues + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>15)</td><td> General Notes </td><td class='px-2'> : </td><td style='text-align: left;'>" + "This time whichever Available Documents are submitted here. The remaining required Documents and as next Demand by Company documents will be submitted in the routin claim process.</td></tr>";
            html += "</tbody></table>";

        }else if(emailValues.claim_type == "Vehicle Accident Death Claim"){

            html += "<b>Subject</b> : " + emailValues.claim_type + " Of " + emailValues.death_claim_type + " Intimation <br>";
            html += "<b>Body</b> : <br>";
            html += "<table style='border-collapse: collapse;'>";
            html += "<tbody style='text-align: right;'>";
            html += "<tr><td style='padding-right:10px;'>01)</td><td> Intimation Date </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.intimationDate + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>02)</td><td> Policy No. </td><td class='px-2'> : </td><td style='text-align: left;'>" +  emailValues.policy_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>03)</td><td> Segment Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.sagmentName + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>04)</td><td> Policy Sum Assured </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_sum_assur + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>05)</td><td> Ins. Comp. Name / Branch </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.insComp + " / " +  emailValues.branch_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>06)</td><td> Policy Holder Name / Contact No. </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_holder + " / " + emailValues.policy_holder_contact_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>07)</td><td> Death Claim Intimation Type </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.claim_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>08)</td><td> Death Claim Type </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_claim_type  + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>09)</td><td> Vehicle Reg. No. / Vehicle Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.vehicle_number + " / " + emailValues.vehicle_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>10)</td><td> Accident Date </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.date_of_incident_1 + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>11)</td><td> Reason Of Death </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_reason + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>12)</td><td> Short Details Of Death </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_short_detail + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>13)</td><td> Hospital Name / Address </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.hospital_name_address + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>14)</td><td> Destination Of Death </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_deatination_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>15)</td><td> If Accident , Police Station Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.police_station_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>16)</td><td> Remarks </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.remarks + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>17)</td><td> Intimation Through </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.uniqueValues + "</td></tr>";
            html += "</tbody></table>";

        }else if(emailValues.claim_type == "General Insurance Death Claim"){

            html += "<b>Subject</b> : " + emailValues.claim_type + " Of " + emailValues.death_claim_type + " Intimation <br>";
            html += "<b>Body</b> : <br>";
            html += "<table style='border-collapse: collapse;'>";
            html += "<tbody style='text-align: right;'>";
            html += "<tr><td style='padding-right:10px;'>01)</td><td> Intimation Date </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.intimationDate + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>02)</td><td> Policy No. </td><td class='px-2'> : </td><td style='text-align: left;'>" +  emailValues.policy_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>03)</td><td> Segment Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.sagmentName + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>04)</td><td> Policy Sum Assured </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_sum_assur + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>05)</td><td> Ins. Comp. Name / Branch </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.insComp + " / " +  emailValues.branch_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>06)</td><td> Policy Holder Name / Contact No. </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.policy_holder + " / " + emailValues.policy_holder_contact_number + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>07)</td><td> If Firm / Person Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.firm_person_name+ "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>08)</td><td> Death Claim Intimation Type </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.claim_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>09)</td><td> Death Claim Type </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_claim_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>10)</td><td> Incident Date </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.date_of_incident_1 + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>11)</td><td> Reason Of Death </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_reason + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>12)</td><td> Short Details Of Death </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_short_detail + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>13)</td><td> Hospital Name / Address </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.hospital_name_address + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>14)</td><td> Destination Of Incident </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.destination_of_acci + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>15)</td><td> Destination Of Death </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_deatination_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>16)</td><td> If Accident , Police Station Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.police_station_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>17)</td><td> Remarks </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.remarks + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>18)</td><td> Intimation Through </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.uniqueValues + "</td></tr>";
            html += "</tbody></table>";

        }else if(emailValues.claim_type == "Other Death Claim"){

            if(emailValues.client_type == 0){
                var policyNum = emailValues.policy_number;
                var segment = emailValues.sagmentName;
                var sumAssured = emailValues.policy_sum_assur;
                var insCompany = emailValues.insComp + " / " +  emailValues.enter_add_city_pin;
                var clientDetail = emailValues.policy_holder + " / " + emailValues.policy_holder_contact_number;

            }else if (emailValues.client_type == 1){
                var policyNum = emailValues.non_policy_num;
                var segment = emailValues.non_segment_name;
                var sumAssured = emailValues.non_sum_assured;
                var insCompany = emailValues.non_ins_comp + " / " +  emailValues.enter_add_city_pin;
                var clientDetail = emailValues.non_policy_holder_name + " / " + emailValues.non_mobile_num;
            }

            html += "<b>Subject</b> : " + emailValues.claim_type + " Of " + emailValues.death_claim_type + " Intimation <br>";
            html += "<b>Body</b> : <br>";
            html += "<table style='border-collapse: collapse;'>";
            html += "<tbody style='text-align: right;'>";
            html += "<tr><td style='padding-right:10px;'>01)</td><td> Intimation Date </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.intimationDate + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>02)</td><td> Policy No. </td><td class='px-2'> : </td><td style='text-align: left;'>" + policyNum + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>03)</td><td> Segment Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + segment  + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>04)</td><td> Policy Sum Assured </td><td class='px-2'> : </td><td style='text-align: left;'>" + sumAssured + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>05)</td><td> Ins. Comp. Name / Authority Name & Address </td><td class='px-2'> : </td><td style='text-align: left;'>" + insCompany + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>06)</td><td> Policy Holder Name / Contact No. </td><td class='px-2'> : </td><td style='text-align: left;'>" + clientDetail + "</td></tr>";        
            html += "<tr><td style='padding-right:10px;'>07)</td><td> If Firm / Person Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.firm_person_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>08)</td><td> Death Claim Intimation Type </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.claim_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>09)</td><td> Death Claim Type </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_claim_type + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>10)</td><td> Incident Date </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.date_of_incident_1 + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>11)</td><td> Reason Of Death </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_reason + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>12)</td><td> Short Details Of Incident </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_short_detail + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>13)</td><td> Hospital Name / Address </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.hospital_name_address + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>14)</td><td> Destination Of Incident </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.destination_of_acci + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>15)</td><td> Destination Of Death </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.death_deatination_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>16)</td><td> If Accident , Police Station Name </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.police_station_name + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>17)</td><td> Remarks </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.remarks + "</td></tr>";
            html += "<tr><td style='padding-right:10px;'>18)</td><td> Intimation Through </td><td class='px-2'> : </td><td style='text-align: left;'>" + emailValues.uniqueValues + "</td></tr>";
            html += "</tbody></table>";

        }else{
            toastr["error"]("please form fill first.");
        }

        $("#sendMailContain").append(html);
    }

    function sendMail(){
        var emailValues = getEmailValues();
        
        if((typeof emailValues.value !== "undefined" || typeof emailValues.value_1 !== "undefined") && (emailValues.value.length != 0 || emailValues.value_1.length != 0)){
            if(emailValues.claim_type == "Mediclaim"){

                var subject = emailValues.claim_type + " Intimation Regarding Policy No. " + emailValues.policy_number + " of " + emailValues.name_of_patient;
                var body ="01)  Claim Type : " + emailValues.claim_type + "\n" +
                          "02)  Policy Number : " + emailValues.policy_number + "\n" +
                          "03)  Policy Holder Name : " + emailValues.policy_holder + "\n" +
                          "04)  Contact No. Of Policy Holder : " + emailValues.policy_holder_contact_number + "\n" +
                          "05)  Name of Patient : " + emailValues.name_of_patient + "\n" +
                          "06)  Date Of Admission : " + emailValues.date_of_admission + "\n" +
                          "07)  Hospital Name : " + emailValues.hospital_name + "\n" +
                          "08)  Hospital Address : " + emailValues.hospital_address + "\n" +
                          "09)  Hospital Contact Number : " + emailValues.hospital_contact_number + "\n" +
                          "10)  Reason For Hospitalise : " + emailValues.reason_for_hospitalise + "\n" +
                          "11)  Estimated Stay Days : " + emailValues.estimated_stay_days + "\n" +
                          "12)  Estimated Expenses Rs. : " + emailValues.estimated_expences_rs ;              

            }else if(emailValues.claim_type == "Life-Health"){

                var subject = emailValues.claim_type + " Intimation Regarding  Policy No. " + emailValues.policy_number + " of " + emailValues.name_of_patient;
                var body ="01)  Claim Type : " + emailValues.claim_type + "\n" +
                          "02)  Policy Number : " + emailValues.policy_number + "\n" +
                          "03)  Policy Holder Name : " + emailValues.policy_holder + "\n" +
                          "04)  Contact No. Of Policy Holder : " + emailValues.policy_holder_contact_number + "\n" +
                          "05)  Name of Patient : " + emailValues.name_of_patient + "\n" +
                          "06)  Date Of Admission : " + emailValues.date_of_admission + "\n" +
                          "07)  Hospital Name : " + emailValues.hospital_name + "\n" +
                          "08)  Hospital Address : " + emailValues.hospital_address + "\n" +
                          "09)  Hospital Contact Number : " + emailValues.hospital_contact_number + "\n" +
                          "10)  Reason For Hospitalise : " + emailValues.reason_for_hospitalise + "\n" +
                          "11)  Estimated Stay Days : " + emailValues.estimated_stay_days + "\n" +
                          "12)  Estimated Expenses Rs. : " + emailValues.estimated_expences_rs + "\n" +
                          "13)  Mediclaim Insurance Co. Name : " + emailValues.mediclaim_insurance_comp_Name + "\n" +
                          "14)  Mediclaim Policy No. : " + emailValues.mediclaim_policy_number + "\n" +
                          "15)  Mediclaim Policy Sum Assured : " + emailValues.mediclaim_sum_assured ;

            }else if(emailValues.claim_type == "WC-Health" || emailValues.claim_type == "WC-Medical" || emailValues.claim_type == "PA-Health"){

                if(emailValues.claim_type == "WC-Health" || emailValues.claim_type == "WC-Medical"){
                    var patientName = emailValues.patient_name;
                }else{
                    var patientName = emailValues.name_of_patient;
                }

                var subject = emailValues.claim_type + " Intimation Regarding  Policy No. " + emailValues.policy_number + " of " + emailValues.name_of_patient;
                var body ="01)  Claim Type : " + emailValues.claim_type + "\n" +
                          "02)  Policy Number : " + emailValues.policy_number + "\n" +
                          "03)  Policy Holder Name : " + emailValues.policy_holder + "\n" +
                          "04)  Contact No. Of Policy Holder : " + emailValues.policy_holder_contact_number + "\n" +
                          "05)  Name of Patient : " + patientName + "\n" +
                          "06)  Date Of Admission : " + emailValues.date_of_admission + "\n" +
                          "07)  Hospital Name : " + emailValues.hospital_name + "\n" +
                          "08)  Hospital Address : " + emailValues.hospital_address + "\n" +
                          "09)  Hospital Contact Number : " + emailValues.hospital_contact_number + "\n" +
                          "10)  Reason For Hospitalise : " + emailValues.reason_for_hospitalise + "\n" +
                          "11)  Estimated Stay Days : " + emailValues.estimated_stay_days + "\n" +
                          "12)  Estimated Expenses Rs. : " + emailValues.estimated_expences_rs + "\n" +
                          "13)  Short Detail Of Incident : " + emailValues.detail_of_incident + "\n" +
                          "14)  Incident Address : " + emailValues.incident_address + "\n" +
                          "15)  Incident Date & Time : " + emailValues.incident_date + " " + emailValues.incident_time ;

            }else if(emailValues.claim_intimation_type == "Vehicle Claim"){
                
                var subject = emailValues.claim_type + " Intimation Regarding  Policy No. " + emailValues.policy_number + " of " + emailValues.policy_holder;
                var body ="01)  Claim Type : " + emailValues.claim_type + "\n" +
                          "02)  Vehicle Claim Owner Type : " + emailValues.vehicle_owner_type + "\n" +
                          "03)  Vehicle Reg. No. / Vehicle Name : " + emailValues.vehicle_number + "/" + emailValues.vehicle_name +"\n" +
                          "04)  Policy Number / Risk To Date : " + emailValues.policy_number + "/" + emailValues.tpl_due_date_1 +"\n" +
                          "05)  Policy Holder Name : " + emailValues.policy_holder + "\n" +
                          "06)  Contact No. Of Policy Holder : " + emailValues.policy_holder_contact_number + "\n" +
                          "07)  Vehicle Driving By : " + emailValues.driving_by + "\n" +
                          "08)  Date Of Incident : " + emailValues.date_of_incident_1 + "\n" +
                          "09)  Short Details Of Incident : " + emailValues.incident_short_detail + "\n" +
                          "10)  Short Details Of Damages : " + emailValues.damage_short_details + "\n" +
                          "11)  Garage Name : " + emailValues.garage_name + "\n" +
                          "12)  Garage Address : " +emailValues. garage_address + "\n" +
                          "13)  Garage Contact No. : " + emailValues.garage_contact_number + "\n" +
                          "14)  Intimation Through : " + emailValues.uniqueValues + "\n" +
                          "15)  Estimated Expenses Rs. : " + emailValues.estimated_expences_rs_1 ;

            }else if(emailValues.claim_intimation_type == "Other Claim"){
                  
                var subject =  emailValues.claim_type + " Intimation Regarding Policy No. " + emailValues.policy_number + " of " + emailValues.policy_holder;
                var body ="01)  Claim Type : " + emailValues.claim_type + "\n" +
                          "02)  Policy Number : " + emailValues.policy_number + "\n" +
                          "03)  Policy Holder Name : " + emailValues.policy_holder +"\n" +
                          "04)  Contact No. Of Policy Holder : " + emailValues.policy_holder_contact_number + "\n" +
                          "05)  Name Of Insurance Company : " + emailValues.insComp + "\n" +
                          "06)  Segment : " + emailValues.sagmentName + "\n" +
                          "07)  Intimation Date : " + emailValues.intimationDate + "\n" +
                          "08)  Date Of Incident : " + emailValues.date_of_incident_1 + "\n" +
                          "09)  Estimated Loss Amount Rs. : " + emailValues.estimatedLossAmt + "\n" +
                          "10)  Reason for Incident : " + emailValues.incidentReason + "\n" +
                          "11)  Short Details Of Incident : " + emailValues.incident_short_detail + "\n" +
                          "12)  Insident Address / Insident Contact No.. : " + emailValues.incident_address + " / " + emailValues.incidentContactNum +"\n" +
                          "13)  Intimated To Police Station ? : " + emailValues.Police + "\n" +
                          "14)  Intimated To Fire Station ? : " + emailValues.Fire ;

            }else if(emailValues.claim_type == "Life Insurance Death Claim"){

                var subject =  emailValues.claim_type + " Of " + emailValues.death_claim_type + " Intimation";
                var body ="01)  Death Claim Intimation Type : " + emailValues.claim_type + "\n" +
                          "02)  Death Claim Type : " + emailValues.death_claim_type  + "\n" +
                          "03)  Policy Holder Name : " + emailValues.policy_holder_death +"\n" +
                          "04)  Nominee Name : " + emailValues.nominee_name + "\n" +
                          "05)  Nominee Contact No. : " + emailValues.nominee_contact_num + "\n" +
                          "06)  Date Of Death : " + emailValues.death_date + "\n" +
                          "07)  Reason Of Death : " + emailValues.death_reason + "\n" +
                          "08)  Short Details Of Death : " + emailValues.death_short_detail + "\n" +
                          "09)  Hospital Name / Address : " + emailValues.hospital_name_address + "\n" +
                          "10)  Destination Of Death : " + emailValues.death_deatination_name + "\n" +
                          "11)  If Accident , Police Station Name : " + emailValues.police_station_name + "\n" +
                          "12)  Total Policy Sum Assured : " + emailValues.total_policy_sum_assur + "\n" +                          
                          "13)  Remarks : " + emailValues.remarks + "\n" +
                          "14)  Intimation Through : " + emailValues.uniqueValues + "\n" +
                          "15)  General Notes : " + "This time whichever Available Documents are submitted here. The remaining required Documents and as next Demand by Company documents will be submitted in the routin claim process.\n";

            }else if(emailValues.claim_type == "Vehicle Accident Death Claim"){

                var subject =  emailValues.claim_type + " Of " + emailValues.death_claim_type + " Intimation ";
                var body ="01)  Intimation Date : " + emailValues.intimationDate + "\n" +
                          "02)  Policy No. : " +  emailValues.policy_number + "\n" +
                          "03)  Segment Name : " + emailValues.sagmentName + "\n" +
                          "04)  Policy Sum Assured : " + emailValues.policy_sum_assur + "\n" +
                          "05)  Ins. Comp. Name / Branch : " + emailValues.insComp + " / " +  emailValues.branch_name + "\n" +
                          "06)  Policy Holder Name / Contact No. : " + emailValues.policy_holder + " / " + emailValues.policy_holder_contact_number + "\n" +
                          "07)  Death Claim Intimation Type : " + emailValues.claim_type + "\n" +
                          "08)  Death Claim Type : " + emailValues.death_claim_type  + "\n" +
                          "09)  Vehicle Reg. No. / Vehicle Name : " + emailValues.vehicle_number + " / " + emailValues.vehicle_name + "\n" +
                          "10)  Accident Date : " + emailValues.date_of_incident_1 + "\n" +
                          "11)  Reason Of Death : " + emailValues.death_reason + "\n" +
                          "12)  Short Details Of Death : " + emailValues.death_short_detail + "\n" +
                          "13)  Hospital Name / Address : " + emailValues.hospital_name_address + "\n" +
                          "14)  Destination Of Death : " + emailValues.death_deatination_name + "\n" +
                          "15)  If Accident , Police Station Name : " + emailValues.police_station_name + "\n" +
                          "16)  Remarks : " + emailValues.remarks + "\n" +
                          "17)  Intimation Through : " + emailValues.uniqueValues ;

            }else if(emailValues.claim_type == "General Insurance Death Claim"){

                var subject = emailValues. claim_type + " Of " + emailValues.death_claim_type + " Intimation";
                var body ="01)  Intimation Date : " + emailValues.intimationDate + "\n" +
                          "02)  Policy No. : " +  emailValues.policy_number + "\n" +
                          "03)  Segment Name : " + emailValues.sagmentName + "\n" +
                          "04)  Policy Sum Assured : " + emailValues.policy_sum_assur + "\n" +
                          "05)  Ins. Comp. Name / Branch : " + emailValues.insComp + " / " + emailValues.branch_name + "\n" +
                          "06)  Policy Holder Name / Contact No. : " + emailValues.policy_holder + " / " + emailValues.policy_holder_contact_number + "\n" +
                          "07)  If Firm / Person Name : " + emailValues.firm_person_name + "\n" +
                          "08)  Death Claim Intimation Type : " + emailValues.claim_type + "\n" +
                          "09)  Death Claim Type : " + emailValues.death_claim_type  + "\n" +
                          "10)  Incident Date : " + emailValues.date_of_incident_1 + "\n" +
                          "11)  Reason Of Death : " + emailValues.death_reason + "\n" +
                          "12)  Short Details Of Death : " + emailValues.death_short_detail + "\n" +
                          "13)  Hospital Name / Address : " + emailValues.hospital_name_address + "\n" +
                          "14)  Destination Of Incident : " + emailValues.destination_of_acci + "\n" +
                          "15)  Destination Of Death : " + emailValues.death_deatination_name + "\n" +
                          "16)  If Accident , Police Station Name : " + emailValues.police_station_name + "\n" +
                          "17)  Remarks : " + emailValues.remarks + "\n" +
                          "18)  Intimation Through : " + emailValues.uniqueValues ;

            }else if(emailValues.claim_type == "Other Death Claim"){
                if(emailValues.client_type == 0){
                    var policyNum = emailValues.policy_number;
                    var segment = emailValues.sagmentName;
                    var sumAssured = emailValues.policy_sum_assur;
                    var insCompany = emailValues.insComp + " / " +  emailValues.enter_add_city_pin;
                    var clientDetail = emailValues.policy_holder + " / " + emailValues.policy_holder_contact_number;

                }else if (emailValues.client_type == 1){
                    var policyNum = emailValues.non_policy_num;
                    var segment = emailValues.non_segment_name;
                    var sumAssured = emailValues.non_sum_assured;
                    var insCompany = emailValues.non_ins_comp + " / " +  emailValues.enter_add_city_pin;
                    var clientDetail = emailValues.non_policy_holder_name + " / " + emailValues.non_mobile_num;
                }
                
                var subject =  emailValues.claim_type + " Of " + emailValues.death_claim_type + " Intimation";
                var body = "01)  Intimation Date : " + emailValues.intimationDate + "\n" +
                           "02)  Policy No. : " +  policyNum + "\n" +
                           "03)  Segment Name : " + segment + "\n" +
                           "04)  Policy Sum Assured : " + sumAssured + "\n" +
                           "05)  Ins. Comp. Name / Authority Name & Address : " + insCompany + "\n" +
                           "06)  Policy Holder Name / Contact No. : " + clientDetail + "\n" +
                           "07)  If Firm / Person Name : " + emailValues.firm_person_name + "\n" +
                           "08)  Death Claim Intimation Type : " + emailValues.claim_type + "\n" +
                           "09)  Death Claim Type : " + emailValues.death_claim_type  + "\n" +
                           "10)  Incident Date : " + emailValues.date_of_incident_1 + "\n" +
                           "11)  Reason Of Death : " + emailValues.death_reason + "\n" +
                           "12)  Short Details Of Incident : " + emailValues.death_short_detail + "\n" +
                           "13)  Hospital Name / Address : " + emailValues.hospital_name_address + "\n" +
                           "14)  Destination Of Incident : " + emailValues.destination_of_acci + "\n" +
                           "15)  Destination Of Death : " + emailValues.death_deatination_name + "\n" +
                           "16)  If Accident , Police Station Name : " + emailValues.police_station_name + "\n" +
                           "17)  Remarks : " + emailValues.remarks + "\n" +
                           "18)  Intimation Through : " + emailValues.uniqueValues ;

            }else{
                toastr["error"]("please form fill first.");
            }

            if(emailValues.claim_type || emailValues.claim_intimation_type){
                if (emailValues.value.length > 0 && emailValues.value_1.length === 0) {
                    window.location.href = "mailto:"+ emailValues.value +"?subject=" + encodeURIComponent(subject) + "&body=" + encodeURIComponent(body);
                } else if (emailValues.value.length === 0 && emailValues.value_1.length > 0) {
                    window.location.href = "mailto:"+ emailValues.value_1 +"?subject=" + encodeURIComponent(subject) + "&body=" + encodeURIComponent(body);
                } else if (emailValues.value.length > 0 && emailValues.value_1.length > 0) {
                    window.location.href = "mailto:"+ emailValues.value + ',' + emailValues.value_1 +"?subject=" + encodeURIComponent(subject) + "&body=" + encodeURIComponent(body);
                }else{
                    toastr["error"]("Email Not Found");
                }
            }

            SaveIntimation();
        }else{
            toastr["error"]("Email Not Found");
        }
    }

    function addBranch() {
        $('#formBranch').trigger("reset").removeClass('was-validated');
        $("#modalBranch").modal('show');
    }

    // for edit/multiple intimation claim data
    $(document).ready(function() {
        //         }   
    });

    $('#addIntimation').on('change', 'input[type="file"]', function() {
        const fileInput = $(this);
        const files = fileInput[0].files;

        const maxFiles = 5;
        const allowedTypes = [
            'image/jpeg',
            'image/png',
            'application/pdf'
        ];
        const allowedExtensions = ['jpg', 'jpeg', 'png', 'pdf'];

        if (files.length > maxFiles) {
            toastr["error"](`Maximum ${maxFiles} files allowed.`);
            fileInput.val(''); // reset the file input
            return;
        }

            // Type + extension validation
        for (let i = 0; i < files.length; i++) {
            const file = files[i];
            const ext = file.name.split('.').pop().toLowerCase();

            if (
                !allowedTypes.includes(file.type) ||
                !allowedExtensions.includes(ext)
            ) {
                toastr.error('Please select a valid file.');
                fileInput.val('');
                return;
            }
        }
    });

    // Add a single delegated event handler for all download buttons
    $(document).on('click', '.download-client-document-btn', function(event) {
        event.preventDefault();
            
        var documentName = $(this).data('document-name');
        var clientId = $(this).data('client-id');
        var claimId = $(this).data('claim-id');
        var type = $(this).data('doc-type');
        var documentNum = $(this).data('download-doc-num');


        if(type == "client_doc"){
            downloadClientDocument(documentName, clientId);
        } else {
            downloadClaimDocument(documentName, documentNum);
        }
        

    });

    function downloadClaimDocument(documentName, documentNum){
        showLoader();

        var params = new URLSearchParams();
        var ajaxURL = "{{ route('download.claim.document') }}";

        params.append('document', documentName);
        params.append('document_number', documentNum);
        params.append('department', 'ClaimIntimation');

        // Create hidden iframe (download target)
        var iframe = document.createElement('iframe');
        iframe.style.display = 'none';
        document.body.appendChild(iframe);

        $.ajax({
            url: ajaxURL + "?" + params.toString(),
            dataType: 'json',
            success: function(result) {
                hideLoader();

                if (result.status == 1) {
                    // Trigger download
                    iframe.src = result.download_url;

                    // Remove iframe after some seconds
                    setTimeout(() => {
                        iframe.remove();
                    }, 8000);
                } else {
                    toastr.error(result.msg || "File not found");
                }
            },
            error: function(xhr) {
                hideLoader();
                toastr.error(xhr.responseJSON?.message || "Error downloading file");
            }
        });
    }

</script>
@endsection