@extends('layouts.default') @section('content')
Life Insurance Form
@csrf
Insurance Co. Details
Insurance Company Name
Select an Option
Plan Name
Select an Option
Sub Plan Name
Select an Option
Proposer Details
Proposer Name
Proposer DOB
Gender
Select an Option
personal_gender=='male' ? 'selected': ''}}>Male
personal_gender=='female' ? 'selected': ''}}>Female
personal_gender=='others' ? 'selected': ''}}>Others
Aadhaar No
Is Pan Card available ?
Select an Option
pancard_available=='Yes' ? 'selected': ''}}>Yes
pancard_available=='No' ? 'selected': ''}}>No
PAN NO
Email
Mobile No
Alternate Mobile No
Employee Type
Please Select Employee Type
emp_type=='salaried' ? 'selected': ''}}>Salaried
emp_type=='self_employed' ? 'selected': ''}}>Self Employed
emp_type=='self_employed_professional' ? 'selected': ''}}>Self Employed Professional
Permanent Address
Same as Permanent Address
Communication Address
Occupation
Annual Income
Life Assured Details
Same as Proposer
Life Assured Name
Life Assured DOB
Life Assured Gender
Select an Option
life_assured_gender == "male" ? 'selected':''}}>Male
life_assured_gender == "female" ? 'selected':''}}>Female
life_assured_gender == "others" ? 'selected':''}}>Others
Nominee Details
Nominee Name
Nominee DOB
Nominee Relationship
Select an Option
@foreach ($relationship as $data)
nominee_relatinship==trim($data->relationship_name ,' ')? 'selected' : ''}}>{{ $data->relationship_name }}
@endforeach
Appointee?
Appointee Name
Appointee DOB
Appointee Relationship
Select an Option
@foreach ($relationship as $data)
appointee_relationship==trim($data->relationship_name ,' ')? 'selected' : ''}}>{{ $data->relationship_name }}
@endforeach
Father Name
Mother Name
Spouse Name
Team Details
TEAM DETAILS
team_detail_type=='employee' ? 'selected' : ''}}>Employee
team_detail_type=='partner' ? 'selected' : ''}}>Partner
Caller
Select an Option
@foreach ($caller_list as $data)
employee_code == $life_insurance->caller_code) selected @endif>{{ $data->firstname }} {{ $data->lastname }}-{{$data->employee_code }}
@endforeach
Team Leader
Assistant Manager
Manager
Center Head
Regional Head / AVP
Zonal Head
Vice President
SM / RM
Select an Option
@foreach ($leads->ResponseObject as $data)
employee_code == $life_insurance->sm_code) selected @endif> {{ $data->firstname }} {{ $data->lastname}}-{{$data->employee_code }}
@endforeach
Branch - Center Location Name
Select an Option
@foreach ($branchlist->ResponseObject as $branch)
branch_id == $life_insurance->team_location_code) selected @endif> {{ $branch->branch_name }}
@endforeach
Partner Details
Choose an option
Manager Details
Relationship Manager
Choose an option
Payout Cycle
Location
CBRE
Is Cashback offered ?
Select an Option
cashback_offered=='Yes' ? 'selected' : ''}}>Yes
cashback_offered=='No' ? 'selected' : ''}}>No
CBRE %
Employee who offered CBRE to Client
Select an Option
@foreach ($leads->ResponseObject as $data)
cbre_to_client)) == 2 && $data->employee_code == explode("-", $life_insurance->cbre_to_client)[1]) selected @endif> {{ $data->firstname }} {{ $data->lastname }}- {{$data->employee_code}}
@endforeach
Remarks
{{$life_insurance->cbre_remarks}}
Attachments
Add Attchment
@if($checkattachfile == 0 || $checkattachfile == "0")
Document Type
Select an Option
Policy Copy
KYC DOC
Proposal Form
Verification Call Recording
Datasheet
Aadhaar Front Side
Aadhaar Back Side
Pan
Recent Photo
Bank passbook
Bank Statement
Bank Cheque
File
Remarks
@endif @foreach($policy_attachmentss as $key => $attchment)
Document Type
Select an Option
Policy Copy
KYC DOC
Proposal Form
Verification Call Recording
Datasheet
Aadhaar Front Side
Aadhaar Back Side
Pan
Recent Photo
Proposal From
Illustration
Receipt Copy / Payment Paid Confirmation
Cancelled Cheque Leaf or Bank Pass Book
Bank passbook
Bank Statement
Bank Cheque
File
@if($attchment['file_attach_type'] == "image")
x
@else
x
@endif
Remarks
{{$attchment['attachments_remarks']}}
@endforeach
Remarks
Add Remarks
Remarks
Remarks Filled by
Submit
@stop