{"id":265058,"date":"2025-04-08T12:39:18","date_gmt":"2025-04-08T06:09:18","guid":{"rendered":"https:\/\/ayasompo.com\/?page_id=265058"},"modified":"2025-06-10T17:41:44","modified_gmt":"2025-06-10T11:11:44","slug":"quick-claim-assistance-form","status":"publish","type":"page","link":"https:\/\/ayasompo.com\/en\/quick-claim-assistance-form\/","title":{"rendered":"Quick Claim Assistance Form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"265058\" class=\"elementor elementor-265058\">\n\t\t\t\t\t\t<section data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-section elementor-top-section elementor-element elementor-element-4c4cb2d elementor-section-boxed elementor-section-height-default elementor-section-height-default parallax_section_no qode_elementor_container_no\" data-id=\"4c4cb2d\" data-element_type=\"section\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5a482ff\" data-id=\"5a482ff\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6bee410 elementor-widget elementor-widget-heading\" data-id=\"6bee410\" data-element_type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Quick Claim Assistance Form<\/p>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-section elementor-top-section elementor-element elementor-element-e094c76 elementor-section-boxed elementor-section-height-default elementor-section-height-default parallax_section_no qode_elementor_container_no\" data-id=\"e094c76\" data-element_type=\"section\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-9125feb\" data-id=\"9125feb\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-63ef6be\" data-id=\"63ef6be\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8a3e46a elementor-widget elementor-widget-metform\" data-id=\"8a3e46a\" data-element_type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"metform.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div id=\"mf-response-props-id-265070\" data-previous-steps-style=\"\" data-editswitchopen=\"\" data-response_type=\"alert\" data-erroricon=\"fas fa-exclamation-triangle\" data-successicon=\"fas fa-check\" data-messageposition=\"top\" class=\"   mf-scroll-top-no\">\n\t\t<div class=\"formpicker_warper formpicker_warper_editable\" data-metform-formpicker-key=\"265070\" >\n\t\t\t\t\n\t\t\t<div class=\"mf-widget-container\">\n\t\t\t\t\r\n\t\t<div\r\n\t\t\tid=\"metform-wrap-8a3e46a-265070\"\r\n\t\t\tclass=\"mf-form-wrapper\"\r\n\t\t\tdata-form-id=\"265070\"\r\n\t\t\tdata-action=\"https:\/\/ayasompo.com\/en\/wp-json\/metform\/v1\/entries\/insert\/265070\"\r\n\t\t\tdata-wp-nonce=\"99c7920460\"\r\n\t\t\tdata-form-nonce=\"7344e60efe\"\r\n\t\t\tdata-quiz-summery = \"false\"\r\n\t\t\tdata-save-progress = \"false\"\r\n\t\t\tdata-form-type=\"general-form\"\r\n\t\t\tdata-stop-vertical-effect=\"\"\r\n\t\t\t><\/div>\r\n\r\n\r\n\t\t<!----------------------------- \r\n\t\t\t* controls_data : find the the props passed indie of data attribute\r\n\t\t\t* props.SubmitResponseMarkup : contains the markup of error or success message\r\n\t\t\t* https:\/\/developer.mozilla.org\/en-US\/docs\/Web\/JavaScript\/Reference\/Template_literals\r\n\t\t--------------------------- -->\r\n\r\n\t\t\t\t<script type=\"text\/mf\" class=\"mf-template\">\r\n\t\t\tfunction controls_data (value){\r\n\t\t\t\tlet currentWrapper = \"mf-response-props-id-265070\";\r\n\t\t\t\tlet currentEl = document.getElementById(currentWrapper);\r\n\t\t\t\t\r\n\t\t\t\treturn currentEl ? currentEl.dataset[value] : false\r\n\t\t\t}\r\n\r\n\r\n\t\t\tlet is_edit_mode = '' ? true : false;\r\n\t\t\tlet message_position = controls_data('messageposition') || 'top';\r\n\r\n\t\t\t\r\n\t\t\tlet message_successIcon = controls_data('successicon') || '';\r\n\t\t\tlet message_errorIcon = controls_data('erroricon') || '';\r\n\t\t\tlet message_editSwitch = controls_data('editswitchopen') === 'yes' ? true : false;\r\n\t\t\tlet message_proClass = controls_data('editswitchopen') === 'yes' ? 'mf_pro_activated' : '';\r\n\t\t\t\r\n\t\t\tlet is_dummy_markup = is_edit_mode && message_editSwitch ? true : false;\r\n\r\n\t\t\t\r\n\t\t\treturn html`\r\n\t\t\t\t<form\r\n\t\t\t\t\tclassName=\"metform-form-content\"\r\n\t\t\t\t\tref=${parent.formContainerRef}\r\n\t\t\t\t\tonSubmit=${ validation.handleSubmit( parent.handleFormSubmit ) }\r\n\t\t\t\t\r\n\t\t\t\t\t>\r\n\t\t\t\r\n\t\t\t\r\n\t\t\t\t\t${is_dummy_markup ? message_position === 'top' ?  props.ResponseDummyMarkup(message_successIcon, message_proClass) : '' : ''}\r\n\t\t\t\t\t${is_dummy_markup ? ' ' :  message_position === 'top' ? props.SubmitResponseMarkup`${parent}${state}${message_successIcon}${message_errorIcon}${message_proClass}` : ''}\r\n\r\n\t\t\t\t\t<!--------------------------------------------------------\r\n\t\t\t\t\t*** IMPORTANT \/ DANGEROUS ***\r\n\t\t\t\t\t${html``} must be used as in immediate child of \"metform-form-main-wrapper\"\r\n\t\t\t\t\tclass otherwise multistep form will not run at all\r\n\t\t\t\t\t---------------------------------------------------------->\r\n\r\n\t\t\t\t\t<div className=\"metform-form-main-wrapper\" key=${'hide-form-after-submit'} ref=${parent.formRef}>\r\n\t\t\t\t\t${html`\r\n\t\t\t\t\t\t\t\t<div data-elementor-type=\"wp-post\" key=\"2\" data-elementor-id=\"265070\" className=\"elementor elementor-265070\">\n\t\t\t\t\t\t<section data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" className=\"elementor-section elementor-top-section elementor-element elementor-element-cb35e81 elementor-section-boxed elementor-section-height-default elementor-section-height-default parallax_section_no qode_elementor_container_no\" data-id=\"cb35e81\" data-element_type=\"section\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t\t<div className=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div className=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-fdd2128\" data-id=\"fdd2128\" data-element_type=\"column\">\n\t\t\t<div className=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div className=\"elementor-element elementor-element-c9a5fb9 elementor-widget elementor-widget-mf-text\" data-id=\"c9a5fb9\" data-element_type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;policy-holder-name&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-c9a5fb9\">\r\n\t\t\t\t\t${ parent.decodeEntities(`Policyholder Name:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-c9a5fb9\"\r\n\t\t\t\tname=\"policy-holder-name\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['policy-holder-name'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"policy-holder-name\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-b86ad94 elementor-widget elementor-widget-mf-telephone\" data-id=\"b86ad94\" data-element_type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;contact-number&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"mf-telephone.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-telephone-b86ad94\">\n\t\t\t\t\t${ parent.decodeEntities(`Contact Number: `) } \t\t\t\t\t<span className=\"mf-input-required-indicator\">*<\/span>\n\t\t\t\t<\/label>\n\t\t\t\n\t\t\t<input\n\t\t\t\ttype=\"tel\"\n\t\t\t\tclassName=\"mf-input \"\n\t\t\t\tid=\"mf-input-telephone-b86ad94\" \n\t\t\t\tname=\"contact-number\"\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\n\t\t\t\t\taria-invalid=${validation.errors['contact-number'] ? 'true' : 'false'}\n\t\t\t\t\tref=${el => parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":true,\"expression\":\"null\"}, el)}\n\t\t\t\t\t\t\t\t\/>\n\t\t\t\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"contact-number\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\n\t\t\t\n\t\t<\/div>\n\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-95f9042 elementor-widget elementor-widget-mf-text\" data-id=\"95f9042\" data-element_type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;policy-number&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"mf-text.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\r\n\t\t<div className=\"mf-input-wrapper\">\r\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-text-95f9042\">\r\n\t\t\t\t\t${ parent.decodeEntities(` Policy Number (optional):`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\r\n\t\t\t\t<\/label>\r\n\t\t\t\r\n\t\t\t<input\r\n\t\t\t\ttype=\"text\"\r\n\t\t\t\tclassName=\"mf-input \"\r\n\t\t\t\tid=\"mf-input-text-95f9042\"\r\n\t\t\t\tname=\"policy-number\"\r\n\t\t\t\tplaceholder=\"${ parent.decodeEntities(``) } \"\r\n\t\t\t\t\t\t\t\t\tonInput=${parent.handleChange}\r\n\t\t\t\t\tonBlur=${parent.handleChange}\r\n\t\t\t\t\taria-invalid=${validation.errors['policy-number'] ? 'true' : 'false'}\r\n\t\t\t\t\tref=${el =>{\r\n\t\t\t\t\t\t\t\t\t\t\t\tparent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false,\"expression\":\"null\"}, el)\r\n\t\t\t\t\t}}\r\n\t\t\t\t\t\t\t\t\/>\r\n\r\n\t\t\t\t\t\t\t<${validation.ErrorMessage}\r\n\t\t\t\t\terrors=${validation.errors}\r\n\t\t\t\t\tname=\"policy-number\"\r\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\r\n\t\t\t\t\t\/>\r\n\t\t\t\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-9c4d672 elementor-widget elementor-widget-mf-select\" data-id=\"9c4d672\" data-element_type=\"widget\" data-settings=\"{&quot;mf_input_name&quot;:&quot;insurance-type&quot;,&quot;mf_input_list&quot;:[{&quot;mf_input_option_text&quot;:&quot;AYA Health Insurance&quot;,&quot;mf_input_option_value&quot;:&quot;AYA Health Insurance&quot;,&quot;_id&quot;:&quot;c7f126c&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;Motor Vehicle Insurance&quot;,&quot;mf_input_option_value&quot;:&quot;Motor Vehicle Insurance&quot;,&quot;_id&quot;:&quot;f87dad4&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;mf_input_option_text&quot;:&quot;AYA Go Travel Insurance&quot;,&quot;mf_input_option_value&quot;:&quot;AYA Go Travel Insurance&quot;,&quot;_id&quot;:&quot;d1251fd&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;_id&quot;:&quot;d47e826&quot;,&quot;mf_input_option_text&quot;:&quot;AYA Joy Travel Insurance&quot;,&quot;mf_input_option_value&quot;:&quot;AYA Joy Travel Insurance&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;_id&quot;:&quot;3f3b72d&quot;,&quot;mf_input_option_text&quot;:&quot;Personal Accident Insurance&quot;,&quot;mf_input_option_value&quot;:&quot;Personal Accident Insurance&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;_id&quot;:&quot;133d19f&quot;,&quot;mf_input_option_text&quot;:&quot;Fire Insurance&quot;,&quot;mf_input_option_value&quot;:&quot;Fire Insurance&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;_id&quot;:&quot;2724241&quot;,&quot;mf_input_option_text&quot;:&quot;Industrial All Risks (IAR) Insurance&quot;,&quot;mf_input_option_value&quot;:&quot;Industrial All Risks (IAR) Insurance&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;_id&quot;:&quot;11aa9e4&quot;,&quot;mf_input_option_text&quot;:&quot;Contractor\\u2019s All Risks (CAR), Erection All Risks (EAR) Insurance&quot;,&quot;mf_input_option_value&quot;:&quot;Contractor\\u2019s All Risks (CAR), Erection All Risks (EAR) Insurance&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;_id&quot;:&quot;d37655c&quot;,&quot;mf_input_option_text&quot;:&quot;Marine Cargo Insurance&quot;,&quot;mf_input_option_value&quot;:&quot;Marine Cargo Insurance&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;},{&quot;_id&quot;:&quot;0e10db9&quot;,&quot;mf_input_option_text&quot;:&quot;Inland Transit Insurance&quot;,&quot;mf_input_option_value&quot;:&quot;Inland Transit Insurance&quot;,&quot;mf_input_option_status&quot;:&quot;&quot;,&quot;mf_input_option_selected&quot;:&quot;&quot;}],&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"mf-select.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\n\t\t\n\t\t<div className=\"mf-input-wrapper\">\n\t\t\t\t\t\t\t<label className=\"mf-input-label\" htmlFor=\"mf-input-select-9c4d672\">\n\t\t\t\t\t${ parent.decodeEntities(`Insurance Type:`) } \t\t\t\t\t<span className=\"mf-input-required-indicator\"><\/span>\n\t\t\t\t<\/label>\n            \n            <${props.Select}\n                className=${\"mf-input mf-input-select  \" + ( validation.errors['insurance-type'] ? 'mf-invalid' : '' )}\n                classNamePrefix=\"mf_select\"\n                name=\"insurance-type\"\n                placeholder=\"${ parent.decodeEntities(``) } \"\n                isSearchable=${false}\n                options=${[{\"label\":\"AYA Health Insurance\",\"value\":\"AYA Health Insurance\",\"isDisabled\":false},{\"label\":\"Motor Vehicle Insurance\",\"value\":\"Motor Vehicle Insurance\",\"isDisabled\":false},{\"label\":\"AYA Go Travel Insurance\",\"value\":\"AYA Go Travel Insurance\",\"isDisabled\":false},{\"label\":\"AYA Joy Travel Insurance\",\"value\":\"AYA Joy Travel Insurance\",\"isDisabled\":false},{\"label\":\"Personal Accident Insurance\",\"value\":\"Personal Accident Insurance\",\"isDisabled\":false},{\"label\":\"Fire Insurance\",\"value\":\"Fire Insurance\",\"isDisabled\":false},{\"label\":\"Industrial All Risks (IAR) Insurance\",\"value\":\"Industrial All Risks (IAR) Insurance\",\"isDisabled\":false},{\"label\":\"Contractor\\u2019s All Risks (CAR), Erection All Risks (EAR) Insurance\",\"value\":\"Contractor\\u2019s All Risks (CAR), Erection All Risks (EAR) Insurance\",\"isDisabled\":false},{\"label\":\"Marine Cargo Insurance\",\"value\":\"Marine Cargo Insurance\",\"isDisabled\":false},{\"label\":\"Inland Transit Insurance\",\"value\":\"Inland Transit Insurance\",\"isDisabled\":false}]}\n                value=${parent.getValue(\"insurance-type\") ? [{\"label\":\"AYA Health Insurance\",\"value\":\"AYA Health Insurance\",\"isDisabled\":false},{\"label\":\"Motor Vehicle Insurance\",\"value\":\"Motor Vehicle Insurance\",\"isDisabled\":false},{\"label\":\"AYA Go Travel Insurance\",\"value\":\"AYA Go Travel Insurance\",\"isDisabled\":false},{\"label\":\"AYA Joy Travel Insurance\",\"value\":\"AYA Joy Travel Insurance\",\"isDisabled\":false},{\"label\":\"Personal Accident Insurance\",\"value\":\"Personal Accident Insurance\",\"isDisabled\":false},{\"label\":\"Fire Insurance\",\"value\":\"Fire Insurance\",\"isDisabled\":false},{\"label\":\"Industrial All Risks (IAR) Insurance\",\"value\":\"Industrial All Risks (IAR) Insurance\",\"isDisabled\":false},{\"label\":\"Contractor\\u2019s All Risks (CAR), Erection All Risks (EAR) Insurance\",\"value\":\"Contractor\\u2019s All Risks (CAR), Erection All Risks (EAR) Insurance\",\"isDisabled\":false},{\"label\":\"Marine Cargo Insurance\",\"value\":\"Marine Cargo Insurance\",\"isDisabled\":false},{\"label\":\"Inland Transit Insurance\",\"value\":\"Inland Transit Insurance\",\"isDisabled\":false}].filter(item => item.value === parent.getValue(\"insurance-type\"))[0] : []}\n                onChange=${(e)=> parent.handleSelect(e, \"insurance-type\")}\n                ref=${() => {\n\t\t\t\t                    register({ name: \"insurance-type\" }, parent.activateValidation({\"message\":\"This field is required.\",\"minLength\":1,\"maxLength\":\"\",\"type\":\"none\",\"required\":false}));\n                    if ( parent.getValue(\"insurance-type\") === '' && false ) {\n\t\t\t\t    parent.setValue( 'insurance-type', '', true );\n                        parent.handleChange({\n                            target: {\n                                name: 'insurance-type',\n                                value: ''\n                            }\n                        });\n                    }\n                }}\n                \/>\n\n            \t\t\t\t<${validation.ErrorMessage}\n\t\t\t\t\terrors=${validation.errors}\n\t\t\t\t\tname=\"insurance-type\"\n\t\t\t\t\tas=${html`<span className=\"mf-error-message\"><\/span>`}\n\t\t\t\t\t\/>\n\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div className=\"elementor-element elementor-element-8aa773d mf-btn--left elementor-widget elementor-widget-mf-button\" data-id=\"8aa773d\" data-element_type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"mf-button.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t<div className=\"mf-btn-wraper \" data-mf-form-conditional-logic-requirement=\"\">\r\n\t\t\t\t\t\t\t<button type=\"submit\" className=\"metform-btn metform-submit-btn \" id=\"\">\r\n\t\t\t\t\t<span>${ parent.decodeEntities(`Submit`) } <\/span>\r\n\t\t\t\t<\/button>\r\n\t\t\t        <\/div>\r\n        \t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" className=\"elementor-section elementor-top-section elementor-element elementor-element-0bae869 elementor-section-boxed elementor-section-height-default elementor-section-height-default parallax_section_no qode_elementor_container_no\" data-id=\"0bae869\" data-element_type=\"section\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t\t<div className=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div className=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7d82302\" data-id=\"7d82302\" data-element_type=\"column\">\n\t\t\t<div className=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div className=\"elementor-element elementor-element-48ee235 elementor-widget elementor-widget-text-editor\" data-id=\"48ee235\" data-element_type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div className=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>For renewal and claim, please contact our customer service 24\/7 at below numbers:<br \/>Claims:\u00a0<a href=\"tel:09777100999\">09777100999<\/a><br \/>Customer Service:\u00a0<a href=\"tel:09777100555\">09777100555<\/a><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t`}\r\n\t\t\t\t\t<\/div>\r\n\r\n\t\t\t\t\t${is_dummy_markup ? message_position === 'bottom' ? props.ResponseDummyMarkup(message_successIcon, message_proClass) : '' : ''}\r\n\t\t\t\t\t${is_dummy_markup ? ' ' : message_position === 'bottom' ? props.SubmitResponseMarkup`${parent}${state}${message_successIcon}${message_errorIcon}${message_proClass}` : ''}\r\n\t\t\t\t\r\n\t\t\t\t<\/form>\r\n\t\t\t`\r\n\t\t<\/script>\r\n\r\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-5ae6f30\" data-id=\"5ae6f30\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Quick Claim Assistance Form<\/p>","protected":false},"author":1,"featured_media":265060,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"class_list":["post-265058","page","type-page","status-publish","has-post-thumbnail","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Quick Claim Assistance Form - AYA SOMPO Insurance<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ayasompo.com\/en\/quick-claim-assistance-form\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Quick Claim Assistance Form - AYA SOMPO Insurance\" \/>\n<meta property=\"og:description\" content=\"Quick Claim Assistance Form\" \/>\n<meta property=\"og:url\" content=\"https:\/\/ayasompo.com\/en\/quick-claim-assistance-form\/\" \/>\n<meta property=\"og:site_name\" content=\"AYA SOMPO Insurance\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ayasompo\" \/>\n<meta property=\"article:modified_time\" content=\"2025-06-10T11:11:44+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/ayasompo.com\/wp-content\/uploads\/2025\/04\/quick-claim-feature.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/ayasompo.com\/quick-claim-assistance-form\/\",\"url\":\"https:\/\/ayasompo.com\/quick-claim-assistance-form\/\",\"name\":\"Quick Claim Assistance Form - AYA SOMPO Insurance\",\"isPartOf\":{\"@id\":\"https:\/\/ayasompo.com\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/ayasompo.com\/quick-claim-assistance-form\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/ayasompo.com\/quick-claim-assistance-form\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/ayasompo.com\/wp-content\/uploads\/2025\/04\/quick-claim-feature.jpg\",\"datePublished\":\"2025-04-08T06:09:18+00:00\",\"dateModified\":\"2025-06-10T11:11:44+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/ayasompo.com\/quick-claim-assistance-form\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/ayasompo.com\/quick-claim-assistance-form\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/ayasompo.com\/quick-claim-assistance-form\/#primaryimage\",\"url\":\"https:\/\/ayasompo.com\/wp-content\/uploads\/2025\/04\/quick-claim-feature.jpg\",\"contentUrl\":\"https:\/\/ayasompo.com\/wp-content\/uploads\/2025\/04\/quick-claim-feature.jpg\",\"width\":1200,\"height\":630},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/ayasompo.com\/quick-claim-assistance-form\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/ayasompo.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Quick Claim Assistance Form\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/ayasompo.com\/#website\",\"url\":\"https:\/\/ayasompo.com\/\",\"name\":\"AYA SOMPO Insurance\",\"description\":\"Your Partner for Life\",\"publisher\":{\"@id\":\"https:\/\/ayasompo.com\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/ayasompo.com\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/ayasompo.com\/#organization\",\"name\":\"AYA SOMPO Insurance\",\"url\":\"https:\/\/ayasompo.com\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/ayasompo.com\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/ayasompo.com\/wp-content\/uploads\/2020\/01\/favicon_ayasompo_new.png\",\"contentUrl\":\"https:\/\/ayasompo.com\/wp-content\/uploads\/2020\/01\/favicon_ayasompo_new.png\",\"width\":124,\"height\":124,\"caption\":\"AYA SOMPO Insurance\"},\"image\":{\"@id\":\"https:\/\/ayasompo.com\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/ayasompo\",\"https:\/\/www.instagram.com\/ayasompo_insurance\/\",\"https:\/\/www.linkedin.com\/company\/ayasompo-insurance\/\",\"https:\/\/www.youtube.com\/channel\/UCqQnRlVP3gu5fkoDuseZcFA\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Quick Claim Assistance Form - AYA SOMPO Insurance","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/ayasompo.com\/en\/quick-claim-assistance-form\/","og_locale":"en_US","og_type":"article","og_title":"Quick Claim Assistance Form - AYA SOMPO Insurance","og_description":"Quick Claim Assistance Form","og_url":"https:\/\/ayasompo.com\/en\/quick-claim-assistance-form\/","og_site_name":"AYA SOMPO Insurance","article_publisher":"https:\/\/www.facebook.com\/ayasompo","article_modified_time":"2025-06-10T11:11:44+00:00","og_image":[{"width":1200,"height":630,"url":"https:\/\/ayasompo.com\/wp-content\/uploads\/2025\/04\/quick-claim-feature.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/ayasompo.com\/quick-claim-assistance-form\/","url":"https:\/\/ayasompo.com\/quick-claim-assistance-form\/","name":"Quick Claim Assistance Form - AYA SOMPO Insurance","isPartOf":{"@id":"https:\/\/ayasompo.com\/#website"},"primaryImageOfPage":{"@id":"https:\/\/ayasompo.com\/quick-claim-assistance-form\/#primaryimage"},"image":{"@id":"https:\/\/ayasompo.com\/quick-claim-assistance-form\/#primaryimage"},"thumbnailUrl":"https:\/\/ayasompo.com\/wp-content\/uploads\/2025\/04\/quick-claim-feature.jpg","datePublished":"2025-04-08T06:09:18+00:00","dateModified":"2025-06-10T11:11:44+00:00","breadcrumb":{"@id":"https:\/\/ayasompo.com\/quick-claim-assistance-form\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/ayasompo.com\/quick-claim-assistance-form\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/ayasompo.com\/quick-claim-assistance-form\/#primaryimage","url":"https:\/\/ayasompo.com\/wp-content\/uploads\/2025\/04\/quick-claim-feature.jpg","contentUrl":"https:\/\/ayasompo.com\/wp-content\/uploads\/2025\/04\/quick-claim-feature.jpg","width":1200,"height":630},{"@type":"BreadcrumbList","@id":"https:\/\/ayasompo.com\/quick-claim-assistance-form\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/ayasompo.com\/"},{"@type":"ListItem","position":2,"name":"Quick Claim Assistance Form"}]},{"@type":"WebSite","@id":"https:\/\/ayasompo.com\/#website","url":"https:\/\/ayasompo.com\/","name":"AYA SOMPO Insurance","description":"Your Partner for Life","publisher":{"@id":"https:\/\/ayasompo.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/ayasompo.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/ayasompo.com\/#organization","name":"AYA SOMPO Insurance","url":"https:\/\/ayasompo.com\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/ayasompo.com\/#\/schema\/logo\/image\/","url":"https:\/\/ayasompo.com\/wp-content\/uploads\/2020\/01\/favicon_ayasompo_new.png","contentUrl":"https:\/\/ayasompo.com\/wp-content\/uploads\/2020\/01\/favicon_ayasompo_new.png","width":124,"height":124,"caption":"AYA SOMPO Insurance"},"image":{"@id":"https:\/\/ayasompo.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ayasompo","https:\/\/www.instagram.com\/ayasompo_insurance\/","https:\/\/www.linkedin.com\/company\/ayasompo-insurance\/","https:\/\/www.youtube.com\/channel\/UCqQnRlVP3gu5fkoDuseZcFA"]}]}},"_links":{"self":[{"href":"https:\/\/ayasompo.com\/en\/wp-json\/wp\/v2\/pages\/265058","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ayasompo.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/ayasompo.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/ayasompo.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ayasompo.com\/en\/wp-json\/wp\/v2\/comments?post=265058"}],"version-history":[{"count":22,"href":"https:\/\/ayasompo.com\/en\/wp-json\/wp\/v2\/pages\/265058\/revisions"}],"predecessor-version":[{"id":267680,"href":"https:\/\/ayasompo.com\/en\/wp-json\/wp\/v2\/pages\/265058\/revisions\/267680"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ayasompo.com\/en\/wp-json\/wp\/v2\/media\/265060"}],"wp:attachment":[{"href":"https:\/\/ayasompo.com\/en\/wp-json\/wp\/v2\/media?parent=265058"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}