{"id":1838,"date":"2023-03-14T03:02:12","date_gmt":"2023-03-14T03:02:12","guid":{"rendered":"http:\/\/bracketweb.com\/insurwp\/?page_id=1838"},"modified":"2023-03-14T03:11:44","modified_gmt":"2023-03-14T03:11:44","slug":"policy-proposal","status":"publish","type":"page","link":"https:\/\/bracketweb.com\/insurwp\/policy-proposal\/","title":{"rendered":"Policy proposal"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1838\" class=\"elementor elementor-1838\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-8a7d204 elementor-section-full_width elementor-section-height-default elementor-section-height-default\" data-id=\"8a7d204\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ea0f6e5\" data-id=\"ea0f6e5\" 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-e0632d2 elementor-widget elementor-widget-insur-contact-form\" data-id=\"e0632d2\" data-element_type=\"widget\" data-widget_type=\"insur-contact-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t    <!--Policy Proposal Start-->\r\n    <section class=\"policy-proposal\">\r\n        <div class=\"container\">\r\n            <div class=\"policy-proposal__inner\">\r\n                                    <p class=\"policy-proposal__text-1\">Please fill out and submit the form below. Our representative will inform you about other requirements for <br \/>\nobtaining an insurance policy:\n<\/p>\r\n                                                    \n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1844-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1844\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/insurwp\/wp-json\/wp\/v2\/pages\/1838#wpcf7-f1844-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"1844\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1844-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<div  class=\"policy-proposal__form contact-form-validated\">\n    <div class=\"row\">\n        <div class=\"col-xl-6\">\n            <div class=\"policy-proposal__input-box\">\n                <p class=\"policy-proposal__input-title\">Select City:<\/p>\n                <div class=\"select-box\">\n                       <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-236\"><select class=\"wpcf7-form-control wpcf7-select wide nice-select\" aria-invalid=\"false\" name=\"menu-236\"><option value=\"Select city\">Select city<\/option><option value=\"Select city 01\">Select city 01<\/option><option value=\"Select city 02\">Select city 02<\/option><option value=\"Select city 03\">Select city 03<\/option><\/select><\/span>\n                <\/div>\n            <\/div>\n        <\/div>\n        <div class=\"col-xl-6\"><\/div>\n        <div class=\"col-xl-6\">\n            <div class=\"policy-proposal__input-box\">\n                <p class=\"policy-proposal__input-title\">Your Full Name:<\/p>\n                <span class=\"wpcf7-form-control-wrap\" data-name=\"full-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"full-name\" \/><\/span>\n            <\/div>\n        <\/div>\n        <div class=\"col-xl-6\">\n            <div class=\"policy-proposal__input-box\">\n                <p class=\"policy-proposal__input-title\">Father\u2019s\/Husband\u2019s Full Name:<\/p>\n                <span class=\"wpcf7-form-control-wrap\" data-name=\"father-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"father-name\" \/><\/span>\n            <\/div>\n        <\/div>\n        <div class=\"col-xl-6\">\n            <div class=\"policy-proposal__input-box\">\n                <p class=\"policy-proposal__input-title\">Indentity No:<\/p>\n                <span class=\"wpcf7-form-control-wrap\" data-name=\"indentity\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"indentity\" \/><\/span>\n            <\/div>\n        <\/div>\n        <div class=\"col-xl-6\">\n            <div class=\"policy-proposal__input-box\">\n                <p class=\"policy-proposal__input-title\">Date of Birth:<\/p>\n                <span class=\"wpcf7-form-control-wrap\" data-name=\"birthdate\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"birthdate\" \/><\/span>\n            <\/div>\n        <\/div>\n        <div class=\"col-xl-6\">\n            <div class=\"policy-proposal__input-box\">\n                <p class=\"policy-proposal__input-title\">Residential Address:<\/p>\n                <span class=\"wpcf7-form-control-wrap\" data-name=\"residential\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"residential\" \/><\/span>\n            <\/div>\n        <\/div>\n        <div class=\"col-xl-6\">\n            <div class=\"policy-proposal__input-box\">\n                <p class=\"policy-proposal__input-title\">Contact No:<\/p>\n                <span class=\"wpcf7-form-control-wrap\" data-name=\"contact-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"contact-number\" \/><\/span>\n            <\/div>\n        <\/div>\n        <div class=\"col-xl-6\">\n            <div class=\"row\">\n                <div class=\"col-xl-6\">\n                    <div class=\"policy-proposal__input-box\">\n                        <p class=\"policy-proposal__input-title\">Fax:<\/p>\n                        <span class=\"wpcf7-form-control-wrap\" data-name=\"fax\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"fax\" \/><\/span>\n                    <\/div>\n                <\/div>\n                <div class=\"col-xl-6\">\n                    <div class=\"policy-proposal__input-box\">\n                        <p class=\"policy-proposal__input-title\">Email:<\/p>\n                        <span class=\"wpcf7-form-control-wrap\" data-name=\"email-7\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email-7\" \/><\/span>\n                    <\/div>\n                <\/div>\n            <\/div>\n        <\/div>\n        <div class=\"col-xl-6\">\n            <div class=\"policy-proposal__input-box\">\n                <p class=\"policy-proposal__input-title\">Your Occupation:<\/p>\n                <span class=\"wpcf7-form-control-wrap\" data-name=\"occupation\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"occupation\" \/><\/span>\n            <\/div>\n        <\/div>\n        <div class=\"col-xl-6\">\n            <div class=\"policy-proposal__input-box\">\n                <p class=\"policy-proposal__input-title\">Monthly Income:<\/p>\n                <span class=\"wpcf7-form-control-wrap\" data-name=\"monthly-income\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"monthly-income\" \/><\/span>\n            <\/div>\n        <\/div>\n        <div class=\"col-xl-6\">\n            <div class=\"row\">\n                <div class=\"col-xl-6\">\n                    <div class=\"policy-proposal__input-box\">\n                        <p class=\"policy-proposal__input-title\">Chose Plan:<\/p>\n                        <div class=\"select-box\">\n                           <span class=\"wpcf7-form-control-wrap\" data-name=\"menu-322\"><select class=\"wpcf7-form-control wpcf7-select wide nice-select\" aria-invalid=\"false\" name=\"menu-322\"><option value=\"Choose policy\">Choose policy<\/option><option value=\"Choose policy 01\">Choose policy 01<\/option><option value=\"Choose policy 02\">Choose policy 02<\/option><option value=\"Choose policy 03\">Choose policy 03<\/option><\/select><\/span>\n                        <\/div>\n                    <\/div>\n                <\/div>\n                <div class=\"col-xl-6\">\n                    <div class=\"policy-proposal__input-box\">\n                        <p class=\"policy-proposal__input-title\">Chose Terms:<\/p>\n                        <div class=\"select-box\">\n                            <span class=\"wpcf7-form-control-wrap\" data-name=\"terms\"><select class=\"wpcf7-form-control wpcf7-select wide nice-select\" aria-invalid=\"false\" name=\"terms\"><option value=\"10\">10<\/option><option value=\"20\">20<\/option><option value=\"30\">30<\/option><\/select><\/span>\n                        <\/div>\n                    <\/div>\n                <\/div>\n            <\/div>\n        <\/div>\n    <\/div>\n    <div class=\"row\">\n        <div class=\"col-xl-12\">\n            <div class=\"policy-proposal__messages-boxes\">\n                <div class=\"policy-proposal__message-one\">\n                    <p class=\"policy-proposal__message-one-title\">Do you have any physical\n                        impairment?\n                        If yes, please state its nature:<\/p>\n                    <div class=\"policy-proposal__textarea-one\">\n                        <span class=\"wpcf7-form-control-wrap\" data-name=\"message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"message\"><\/textarea><\/span>\n                    <\/div>\n                <\/div>\n                <div class=\"policy-proposal__message-two\">\n                    <p class=\"policy-proposal__message-two-title\">Do you now or ever had heart\n                        disease,\n                        diabetes, high blood pressure, TB, jaundice or liver, stomach, renal\n                        disease,\n                        cancer, asthma, epilepsy, nervous or psychological disorders? If so specify\n                        with\n                        dates:<\/p>\n                    <div class=\"policy-proposal__textarea-two\">\n                        <span class=\"wpcf7-form-control-wrap\" data-name=\"message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"message\"><\/textarea><\/span>\n                    <\/div>\n                <\/div>\n                <div class=\"policy-proposal__message-three\">\n                    <p class=\"policy-proposal__message-three-title\">Are you in good health? If not,\n                        describe the nature of ailment:<\/p>\n                    <div class=\"policy-proposal__textarea-three\">\n                        <span class=\"wpcf7-form-control-wrap\" data-name=\"messagethree\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"messagethree\"><\/textarea><\/span>\n                    <\/div>\n                <\/div>\n                <button type=\"submit\" class=\"thm-btn policy-proposal__btn\">Submit Proposal<\/button>\n            <\/div>\n        <\/div>\n    <\/div>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n                            <\/div>\r\n        <\/div>\r\n    <\/section>\r\n    <!--Policy Proposal End-->\r\n\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","protected":false},"excerpt":{"rendered":"<p>Please fill out and submit the form below. Our representative will inform you about other requirements for obtaining an insurance policy: Select City: Select citySelect city 01Select city 02Select city 03 Your Full Name: Father\u2019s\/Husband\u2019s Full Name: Indentity No: Date of Birth: Residential Address: Contact No: Fax: Email: Your Occupation: Monthly Income: Chose Plan: Choose [&hellip;]<\/p>\n","protected":false},"author":5,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-1838","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/bracketweb.com\/insurwp\/wp-json\/wp\/v2\/pages\/1838","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bracketweb.com\/insurwp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/bracketweb.com\/insurwp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/bracketweb.com\/insurwp\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/bracketweb.com\/insurwp\/wp-json\/wp\/v2\/comments?post=1838"}],"version-history":[{"count":7,"href":"https:\/\/bracketweb.com\/insurwp\/wp-json\/wp\/v2\/pages\/1838\/revisions"}],"predecessor-version":[{"id":1847,"href":"https:\/\/bracketweb.com\/insurwp\/wp-json\/wp\/v2\/pages\/1838\/revisions\/1847"}],"wp:attachment":[{"href":"https:\/\/bracketweb.com\/insurwp\/wp-json\/wp\/v2\/media?parent=1838"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}