{"id":308,"date":"2025-05-05T03:39:43","date_gmt":"2025-05-05T03:39:43","guid":{"rendered":"https:\/\/mitigrisk.co.za\/site\/?page_id=308"},"modified":"2025-05-05T04:04:03","modified_gmt":"2025-05-05T04:04:03","slug":"glass-claim","status":"publish","type":"page","link":"https:\/\/mitigrisk.co.za\/index.php\/glass-claim\/","title":{"rendered":"Glass Claim"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"308\" class=\"elementor elementor-308\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a5d9c6e e-flex e-con-boxed e-con e-parent\" data-id=\"a5d9c6e\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-72fd4aa e-con-full e-flex e-con e-child\" data-id=\"72fd4aa\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-61242ff e-con-full e-flex e-con e-child\" data-id=\"61242ff\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-77c386a jltma-glass-effect-no elementor-widget elementor-widget-heading\" data-id=\"77c386a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Authorised financial services provider: FSP 54273<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0f5ed08 e-flex e-con-boxed e-con e-parent\" data-id=\"0f5ed08\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-410216e jltma-glass-effect-no elementor-widget elementor-widget-shortcode\" data-id=\"410216e\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f327-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"327\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/308#wpcf7-f327-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"327\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0.5\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f327-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<h3>Type of Policy\n<\/h3>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"policy-type\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><span class=\"wpcf7-list-item-label\">Personal<\/span><input type=\"radio\" name=\"policy-type\" value=\"Personal\" \/><\/span><span class=\"wpcf7-list-item\"><span class=\"wpcf7-list-item-label\">Commercial<\/span><input type=\"radio\" name=\"policy-type\" value=\"Commercial\" \/><\/span><span class=\"wpcf7-list-item last\"><span class=\"wpcf7-list-item-label\">Agri<\/span><input type=\"radio\" name=\"policy-type\" value=\"Agri\" \/><\/span><\/span><\/span>\n<\/p>\n<h5>Policy Number\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"policy-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Enter Policy Number\" value=\"\" type=\"text\" name=\"policy-number\" \/><\/span>\n<\/p>\n<h3>Insured Details\n<\/h3>\n<h5>First\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"First Name\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span>\n<\/p>\n<h5>Last\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Last Name\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span>\n<\/p>\n<h5>Occupation\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"occupation\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Occupation\" value=\"\" type=\"text\" name=\"occupation\" \/><\/span>\n<\/p>\n<h4>Address\n<\/h4>\n<h5>Street Address\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"street-address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Street Address\" value=\"\" type=\"text\" name=\"street-address\" \/><\/span>\n<\/p>\n<h5>Address Line 2\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"address-line-2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Address Line 2\" value=\"\" type=\"text\" name=\"address-line-2\" \/><\/span>\n<\/p>\n<h5>City\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"City\" value=\"\" type=\"text\" name=\"city\" \/><\/span>\n<\/p>\n<h5>Province\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"province\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Province\" value=\"\" type=\"text\" name=\"province\" \/><\/span>\n<\/p>\n<h5>Postal Code\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"postal-code\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Postal Code\" value=\"\" type=\"text\" name=\"postal-code\" \/><\/span>\n<\/p>\n<h4>Contact Details\n<\/h4>\n<h5>Contact Method\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"contact-method\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"contact-method\"><option value=\"--Please choose an option--\">--Please choose an option--<\/option><option value=\"Cell number\">Cell number<\/option><option value=\"Tel no. (Work)\">Tel no. (Work)<\/option><option value=\"Tel no. (Alternative)\">Tel no. (Alternative)<\/option><\/select><\/span>\n<\/p>\n<h5>Cell Number\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"cell-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" placeholder=\"Cell Number\" value=\"\" type=\"tel\" name=\"cell-number\" \/><\/span>\n<\/p>\n<h5>Work Number\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"work-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" placeholder=\"Work Number\" value=\"\" type=\"tel\" name=\"work-number\" \/><\/span>\n<\/p>\n<h5>Alternative Number\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"alt-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" placeholder=\"Alternative Number\" value=\"\" type=\"tel\" name=\"alt-number\" \/><\/span>\n<\/p>\n<h5>Email Address\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"emailaddress\"><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\" placeholder=\"Email Address\" value=\"\" type=\"email\" name=\"emailaddress\" \/><\/span>\n<\/p>\n<h3>Vehicle Details\n<\/h3>\n<h5>Vehicle Make\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"vehicle-make\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Vehicle Make\" value=\"\" type=\"text\" name=\"vehicle-make\" \/><\/span>\n<\/p>\n<h5>Vehicle Model\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"vehicle-model\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Vehicle Model\" value=\"\" type=\"text\" name=\"vehicle-model\" \/><\/span>\n<\/p>\n<h5>Year of Manufacture\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"year-manufacture\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Year (e.g., 2020)\" value=\"\" type=\"text\" name=\"year-manufacture\" \/><\/span>\n<\/p>\n<h5>VIN Number\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"vin-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"VIN Number\" value=\"\" type=\"text\" name=\"vin-number\" \/><\/span>\n<\/p>\n<h5>Registration Number\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"registration-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Registration Number\" value=\"\" type=\"text\" name=\"registration-number\" \/><\/span>\n<\/p>\n<h3>Cause of Loss or Damage\n<\/h3>\n<h5>Description of Incident\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"incident-description\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Describe the incident\" name=\"incident-description\"><\/textarea><\/span>\n<\/p>\n<h3>Previous Loss or Damage\n<\/h3>\n<h5>Have you previously had a glass claim?\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"previous-loss\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"previous-loss\" value=\"Yes\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"previous-loss\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<h3>Statement of Property lost, stolen or damaged\n<\/h3>\n<h3>Uploads\n<\/h3>\n<h5>Damage Report\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"damage-report\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\"audio\/*,video\/*,image\/*\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"damage-report\" \/><\/span>\n<\/p>\n<h3>Claim Form Completed By\n<\/h3>\n<h5>Completed By\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"completed-by\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"completed-by\" value=\"Broker \/ Admin\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Broker \/ Admin<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"completed-by\" value=\"Client\" \/><span class=\"wpcf7-list-item-label\">Client<\/span><\/span><\/span><\/span>\n<\/p>\n<h3>Declaration\n<\/h3>\n<h5>Capacity\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"capacity\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Your capacity\" value=\"\" type=\"text\" name=\"capacity\" \/><\/span>\n<\/p>\n<h5>Signed Date\n<\/h5>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"signed-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" readonly=\"readonly\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"signed-date\" \/><\/span>\n<\/p>\n<h5>Signature\n<\/h5>\n<p><div class=\"dscf7_signature\">\n\t\t\t<div class=\"dscf7_signature_inner\">\n\t\t\t\t<canvas id=\"digital_signature-pad_signature-274\" name=\"signature-274\" class=\"digital_signature-pad\" color=\"#000000\" backcolor=\"#dddddd\" width=\"300\" height=\"200\"><\/canvas>\n\t\t\t\t<input class=\"clearButton\" type=\"button\" value=\"+\">\n\t\t\t<\/div>\n\t\t\t<span class=\"wpcf7-form-control-wrap signature-274\" data-name=\"signature-274\">\n\t\t\t\t<input class=\"wpcf7-form-control wpcf7-signature wpcf7-validates-as-required wpcf7-validates-as-signature dscf7-signature\" value=\"\" type=\"hidden\" name=\"signature-274\"\/>\n\t\t\t\t<input type=\"hidden\" name=\"signature-274-attachment\" class=\"wpcf7_input_signature-274_attachment\"\/>\n\t\t\t\t<input type=\"hidden\" name=\"signature-274-inline\" class=\"wpcf7_input_signature-274_inline\"\/>\n\t\t\t<\/span>\n\t\t<\/div>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit Claim\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Authorised financial services provider: FSP 54273<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-308","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/mitigrisk.co.za\/index.php\/wp-json\/wp\/v2\/pages\/308","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mitigrisk.co.za\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mitigrisk.co.za\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mitigrisk.co.za\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mitigrisk.co.za\/index.php\/wp-json\/wp\/v2\/comments?post=308"}],"version-history":[{"count":7,"href":"https:\/\/mitigrisk.co.za\/index.php\/wp-json\/wp\/v2\/pages\/308\/revisions"}],"predecessor-version":[{"id":330,"href":"https:\/\/mitigrisk.co.za\/index.php\/wp-json\/wp\/v2\/pages\/308\/revisions\/330"}],"wp:attachment":[{"href":"https:\/\/mitigrisk.co.za\/index.php\/wp-json\/wp\/v2\/media?parent=308"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}