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<?php include("includes/login-sidebar.php"); ?> <div class="page-container"> <div class="header-page flex-col"> <h1 class="title-h2">insurer dashboard</h1> <p class="f-14">manage all policies at one place</p> </div> <div class="body-dashbord"> <ul class="tabBlock-tabs dash-tab"> <li class="tabBlock-tab dash-li is-active"> Insurer details </li> <li class="tabBlock-tab dash-li">Create new Insurer</li> </ul> <div class="tabBlock-content dash-contents"> <div class="tabBlock-pane dash-wrap is-active"> <div class="tabledata-start pos-relative"> <div class="exportdata text-right"> <a href="#" class="dashbord-btn btn-export"> Export Client Data </a> </div> <table id="companylist-table" class="displayx" cellspacing="0" width="100%"> <thead> <tr> <th>Sr.</th> <th> <label class="form-controlv1"> <input type="checkbox" name="checkbox-checked" /> </label> </th> <th>Insurer</th> <th>No. of policies providing</th> <th>Plan</th> <th width="70">Action</th> </tr> </thead> <tbody> <tr> <td>05</td> <td> <label class="form-controlv1"> <input type="checkbox" name="checkbox-checked" /> </label> </td> <td>Company A</td> <td>Edinburgh</td> <td> <ul> <li class="defualt-tag sponsored"> base plan </li> </ul> </td> <td> <button type="button" class="btn-edit"> <svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none"> <g clip-path="url(#clip0_10_1093)"> <path d="M12.8889 4C13.1154 4.00025 13.3334 4.087 13.4981 4.24253C13.6628 4.39806 13.762 4.61062 13.7753 4.8368C13.7885 5.06297 13.715 5.28567 13.5695 5.45941C13.4241 5.63314 13.2179 5.7448 12.9929 5.77156L12.8889 5.77778H5.77778V18.2222H18.2222V11.1111C18.2225 10.8846 18.3092 10.6666 18.4648 10.5019C18.6203 10.3372 18.8328 10.238 19.059 10.2247C19.2852 10.2115 19.5079 10.285 19.6816 10.4305C19.8554 10.5759 19.967 10.7821 19.9938 11.0071L20 11.1111V18.2222C20.0001 18.6707 19.8308 19.1027 19.5258 19.4316C19.2208 19.7605 18.8028 19.9619 18.3556 19.9956L18.2222 20H5.77778C5.32927 20.0001 4.89727 19.8308 4.5684 19.5258C4.23953 19.2208 4.03808 18.8028 4.00444 18.3556L4 18.2222V5.77778C3.99986 5.32927 4.16925 4.89727 4.47422 4.5684C4.77919 4.23953 5.1972 4.03808 5.64444 4.00444L5.77778 4H12.8889ZM18.4382 4.30489C18.5982 4.14547 18.8128 4.05291 19.0386 4.04602C19.2643 4.03913 19.4842 4.11841 19.6536 4.26778C19.823 4.41714 19.9292 4.62538 19.9506 4.8502C19.972 5.07502 19.907 5.29956 19.7689 5.47822L19.6951 5.56267L10.8951 14.3618C10.7351 14.5212 10.5205 14.6138 10.2948 14.6206C10.069 14.6275 9.84914 14.5483 9.67975 14.3989C9.51036 14.2495 9.40417 14.0413 9.38276 13.8165C9.36134 13.5916 9.4263 13.3671 9.56444 13.1884L9.63822 13.1049L18.4382 4.30489Z" fill="#8A97AA" /> </g> <defs> <clipPath id="clip0_10_1093"> <rect width="24" height="24" fill="white" /> </clipPath> </defs> </svg> </button> </td> </tr> <tr> <td>02</td> <td> <label class="form-controlv1"> <input type="checkbox" name="checkbox-checked" /> </label> </td> <td>Company A</td> <td>Edinburgh</td> <td> <ul> <li class="defualt-tag deactive"> deactivated </li> </ul> </td> <td> <button type="button" class="btn-edit"> <svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none"> <g clip-path="url(#clip0_10_1093)"> <path d="M12.8889 4C13.1154 4.00025 13.3334 4.087 13.4981 4.24253C13.6628 4.39806 13.762 4.61062 13.7753 4.8368C13.7885 5.06297 13.715 5.28567 13.5695 5.45941C13.4241 5.63314 13.2179 5.7448 12.9929 5.77156L12.8889 5.77778H5.77778V18.2222H18.2222V11.1111C18.2225 10.8846 18.3092 10.6666 18.4648 10.5019C18.6203 10.3372 18.8328 10.238 19.059 10.2247C19.2852 10.2115 19.5079 10.285 19.6816 10.4305C19.8554 10.5759 19.967 10.7821 19.9938 11.0071L20 11.1111V18.2222C20.0001 18.6707 19.8308 19.1027 19.5258 19.4316C19.2208 19.7605 18.8028 19.9619 18.3556 19.9956L18.2222 20H5.77778C5.32927 20.0001 4.89727 19.8308 4.5684 19.5258C4.23953 19.2208 4.03808 18.8028 4.00444 18.3556L4 18.2222V5.77778C3.99986 5.32927 4.16925 4.89727 4.47422 4.5684C4.77919 4.23953 5.1972 4.03808 5.64444 4.00444L5.77778 4H12.8889ZM18.4382 4.30489C18.5982 4.14547 18.8128 4.05291 19.0386 4.04602C19.2643 4.03913 19.4842 4.11841 19.6536 4.26778C19.823 4.41714 19.9292 4.62538 19.9506 4.8502C19.972 5.07502 19.907 5.29956 19.7689 5.47822L19.6951 5.56267L10.8951 14.3618C10.7351 14.5212 10.5205 14.6138 10.2948 14.6206C10.069 14.6275 9.84914 14.5483 9.67975 14.3989C9.51036 14.2495 9.40417 14.0413 9.38276 13.8165C9.36134 13.5916 9.4263 13.3671 9.56444 13.1884L9.63822 13.1049L18.4382 4.30489Z" fill="#8A97AA" /> </g> <defs> <clipPath id="clip0_10_1093"> <rect width="24" height="24" fill="white" /> </clipPath> </defs> </svg> </button> </td> </tr> <tr> <td>03</td> <td> <label class="form-controlv1"> <input type="checkbox" name="checkbox-checked" /> </label> </td> <td>Company A</td> <td>Edinburgh</td> <td> <ul> <li class="defualt-tag"> base plan </li> </ul> </td> <td> <button type="button" class="btn-edit"> <svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none"> <g clip-path="url(#clip0_10_1093)"> <path d="M12.8889 4C13.1154 4.00025 13.3334 4.087 13.4981 4.24253C13.6628 4.39806 13.762 4.61062 13.7753 4.8368C13.7885 5.06297 13.715 5.28567 13.5695 5.45941C13.4241 5.63314 13.2179 5.7448 12.9929 5.77156L12.8889 5.77778H5.77778V18.2222H18.2222V11.1111C18.2225 10.8846 18.3092 10.6666 18.4648 10.5019C18.6203 10.3372 18.8328 10.238 19.059 10.2247C19.2852 10.2115 19.5079 10.285 19.6816 10.4305C19.8554 10.5759 19.967 10.7821 19.9938 11.0071L20 11.1111V18.2222C20.0001 18.6707 19.8308 19.1027 19.5258 19.4316C19.2208 19.7605 18.8028 19.9619 18.3556 19.9956L18.2222 20H5.77778C5.32927 20.0001 4.89727 19.8308 4.5684 19.5258C4.23953 19.2208 4.03808 18.8028 4.00444 18.3556L4 18.2222V5.77778C3.99986 5.32927 4.16925 4.89727 4.47422 4.5684C4.77919 4.23953 5.1972 4.03808 5.64444 4.00444L5.77778 4H12.8889ZM18.4382 4.30489C18.5982 4.14547 18.8128 4.05291 19.0386 4.04602C19.2643 4.03913 19.4842 4.11841 19.6536 4.26778C19.823 4.41714 19.9292 4.62538 19.9506 4.8502C19.972 5.07502 19.907 5.29956 19.7689 5.47822L19.6951 5.56267L10.8951 14.3618C10.7351 14.5212 10.5205 14.6138 10.2948 14.6206C10.069 14.6275 9.84914 14.5483 9.67975 14.3989C9.51036 14.2495 9.40417 14.0413 9.38276 13.8165C9.36134 13.5916 9.4263 13.3671 9.56444 13.1884L9.63822 13.1049L18.4382 4.30489Z" fill="#8A97AA" /> </g> <defs> <clipPath id="clip0_10_1093"> <rect width="24" height="24" fill="white" /> </clipPath> </defs> </svg> </button> </td> </tr> <tr> <td>04</td> <td> <label class="form-controlv1"> <input type="checkbox" name="checkbox-checked" /> </label> </td> <td>Company A</td> <td>Edinburgh</td> <td> <ul> <li class="defualt-tag"> base plan </li> </ul> </td> <td> <button type="button" class="btn-edit"> <svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none"> <g clip-path="url(#clip0_10_1093)"> <path d="M12.8889 4C13.1154 4.00025 13.3334 4.087 13.4981 4.24253C13.6628 4.39806 13.762 4.61062 13.7753 4.8368C13.7885 5.06297 13.715 5.28567 13.5695 5.45941C13.4241 5.63314 13.2179 5.7448 12.9929 5.77156L12.8889 5.77778H5.77778V18.2222H18.2222V11.1111C18.2225 10.8846 18.3092 10.6666 18.4648 10.5019C18.6203 10.3372 18.8328 10.238 19.059 10.2247C19.2852 10.2115 19.5079 10.285 19.6816 10.4305C19.8554 10.5759 19.967 10.7821 19.9938 11.0071L20 11.1111V18.2222C20.0001 18.6707 19.8308 19.1027 19.5258 19.4316C19.2208 19.7605 18.8028 19.9619 18.3556 19.9956L18.2222 20H5.77778C5.32927 20.0001 4.89727 19.8308 4.5684 19.5258C4.23953 19.2208 4.03808 18.8028 4.00444 18.3556L4 18.2222V5.77778C3.99986 5.32927 4.16925 4.89727 4.47422 4.5684C4.77919 4.23953 5.1972 4.03808 5.64444 4.00444L5.77778 4H12.8889ZM18.4382 4.30489C18.5982 4.14547 18.8128 4.05291 19.0386 4.04602C19.2643 4.03913 19.4842 4.11841 19.6536 4.26778C19.823 4.41714 19.9292 4.62538 19.9506 4.8502C19.972 5.07502 19.907 5.29956 19.7689 5.47822L19.6951 5.56267L10.8951 14.3618C10.7351 14.5212 10.5205 14.6138 10.2948 14.6206C10.069 14.6275 9.84914 14.5483 9.67975 14.3989C9.51036 14.2495 9.40417 14.0413 9.38276 13.8165C9.36134 13.5916 9.4263 13.3671 9.56444 13.1884L9.63822 13.1049L18.4382 4.30489Z" fill="#8A97AA" /> </g> <defs> <clipPath id="clip0_10_1093"> <rect width="24" height="24" fill="white" /> </clipPath> </defs> </svg> </button> </td> </tr> <tr> <td>05</td> <td> <label class="form-controlv1"> <input type="checkbox" name="checkbox-checked" /> </label> </td> <td>Company A</td> <td>Edinburgh</td> <td> <ul> <li class="defualt-tag"> base plan </li> </ul> </td> <td> <button type="button" class="btn-edit"> <svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none"> <g clip-path="url(#clip0_10_1093)"> <path d="M12.8889 4C13.1154 4.00025 13.3334 4.087 13.4981 4.24253C13.6628 4.39806 13.762 4.61062 13.7753 4.8368C13.7885 5.06297 13.715 5.28567 13.5695 5.45941C13.4241 5.63314 13.2179 5.7448 12.9929 5.77156L12.8889 5.77778H5.77778V18.2222H18.2222V11.1111C18.2225 10.8846 18.3092 10.6666 18.4648 10.5019C18.6203 10.3372 18.8328 10.238 19.059 10.2247C19.2852 10.2115 19.5079 10.285 19.6816 10.4305C19.8554 10.5759 19.967 10.7821 19.9938 11.0071L20 11.1111V18.2222C20.0001 18.6707 19.8308 19.1027 19.5258 19.4316C19.2208 19.7605 18.8028 19.9619 18.3556 19.9956L18.2222 20H5.77778C5.32927 20.0001 4.89727 19.8308 4.5684 19.5258C4.23953 19.2208 4.03808 18.8028 4.00444 18.3556L4 18.2222V5.77778C3.99986 5.32927 4.16925 4.89727 4.47422 4.5684C4.77919 4.23953 5.1972 4.03808 5.64444 4.00444L5.77778 4H12.8889ZM18.4382 4.30489C18.5982 4.14547 18.8128 4.05291 19.0386 4.04602C19.2643 4.03913 19.4842 4.11841 19.6536 4.26778C19.823 4.41714 19.9292 4.62538 19.9506 4.8502C19.972 5.07502 19.907 5.29956 19.7689 5.47822L19.6951 5.56267L10.8951 14.3618C10.7351 14.5212 10.5205 14.6138 10.2948 14.6206C10.069 14.6275 9.84914 14.5483 9.67975 14.3989C9.51036 14.2495 9.40417 14.0413 9.38276 13.8165C9.36134 13.5916 9.4263 13.3671 9.56444 13.1884L9.63822 13.1049L18.4382 4.30489Z" fill="#8A97AA" /> </g> <defs> <clipPath id="clip0_10_1093"> <rect width="24" height="24" fill="white" /> </clipPath> </defs> </svg> </button> </td> </tr> <tr> <td>06</td> <td> <label class="form-controlv1"> <input type="checkbox" name="checkbox-checked" /> </label> </td> <td>Company A</td> <td>Edinburgh</td> <td> <ul> <li class="defualt-tag"> base plan </li> </ul> </td> <td> <button type="button" class="btn-edit"> <svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none"> <g clip-path="url(#clip0_10_1093)"> <path d="M12.8889 4C13.1154 4.00025 13.3334 4.087 13.4981 4.24253C13.6628 4.39806 13.762 4.61062 13.7753 4.8368C13.7885 5.06297 13.715 5.28567 13.5695 5.45941C13.4241 5.63314 13.2179 5.7448 12.9929 5.77156L12.8889 5.77778H5.77778V18.2222H18.2222V11.1111C18.2225 10.8846 18.3092 10.6666 18.4648 10.5019C18.6203 10.3372 18.8328 10.238 19.059 10.2247C19.2852 10.2115 19.5079 10.285 19.6816 10.4305C19.8554 10.5759 19.967 10.7821 19.9938 11.0071L20 11.1111V18.2222C20.0001 18.6707 19.8308 19.1027 19.5258 19.4316C19.2208 19.7605 18.8028 19.9619 18.3556 19.9956L18.2222 20H5.77778C5.32927 20.0001 4.89727 19.8308 4.5684 19.5258C4.23953 19.2208 4.03808 18.8028 4.00444 18.3556L4 18.2222V5.77778C3.99986 5.32927 4.16925 4.89727 4.47422 4.5684C4.77919 4.23953 5.1972 4.03808 5.64444 4.00444L5.77778 4H12.8889ZM18.4382 4.30489C18.5982 4.14547 18.8128 4.05291 19.0386 4.04602C19.2643 4.03913 19.4842 4.11841 19.6536 4.26778C19.823 4.41714 19.9292 4.62538 19.9506 4.8502C19.972 5.07502 19.907 5.29956 19.7689 5.47822L19.6951 5.56267L10.8951 14.3618C10.7351 14.5212 10.5205 14.6138 10.2948 14.6206C10.069 14.6275 9.84914 14.5483 9.67975 14.3989C9.51036 14.2495 9.40417 14.0413 9.38276 13.8165C9.36134 13.5916 9.4263 13.3671 9.56444 13.1884L9.63822 13.1049L18.4382 4.30489Z" fill="#8A97AA" /> </g> <defs> <clipPath id="clip0_10_1093"> <rect width="24" height="24" fill="white" /> </clipPath> </defs> </svg> </button> </td> </tr> <tr> <td>07</td> <td> <label class="form-controlv1"> <input type="checkbox" name="checkbox-checked" /> </label> </td> <td>Company A</td> <td>Edinburgh</td> <td> <ul> <li class="defualt-tag sponsored"> base plan </li> </ul> </td> <td> <button type="button" class="btn-edit"> <svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none"> <g clip-path="url(#clip0_10_1093)"> <path d="M12.8889 4C13.1154 4.00025 13.3334 4.087 13.4981 4.24253C13.6628 4.39806 13.762 4.61062 13.7753 4.8368C13.7885 5.06297 13.715 5.28567 13.5695 5.45941C13.4241 5.63314 13.2179 5.7448 12.9929 5.77156L12.8889 5.77778H5.77778V18.2222H18.2222V11.1111C18.2225 10.8846 18.3092 10.6666 18.4648 10.5019C18.6203 10.3372 18.8328 10.238 19.059 10.2247C19.2852 10.2115 19.5079 10.285 19.6816 10.4305C19.8554 10.5759 19.967 10.7821 19.9938 11.0071L20 11.1111V18.2222C20.0001 18.6707 19.8308 19.1027 19.5258 19.4316C19.2208 19.7605 18.8028 19.9619 18.3556 19.9956L18.2222 20H5.77778C5.32927 20.0001 4.89727 19.8308 4.5684 19.5258C4.23953 19.2208 4.03808 18.8028 4.00444 18.3556L4 18.2222V5.77778C3.99986 5.32927 4.16925 4.89727 4.47422 4.5684C4.77919 4.23953 5.1972 4.03808 5.64444 4.00444L5.77778 4H12.8889ZM18.4382 4.30489C18.5982 4.14547 18.8128 4.05291 19.0386 4.04602C19.2643 4.03913 19.4842 4.11841 19.6536 4.26778C19.823 4.41714 19.9292 4.62538 19.9506 4.8502C19.972 5.07502 19.907 5.29956 19.7689 5.47822L19.6951 5.56267L10.8951 14.3618C10.7351 14.5212 10.5205 14.6138 10.2948 14.6206C10.069 14.6275 9.84914 14.5483 9.67975 14.3989C9.51036 14.2495 9.40417 14.0413 9.38276 13.8165C9.36134 13.5916 9.4263 13.3671 9.56444 13.1884L9.63822 13.1049L18.4382 4.30489Z" fill="#8A97AA" /> </g> <defs> <clipPath id="clip0_10_1093"> <rect width="24" height="24" fill="white" /> </clipPath> </defs> </svg> </button> </td> </tr> <tr> <td>08</td> <td> <label class="form-controlv1"> <input type="checkbox" name="checkbox-checked" /> </label> </td> <td>Company A</td> <td>Edinburgh</td> <td> <ul> <li class="defualt-tag sponsored"> base plan </li> </ul> </td> <td> <button type="button" class="btn-edit"> <svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none"> <g clip-path="url(#clip0_10_1093)"> <path d="M12.8889 4C13.1154 4.00025 13.3334 4.087 13.4981 4.24253C13.6628 4.39806 13.762 4.61062 13.7753 4.8368C13.7885 5.06297 13.715 5.28567 13.5695 5.45941C13.4241 5.63314 13.2179 5.7448 12.9929 5.77156L12.8889 5.77778H5.77778V18.2222H18.2222V11.1111C18.2225 10.8846 18.3092 10.6666 18.4648 10.5019C18.6203 10.3372 18.8328 10.238 19.059 10.2247C19.2852 10.2115 19.5079 10.285 19.6816 10.4305C19.8554 10.5759 19.967 10.7821 19.9938 11.0071L20 11.1111V18.2222C20.0001 18.6707 19.8308 19.1027 19.5258 19.4316C19.2208 19.7605 18.8028 19.9619 18.3556 19.9956L18.2222 20H5.77778C5.32927 20.0001 4.89727 19.8308 4.5684 19.5258C4.23953 19.2208 4.03808 18.8028 4.00444 18.3556L4 18.2222V5.77778C3.99986 5.32927 4.16925 4.89727 4.47422 4.5684C4.77919 4.23953 5.1972 4.03808 5.64444 4.00444L5.77778 4H12.8889ZM18.4382 4.30489C18.5982 4.14547 18.8128 4.05291 19.0386 4.04602C19.2643 4.03913 19.4842 4.11841 19.6536 4.26778C19.823 4.41714 19.9292 4.62538 19.9506 4.8502C19.972 5.07502 19.907 5.29956 19.7689 5.47822L19.6951 5.56267L10.8951 14.3618C10.7351 14.5212 10.5205 14.6138 10.2948 14.6206C10.069 14.6275 9.84914 14.5483 9.67975 14.3989C9.51036 14.2495 9.40417 14.0413 9.38276 13.8165C9.36134 13.5916 9.4263 13.3671 9.56444 13.1884L9.63822 13.1049L18.4382 4.30489Z" fill="#8A97AA" /> </g> <defs> <clipPath id="clip0_10_1093"> <rect width="24" height="24" fill="white" /> </clipPath> </defs> </svg> </button> </td> </tr> <tr> <td>09</td> <td> <label class="form-controlv1"> <input type="checkbox" name="checkbox-checked" /> </label> </td> <td>Company A</td> <td>Edinburgh</td> <td> <ul> <li class="defualt-tag sponsored"> base plan </li> </ul> </td> <td> <button type="button" class="btn-edit"> <svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none"> <g clip-path="url(#clip0_10_1093)"> <path d="M12.8889 4C13.1154 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xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none"> <g clip-path="url(#clip0_10_1093)"> <path d="M12.8889 4C13.1154 4.00025 13.3334 4.087 13.4981 4.24253C13.6628 4.39806 13.762 4.61062 13.7753 4.8368C13.7885 5.06297 13.715 5.28567 13.5695 5.45941C13.4241 5.63314 13.2179 5.7448 12.9929 5.77156L12.8889 5.77778H5.77778V18.2222H18.2222V11.1111C18.2225 10.8846 18.3092 10.6666 18.4648 10.5019C18.6203 10.3372 18.8328 10.238 19.059 10.2247C19.2852 10.2115 19.5079 10.285 19.6816 10.4305C19.8554 10.5759 19.967 10.7821 19.9938 11.0071L20 11.1111V18.2222C20.0001 18.6707 19.8308 19.1027 19.5258 19.4316C19.2208 19.7605 18.8028 19.9619 18.3556 19.9956L18.2222 20H5.77778C5.32927 20.0001 4.89727 19.8308 4.5684 19.5258C4.23953 19.2208 4.03808 18.8028 4.00444 18.3556L4 18.2222V5.77778C3.99986 5.32927 4.16925 4.89727 4.47422 4.5684C4.77919 4.23953 5.1972 4.03808 5.64444 4.00444L5.77778 4H12.8889ZM18.4382 4.30489C18.5982 4.14547 18.8128 4.05291 19.0386 4.04602C19.2643 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14.5212 10.5205 14.6138 10.2948 14.6206C10.069 14.6275 9.84914 14.5483 9.67975 14.3989C9.51036 14.2495 9.40417 14.0413 9.38276 13.8165C9.36134 13.5916 9.4263 13.3671 9.56444 13.1884L9.63822 13.1049L18.4382 4.30489Z" fill="#8A97AA" /> </g> <defs> <clipPath id="clip0_10_1093"> <rect width="24" height="24" fill="white" /> </clipPath> </defs> </svg> </button> </td> </tr> </tbody> </table> </div> </div> <!-- let start tab 2 --> <div class="tabBlock-pane dash-wrap"> <div class="exportdata"> <h2 class="title-h4">Update insurer</h2> <p class="f-14 color-gray ">save before changing to other window</p> </div> <form class="form-insurer update-insurer" action="#"> <div class="borderfor-wrap"> <div class="componentv1 mt-0 images-list"> <ul class="uploaded-img-list perview-container"> <li class="list-img uploading-img-count"> <img src="./img/rectangle.png" class="responsive-img" width="124" height="124" alt="search icons"> <span class="removeimage icons-remove">✕</span> </li> </ul> <div class="upload-btn multiupload width-330"> <div class="pos-relative input-upload-box"> <input type="text" class="form-upload-img showing-upload-label" disabled="" placeholder="img.png"> </div> <button class="pos-relative upload-field target-click" type="button"> <input type="file" class="hidden-file-input input-file-call"> Select image </button> </div> </div> <!-- 1 --> <div class="componentv1 width-330 radius-list"> <label class="control-label">Plans & Subscriptions</label> <div class="col-full"> <select class="control-input" aria-label="Plans & Subscriptions"> <option selected="">Sponsored</option> <option value="1">Sponsored</option> <option value="2">Deactivated</option> <option value="3">Base Pla</option> </select> </div> </div> <div class="componentv1 width-330 input-list required"> <label for="insurer-name" class="control-label">insurer name </label> <div class="col-full"> <input type="text" name="insurer-name" id="" class="control-input" placeholder="Company name" required> </div> </div> <!-- 1 --> <div class="componentv1 width-330 radius-list"> <label for="Currency" class="control-label">Currency</label> <div class="col-full"> <select class="control-input" aria-label="Currency"> <option selected="">USD</option> <option value="1">Thai</option> </select> </div> </div> <div class="fm-title pos-relative"> <h2 class="color-gray">contact details</h2> <div class="divider-fm"></div> </div> <div class="componentv1 width-330 input-list required"> <label for="web-url" class="control-label">Website</label> <div class="col-full"> <input type="url" name="website" id="web-url" class="control-input" placeholder="https://example.com" required=""> </div> </div> <div class="componentv1 width-330 input-list required"> <label for="mobile-url" class="control-label">Contact Number</label> <div class="col-full"> <input type="tel" name="mobile" pattern="[0-9]{13}" id="mobile" class="control-input" placeholder="+64 0000 000 0000" required> </div> </div> <div class="componentv1 width-330 input-list required"> <label for="email" class="control-label">Email</label> <div class="col-full"> <input type="email" name="email" id="" class="control-input" placeholder="example@test.com" required> </div> </div> <div class="fm-title pos-relative"> <h2 class="color-gray">Assets</h2> <div class="divider-fm"></div> </div> <div class="componentv1"> <div class="upload-applicant"> <div class="uploadlf"> <label for="application" class="control-label">Application form</label> <div class="applicant-file"> <input type="file" class="upload fileupdate-list file-input" accept=".csv, .pdf, image/*" id="file-input-application"> <label for="file-input-addplication" class="my-3 file-label"> <span tabindex="-1" class="upload_tagline">Drag and drop or <span class="text-primary">browse</span> your addplication file</span> </label> </div> </div> <div class="uploadlf"> <label for="application" class="control-label">Company Broacher</label> <div class="applicant-file"> <input type="file" class="upload fileupdate-list file-input" accept=".csv, .pdf, image/*" id="file-input-application"> <label for="file-input-addplication" class="my-3 file-label"> <span tabindex="-1" class="upload_tagline">Drag and drop or <span class="text-primary">browse</span> your Company Broacher </span> </label> </div> </div> </div> </div> <div class="fm-title pos-relative"> <h2 class="color-gray">Deductibles</h2> <div class="divider-fm"></div> <button type="button" class="btn-more mang-abs addmore-btn"> <span><svg xmlns="http://www.w3.org/2000/svg" width="16" height="16" viewBox="0 0 16 16" fill="none"> <path d="M7.33203 8.66634H3.33203V7.33301H7.33203V3.33301H8.66536V7.33301H12.6654V8.66634H8.66536V12.6663H7.33203V8.66634Z" fill="#343434"/> </svg></span> Add New Area </button> </div> <div class="componentcard mt-24"> <div class="grids-3 deduct-x"> <div class="deduct-card"> <div class="component-list"> <label for="email" class="control-label">reginal deductible name </label> <div class="col-full"> <input type="text" name="email" id="" class="control-input" placeholder="Area 1 Worldwide" required=""> </div> </div> <div class="xcsv-file"> <div class="applicant-file"> <input type="file" class="upload fileupdate-list file-deduct" accept=".csv, .pdf, image/*" id="file-input-csv"> <label for="file-deduct" class="my-3 file-label-deduct"> <span tabindex="-1" class="upload_tagline"><span class="text-primary">Upload</span> csv/xlsm/xls/xlsx</span> </label> </div> </div> <div class="row-heading"> <div class="space-deductible"> Deductible Rate </div> <div class="space-rate">Rate % </div> </div> <div class="clone-container"> <div class="row-heading addmore-row"> <div class="space-deductible"> <input type="text" name="deductible" id="" class="control-input" placeholder="" required=""> </div> <div class="space-rate"><input type="text" name="rate" id="" class="control-input" placeholder="" required=""> </div> <div class="icons-space remove-current"> <img src="./icons/icons-red-remove.svg" alt="delete current"> </div> </div> </div> <div class="themore-add"> <button type="button" class="btn-more addmore-deduct"> <svg xmlns="http://www.w3.org/2000/svg" width="25" height="24" viewBox="0 0 25 24" fill="none"><path d="M11.5 13H5.5V11H11.5V5H13.5V11H19.5V13H13.5V19H11.5V13Z" fill="#8A97AA"/></svg> Add New</button> <button type="button" class="btn-more delete-current"> <svg xmlns="http://www.w3.org/2000/svg" width="16" height="16" viewBox="0 0 16 16" fill="none"> <path fill-rule="evenodd" clip-rule="evenodd" d="M5.75 3V1.5H10.25V3H5.75ZM4.25 3V1C4.25 0.734784 4.35536 0.48043 4.54289 0.292893C4.73043 0.105357 4.98478 0 5.25 0L10.75 0C11.0152 0 11.2696 0.105357 11.4571 0.292893C11.6446 0.48043 11.75 0.734784 11.75 1V3H14.25C14.4489 3 14.6397 3.07902 14.7803 3.21967C14.921 3.36032 15 3.55109 15 3.75C15 3.94891 14.921 4.13968 14.7803 4.28033C14.6397 4.42098 14.4489 4.5 14.25 4.5H13.885L13.142 14.153C13.1034 14.6554 12.8767 15.1248 12.507 15.4673C12.1373 15.8097 11.6519 16 11.148 16H4.852C4.34808 16 3.86274 15.8097 3.49304 15.4673C3.12335 15.1248 2.89655 14.6554 2.858 14.153L2.115 4.5H1.75C1.55109 4.5 1.36032 4.42098 1.21967 4.28033C1.07902 4.13968 1 3.94891 1 3.75C1 3.55109 1.07902 3.36032 1.21967 3.21967C1.36032 3.07902 1.55109 3 1.75 3H4.25ZM3.62 4.5H12.38L11.646 14.038C11.6364 14.1636 11.5798 14.2809 11.4875 14.3666C11.3952 14.4522 11.2739 14.4999 11.148 14.5H4.852C4.72607 14.4999 4.60482 14.4522 4.5125 14.3666C4.42017 14.2809 4.36357 14.1636 4.354 14.038L3.62 4.5Z" fill="#ED5C5C"/> </svg> Delete table </button> </div> </div> <!-- 1 --> </div> </div> </div> <button type="submit" class="combtn form-submit" aria-label="get quotes">Create insurer</button> </form> </div> </div> </div> </div> <style> </style> <?php include("includes/login-footer.php"); ?>
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