{"id":8989,"date":"2023-10-09T15:02:09","date_gmt":"2023-10-09T15:02:09","guid":{"rendered":"https:\/\/insurewithsnyder.com\/?page_id=8989"},"modified":"2024-01-16T19:52:06","modified_gmt":"2024-01-16T19:52:06","slug":"claims","status":"publish","type":"page","link":"https:\/\/insurewithsnyder.com\/claims\/","title":{"rendered":"Claims"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"8989\" class=\"elementor elementor-8989\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-dee1c25 e-con-full e-flex e-con e-parent\" data-id=\"dee1c25\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t<div class=\"elementor-element elementor-element-f2fea3d e-con-full e-flex e-con e-child\" data-id=\"f2fea3d\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-873e3b5 elementor-widget elementor-widget-heading\" data-id=\"873e3b5\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.21.0 - 18-04-2024 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h1 class=\"elementor-heading-title elementor-size-default\">Submit a Claim<\/h1>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-9b5b39d e-con-full e-flex e-con e-child\" data-id=\"9b5b39d\" data-element_type=\"container\">\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-417e98a e-flex e-con-boxed e-con e-parent\" data-id=\"417e98a\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-73f844b e-con-full e-flex e-con e-child\" data-id=\"73f844b\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3b3996d elementor-widget elementor-widget-text-editor\" data-id=\"3b3996d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.21.0 - 18-04-2024 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<p>No one likes to think of worst case scenarios. As insurance professionals though, that&#8217;s exactly what we do. We ensure that when disaster strikes, you&#8217;re properly covered. We also strive to make sure that your claim process is as smooth and easy as it can be.\u00a0<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-28d6763 e-con-full e-flex e-con e-child\" data-id=\"28d6763\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ce8ecd5 elementor-widget elementor-widget-heading\" data-id=\"ce8ecd5\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Our service sets us apart.<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-99f6090 elementor-widget elementor-widget-text-editor\" data-id=\"99f6090\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><em>Service beyond expectations.<\/em><br \/>It&#8217;s more than a motto to us. It&#8217;s how we do business.\u00a0<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ef24206 elementor-widget elementor-widget-heading\" data-id=\"ef24206\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Start Your Claim Below or <\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-35078bd e-flex e-con-boxed e-con e-child\" data-id=\"35078bd\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-697e121 e-flex e-con-boxed e-con e-child\" data-id=\"697e121\" 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-4a20c73 elementor-align-justify elementor-widget elementor-widget-button\" data-id=\"4a20c73\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-shrink\" href=\"tel:877-725-1800\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Call Us at 877-725-1800<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\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-cc62ab4 e-flex e-con-boxed e-con e-child\" data-id=\"cc62ab4\" 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-7342240 elementor-align-justify elementor-widget elementor-widget-button\" data-id=\"7342240\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-shrink\" href=\"mailto:claims@insurewithsnyder.com\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Email Us<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\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\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-ca9c3d3 e-flex e-con-boxed e-con e-parent\" data-id=\"ca9c3d3\" 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-0c5c249 uael-ct-stack--none elementor-widget elementor-widget-uael-content-toggle\" data-id=\"0c5c249\" data-element_type=\"widget\" data-settings=\"{&quot;rds_button_headings_spacing_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:14,&quot;sizes&quot;:[]},&quot;rds_headings_content_spacing_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:0,&quot;sizes&quot;:[]},&quot;rds_headings_content_spacing_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:0,&quot;sizes&quot;:[]},&quot;rds_switch_size&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:15,&quot;sizes&quot;:[]},&quot;rds_switch_size_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;rds_switch_size_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;rds_heading_alignment&quot;:&quot;center&quot;,&quot;rds_button_headings_spacing&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:5,&quot;sizes&quot;:[]},&quot;rds_button_headings_spacing_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;rds_headings_content_spacing&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:10,&quot;sizes&quot;:[]}}\" data-widget_type=\"uael-content-toggle.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\n<div class=\"uael-ct-desktop-stack--no uael-rbs-wrapper\">\n\t<div class=\"uael-rbs-toggle\">\n\t\t<div class=\"uael-sec-1\">\n\t\t\t<h5 class=\"uael-rbs-head-1\" data-elementor-inline-editing-toolbar=\"basic\">Select Auto Claim<\/h5>\n\t\t<\/div>\n\t\t<div class=\"uael-main-btn\" data-switch-type=\"round_1\">\n\n\t\t\t\t\t\t\t\t\t\n\t\t\t<!-- Display Switch -->\n\t\t\t<label class=\"uael-rbs-switch-label\"><input class=\"uael-rbs-switch uael-switch-round-1 elementor-clickable\" type=\"checkbox\" ><span class=\"uael-rbs-slider uael-rbs-round elementor-clickable\"><\/span><\/label> \n\n\t\t<\/div>\n\t\t<div class=\"uael-sec-2\">\n\t\t\t<h5 class=\"uael-rbs-head-2\" data-elementor-inline-editing-toolbar=\"basic\">Select Property Claim<\/h5>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"uael-rbs-toggle-sections\">\n\t\t<div class=\"uael-rbs-section-1\">\n\t\t\t\t\t<div data-elementor-type=\"page\" data-elementor-id=\"9101\" class=\"elementor elementor-9101\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7ac37d8 e-flex e-con-boxed e-con e-parent\" data-id=\"7ac37d8\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-81cf3fe e-con-full e-flex e-con e-child\" data-id=\"81cf3fe\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-dfc4be4 elementor-widget elementor-widget-shortcode\" data-id=\"dfc4be4\" 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<div class=\"elementor-shortcode\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-8518 forminator-design--material  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-8518\" data-uid=\"662fb9adc053e\"><br\/><\/div><form\r\n\t\t\t\tid=\"forminator-module-8518\"\r\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-8518 forminator-design--material  forminator_ajax\"\r\n\t\t\t\tmethod=\"post\"\r\n\t\t\t\tdata-forminator-render=\"0\"\r\n\t\t\t\tdata-form-id=\"8518\"\r\n\t\t\t\t\r\n\t\t\t\tdata-design=\"material\"\r\n\t\t\t\t\r\n\t\t\t\t\r\n\t\t\t\t\r\n\t\t\t\tdata-grid=\"open\"\r\n\t\t\t\t\r\n\t\t\t\t\r\n\t\t\t\tstyle=\"display: none;\"\r\n\t\t\t\t\r\n\t\t\t\tdata-uid=\"662fb9adc053e\"\r\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-pagination-progress\" aria-hidden=\"true\"><\/div><div tabindex=\"0\" role=\"tabpanel\" id=\"forminator-custom-form-8518--page-0\" class=\"forminator-pagination forminator-pagination-start\" aria-labelledby=\"forminator-custom-form-8518--page-0-label\" data-step=\"0\" data-label=\"Finish\" data-name=\"page-break-1\"><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"html-1\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-1\"><label class=\"forminator-label\">Fill out the following form as completely as possible. Once you have completed the form, click the submit button to send your information. Your request will be handled promptly.<\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_662fb9adc053e\" id=\"forminator-field-name-1_662fb9adc053e-label\" class=\"forminator-label\">Contact Person Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"\" id=\"forminator-field-name-1_662fb9adc053e\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_662fb9adc053e\" id=\"forminator-field-phone-1_662fb9adc053e-label\" class=\"forminator-label\">Contact Person Phone Number <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-1_662fb9adc053e\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" data-validation=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-4\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-662fb9adc053e-label\" aria-describedby=\"forminator-radiogroup-662fb9adc053e-description\"><span id=\"forminator-radiogroup-662fb9adc053e-label\" class=\"forminator-label\">Is the contact person also the person that was driving? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-4-label-1\" for=\"forminator-field-radio-4-1-662fb9adc053e\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-4\" value=\"yes\" id=\"forminator-field-radio-4-1-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-4-label-1\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-4-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-4-label-2\" for=\"forminator-field-radio-4-2-662fb9adc053e\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-4\" value=\"no\" id=\"forminator-field-radio-4-2-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-4-label-2\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-4-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-2\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-row forminator-no-margin\" data-multiple=\"true\"><div class=\"forminator-col forminator-col-md-6\"><div class=\"forminator-field\"><label for=\"forminator-field-first-name-2_662fb9adc053e\" id=\"forminator-field-first-name-2_662fb9adc053e-label\" class=\"forminator-label\">Driver&#039;s first name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-2-first-name\" placeholder=\"\" id=\"forminator-field-first-name-2_662fb9adc053e\" class=\"forminator-input\" aria-required=\"true\" data-multi=\"1\" value=\"\" \/><\/div><\/div><div class=\"forminator-col forminator-col-md-6\"><div class=\"forminator-field\"><label for=\"forminator-field-last-name-2_662fb9adc053e\" id=\"forminator-field-last-name-2_662fb9adc053e-label\" class=\"forminator-label\">Driver&#039;s last name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-2-last-name\" placeholder=\"\" id=\"forminator-field-last-name-2_662fb9adc053e\" class=\"forminator-input\" aria-required=\"true\" data-multi=\"1\" value=\"\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-8\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-8_662fb9adc053e\" id=\"forminator-field-text-8_662fb9adc053e-label\" class=\"forminator-label\">Driver&#039;s phone number<\/label><input type=\"text\" name=\"text-8\" value=\"\" placeholder=\"\" id=\"forminator-field-text-8_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-6\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-6_662fb9adc053e\" id=\"forminator-field-text-6_662fb9adc053e-label\" class=\"forminator-label\">Driver&#039;s Date of birth<\/label><input type=\"text\" name=\"text-6\" value=\"\" placeholder=\"\" id=\"forminator-field-text-6_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-7\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-7_662fb9adc053e\" id=\"forminator-field-text-7_662fb9adc053e-label\" class=\"forminator-label\">Driver&#039;s license number<\/label><input type=\"text\" name=\"text-7\" value=\"\" placeholder=\"\" id=\"forminator-field-text-7_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><\/div><\/div><div tabindex=\"0\" role=\"tabpanel\" id=\"forminator-custom-form-8518--page-1\" class=\"forminator-pagination\" aria-labelledby=\"forminator-custom-form-8518--page-1-label\" aria-hidden=\"true\" data-step=\"1\" data-label=\"Page  1\" data-name=\"page-break-2\" hidden><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_662fb9adc053e\" id=\"forminator-field-text-1_662fb9adc053e-label\" class=\"forminator-label\">Policy Number <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"\" id=\"forminator-field-text-1_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-1\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-662fb9adc053e-label\" aria-describedby=\"forminator-radiogroup-662fb9adc053e-description\"><span id=\"forminator-radiogroup-662fb9adc053e-label\" class=\"forminator-label\">Is this a personal or commercial auto policy?<\/span><label id=\"forminator-field-radio-1-label-1\" for=\"forminator-field-radio-1-1-662fb9adc053e\" class=\"forminator-radio\" title=\"Personal\"><input type=\"radio\" name=\"radio-1\" value=\"personal\" id=\"forminator-field-radio-1-1-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-1-label-1\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-1-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Personal<\/span><\/label><label id=\"forminator-field-radio-1-label-2\" for=\"forminator-field-radio-1-2-662fb9adc053e\" class=\"forminator-radio\" title=\"Commercial\"><input type=\"radio\" name=\"radio-1\" value=\"commercial\" id=\"forminator-field-radio-1-2-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-1-label-2\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-1-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Commercial<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-9\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-9_662fb9adc053e\" id=\"forminator-field-text-9_662fb9adc053e-label\" class=\"forminator-label\">Business Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-9\" value=\"\" placeholder=\"\" id=\"forminator-field-text-9_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><\/div><\/div><div tabindex=\"0\" role=\"tabpanel\" id=\"forminator-custom-form-8518--page-2\" class=\"forminator-pagination\" aria-labelledby=\"forminator-custom-form-8518--page-2-label\" aria-hidden=\"true\" data-step=\"2\" data-label=\"Page  2\" data-name=\"page-break-3\" hidden><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"text-2\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-2_662fb9adc053e\" id=\"forminator-field-text-2_662fb9adc053e-label\" class=\"forminator-label\">What date did the incident take place? <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"\" id=\"forminator-field-text-2_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-12\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-12_662fb9adc053e\" id=\"forminator-field-text-12_662fb9adc053e-label\" class=\"forminator-label\">Time incident occured<\/label><input type=\"text\" name=\"text-12\" value=\"\" placeholder=\"\" id=\"forminator-field-text-12_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-10\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-10_662fb9adc053e\" id=\"forminator-field-text-10_662fb9adc053e-label\" class=\"forminator-label\">Where did the incident take place?<\/label><input type=\"text\" name=\"text-10\" value=\"\" placeholder=\"\" id=\"forminator-field-text-10_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_662fb9adc053e\" id=\"forminator-field-textarea-1_662fb9adc053e-label\" class=\"forminator-label\">Describe the incident <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-1\" placeholder=\"\" id=\"forminator-field-textarea-1_662fb9adc053e\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-5\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-662fb9adc053e-label\" aria-describedby=\"forminator-radiogroup-662fb9adc053e-description\"><span id=\"forminator-radiogroup-662fb9adc053e-label\" class=\"forminator-label\">Was the incident reported to the police?<\/span><label id=\"forminator-field-radio-5-label-1\" for=\"forminator-field-radio-5-1-662fb9adc053e\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-5\" value=\"yes\" id=\"forminator-field-radio-5-1-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-5-label-1\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-5-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-5-label-2\" for=\"forminator-field-radio-5-2-662fb9adc053e\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-5\" value=\"no\" id=\"forminator-field-radio-5-2-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-5-label-2\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-5-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-11\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-11_662fb9adc053e\" id=\"forminator-field-text-11_662fb9adc053e-label\" class=\"forminator-label\">Name of the police department<\/label><input type=\"text\" name=\"text-11\" value=\"\" placeholder=\"\" id=\"forminator-field-text-11_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><\/div><\/div><div tabindex=\"0\" role=\"tabpanel\" id=\"forminator-custom-form-8518--page-3\" class=\"forminator-pagination\" aria-labelledby=\"forminator-custom-form-8518--page-3-label\" aria-hidden=\"true\" data-step=\"3\" data-label=\"Page  3\" data-name=\"page-break-4\" hidden><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"text-3\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-3_662fb9adc053e\" id=\"forminator-field-text-3_662fb9adc053e-label\" class=\"forminator-label\">Year\/make\/model of insured vehicle <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"\" id=\"forminator-field-text-3_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-14\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-14_662fb9adc053e\" id=\"forminator-field-text-14_662fb9adc053e-label\" class=\"forminator-label\">Insured vehicle VIN<\/label><input type=\"text\" name=\"text-14\" value=\"\" placeholder=\"\" id=\"forminator-field-text-14_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-1\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-8518__field--select-1_662fb9adc053e\" id=\"forminator-form-8518__field--select-1_662fb9adc053e-label\" class=\"forminator-label\">How severe was the damage? <span class=\"forminator-required\">*<\/span><\/label><select id=\"forminator-form-8518__field--select-1_662fb9adc053e\" class=\"forminator-select--field forminator-select2\" data-required=\"1\" name=\"select-1\" data-default-value=\"\" data-placeholder=\"Please select an option\" data-search=\"false\" aria-labelledby=\"forminator-form-8518__field--select-1_662fb9adc053e-label\" aria-describedby=\"forminator-form-8518__field--select-1_662fb9adc053e-description\"><option value=\"\">Please select an option<\/option><option value=\"minor\"  data-calculation=\"0\">Minor<\/option><option value=\"moderate\"  data-calculation=\"0\">Moderate<\/option><option value=\"severe\"  data-calculation=\"0\">Severe<\/option><option value=\"unknown\"  data-calculation=\"0\">Unknown<\/option><option value=\"none\"  data-calculation=\"0\">None<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-3\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-662fb9adc053e-label\" aria-describedby=\"forminator-radiogroup-662fb9adc053e-description\"><span id=\"forminator-radiogroup-662fb9adc053e-label\" class=\"forminator-label\">Is the vehicle driveable?<\/span><label id=\"forminator-field-radio-3-label-1\" for=\"forminator-field-radio-3-1-662fb9adc053e\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-3\" value=\"yes\" id=\"forminator-field-radio-3-1-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-3-label-1\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-3-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-3-label-2\" for=\"forminator-field-radio-3-2-662fb9adc053e\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-3\" value=\"no\" id=\"forminator-field-radio-3-2-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-3-label-2\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-3-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-3\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-3_662fb9adc053e\" id=\"forminator-field-textarea-3_662fb9adc053e-label\" class=\"forminator-label\">Describe the damage<\/label><textarea name=\"textarea-3\" placeholder=\"E.g. text placeholder\" id=\"forminator-field-textarea-3_662fb9adc053e\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-6\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-662fb9adc053e-label\" aria-describedby=\"forminator-radiogroup-662fb9adc053e-description\"><span id=\"forminator-radiogroup-662fb9adc053e-label\" class=\"forminator-label\">Was the vehicle towed?<\/span><label id=\"forminator-field-radio-6-label-1\" for=\"forminator-field-radio-6-1-662fb9adc053e\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-6\" value=\"yes\" id=\"forminator-field-radio-6-1-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-6-label-1\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-6-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-6-label-2\" for=\"forminator-field-radio-6-2-662fb9adc053e\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-6\" value=\"no\" id=\"forminator-field-radio-6-2-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-6-label-2\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-6-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-4\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-4_662fb9adc053e\" id=\"forminator-field-text-4_662fb9adc053e-label\" class=\"forminator-label\">Where is the vehicle currently located? <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"\" id=\"forminator-field-text-4_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><\/div><\/div><div tabindex=\"0\" role=\"tabpanel\" id=\"forminator-custom-form-8518--page-4\" class=\"forminator-pagination\" aria-labelledby=\"forminator-custom-form-8518--page-4-label\" aria-hidden=\"true\" data-step=\"4\" data-label=\"Page  4\" data-name=\"page-break-5\" hidden><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"radio-2\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-662fb9adc053e-label\" aria-describedby=\"forminator-radiogroup-662fb9adc053e-description\"><span id=\"forminator-radiogroup-662fb9adc053e-label\" class=\"forminator-label\">Was there another vehicle involved? <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-2-label-1\" for=\"forminator-field-radio-2-1-662fb9adc053e\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-2\" value=\"yes\" id=\"forminator-field-radio-2-1-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-2-label-1\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-2-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-2-label-2\" for=\"forminator-field-radio-2-2-662fb9adc053e\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-2\" value=\"no\" id=\"forminator-field-radio-2-2-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-2-label-2\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-2-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-13\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-13_662fb9adc053e\" id=\"forminator-field-text-13_662fb9adc053e-label\" class=\"forminator-label\">Year\/make\/model of other vehicle<\/label><input type=\"text\" name=\"text-13\" value=\"\" placeholder=\"\" id=\"forminator-field-text-13_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-15\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-15_662fb9adc053e\" id=\"forminator-field-text-15_662fb9adc053e-label\" class=\"forminator-label\">Other vehicle VIN<\/label><input type=\"text\" name=\"text-15\" value=\"\" placeholder=\"\" id=\"forminator-field-text-15_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-16\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-16_662fb9adc053e\" id=\"forminator-field-text-16_662fb9adc053e-label\" class=\"forminator-label\">Other vehicle driver&#039;s name<\/label><input type=\"text\" name=\"text-16\" value=\"\" placeholder=\"\" id=\"forminator-field-text-16_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-17\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-17_662fb9adc053e\" id=\"forminator-field-text-17_662fb9adc053e-label\" class=\"forminator-label\">Other vehicle driver&#039;s date of birth<\/label><input type=\"text\" name=\"text-17\" value=\"\" placeholder=\"\" id=\"forminator-field-text-17_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-18\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-18_662fb9adc053e\" id=\"forminator-field-text-18_662fb9adc053e-label\" class=\"forminator-label\">Other vehicle driver&#039;s license number<\/label><input type=\"text\" name=\"text-18\" value=\"\" placeholder=\"\" id=\"forminator-field-text-18_662fb9adc053e\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-4\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-4_662fb9adc053e\" id=\"forminator-field-textarea-4_662fb9adc053e-label\" class=\"forminator-label\">Describe the damage to the other vehicle<\/label><textarea name=\"textarea-4\" placeholder=\"\" id=\"forminator-field-textarea-4_662fb9adc053e\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><\/div><\/div><div tabindex=\"0\" role=\"tabpanel\" id=\"forminator-custom-form-8518--page-5\" class=\"forminator-pagination\" aria-labelledby=\"forminator-custom-form-8518--page-5-label\" aria-hidden=\"true\" data-step=\"5\" data-label=\"Page  5\" data-name=\"\" hidden><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"radio-7\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-662fb9adc053e-label\" aria-describedby=\"forminator-radiogroup-662fb9adc053e-description\"><span id=\"forminator-radiogroup-662fb9adc053e-label\" class=\"forminator-label\">Were there any injuries?<\/span><label id=\"forminator-field-radio-7-label-1\" for=\"forminator-field-radio-7-1-662fb9adc053e\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-7\" value=\"yes\" id=\"forminator-field-radio-7-1-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-7-label-1\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-7-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-7-label-2\" for=\"forminator-field-radio-7-2-662fb9adc053e\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-7\" value=\"no\" id=\"forminator-field-radio-7-2-662fb9adc053e\" aria-labelledby=\"forminator-field-radio-7-label-2\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-7-662fb9adc053e-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-5\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-5_662fb9adc053e\" id=\"forminator-field-textarea-5_662fb9adc053e-label\" class=\"forminator-label\">List the names and phone numbers of the injured<\/label><textarea name=\"textarea-5\" placeholder=\"\" id=\"forminator-field-textarea-5_662fb9adc053e\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-6\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-6_662fb9adc053e\" id=\"forminator-field-textarea-6_662fb9adc053e-label\" class=\"forminator-label\">List any witness names and phone numbers<\/label><textarea name=\"textarea-6\" placeholder=\"\" id=\"forminator-field-textarea-6_662fb9adc053e\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-2\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-2_662fb9adc053e\" id=\"forminator-field-textarea-2_662fb9adc053e-label\" class=\"forminator-label\">Additional comments\/questions<\/label><textarea name=\"textarea-2\" placeholder=\"\" id=\"forminator-field-textarea-2_662fb9adc053e\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><\/div><button class=\"forminator-button forminator-pagination-submit\" style=\"display: none;\" disabled><span class=\"forminator-button--mask\" aria-label=\"hidden\"><\/span><span class=\"forminator-button--text\">Submit form<\/span><\/button><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"ec85e42830\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/8989\" \/><input type=\"hidden\" name=\"form_id\" value=\"8518\"><input type=\"hidden\" name=\"page_id\" value=\"8989\"><input type=\"hidden\" name=\"form_type\" value=\"\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/insurewithsnyder.com\/claims\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form><\/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\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div style=\"display: none;\" class=\"uael-rbs-section-2\">\n\t\t\t\t\t<div data-elementor-type=\"page\" data-elementor-id=\"9102\" class=\"elementor elementor-9102\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t<div class=\"elementor-element elementor-element-798e590 e-flex e-con-boxed e-con e-parent\" data-id=\"798e590\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-f8e9283 e-con-full e-flex e-con e-child\" data-id=\"f8e9283\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-e50dd6c elementor-widget elementor-widget-shortcode\" data-id=\"e50dd6c\" 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<div class=\"elementor-shortcode\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-8517 forminator-design--material  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-8517\" data-uid=\"662fb9ae0d477\"><br\/><\/div><form\r\n\t\t\t\tid=\"forminator-module-8517\"\r\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-8517 forminator-design--material  forminator_ajax\"\r\n\t\t\t\tmethod=\"post\"\r\n\t\t\t\tdata-forminator-render=\"0\"\r\n\t\t\t\tdata-form-id=\"8517\"\r\n\t\t\t\t\r\n\t\t\t\tdata-design=\"material\"\r\n\t\t\t\t\r\n\t\t\t\t\r\n\t\t\t\t\r\n\t\t\t\tdata-grid=\"open\"\r\n\t\t\t\t\r\n\t\t\t\t\r\n\t\t\t\tstyle=\"display: none;\"\r\n\t\t\t\t\r\n\t\t\t\tdata-uid=\"662fb9ae0d477\"\r\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-pagination-progress\" aria-hidden=\"true\"><\/div><div tabindex=\"0\" role=\"tabpanel\" id=\"forminator-custom-form-8517--page-0\" class=\"forminator-pagination forminator-pagination-start\" aria-labelledby=\"forminator-custom-form-8517--page-0-label\" data-step=\"0\" data-label=\"Finish\" data-name=\"page-break-2\"><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"html-1\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-1\"><label class=\"forminator-label\">Fill out the following form as completely as possible. Once you have completed the form, click the submit button to send your information. Your request will be handled promptly.<\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_662fb9ae0d477\" id=\"forminator-field-name-1_662fb9ae0d477-label\" class=\"forminator-label\">Contact Person Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"\" id=\"forminator-field-name-1_662fb9ae0d477\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_662fb9ae0d477\" id=\"forminator-field-phone-1_662fb9ae0d477-label\" class=\"forminator-label\">Contact Person Phone Number <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-1_662fb9ae0d477\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" data-validation=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_662fb9ae0d477\" id=\"forminator-field-text-1_662fb9ae0d477-label\" class=\"forminator-label\">Policy Number <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"\" id=\"forminator-field-text-1_662fb9ae0d477\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-1\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-662fb9ae0d477-label\" aria-describedby=\"forminator-radiogroup-662fb9ae0d477-description\"><span id=\"forminator-radiogroup-662fb9ae0d477-label\" class=\"forminator-label\">Is this a residential (home\/renter&#039;s) or commercial policy?<\/span><label id=\"forminator-field-radio-1-label-1\" for=\"forminator-field-radio-1-1-662fb9ae0d477\" class=\"forminator-radio\" title=\"Residential\"><input type=\"radio\" name=\"radio-1\" value=\"residential\" id=\"forminator-field-radio-1-1-662fb9ae0d477\" aria-labelledby=\"forminator-field-radio-1-label-1\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-1-662fb9ae0d477-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Residential<\/span><\/label><label id=\"forminator-field-radio-1-label-2\" for=\"forminator-field-radio-1-2-662fb9ae0d477\" class=\"forminator-radio\" title=\"Commercial\"><input type=\"radio\" name=\"radio-1\" value=\"commercial\" id=\"forminator-field-radio-1-2-662fb9ae0d477\" aria-labelledby=\"forminator-field-radio-1-label-2\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-1-662fb9ae0d477-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Commercial<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-9\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-9_662fb9ae0d477\" id=\"forminator-field-text-9_662fb9ae0d477-label\" class=\"forminator-label\">Business Name <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-9\" value=\"\" placeholder=\"\" id=\"forminator-field-text-9_662fb9ae0d477\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-19\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-19_662fb9ae0d477\" id=\"forminator-field-text-19_662fb9ae0d477-label\" class=\"forminator-label\">Manager on duty<\/label><input type=\"text\" name=\"text-19\" value=\"\" placeholder=\"\" id=\"forminator-field-text-19_662fb9ae0d477\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-20\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-20_662fb9ae0d477\" id=\"forminator-field-text-20_662fb9ae0d477-label\" class=\"forminator-label\">Manager on duty&#039;s phone number<\/label><input type=\"text\" name=\"text-20\" value=\"\" placeholder=\"\" id=\"forminator-field-text-20_662fb9ae0d477\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><\/div><\/div><div tabindex=\"0\" role=\"tabpanel\" id=\"forminator-custom-form-8517--page-1\" class=\"forminator-pagination\" aria-labelledby=\"forminator-custom-form-8517--page-1-label\" aria-hidden=\"true\" data-step=\"1\" data-label=\"Page  1\" data-name=\"\" hidden><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"text-2\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-2_662fb9ae0d477\" id=\"forminator-field-text-2_662fb9ae0d477-label\" class=\"forminator-label\">What date did the incident take place? <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"\" id=\"forminator-field-text-2_662fb9ae0d477\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-12\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-12_662fb9ae0d477\" id=\"forminator-field-text-12_662fb9ae0d477-label\" class=\"forminator-label\">Time incident occured<\/label><input type=\"text\" name=\"text-12\" value=\"\" placeholder=\"\" id=\"forminator-field-text-12_662fb9ae0d477\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-10\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-10_662fb9ae0d477\" id=\"forminator-field-text-10_662fb9ae0d477-label\" class=\"forminator-label\">Where did the incident take place?<\/label><input type=\"text\" name=\"text-10\" value=\"\" placeholder=\"\" id=\"forminator-field-text-10_662fb9ae0d477\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_662fb9ae0d477\" id=\"forminator-field-textarea-1_662fb9ae0d477-label\" class=\"forminator-label\">Cause of loss \u2014 Explain in detail how the damage occurred (E.g. theft, vandalism, wind, hail, lightning, mechanical breakdown, etc.) <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-1\" placeholder=\"\" id=\"forminator-field-textarea-1_662fb9ae0d477\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-3\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-3_662fb9ae0d477\" id=\"forminator-field-textarea-3_662fb9ae0d477-label\" class=\"forminator-label\">Description of damaged property<\/label><textarea name=\"textarea-3\" placeholder=\"\" id=\"forminator-field-textarea-3_662fb9ae0d477\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-5\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-662fb9ae0d477-label\" aria-describedby=\"forminator-radiogroup-662fb9ae0d477-description\"><span id=\"forminator-radiogroup-662fb9ae0d477-label\" class=\"forminator-label\">Was the incident reported to the police?<\/span><label id=\"forminator-field-radio-5-label-1\" for=\"forminator-field-radio-5-1-662fb9ae0d477\" class=\"forminator-radio\" title=\"Yes\"><input type=\"radio\" name=\"radio-5\" value=\"yes\" id=\"forminator-field-radio-5-1-662fb9ae0d477\" aria-labelledby=\"forminator-field-radio-5-label-1\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-5-662fb9ae0d477-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Yes<\/span><\/label><label id=\"forminator-field-radio-5-label-2\" for=\"forminator-field-radio-5-2-662fb9ae0d477\" class=\"forminator-radio\" title=\"No\"><input type=\"radio\" name=\"radio-5\" value=\"no\" id=\"forminator-field-radio-5-2-662fb9ae0d477\" aria-labelledby=\"forminator-field-radio-5-label-2\" data-calculation=\"0\"   aria-describedby=\"forminator-field-radio-5-662fb9ae0d477-description\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-11\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-11_662fb9ae0d477\" id=\"forminator-field-text-11_662fb9ae0d477-label\" class=\"forminator-label\">Name of the police department<\/label><input type=\"text\" name=\"text-11\" value=\"\" placeholder=\"\" id=\"forminator-field-text-11_662fb9ae0d477\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-3\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-3_662fb9ae0d477\" id=\"forminator-field-text-3_662fb9ae0d477-label\" class=\"forminator-label\">Probable amount of loss (if known) <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"\" id=\"forminator-field-text-3_662fb9ae0d477\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-6\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-6_662fb9ae0d477\" id=\"forminator-field-textarea-6_662fb9ae0d477-label\" class=\"forminator-label\">List any witness names and phone numbers<\/label><textarea name=\"textarea-6\" placeholder=\"\" id=\"forminator-field-textarea-6_662fb9ae0d477\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-2\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-2_662fb9ae0d477\" id=\"forminator-field-textarea-2_662fb9ae0d477-label\" class=\"forminator-label\">Additional comments\/questions<\/label><textarea name=\"textarea-2\" placeholder=\"\" id=\"forminator-field-textarea-2_662fb9ae0d477\" class=\"forminator-textarea\" rows=\"6\" style=\"min-height:140px;\" ><\/textarea><\/div><\/div><\/div><\/div><button class=\"forminator-button forminator-pagination-submit\" style=\"display: none;\" disabled><span class=\"forminator-button--mask\" aria-label=\"hidden\"><\/span><span class=\"forminator-button--text\">Submit form<\/span><\/button><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"ec85e42830\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/8989\" \/><input type=\"hidden\" name=\"form_id\" value=\"8517\"><input type=\"hidden\" name=\"page_id\" value=\"8989\"><input type=\"hidden\" name=\"form_type\" value=\"\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/insurewithsnyder.com\/claims\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form><\/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\t\t<\/div>\n\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\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>Submit a Claim No one likes to think of worst case scenarios. As insurance professionals though, that&#8217;s exactly what we do. We ensure that when disaster strikes, you&#8217;re properly covered. We also strive to make sure that your claim process is as smooth and easy as it can be.\u00a0 Our service sets us apart. Service [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":9197,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/insurewithsnyder.com\/wp-json\/wp\/v2\/pages\/8989"}],"collection":[{"href":"https:\/\/insurewithsnyder.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/insurewithsnyder.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/insurewithsnyder.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/insurewithsnyder.com\/wp-json\/wp\/v2\/comments?post=8989"}],"version-history":[{"count":75,"href":"https:\/\/insurewithsnyder.com\/wp-json\/wp\/v2\/pages\/8989\/revisions"}],"predecessor-version":[{"id":10187,"href":"https:\/\/insurewithsnyder.com\/wp-json\/wp\/v2\/pages\/8989\/revisions\/10187"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/insurewithsnyder.com\/wp-json\/wp\/v2\/media\/9197"}],"wp:attachment":[{"href":"https:\/\/insurewithsnyder.com\/wp-json\/wp\/v2\/media?parent=8989"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}