<div class="x-body-el css-view-body-el x-container-body-el x-component-body-el x-scroller x-nativescroller x-overflow-x-hidden x-overflow-y-auto x-layout-auto" id="ext-element-526"><div data-componentid="ext-container-23" class="x-container x-component x-hidden x-hidden-display x-layout-auto-item" data-xid="181" id="ext-container-23" njm-id="claimdetailserrorContent"><div class="x-body-el x-container-body-el x-component-body-el x-layout-box x-layout-vbox x-vertical x-align-stretch x-pack-start" id="ext-element-536"><div data-componentid="ext-container-24" class="x-container x-component x-layout-box-item x-layout-vbox-item" data-xid="182" id="ext-container-24" njm-id="view-claims-error-msg"><div class="x-body-el x-container-body-el x-component-body-el x-layout-auto" id="ext-element-537"><div class="x-innerhtml" id="ext-element-538"><div class="claim-alert error">An error occurred retrieving your claim information. Please try again later.</div></div></div></div></div></div><div data-componentid="ext-container-25" class="x-container x-component x-hidden x-hidden-display x-layout-auto-item" data-xid="183" id="ext-container-25" njm-id="claimdetailsnotFoundContent"><div class="x-body-el x-container-body-el x-component-body-el x-layout-box x-layout-vbox x-vertical x-align-stretch x-pack-start" id="ext-element-539"><div data-componentid="ext-container-26" class="x-container x-component x-layout-box-item x-layout-vbox-item" data-xid="184" id="ext-container-26" njm-id="view-claims-info-msg"><div class="x-body-el x-container-body-el x-component-body-el x-layout-auto" id="ext-element-540"><div class="x-innerhtml" id="ext-element-541"><div class="claim-alert info">Information about your claim will be posted below as it becomes available.</div></div></div></div></div></div><div data-componentid="ext-container-27" class="x-container x-component x-layout-auto-item" data-xid="185" id="ext-container-27" njm-id="claimdetailsviewContent" style="margin: 0px 0px 10px !important;"><div class="x-body-el x-container-body-el x-component-body-el x-scroller x-nativescroller x-overflow-x-auto x-overflow-y-auto x-layout-box x-layout-vbox x-vertical x-align-stretch x-pack-start" id="ext-element-542"><div data-componentid="ext-component-21" class="x-component x-user-selectable-text x-component-bg-white x-component-blue x-layout-box-item x-layout-vbox-item" data-xid="186" id="ext-component-21" njm-id="view-claims-claim-num"><div class="x-innerhtml" id="ext-element-642"><div class="claim-number">Claim Number: <strong>2024-906042</strong></div></div></div><div data-componentid="ext-container-28" class="x-container x-component x-container-bg-white x-component-bg-white x-container-blue x-component-blue x-layout-box-item x-layout-vbox-item" data-xid="187" id="ext-container-28" njm-id="view-claims-hdr-panel"><div class="x-body-el x-container-body-el x-component-body-el x-layout-box x-pack-center x-layout-hbox x-horizontal x-align-stretch x-user-selectable-text x-container-bg-white-body-el x-component-bg-white-body-el x-container-blue-body-el x-component-blue-body-el" id="ext-element-543"><div data-componentid="ext-button-48" class="x-component x-button x-widthed x-has-text x-icon-align-left x-arrow-align-right x-button-green x-component-green x-layout-box-item x-layout-hbox-item" data-xid="188" id="ext-button-48" njm-id="view-claims-upload-photo" style="margin: 3px 0px 5px !important; width: 200px;"><div class="x-inner-el" id="ext-element-546"><div class="x-body-el" id="ext-element-545"><div class="x-icon-el x-font-icon" id="ext-element-548"></div><div class="x-text-el" id="ext-element-547">Upload Photographs</div></div><div class="x-arrow-el x-font-icon"></div></div><div class="x-badge-el"></div><button class="x-button-el" type="button" id="ext-element-544" data-gb-name="view-claims-upload-photo" data-componentid="ext-button-48"></button></div></div></div><div data-componentid="ext-component-22" class="x-component x-user-selectable-text x-component-bg-white x-component-blue x-layout-box-item x-layout-vbox-item" data-xid="189" id="ext-component-22" njm-id="view-claims-details-info"><div class="x-innerhtml" id="ext-element-643"><table class="overview display-table"><thead><tr><th scope="col">Claim Type</th><th scope="col">Date of Loss</th><th scope="col">Claim Status</th></tr></thead><tbody><tr><td data-label="Claim Type"><strong>Auto</strong> F10577029</td><td data-label="Date of Loss">12/12/2024</td><td data-label="Claim Status" class="Open">Open</td></tr></tbody></table></div></div><div id="ext-panel-2" data-componentid="ext-panel-2" class="x-panel x-container x-component x-noborder-trbl x-header-position-top x-panel-bg-white x-container-bg-white x-component-bg-white x-panel-blue x-container-blue x-component-blue x-managed-borders x-layout-box-item x-layout-vbox-item" data-xid="190" njm-id="view-claims-general-info"><div data-componentid="ext-panelheader-6" class="x-panelheader x-container x-component x-panelheader-bg-white x-container-bg-white x-component-bg-white x-panelheader-blue x-container-blue x-component-blue x-docked-top x-horizontal x-noborder-trl" data-xid="192" id="ext-panelheader-6"><div class="x-body-el x-panelheader-body-el x-container-body-el x-component-body-el x-layout-box x-layout-hbox x-horizontal x-align-center x-pack-start x-panelheader-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panelheader-blue-body-el x-container-blue-body-el x-component-blue-body-el" id="ext-element-551"><div class="x-unselectable x-paneltitle x-component x-text-align-left x-icon-align-left x-horizontal x-paneltitle-bg-white x-component-bg-white x-paneltitle-blue x-component-blue x-layout-box-item x-layout-hbox-item x-flexed" data-componentid="ext-paneltitle-6" data-xid="193" id="ext-paneltitle-6" style="flex: 1 1 auto;"><div class="x-body-el" id="ext-element-552"><div class="x-icon-el x-font-icon"></div><div class="x-text-el" id="ext-element-553" data-title="General Claim Information">General Claim Information</div></div></div><div tabindex="0" data-componentid="ext-paneltool-3" class="x-tool x-component x-paneltool x-paneltool- x-tool-bg-white x-component-bg-white x-paneltool-bg-white x-tool-blue x-component-blue x-paneltool-blue x-layout-box-item x-layout-hbox-item x-end" data-xid="240" id="ext-paneltool-3"><div class="x-icon-el x-font-icon x-tool-type-up" id="ext-element-626"></div></div></div></div><div class="x-body-wrap-el x-panel-body-wrap-el x-container-body-wrap-el x-component-body-wrap-el x-panel-bg-white-body-wrap-el x-container-bg-white-body-wrap-el x-component-bg-white-body-wrap-el x-panel-blue-body-wrap-el x-container-blue-body-wrap-el x-component-blue-body-wrap-el" id="ext-element-549"><div class="x-body-el x-panel-body-el x-container-body-el x-component-body-el x-layout-box x-layout-vbox x-vertical x-align-stretch x-pack-start x-user-selectable-text x-panel-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panel-blue-body-el x-container-blue-body-el x-component-blue-body-el x-noborder-rbl" id="ext-element-550" style="border-width: 0px; padding: 0px;"><div data-componentid="ext-component-23" class="x-component x-layout-box-item x-layout-vbox-item" data-xid="191" id="ext-component-23" njm-id="view-claims-general-info-details"><div class="x-innerhtml" id="ext-element-644"><table class="exposures display-table"><thead><tr><th scope="col">Coverage</th><th scope="col">Status</th><th scope="col">Claims Rep</th><th scope="col">Phone</th><th scope="col">Email</th></tr></thead><tbody><tr><td data-label="Coverage">Property Damage</td><td data-label="Status" class="Open">Open</td><td data-label="Claims Rep">Oleg Ignatenko</td><td data-label="Phone">609-956-2631</td><td data-label="Email">
[email protected]</td></tr></tbody></table></div></div></div></div></div><div data-componentid="ext-panel-3" class="x-panel x-container x-component x-noborder-trbl x-header-position-top x-panel-bg-white x-container-bg-white x-component-bg-white x-panel-blue x-container-blue x-component-blue x-managed-borders x-layout-box-item x-layout-vbox-item" data-xid="194" id="ext-panel-3" njm-id="view-claims-medical-cov-info"><div data-componentid="ext-panelheader-7" class="x-panelheader x-container x-component x-panelheader-bg-white x-container-bg-white x-component-bg-white x-panelheader-blue x-container-blue x-component-blue x-docked-top x-horizontal x-noborder-trl" data-xid="196" id="ext-panelheader-7"><div class="x-body-el x-panelheader-body-el x-container-body-el x-component-body-el x-layout-box x-layout-hbox x-horizontal x-align-center x-pack-start x-panelheader-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panelheader-blue-body-el x-container-blue-body-el x-component-blue-body-el" id="ext-element-555"><div class="x-unselectable x-paneltitle x-component x-text-align-left x-icon-align-left x-horizontal x-paneltitle-bg-white x-component-bg-white x-paneltitle-blue x-component-blue x-layout-box-item x-layout-hbox-item x-flexed" data-componentid="ext-paneltitle-7" data-xid="197" id="ext-paneltitle-7" style="flex: 1 1 auto;"><div class="x-body-el" id="ext-element-556"><div class="x-icon-el x-font-icon"></div><div class="x-text-el" id="ext-element-557" data-title="Medical Coverage Information">Medical Coverage Information</div></div></div><div tabindex="0" data-componentid="ext-paneltool-4" class="x-tool x-component x-paneltool x-paneltool- x-tool-bg-white x-component-bg-white x-paneltool-bg-white x-tool-blue x-component-blue x-paneltool-blue x-layout-box-item x-layout-hbox-item x-end" data-xid="241" id="ext-paneltool-4"><div class="x-icon-el x-font-icon x-tool-type-down" id="ext-element-627"></div></div></div></div><div class="x-body-wrap-el x-panel-body-wrap-el x-container-body-wrap-el x-component-body-wrap-el x-panel-bg-white-body-wrap-el x-container-bg-white-body-wrap-el x-component-bg-white-body-wrap-el x-panel-blue-body-wrap-el x-container-blue-body-wrap-el x-component-blue-body-wrap-el x-hidden-display" id="ext-element-558"><div class="x-body-el x-panel-body-el x-container-body-el x-component-body-el x-layout-box x-layout-vbox x-vertical x-align-stretch x-pack-start x-user-selectable-text x-panel-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panel-blue-body-el x-container-blue-body-el x-component-blue-body-el x-noborder-rbl" style="border-width: 0px; padding: 0px;" id="ext-element-554"><div data-componentid="ext-component-24" class="x-component x-layout-box-item x-layout-vbox-item" data-xid="195" id="ext-component-24" njm-id="view-claims-medicalcov-details"><div class="x-innerhtml" id="ext-element-645"><table class="exposures display-table"><thead><tr><th scope="col">Coverage</th><th scope="col">Claimant</th><th scope="col">Status</th><th scope="col">Claims Rep</th><th scope="col">Phone</th><th scope="col">Email</th></tr></thead><tbody><tr><td data-label="Coverage">PIP</td><td data-label="Claimant">MARIA INES LUZURIAGA ORTIZ</td><td data-label="Status" class="Open">Open</td><td data-label="Claims Rep">Jessica Forth</td><td data-label="Phone">609-956-2673</td><td data-label="Email">
[email protected]</td></tr></tbody></table></div></div></div></div></div><div data-componentid="ext-panel-4" class="x-panel x-container x-component x-noborder-trbl x-header-position-top x-panel-bg-white x-container-bg-white x-component-bg-white x-panel-blue x-container-blue x-component-blue x-managed-borders x-layout-box-item x-layout-vbox-item x-hidden x-hidden-display" data-xid="198" id="ext-panel-4" njm-id="view-claims-hdr-panel"><div data-componentid="ext-panelheader-8" class="x-panelheader x-container x-component x-panelheader-bg-white x-container-bg-white x-component-bg-white x-panelheader-blue x-container-blue x-component-blue x-docked-top x-horizontal x-noborder-trl" data-xid="200" id="ext-panelheader-8"><div class="x-body-el x-panelheader-body-el x-container-body-el x-component-body-el x-layout-box x-layout-hbox x-horizontal x-align-center x-pack-start x-panelheader-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panelheader-blue-body-el x-container-blue-body-el x-component-blue-body-el" id="ext-element-560"><div class="x-unselectable x-paneltitle x-component x-text-align-left x-horizontal x-paneltitle-bg-white x-component-bg-white x-paneltitle-blue x-component-blue x-layout-box-item x-layout-hbox-item x-flexed x-has-icon x-icon-align-right x-paint-monitored" data-componentid="ext-paneltitle-8" data-xid="201" id="ext-paneltitle-8" njm-id="view-claims-subro-info" style="flex: 1 1 auto;"><div class="x-body-el" id="ext-element-561"><div class="x-icon-el x-font-icon x-help-icon x-fa fa-question-circle" id="ext-element-563"></div><div class="x-text-el" id="ext-element-562" data-title="Subrogation Information">Subrogation Information</div></div><div class="x-paint-monitor cssanimation"></div></div><div tabindex="0" data-componentid="ext-paneltool-5" class="x-tool x-component x-paneltool x-paneltool- x-tool-bg-white x-component-bg-white x-paneltool-bg-white x-tool-blue x-component-blue x-paneltool-blue x-layout-box-item x-layout-hbox-item x-end" data-xid="242" id="ext-paneltool-5"><div class="x-icon-el x-font-icon x-tool-type-down" id="ext-element-628"></div></div></div></div><div class="x-body-wrap-el x-panel-body-wrap-el x-container-body-wrap-el x-component-body-wrap-el x-panel-bg-white-body-wrap-el x-container-bg-white-body-wrap-el x-component-bg-white-body-wrap-el x-panel-blue-body-wrap-el x-container-blue-body-wrap-el x-component-blue-body-wrap-el x-hidden-display" id="ext-element-567"><div class="x-body-el x-panel-body-el x-container-body-el x-component-body-el x-layout-box x-layout-vbox x-vertical x-align-stretch x-pack-start x-user-selectable-text x-panel-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panel-blue-body-el x-container-blue-body-el x-component-blue-body-el x-noborder-rbl" style="border-width: 0px; padding: 0px;" id="ext-element-559"><div data-componentid="ext-component-25" class="x-component x-layout-box-item x-layout-vbox-item" data-xid="199" id="ext-component-25" njm-id="view-claims-subro-assign-info"><div class="x-innerhtml" id="ext-element-646"><table class="subrogations display-table"><thead><tr><th scope="col">Subrogation Status</th><th scope="col">Subrogation Rep</th><th scope="col">Phone</th><th scope="col">Email</th></tr></thead><tbody></tbody></table></div></div></div></div></div><div data-componentid="ext-panel-5" class="x-panel x-container x-component x-noborder-trbl x-header-position-top appraisal-repair-panel x-panel-bg-white x-container-bg-white x-component-bg-white x-panel-blue x-container-blue x-component-blue x-managed-borders x-layout-box-item x-layout-vbox-item x-hidden x-hidden-display" data-xid="203" id="ext-panel-5" njm-id="view-claims-repair-shop-info"><div data-componentid="ext-panelheader-12" class="x-panelheader x-container x-component x-panelheader-bg-white x-container-bg-white x-component-bg-white x-panelheader-blue x-container-blue x-component-blue x-docked-top x-horizontal x-noborder-trl" data-xid="216" id="ext-panelheader-12"><div class="x-body-el x-panelheader-body-el x-container-body-el x-component-body-el x-layout-box x-layout-hbox x-horizontal x-align-center x-pack-start x-panelheader-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panelheader-blue-body-el x-container-blue-body-el x-component-blue-body-el" id="ext-element-590"><div class="x-unselectable x-paneltitle x-component x-text-align-left x-icon-align-left x-horizontal x-paneltitle-bg-white x-component-bg-white x-paneltitle-blue x-component-blue x-layout-box-item x-layout-hbox-item x-flexed" data-componentid="ext-paneltitle-12" data-xid="217" id="ext-paneltitle-12" style="flex: 1 1 auto;"><div class="x-body-el" id="ext-element-591"><div class="x-icon-el x-font-icon"></div><div class="x-text-el" id="ext-element-592" data-title="Appraisal and Repair Information">Appraisal and Repair Information</div></div></div><div tabindex="0" data-componentid="ext-paneltool-6" class="x-tool x-component x-paneltool x-paneltool- x-tool-bg-white x-component-bg-white x-paneltool-bg-white x-tool-blue x-component-blue x-paneltool-blue x-layout-box-item x-layout-hbox-item x-end" data-xid="243" id="ext-paneltool-6"><div class="x-icon-el x-font-icon x-tool-type-down" id="ext-element-629"></div></div></div></div><div class="x-body-wrap-el x-panel-body-wrap-el x-container-body-wrap-el x-component-body-wrap-el x-panel-bg-white-body-wrap-el x-container-bg-white-body-wrap-el x-component-bg-white-body-wrap-el x-panel-blue-body-wrap-el x-container-blue-body-wrap-el x-component-blue-body-wrap-el x-hidden-display" id="ext-element-593"><div class="x-body-el x-panel-body-el x-container-body-el x-component-body-el x-layout-box x-layout-vbox x-vertical x-align-stretch x-pack-start x-user-selectable-text x-panel-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panel-blue-body-el x-container-blue-body-el x-component-blue-body-el x-noborder-rbl" style="border-width: 0px; padding: 0px;" id="ext-element-568"><div data-componentid="ext-component-26" class="x-component x-hidden x-hidden-display x-layout-box-item x-layout-vbox-item" data-xid="204" id="ext-component-26" njm-id="view-claims-repair-shop-details"><div class="x-innerhtml" id="ext-element-647"><div class="repair-shop"><div style="color: #0077bd; padding-bottom: 8px"><strong>Repair Shop</strong></div><div class="mb5 repair-shop-name"><strong></strong></div></div></div></div><div data-componentid="ext-container-29" class="x-container x-component x-layout-box-item x-layout-vbox-item" data-xid="205" id="ext-container-29"><div class="x-body-el x-container-body-el x-component-body-el x-layout-auto" id="ext-element-569" style="padding: 5px 20px 5px 6px !important;"><div data-componentid="ext-panel-6" class="x-panel x-container x-component x-noborder-trbl x-header-position-top x-panel-offwhite x-container-offwhite x-component-offwhite x-managed-borders x-layout-auto-item x-hidden x-hidden-display" data-xid="206" id="ext-panel-6" style="margin: 15px 0px !important; max-width: 100%;"><div data-componentid="ext-panelheader-9" class="x-panelheader x-container x-component x-panelheader-offwhite x-container-offwhite x-component-offwhite x-docked-top x-horizontal x-noborder-trl" data-xid="207" id="ext-panelheader-9"><div class="x-dock x-dock-horizontal" id="ext-element-631"><div tabindex="0" data-componentid="ext-paneltool-7" class="x-tool x-component x-paneltool x-paneltool- x-tool-offwhite x-component-offwhite x-paneltool-offwhite x-dock-item x-docked-left x-end" data-xid="244" id="ext-paneltool-7"><div class="x-icon-el x-font-icon x-tool-type-down" id="ext-element-630"></div></div><div class="x-body-el x-panelheader-body-el x-container-body-el x-component-body-el x-layout-box x-layout-hbox x-horizontal x-align-center x-pack-start x-panelheader-offwhite-body-el x-container-offwhite-body-el x-component-offwhite-body-el" id="ext-element-571"><div class="x-unselectable x-paneltitle x-component x-text-align-left x-icon-align-left x-horizontal x-layout-box-item x-layout-hbox-item x-flexed x-paneltitle-offwhite x-component-offwhite" data-componentid="ext-paneltitle-9" data-xid="208" id="ext-paneltitle-9" style="flex: 1 1 auto;"><div class="x-body-el" id="ext-element-572"><div class="x-icon-el x-font-icon"></div><div class="x-text-el" id="ext-element-573" data-title="Vehicle Status <span class="x-help-icon x-fa fa-question-circle" style="font-size: 14px"></span>">Vehicle Status <span class="x-help-icon x-fa fa-question-circle" style="font-size: 14px" id="ext-element-576"></span></div></div></div></div></div></div><div class="x-body-wrap-el x-panel-body-wrap-el x-container-body-wrap-el x-component-body-wrap-el x-panel-offwhite-body-wrap-el x-container-offwhite-body-wrap-el x-component-offwhite-body-wrap-el x-hidden-display" id="ext-element-579"><div class="x-body-el x-panel-body-el x-container-body-el x-component-body-el x-layout-auto x-panel-offwhite-body-el x-container-offwhite-body-el x-component-offwhite-body-el x-noborder-rbl" style="border-width: 0px; padding: 8px 10px 0px 15px;" id="ext-element-570"><div class="x-innerhtml" id="ext-element-640"></div></div></div></div><div data-componentid="ext-panel-7" class="x-panel x-container x-component x-noborder-trbl x-header-position-top x-hidden x-hidden-display x-panel-offwhite x-container-offwhite x-component-offwhite x-managed-borders x-layout-auto-item" data-xid="210" id="ext-panel-7" style="margin: 15px 0px !important; max-width: 100%;"><div data-componentid="ext-panelheader-10" class="x-panelheader x-container x-component x-panelheader-offwhite x-container-offwhite x-component-offwhite x-docked-top x-horizontal x-noborder-trl" data-xid="211" id="ext-panelheader-10"><div class="x-dock x-dock-horizontal" id="ext-element-633"><div tabindex="0" data-componentid="ext-paneltool-8" class="x-tool x-component x-paneltool x-paneltool- x-tool-offwhite x-component-offwhite x-paneltool-offwhite x-dock-item x-docked-left x-end" data-xid="245" id="ext-paneltool-8"><div class="x-icon-el x-font-icon x-tool-type-down" id="ext-element-632"></div></div><div class="x-body-el x-panelheader-body-el x-container-body-el x-component-body-el x-layout-box x-layout-hbox x-horizontal x-align-center x-pack-start x-panelheader-offwhite-body-el x-container-offwhite-body-el x-component-offwhite-body-el" id="ext-element-581"><div class="x-unselectable x-paneltitle x-component x-text-align-left x-icon-align-left x-horizontal x-paneltitle-offwhite x-component-offwhite x-layout-box-item x-layout-hbox-item x-flexed" data-componentid="ext-paneltitle-10" data-xid="212" id="ext-paneltitle-10" style="flex: 1 1 auto;"><div class="x-body-el" id="ext-element-582"><div class="x-icon-el x-font-icon"></div><div class="x-text-el" id="ext-element-583" data-title="Appraisal Method">Appraisal Method</div></div></div></div></div></div><div class="x-body-wrap-el x-panel-body-wrap-el x-container-body-wrap-el x-component-body-wrap-el x-panel-offwhite-body-wrap-el x-container-offwhite-body-wrap-el x-component-offwhite-body-wrap-el x-hidden-display" id="ext-element-584"><div class="x-body-el x-panel-body-el x-container-body-el x-component-body-el x-layout-auto x-panel-offwhite-body-el x-container-offwhite-body-el x-component-offwhite-body-el x-noborder-rbl" style="border-width: 0px; padding: 8px 10px 0px 15px;" id="ext-element-580"><div class="x-innerhtml" id="ext-element-641"><strong>Premier Car Care</strong><br>Using a participating facility may expedite the repair of your vehicle and settlement of your claim. After you notify your claims representative, they will provide the shop with an assignment. Please contact the shop to schedule an appraisal and complete repairs. Upon completion of repairs the shop will bill directly for the costs above your deductible. Visit our <a href="https://www.njm.com/insurance/auto/claims/body-shops" style="color: #0079c2;" target="_blank"><span style="text-decoration: underline; font-weight: normal;">Auto Body Shop Search</span></a> to search for repair shops in your area.<br><br><strong>Xprestimate</strong><br>If you choose this option, after receiving a link to Xprestimate via text, you can take photographs and videos of the damage to your vehicle. An appraiser will use these photographs to complete an initial estimate. <br><br><strong> Appraiser</strong><br>If you choose this option, an appraiser will reach out to you within 2 business days to schedule a date and time to complete an initial estimate.</div></div></div></div><div data-componentid="ext-panel-8" class="x-panel x-container x-component x-noborder-trbl x-header-position-top x-hidden x-hidden-display x-panel-offwhite x-container-offwhite x-component-offwhite x-managed-borders x-layout-auto-item" data-xid="213" id="ext-panel-8" style="margin: 15px 0px !important; max-width: 100%;"><div data-componentid="ext-panelheader-11" class="x-panelheader x-container x-component x-panelheader-offwhite x-container-offwhite x-component-offwhite x-docked-top x-horizontal x-noborder-trl" data-xid="214" id="ext-panelheader-11"><div class="x-dock x-dock-horizontal" id="ext-element-635"><div tabindex="0" data-componentid="ext-paneltool-9" class="x-tool x-component x-paneltool x-paneltool- x-tool-offwhite x-component-offwhite x-paneltool-offwhite x-dock-item x-docked-left x-end" data-xid="246" id="ext-paneltool-9"><div class="x-icon-el x-font-icon x-tool-type-down" id="ext-element-634"></div></div><div class="x-body-el x-panelheader-body-el x-container-body-el x-component-body-el x-layout-box x-layout-hbox x-horizontal x-align-center x-pack-start x-panelheader-offwhite-body-el x-container-offwhite-body-el x-component-offwhite-body-el" id="ext-element-586"><div class="x-unselectable x-paneltitle x-component x-text-align-left x-icon-align-left x-horizontal x-paneltitle-offwhite x-component-offwhite x-layout-box-item x-layout-hbox-item x-flexed" data-componentid="ext-paneltitle-11" data-xid="215" id="ext-paneltitle-11" style="flex: 1 1 auto;"><div class="x-body-el" id="ext-element-587"><div class="x-icon-el x-font-icon"></div><div class="x-text-el" id="ext-element-588" data-title="Appraisal Status">Appraisal Status</div></div></div></div></div></div><div class="x-body-wrap-el x-panel-body-wrap-el x-container-body-wrap-el x-component-body-wrap-el x-panel-offwhite-body-wrap-el x-container-offwhite-body-wrap-el x-component-offwhite-body-wrap-el x-hidden-display" id="ext-element-589"><div class="x-body-el x-panel-body-el x-container-body-el x-component-body-el x-layout-auto x-panel-offwhite-body-el x-container-offwhite-body-el x-component-offwhite-body-el x-noborder-rbl" style="border-width: 0px; padding: 8px 10px 0px 15px;" id="ext-element-585"><div class="x-innerhtml" id="ext-element-649"></div></div></div></div></div></div></div></div></div><div data-componentid="ext-panel-9" class="x-panel x-container x-component x-noborder-trbl x-header-position-top x-panel-bg-white x-container-bg-white x-component-bg-white x-panel-blue x-container-blue x-component-blue x-managed-borders x-layout-box-item x-layout-vbox-item x-hidden x-hidden-display" data-xid="218" id="ext-panel-9" njm-id="view-claims-rental-info"><div data-componentid="ext-panelheader-13" class="x-panelheader x-container x-component x-panelheader-bg-white x-container-bg-white x-component-bg-white x-panelheader-blue x-container-blue x-component-blue x-docked-top x-horizontal x-noborder-trl" data-xid="220" id="ext-panelheader-13"><div class="x-body-el x-panelheader-body-el x-container-body-el x-component-body-el x-layout-box x-layout-hbox x-horizontal x-align-center x-pack-start x-panelheader-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panelheader-blue-body-el x-container-blue-body-el x-component-blue-body-el" id="ext-element-595"><div class="x-unselectable x-paneltitle x-component x-text-align-left x-icon-align-left x-horizontal x-paneltitle-bg-white x-component-bg-white x-paneltitle-blue x-component-blue x-layout-box-item x-layout-hbox-item x-flexed" data-componentid="ext-paneltitle-13" data-xid="221" id="ext-paneltitle-13" style="flex: 1 1 auto;"><div class="x-body-el" id="ext-element-596"><div class="x-icon-el x-font-icon"></div><div class="x-text-el" id="ext-element-597" data-title="Rental Reservation">Rental Reservation</div></div></div><div tabindex="0" data-componentid="ext-paneltool-10" class="x-tool x-component x-paneltool x-paneltool- x-tool-bg-white x-component-bg-white x-paneltool-bg-white x-tool-blue x-component-blue x-paneltool-blue x-layout-box-item x-layout-hbox-item x-end" data-xid="247" id="ext-paneltool-10"><div class="x-icon-el x-font-icon x-tool-type-down" id="ext-element-636"></div></div></div></div><div class="x-body-wrap-el x-panel-body-wrap-el x-container-body-wrap-el x-component-body-wrap-el x-panel-bg-white-body-wrap-el x-container-bg-white-body-wrap-el x-component-bg-white-body-wrap-el x-panel-blue-body-wrap-el x-container-blue-body-wrap-el x-component-blue-body-wrap-el x-hidden-display" id="ext-element-598"><div class="x-body-el x-panel-body-el x-container-body-el x-component-body-el x-layout-box x-layout-vbox x-vertical x-align-stretch x-pack-start x-user-selectable-text x-panel-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panel-blue-body-el x-container-blue-body-el x-component-blue-body-el x-noborder-rbl" style="border-width: 0px; padding: 0px;" id="ext-element-594"><div data-componentid="ext-component-27" class="x-component x-layout-box-item x-layout-vbox-item" data-xid="219" id="ext-component-27" njm-id="view-claims-rental-details"><div class="x-innerhtml" id="ext-element-648"><table class="reservations display-table"><thead><tr><th scope="col">Rental Company</th><th scope="col">Reservation Number</th><th scope="col">NJM Authorized Rate/Type</th></tr></thead><tbody></tbody></table></div></div></div></div></div><div data-componentid="ext-panel-10" class="x-panel x-container x-component x-noborder-trbl x-header-position-top x-panel-bg-white x-container-bg-white x-component-bg-white x-panel-blue x-container-blue x-component-blue x-managed-borders x-layout-box-item x-layout-vbox-item x-hidden x-hidden-display" data-xid="222" id="ext-panel-10" njm-id="view-claims-medical-info"><div data-componentid="ext-panelheader-14" class="x-panelheader x-container x-component x-panelheader-bg-white x-container-bg-white x-component-bg-white x-panelheader-blue x-container-blue x-component-blue x-docked-top x-horizontal x-noborder-trl" data-xid="224" id="ext-panelheader-14"><div class="x-body-el x-panelheader-body-el x-container-body-el x-component-body-el x-layout-box x-layout-hbox x-horizontal x-align-center x-pack-start x-panelheader-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panelheader-blue-body-el x-container-blue-body-el x-component-blue-body-el" id="ext-element-600"><div class="x-unselectable x-paneltitle x-component x-text-align-left x-icon-align-left x-horizontal x-paneltitle-bg-white x-component-bg-white x-paneltitle-blue x-component-blue x-layout-box-item x-layout-hbox-item x-flexed" data-componentid="ext-paneltitle-14" data-xid="225" id="ext-paneltitle-14" style="flex: 1 1 auto;"><div class="x-body-el" id="ext-element-601"><div class="x-icon-el x-font-icon"></div><div class="x-text-el" id="ext-element-602" data-title="Independent Medical Examination(s)">Independent Medical Examination(s)</div></div></div><div tabindex="0" data-componentid="ext-paneltool-11" class="x-tool x-component x-paneltool x-paneltool- x-tool-bg-white x-component-bg-white x-paneltool-bg-white x-tool-blue x-component-blue x-paneltool-blue x-layout-box-item x-layout-hbox-item x-end" data-xid="248" id="ext-paneltool-11"><div class="x-icon-el x-font-icon x-tool-type-down" id="ext-element-637"></div></div></div></div><div class="x-body-wrap-el x-panel-body-wrap-el x-container-body-wrap-el x-component-body-wrap-el x-panel-bg-white-body-wrap-el x-container-bg-white-body-wrap-el x-component-bg-white-body-wrap-el x-panel-blue-body-wrap-el x-container-blue-body-wrap-el x-component-blue-body-wrap-el x-hidden-display" id="ext-element-603"><div class="x-body-el x-panel-body-el x-container-body-el x-component-body-el x-layout-box x-layout-vbox x-vertical x-align-stretch x-pack-start x-user-selectable-text x-panel-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panel-blue-body-el x-container-blue-body-el x-component-blue-body-el x-noborder-rbl" style="border-width: 0px; padding: 0px;" id="ext-element-599"><div data-componentid="ext-component-28" class="x-component x-layout-box-item x-layout-vbox-item" data-xid="223" id="ext-component-28" njm-id="view-claims-medical-details"><div class="x-innerhtml" id="ext-element-650"><table class="exams display-table"><thead><tr><th scope="col">Specialty Information</th><th scope="col">Physician Name</th><th scope="col">Physician Address</th><th scope="col">Phone Number</th><th scope="col">Date of Exam</th></tr></thead><tbody></tbody></table></div></div></div></div></div><div data-componentid="ext-panel-11" class="x-panel x-container x-component x-noborder-trbl x-header-position-top x-panel-bg-white x-container-bg-white x-component-bg-white x-panel-blue x-container-blue x-component-blue x-managed-borders x-layout-box-item x-layout-vbox-item" data-xid="226" id="ext-panel-11" njm-id="view-claims-docs"><div data-componentid="ext-panelheader-15" class="x-panelheader x-container x-component x-panelheader-bg-white x-container-bg-white x-component-bg-white x-panelheader-blue x-container-blue x-component-blue x-docked-top x-horizontal x-noborder-trl" data-xid="233" id="ext-panelheader-15"><div class="x-body-el x-panelheader-body-el x-container-body-el x-component-body-el x-layout-box x-layout-hbox x-horizontal x-align-center x-pack-start x-panelheader-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panelheader-blue-body-el x-container-blue-body-el x-component-blue-body-el" id="ext-element-615"><div class="x-unselectable x-paneltitle x-component x-text-align-left x-icon-align-left x-horizontal x-paneltitle-bg-white x-component-bg-white x-paneltitle-blue x-component-blue x-layout-box-item x-layout-hbox-item x-flexed" data-componentid="ext-paneltitle-15" data-xid="234" id="ext-paneltitle-15" style="flex: 1 1 auto;"><div class="x-body-el" id="ext-element-616"><div class="x-icon-el x-font-icon"></div><div class="x-text-el" id="ext-element-617" data-title="Claim Documents">Claim Documents</div></div></div><div tabindex="0" data-componentid="ext-paneltool-12" class="x-tool x-component x-paneltool x-paneltool- x-tool-bg-white x-component-bg-white x-paneltool-bg-white x-tool-blue x-component-blue x-paneltool-blue x-layout-box-item x-layout-hbox-item x-end" data-xid="249" id="ext-paneltool-12"><div class="x-icon-el x-font-icon x-tool-type-down" id="ext-element-638"></div></div></div></div><div class="x-body-wrap-el x-panel-body-wrap-el x-container-body-wrap-el x-component-body-wrap-el x-panel-bg-white-body-wrap-el x-container-bg-white-body-wrap-el x-component-bg-white-body-wrap-el x-panel-blue-body-wrap-el x-container-blue-body-wrap-el x-component-blue-body-wrap-el x-hidden-display" id="ext-element-618"><div class="x-body-el x-panel-body-el x-container-body-el x-component-body-el x-layout-box x-layout-vbox x-vertical x-align-stretch x-pack-start x-user-selectable-text x-panel-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panel-blue-body-el x-container-blue-body-el x-component-blue-body-el x-noborder-rbl" style="border-width: 0px; padding: 0px;" id="ext-element-604"><div data-componentid="ext-component-29" class="x-component x-layout-box-item x-layout-vbox-item" data-xid="227" id="ext-component-29" njm-id="view-claims-docs-info"><div class="x-innerhtml" id="ext-element-605"><div class="documents"><div class="instruction">Following are your claim specific documents for your reference:</div></div></div></div><div data-componentid="ext-dataview-3" class="x-dataview x-container x-component x-layout-box-item x-layout-vbox-item" data-xid="228" tabindex="0" id="ext-dataview-3" njm-id="view-claims-docs-sitecore-view"><div class="x-body-el x-dataview-body-el x-container-body-el x-component-body-el x-scroller x-nativescroller x-overflow-x-auto x-overflow-y-auto x-show-selection x-layout-auto" id="ext-element-606"></div></div><div data-componentid="ext-component-30" class="x-component x-layout-box-item x-layout-vbox-item" data-xid="229" id="ext-component-30" njm-id="view-claims-docs-onbase-view"><div class="x-innerhtml" id="ext-element-651"><div class="document"><a target="_blank" href="/cssapi/download/530693675">Claim Acknowledgement Auto</a></div></div></div><div data-componentid="ext-container-30" class="x-container x-component x-hidden x-hidden-display x-layout-box-item x-layout-vbox-item" data-xid="230" id="ext-container-30"><div class="x-body-el x-container-body-el x-component-body-el x-layout-auto" id="ext-element-607"><div data-componentid="ext-button-49" class="x-component x-button x-has-text mt20 mb20 theft-qnr-btn x-icon-align-left x-arrow-align-right x-button-link x-component-link x-button-small x-component-small x-layout-auto-item" data-xid="231" id="ext-button-49" style="max-width: 100%;"><div class="x-inner-el" id="ext-element-610"><div class="x-body-el" id="ext-element-609"><div class="x-icon-el x-font-icon" id="ext-element-612"></div><div class="x-text-el" id="ext-element-611">Vehicle Theft Questionnaire (To be completed)</div></div><div class="x-arrow-el x-font-icon"></div></div><div class="x-badge-el"></div><button class="x-button-el" type="button" id="ext-element-608" data-componentid="ext-button-49"></button></div><div data-componentid="ext-container-31" class="x-container x-component page-error x-hidden x-hidden-display x-layout-auto-item" data-xid="232" id="ext-container-31" style="margin: 0px 10px 10px 15px !important;"><div class="x-body-el x-container-body-el x-component-body-el x-layout-auto" id="ext-element-613"><div class="x-innerhtml" id="ext-element-614">An error occurred while requesting the Vehicle Theft Questionnaire form. Please try again later.</div></div></div></div></div></div></div></div><div data-componentid="ext-panel-12" class="x-panel x-container x-component x-noborder-trbl x-header-position-top x-hidden x-hidden-display x-panel-bg-white x-container-bg-white x-component-bg-white x-panel-blue x-container-blue x-component-blue x-managed-borders x-layout-box-item x-layout-vbox-item" data-xid="235" id="ext-panel-12" njm-id="view-payment-details-info"><div data-componentid="ext-panelheader-16" class="x-panelheader x-container x-component x-panelheader-bg-white x-container-bg-white x-component-bg-white x-panelheader-blue x-container-blue x-component-blue x-docked-top x-horizontal x-noborder-trl" data-xid="237" id="ext-panelheader-16"><div class="x-body-el x-panelheader-body-el x-container-body-el x-component-body-el x-layout-box x-layout-hbox x-horizontal x-align-center x-pack-start x-panelheader-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panelheader-blue-body-el x-container-blue-body-el x-component-blue-body-el" id="ext-element-620"><div class="x-unselectable x-paneltitle x-component x-text-align-left x-icon-align-left x-horizontal x-paneltitle-bg-white x-component-bg-white x-paneltitle-blue x-component-blue x-layout-box-item x-layout-hbox-item x-flexed" data-componentid="ext-paneltitle-16" data-xid="238" id="ext-paneltitle-16" style="flex: 1 1 auto;"><div class="x-body-el" id="ext-element-621"><div class="x-icon-el x-font-icon"></div><div class="x-text-el" id="ext-element-622" data-title="Payment Details">Payment Details</div></div></div><div tabindex="0" data-componentid="ext-paneltool-13" class="x-tool x-component x-paneltool x-paneltool- x-tool-bg-white x-component-bg-white x-paneltool-bg-white x-tool-blue x-component-blue x-paneltool-blue x-layout-box-item x-layout-hbox-item x-end" data-xid="250" id="ext-paneltool-13"><div class="x-icon-el x-font-icon x-tool-type-down" id="ext-element-639"></div></div></div></div><div class="x-body-wrap-el x-panel-body-wrap-el x-container-body-wrap-el x-component-body-wrap-el x-panel-bg-white-body-wrap-el x-container-bg-white-body-wrap-el x-component-bg-white-body-wrap-el x-panel-blue-body-wrap-el x-container-blue-body-wrap-el x-component-blue-body-wrap-el x-hidden-display" id="ext-element-623"><div class="x-body-el x-panel-body-el x-container-body-el x-component-body-el x-layout-box x-layout-vbox x-vertical x-align-stretch x-pack-start x-user-selectable-text x-panel-bg-white-body-el x-container-bg-white-body-el x-component-bg-white-body-el x-panel-blue-body-el x-container-blue-body-el x-component-blue-body-el x-noborder-rbl" style="border-width: 0px; padding: 0px;" id="ext-element-619"><div data-componentid="ext-component-31" class="x-component x-layout-box-item x-layout-vbox-item" data-xid="236" id="ext-component-31" njm-id="view-payment-details-info-details"><div class="x-innerhtml" id="ext-element-652"><table class="exposures display-table"><thead><tr><th scope="col">Date</th><th scope="col">Pay To</th><th scope="col">Amount</th><th scope="col">EOB</th></tr></thead><tbody></tbody></table></div></div></div></div></div></div></div></div>
