Hello Admin
New Customer details request as below.
Title
:
{{$title}}
First Name
:
{{ucfirst($first_name)}}
Last Name
:
{{ucfirst($last_name)}}
Email
:
{{$email}}
Phone
:
{{$phone}}
D.O.B.
:
{{$dob}}
Cover Type
:
{{$cover_type}}
@if($cover_type == 'Accident & Sickness only')
How much sick pay are you entitled to ?
:
£ {{$sick_pay}}
Do you have any medical conditions or injuries? ?
:
£ {{$medical_condition}}
Have you smoked in the last 12 months?
:
£ {{$smoke}}
@endif
Monthly Benifit amount
:
£ {{$monthly_benifit_amount}}
Excess Period
:
{{$excess_period}}
Employee Status
:
{{$emp_status}}
Company Name
:
{{$company_name}}
Occupation
:
{{$occupation}}
Company Name
:
{{$company_name}}
Lenght time of current employer
:
{{$lenth_time_current_employed}}
Gross annual salary
:
{{$gross_annual_salary}}
Residential status
:
{{$residential_status}}
Monthly mortgage or rent payments
:
{{$monthly_payments}}
Bestinsurance
}}){kind=small}