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medical-checkout.html
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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="utf-8">
<title>Insuredoo - Medical Checkout</title>
<meta content="width=device-width, initial-scale=1.0" name="viewport">
<meta content="" name="keywords">
<meta content="" name="description">
<!-- Favicons -->
<link href="img/favicon.png" rel="icon">
<link href="img/apple-touch-icon.png" rel="apple-touch-icon">
<!-- Google Fonts -->
<link href="https://fonts.googleapis.com/css?family=Open+Sans:300,300i,400,400i,500,600,700,700i" rel="stylesheet">
<link href="https://fonts.googleapis.com/css?family=DM+Serif+Text&display=swap" rel="stylesheet">
<!-- Bootstrap CSS File -->
<link href="lib/bootstrap/css/bootstrap.min.css" rel="stylesheet">
<!-- Libraries CSS Files -->
<link href="lib/font-awesome/css/font-awesome.min.css" rel="stylesheet">
<link href="lib/animate/css/animate.min.css" rel="stylesheet">
<link href="lib/owlcarousel/css/owl.carousel.min.css" rel="stylesheet">
<link href="lib/fancybox/css/jquery.fancybox.min.css" rel="stylesheet" />
<link href="lib/tooltip/css/tooltipster.bundle.min.css" rel="stylesheet" />
<link href="lib/form/css/select2.min.css" rel="stylesheet" />
<link href="lib/form/css/select2-bootstrap4.css" rel="stylesheet" />
<link href="lib/tooltip/css/plugins/tooltipster/sideTip/themes/tooltipster-sideTip-light.min.css" rel="stylesheet" />
<!-- Main Stylesheet File -->
<link href="css/style.css" rel="stylesheet">
</head>
<body>
<a href="#" class="need-help-btn wow fadeInRight" data-wow-duration="1.4s"><i class="fa fa-envelope-o"></i> Need help?</a>
<!--==========================
Header
============================-->
<header id="header">
<div class="container-fluid">
<nav class="main-nav float-left d-none d-lg-block">
<ul>
<li><a href="about-insuredoo.html">About Us</a></li>
<li><a href="#products">Products</a></li>
<li><a href="#blog">Blog</a></li>
<li><a href="#claim">Claim</a></li>
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<!-- .main-nav -->
<div class="logo float-left d-lg-block">
<h1 class="text-center"><a href="index.html" class="scrollto"><img src="img/logo.png" alt="Insuredoo,The Easiest Way To Insure" class="img-fluid"></a></h1>
</div>
<div id="topbar" class="float-right d-lg-block">
<div class="right-menu">
<div class="right-menu-main-div login">
<p class="btn">Login</p>
<div class="login_box_container">
<div class="arrow-up"></div>
<div class="loginformholder">
<form action="index.html" method="post">
<p>
<label for="email_txt">Email</label>
<input type="email" placeholder="[email protected]" name="email_txt" id="email_txt" data-validation="required email" data-validation-error-msg="Please enter a valid email" />
</p>
<p>
<label for="password_txt">Password</label>
<input type="password" name="password_txt" id="password_txt" autocomplete="new-password" data-validation="required" data-validation-error-msg="Please enter your valid password" />
</p>
<input type="submit" value="Login" />
</form>
<div class="other_links"> <a href="#" class="forgot_my_password">Forgot my password</a> <a href="#" class="sign_up">Sign up</a> </div>
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<div class="right-menu-main-div language d-none d-lg-block"><a href="index.html">E</a></div>
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</div>
</div>
</div>
</header>
<!-- #header -->
<main id="checkout_page">
<section id="checkout_page_intro" class="clearfix main_section">
<div class="container">
<header class="inner-page-section-header text-center">
<h2>SECURE CHECKOUT</h2>
</header>
<div class="row row-eq-height row-content title-summary-checkout mt-5">
<div class="col-xl-2 col-lg-2 col-md-2 col-sm-12 mb-3 text-center"><img src="img/m_logo_1.png" alt="company logo" class="img-fluid mw-200"></div>
<div class="col-xl-8 col-lg-8 col-md-8 col-sm-12 mb-3 align-self-center">
<h4 class="mb-1">Watania Insurance - Silk Road</h4>
</div>
<div class="col-xl-2 col-lg-2 col-md-2 col-sm-12 mb-3">
<h4 class="mb-1 text-center summary-checkout-amount" data-value="15,813"><span class="checkout-amount-price-currency">AED</span> <span class="checkout-amount-price-value">15,813</span></h4>
<p class="text-center">Annual Premium</p>
</div>
</div>
<div class="row row-eq-height row-content">
<div class="col-xl-6 col-lg-6 col-md-6 col-sm-12 mt-4">
<div class="data-summary-checkout"> <img src="img/star_sign.png" alt="Policy Feature Summary" class="img-fluid d-block">
<h4 class="mt-4 text-center">Policy Features</h4>
<p><strong>Deductibles</strong><br>
20% (MAX AED 50)</p>
<p><strong>Annual Coverage</strong><br>
AED 1,000,000</p>
<p><strong>Coverage</strong><br>
Worldwide</p>
<p><strong>Dental</strong><br>
AED 3,500 WITH 20% CO INSURANCE</p>
<p><strong>Networks</strong><br>
Hospitals 11 Clinics 432</p>
<p><strong>Maternity</strong><br>
Up To AED 10,000 For Normal (AED 10,000 For Medically Essential C-Section & Complications); Medical Emergency Expenses Related To Maternity Covered Up To A Sublimit Of AED 150,000; 10% Co-Pay On All Maternity Treatments</p>
<p><strong>Pharmaceuticals</strong><br>
Chronic Medications Prescribed For More Than 1 Month & Prescription Cost Above AED 500</p>
</div>
</div>
<div class="col-xl-6 col-lg-6 col-md-6 col-sm-12 mt-4">
<div class="data-summary-checkout"> <img src="img/include_sign.png" alt="Policy Feature Summary" class="img-fluid d-block">
<h4 class="mt-4 text-center">Details</h4>
<p><strong>Sponsor</strong><br>
Tariq Humaidi, Sharjah<br>
Salary Over 4k</p>
<p><strong>Member 1</strong><br>
Male, 39, I'm The Sponsor<br>
Salary Over 4k<br>
AED 1,961<br><strong>BASMAH Patient Support Program By DHA</strong><br>
AED 21.6</p>
<p><strong>Member 2</strong><br>
Female (Single), 10, Child<br>
Salary Over 4k<br>
AED 1,330<br>
<strong>BASMAH Patient Support Program By DHA</strong><br>
AED 21.6</p>
<p><strong>Member 3</strong><br>
Female (Married), 33, Spouse<br>
Salary Over 4k<br>
AED 3,124<br>
<strong>BASMAH Patient Support Program By DHA</strong><br>
AED 21.6</p>
</div>
</div>
</div>
<div class="row row-eq-height row-content">
<div class="col-xl-6 col-lg-6 col-md-6 col-sm-12 mt-4">
<div class="shop-with-confidence d-table">
<div class="shop-with-confidence-description">
<h5 class="mb-1">shop with confidence</h5>
<h4 class="mb-3">LOWEST PRICE ONLINE GUARANTEED</h4>
<p>we guarantee that if you find the exact same policy cheaper online, we'll refund you twice the difference! see our terms and conditions page for details.</p>
</div>
<img src="img/low_price_icon.png" alt="shop with confidence" class="shop-with-confidence-image">
</div>
</div>
<div class="col-xl-6 col-lg-6 col-md-6 col-sm-12 mt-4">
<div class="what-happens-next">
<h5>what happens next?</h5>
<p>If you decide that this policy is for you, here are the next steps:</p>
<ol>
<li>Choose to buy online using our secure checkout, OR pay with cash.</li>
<li>we'll send a receipt to your email address and give you a call.</li>
<li>we'll take care of all the hassle for you!</li>
</ol>
<p>It really is that simple! however if you do want to get in touch with any questions, give us a call on <a class="tel-number" href="tel:8002667273">8002667273</a></p>
</div>
</div>
</div>
<div class="row row-content">
<div class="col-sm-12 mt-5">
<div class="checkout-additional-peace">
<h4>Additional cover for added peace of mind</h4>
</div>
<div class="checkout-additional-peace-vat-msg">
<p>* These prices are indicative and subject to change at the discretion of the insurer</p>
<p>* The prices you see here are exclusive of 5% VAT. VAT will be added on next step.</p>
</div>
</div>
</div>
<form method="post" action="payment.html">
<div class="row row-eq-height row-content">
<div class="col-xl-8 col-lg-8 col-md-8 col-sm-12 mt-4"> </div>
<div class="col-xl-4 col-lg-4 col-md-4 col-sm-12 mt-4 checkout-total-summary">
<div class="row mb-4">
<div class="col-8 p-1">
<input type="text" name="discount_coupon" id="discount_coupon" class="form-control" placeholder="Disount Coupon" data-validation-error-msg="Please enter a valid discount coupon">
</div>
<div class="col-4 p-1">
<button value="1" class="form-control btn coupon-btn" name="apply_coupon" id="apply_coupon">Apply</button>
<i class="help-sign fa fa-question-circle" title="Discount is applied on the premium only, excluding additional covers"></i></div>
</div>
<h5>Annual Premium: <span class="initial-total-value">15,813 AED</span></h5>
<h5 class="total-saving-text">Total Savings: 321 AED</h5>
<h4>Total amount due:</h4>
<h3 class="mb-1 summary-checkout-amount" data-value="15,813"><span class="checkout-amount-price-currency">AED</span> <span class="checkout-amount-price-value">15,813</span></h3>
</div>
</div>
<div class="row row-content">
<div class="col-sm-12 mt-5 proceed-to-payment-row">
<label class="checkbox-label with-label" for="terms_and_condition_agree">
<input type="checkbox" name="terms_and_condition_agree" id="terms_and_condition_agree" class="agree_checkbox" value="1" />
<span class="checkbox-custom circular"></span> </label>
I agree to <a href="#">terms and conditions</a>
</div>
<div class="col-md-12 col-sm-12 mt-5 small text-justify">
<label class="checkbox-label with-label" for="acknowledge_agree">
<input type="checkbox" name="acknowledge_agree" id="acknowledge_agree" class="agree_checkbox" value="1" />
<span class="checkbox-custom circular"></span> </label>
I understand and acknowledge any pregnancy not declared at the time of this application's coverage will be at the sole discretion of the insurer. The insurer has the right to not cover any maternity claims to any undeclared pregnancy. I also acknowledge and understand any pregnancy, which arises within forty calendar days from the date of this application; coverage will also be at the discretion of the insurer.
<div class="w-100 mb-3"></div>
<div class="col-sm-12 text-right m-0 p-0">
<input type="submit" class="btn" name="proceed_to_payment" id="proceed_to_payment" value="Proceed to Payment" disabled></div>
</div>
</div>
</form>
</div>
</section>
</main>
<!--==========================
Footer
============================-->
<footer id="footer" class="section-bg">
<div class="footer-top">
<div class="container">
<div class="row">
<div class="col-lg-12">
<div class="footer-newsletter">
<h2 class="pb-3">NEWSLETTER</h2>
<form action="index.html" method="post" class="newsletterForm">
<div class="form-group">
<input type="text" class="form-control" id="newsletter_name" name="newsletter_name" placeholder="Your Name" data-validation="required length alphanumeric" data-validation-length="3-16" data-validation-error-msg="Please enter your name" />
<div class="validation"></div>
</div>
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<input type="email" class="form-control" name="newsletter_email" id="newsletter_email" placeholder="Your Email" data-rule="email" data-validation="required email" data-validation-error-msg="Please enter a valid email" />
<div class="validation"></div>
</div>
<div id="sendmessage">Your message has been sent. Thank you!</div>
<input type="submit" class="form-control" value="Subscribe">
</form>
</div>
</div>
</div>
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<div class="col-lg-3 col-md-12 col-sm-12 col-xs-12">
<div class="footer-info"> <img src="img/logo_white.png" alt="Insuredoo,The Easiest Way To Insure" class="img-fluid">
<p>Why I say old chap that is sping lavatory chip shop gosh off his, smashing boot are you taking the piss posh loo brilliant matie boy young.!!</p>
</div>
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<div class="footer-links">
<ul>
<li><a href="motor.html">Motor Insurance</a></li>
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<div class="twitter-item"> BrandtWaldemar An awesome end to a great year. Congrats & happy 2020 <br>
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January 04, 2020</span> </div>
<div class="twitter-item"> BrandtWaldemar An awesome end to a great year. Congrats & happy 2020 <br>
<span>Unsplash<br>
January 04, 2020</span> </div>
<div class="twitter-item"> BrandtWaldemar An awesome end to a great year. Congrats & happy 2020 <br>
<span>Unsplash<br>
January 04, 2020</span> </div>
<div class="twitter-item"> BrandtWaldemar An awesome end to a great year. Congrats & happy 2020 <br>
<span>Unsplash<br>
January 04, 2020</span> </div>
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