{"id":3539,"date":"2020-10-08T10:43:10","date_gmt":"2020-10-08T10:43:10","guid":{"rendered":"https:\/\/dunach.com\/index_beta.php?page_id=3539"},"modified":"2024-12-04T11:47:52","modified_gmt":"2024-12-04T09:47:52","slug":"comunicacio-sinistre","status":"publish","type":"page","link":"https:\/\/dunach.com\/index_beta.php\/comunicacio-sinistre\/","title":{"rendered":"Comunicaci\u00f3 de sinistre"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"3539\" class=\"elementor elementor-3539\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d70cb83 elementor-section-full_width elementor-section-height-min-height elementor-section-height-default elementor-section-items-middle\" data-id=\"d70cb83\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;background_motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;background_motion_fx_translateY_effect&quot;:&quot;yes&quot;,&quot;background_motion_fx_translateY_direction&quot;:&quot;negative&quot;,&quot;background_motion_fx_translateY_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:4,&quot;sizes&quot;:[]},&quot;background_motion_fx_translateY_affectedRange&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:0,&quot;end&quot;:100}},&quot;background_motion_fx_devices&quot;:[&quot;desktop&quot;,&quot;tablet&quot;,&quot;mobile&quot;]}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6fedc89\" data-id=\"6fedc89\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-bcf806b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"bcf806b\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-8d02bcc\" data-id=\"8d02bcc\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2b8bad5 elementor-widget elementor-widget-heading\" data-id=\"2b8bad5\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Comunicaci\u00f3 de sinistres\n\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c0511c2 elementor-widget elementor-widget-text-editor\" data-id=\"c0511c2\" 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\t\t<h3><strong>Millor el m\u00e9s pr\u00f2xim: el mediador<\/strong><\/h3><p>En cas de sinistre, mantingui el cap fred.<\/p><p>Empri tots els mitjans al seu abast per a minorar les conseq\u00fc\u00e8ncies de la conting\u00e8ncia. Per exemple, tancar la clau de l&#8217;aigua o intentar sufocar l&#8217;incendi, sempre que no es corri risc personal.<\/p><p>Cal fer la declaraci\u00f3 de sinistre a l&#8217;asseguran\u00e7a en un termini m\u00e0xim de set dies des del coneixement del sinistre, tret que la p\u00f2lissa prevegi un termini m\u00e9s ampli.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3ecdd02 elementor-widget elementor-widget-heading\" data-id=\"3ecdd02\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Ompli aquest formulari i ens posarem en contacte amb vost\u00e8.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-e9f96d8\" data-id=\"e9f96d8\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-ebe0b90 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"ebe0b90\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-dc76175\" data-id=\"dc76175\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ff21b5c elementor-widget elementor-widget-breadcrumbs\" data-id=\"ff21b5c\" data-element_type=\"widget\" data-widget_type=\"breadcrumbs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p id=\"breadcrumbs\"><span><span><a href=\"https:\/\/dunach.com\/index_beta.php\">Inici<\/a><\/span><\/span><\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-18d90fe elementor-widget elementor-widget-shortcode\" data-id=\"18d90fe\" 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\t\t<div class=\"elementor-shortcode\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-19324 forminator-design--default  \" data-forminator-render=\"0\" data-form=\"forminator-module-19324\" data-uid=\"6ac8d6e1f0637\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-19324\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-19324 forminator-design--default  \"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"19324\"\n\t\t\t\tenctype=\"multipart\/form-data\" data-color-option=\"default\" data-design=\"default\" data-grid=\"open\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"6ac8d6e1f0637\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div role=\"tablist\" class=\"forminator-pagination-steps\" aria-label=\"Pagination\"><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-19324--page-0\"\n\t\t\t\tclass=\"forminator-pagination forminator-pagination-start\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-19324--page-0-label\"\n\t\t\t\tdata-step=\"0\"\n\t\t\t\tdata-label=\"CONTACTE\"\n\t\t\t\tdata-actual-label=\"DADES\"\n\t\t\t\tdata-name=\"page-break-1\"\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_6ac8d6e1f0637\" id=\"forminator-field-text-1_6ac8d6e1f0637-label\" class=\"forminator-label\">Nom i Cognoms: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"\" id=\"forminator-field-text-1_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-24\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-24_6ac8d6e1f0637\" id=\"forminator-field-text-24_6ac8d6e1f0637-label\" class=\"forminator-label\">NIF\/CIF\/NIE: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-24\" value=\"\" placeholder=\"\" id=\"forminator-field-text-24_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"1\" maxlength=\"9\" \/><span id=\"forminator-field-text-24_6ac8d6e1f0637-description\" class=\"forminator-description\"><span data-limit=\"9\" data-type=\"characters\">0 \/ 9<\/span><\/span><\/div><\/div><\/div><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_6ac8d6e1f0637\" id=\"forminator-field-text-2_6ac8d6e1f0637-label\" class=\"forminator-label\">Adre\u00e7a: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"\" id=\"forminator-field-text-2_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-3\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-3_6ac8d6e1f0637\" id=\"forminator-field-text-3_6ac8d6e1f0637-label\" class=\"forminator-label\">Codi Postal: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"\" id=\"forminator-field-text-3_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"1\" maxlength=\"5\" \/><span id=\"forminator-field-text-3_6ac8d6e1f0637-description\" class=\"forminator-description\"><span data-limit=\"5\" data-type=\"characters\">0 \/ 5<\/span><\/span><\/div><\/div><div id=\"text-4\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-4_6ac8d6e1f0637\" id=\"forminator-field-text-4_6ac8d6e1f0637-label\" class=\"forminator-label\">Poblaci\u00f3:<\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"\" id=\"forminator-field-text-4_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_6ac8d6e1f0637\" id=\"forminator-field-phone-1_6ac8d6e1f0637-label\" class=\"forminator-label\">Tel\u00e8fon: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-1_6ac8d6e1f0637\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" data-national_mode=\"disabled\" data-country=\"es\" data-validation=\"international\" \/><\/div><\/div><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6ac8d6e1f0637\" id=\"forminator-field-email-1_6ac8d6e1f0637-label\" class=\"forminator-label\">E-MAIL: <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"\" id=\"forminator-field-email-1_6ac8d6e1f0637\" class=\"forminator-input forminator-email--field\" data-required=\"1\" aria-required=\"true\" autocomplete=\"email\" \/><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-19324--page-1\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-19324--page-1-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"1\"\n\t\t\t\tdata-label=\"DADES\"\n\t\t\t\tdata-actual-label=\"SINISTRE\"\n\t\t\t\tdata-name=\"page-break-2\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"radio-8\" class=\"forminator-field-radio forminator-col forminator-col-12  races\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-8-6ac8d6e1f0637-label\"><span id=\"forminator-radiogroup-radio-8-6ac8d6e1f0637-label\" class=\"forminator-label\">TIPUS D&#039;ASSEGURAN\u00c7A:<\/span><label id=\"forminator-field-radio-8-label-1\" for=\"forminator-field-radio-8-1-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Embarcacions\"><input type=\"radio\" name=\"radio-8\" value=\"one\" id=\"forminator-field-radio-8-1-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Embarcacions<\/span><\/label><label id=\"forminator-field-radio-8-label-2\" for=\"forminator-field-radio-8-2-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Llar\"><input type=\"radio\" name=\"radio-8\" value=\"two\" id=\"forminator-field-radio-8-2-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Llar<\/span><\/label><label id=\"forminator-field-radio-8-label-3\" for=\"forminator-field-radio-8-3-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Negoci\"><input type=\"radio\" name=\"radio-8\" value=\"Negocio\" id=\"forminator-field-radio-8-3-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Negoci<\/span><\/label><label id=\"forminator-field-radio-8-label-4\" for=\"forminator-field-radio-8-4-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Personal\"><input type=\"radio\" name=\"radio-8\" value=\"Personal\" id=\"forminator-field-radio-8-4-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-4\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Personal<\/span><\/label><label id=\"forminator-field-radio-8-label-5\" for=\"forminator-field-radio-8-5-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Vehicles\"><input type=\"radio\" name=\"radio-8\" value=\"Veh\u00edculos\" id=\"forminator-field-radio-8-5-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-5\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Vehicles<\/span><\/label><label id=\"forminator-field-radio-8-label-6\" for=\"forminator-field-radio-8-6-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Responsabilitat civil\"><input type=\"radio\" name=\"radio-8\" value=\"Responsabilidad-civil\" id=\"forminator-field-radio-8-6-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-6\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Responsabilitat civil<\/span><\/label><label id=\"forminator-field-radio-8-label-7\" for=\"forminator-field-radio-8-7-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Comunitats\"><input type=\"radio\" name=\"radio-8\" value=\"Comunidades\" id=\"forminator-field-radio-8-7-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-7\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Comunitats<\/span><\/label><label id=\"forminator-field-radio-8-label-8\" for=\"forminator-field-radio-8-8-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Transports\"><input type=\"radio\" name=\"radio-8\" value=\"Transportes\" id=\"forminator-field-radio-8-8-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-8\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Transports<\/span><\/label><label id=\"forminator-field-radio-8-label-9\" for=\"forminator-field-radio-8-9-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Defensa jur\u00eddica\"><input type=\"radio\" name=\"radio-8\" value=\"Defensa-jur\u00eddica\" id=\"forminator-field-radio-8-9-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-9\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Defensa jur\u00eddica<\/span><\/label><label id=\"forminator-field-radio-8-label-10\" for=\"forminator-field-radio-8-10-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Animals\"><input type=\"radio\" name=\"radio-8\" value=\"Animales\" id=\"forminator-field-radio-8-10-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-10\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Animals<\/span><\/label><label id=\"forminator-field-radio-8-label-11\" for=\"forminator-field-radio-8-11-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Assist\u00e8ncia en viatge\"><input type=\"radio\" name=\"radio-8\" value=\"Asistencia-en-viaje\" id=\"forminator-field-radio-8-11-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-11\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Assist\u00e8ncia en viatge<\/span><\/label><label id=\"forminator-field-radio-8-label-12\" for=\"forminator-field-radio-8-12-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Activitats de construcci\u00f3 i muntatge\"><input type=\"radio\" name=\"radio-8\" value=\"Actividades-de-construcci\u00f3n-y-montaje\" id=\"forminator-field-radio-8-12-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-12\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Activitats de construcci\u00f3 i muntatge<\/span><\/label><label id=\"forminator-field-radio-8-label-13\" for=\"forminator-field-radio-8-13-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Activitats a l&#039;aire lliure\"><input type=\"radio\" name=\"radio-8\" value=\"Actividades-al-aire-libre\" id=\"forminator-field-radio-8-13-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-13\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Activitats a l'aire lliure<\/span><\/label><label id=\"forminator-field-radio-8-label-14\" for=\"forminator-field-radio-8-14-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Reparadors navals\"><input type=\"radio\" name=\"radio-8\" value=\"Reparadores-navales\" id=\"forminator-field-radio-8-14-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-8-label-14\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Reparadors navals<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-7\" class=\"forminator-field-text forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-7_6ac8d6e1f0637\" id=\"forminator-field-text-7_6ac8d6e1f0637-label\" class=\"forminator-label\">Dia del sinistre: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-7\" value=\"\" placeholder=\"\" id=\"forminator-field-text-7_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"1\" maxlength=\"10\" aria-describedby=\"forminator-field-text-7_6ac8d6e1f0637-description\" \/><span id=\"forminator-field-text-7_6ac8d6e1f0637-description\" class=\"forminator-description\">DD\/MM\/AAAA<span data-limit=\"10\" data-type=\"characters\">0 \/ 10<\/span><\/span><\/div><\/div><div id=\"text-8\" class=\"forminator-field-text forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-8_6ac8d6e1f0637\" id=\"forminator-field-text-8_6ac8d6e1f0637-label\" class=\"forminator-label\">Hora:<\/label><input type=\"text\" name=\"text-8\" value=\"\" placeholder=\"\" id=\"forminator-field-text-8_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" maxlength=\"5\" \/><span id=\"forminator-field-text-8_6ac8d6e1f0637-description\" class=\"forminator-description\"><span data-limit=\"5\" data-type=\"characters\">0 \/ 5<\/span><\/span><\/div><\/div><div id=\"text-9\" class=\"forminator-field-text forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-9_6ac8d6e1f0637\" id=\"forminator-field-text-9_6ac8d6e1f0637-label\" class=\"forminator-label\">Lloc: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-9\" value=\"\" placeholder=\"\" id=\"forminator-field-text-9_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-5\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-5_6ac8d6e1f0637\" id=\"forminator-field-text-5_6ac8d6e1f0637-label\" class=\"forminator-label\">Asseguradora:<\/label><input type=\"text\" name=\"text-5\" value=\"\" placeholder=\"\" id=\"forminator-field-text-5_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-6\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-6_6ac8d6e1f0637\" id=\"forminator-field-text-6_6ac8d6e1f0637-label\" class=\"forminator-label\">N\u00fam. de p\u00f2lissa:<\/label><input type=\"text\" name=\"text-6\" value=\"\" placeholder=\"\" id=\"forminator-field-text-6_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-9\" class=\"forminator-field-radio forminator-col forminator-col-12  races\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-9-6ac8d6e1f0637-label\"><span id=\"forminator-radiogroup-radio-9-6ac8d6e1f0637-label\" class=\"forminator-label\">Causa del dany:<\/span><label id=\"forminator-field-radio-9-label-1\" for=\"forminator-field-radio-9-1-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Incendi\"><input type=\"radio\" name=\"radio-9\" value=\"one\" id=\"forminator-field-radio-9-1-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-9-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Incendi<\/span><\/label><label id=\"forminator-field-radio-9-label-2\" for=\"forminator-field-radio-9-2-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Aigua\"><input type=\"radio\" name=\"radio-9\" value=\"two\" id=\"forminator-field-radio-9-2-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-9-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Aigua<\/span><\/label><label id=\"forminator-field-radio-9-label-3\" for=\"forminator-field-radio-9-3-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Vandalisme\"><input type=\"radio\" name=\"radio-9\" value=\"Vandalisme\" id=\"forminator-field-radio-9-3-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-9-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Vandalisme<\/span><\/label><label id=\"forminator-field-radio-9-label-4\" for=\"forminator-field-radio-9-4-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Robatori\"><input type=\"radio\" name=\"radio-9\" value=\"Robatori\" id=\"forminator-field-radio-9-4-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-9-label-4\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Robatori<\/span><\/label><label id=\"forminator-field-radio-9-label-5\" for=\"forminator-field-radio-9-5-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Danys el\u00e8ctrics\"><input type=\"radio\" name=\"radio-9\" value=\"Danys-el\u00e8ctrics\" id=\"forminator-field-radio-9-5-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-9-label-5\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Danys el\u00e8ctrics<\/span><\/label><label id=\"forminator-field-radio-9-label-6\" for=\"forminator-field-radio-9-6-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Rotura vidres\"><input type=\"radio\" name=\"radio-9\" value=\"Rotura-vidres\" id=\"forminator-field-radio-9-6-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-9-label-6\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Rotura vidres<\/span><\/label><label id=\"forminator-field-radio-9-label-7\" for=\"forminator-field-radio-9-7-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Fen\u00f2mens atmosf\u00e8rics\"><input type=\"radio\" name=\"radio-9\" value=\"Fen\u00f2mens-atmosf\u00e8rics\" id=\"forminator-field-radio-9-7-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-9-label-7\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Fen\u00f2mens atmosf\u00e8rics<\/span><\/label><label id=\"forminator-field-radio-9-label-8\" for=\"forminator-field-radio-9-8-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Responsabilitat civil\"><input type=\"radio\" name=\"radio-9\" value=\"Responsabilitat-civil\" id=\"forminator-field-radio-9-8-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-9-label-8\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Responsabilitat civil<\/span><\/label><label id=\"forminator-field-radio-9-label-9\" for=\"forminator-field-radio-9-9-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Col\u00b7lisi\u00f3\"><input type=\"radio\" name=\"radio-9\" value=\"Colisi\u00f3\" id=\"forminator-field-radio-9-9-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-9-label-9\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Col\u00b7lisi\u00f3<\/span><\/label><label id=\"forminator-field-radio-9-label-10\" for=\"forminator-field-radio-9-10-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"Altres causes\"><input type=\"radio\" name=\"radio-9\" value=\"Altres-causes\" id=\"forminator-field-radio-9-10-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-9-label-10\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Altres causes<\/span><\/label><\/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_6ac8d6e1f0637\" id=\"forminator-field-textarea-1_6ac8d6e1f0637-label\" class=\"forminator-label\">Descripci\u00f3 altres causes:<\/label><textarea name=\"textarea-1\" placeholder=\"\" id=\"forminator-field-textarea-1_6ac8d6e1f0637\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-2\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">Relaci\u00f3 d&#039;elements afectats:<\/label><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Afegir aparell&quot;,&quot;remove_text&quot;:&quot;Eliminar aparell&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"text-17\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-17_6ac8d6e1f0637\" id=\"forminator-field-text-17_6ac8d6e1f0637-label\" class=\"forminator-label\">Aparell afectat<\/label><input type=\"text\" name=\"text-17\" value=\"\" placeholder=\"\" id=\"forminator-field-text-17_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"number-1\" class=\"forminator-field-number forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-number-1_6ac8d6e1f0637\" id=\"forminator-field-number-1_6ac8d6e1f0637-label\" class=\"forminator-label\">Any antig\u00fcetat<\/label><input name=\"number-1\" value=\"\" placeholder=\"\" id=\"forminator-field-number-1_6ac8d6e1f0637\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"\" data-decimals=\"0\" aria-required=\"false\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;.&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" data-hidden-behavior=\"zero\" \/><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Afegir aparell\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Eliminar aparell\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-1\" class=\"forminator-field-upload forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-1_6ac8d6e1f0637\" id=\"forminator-field-upload-1_6ac8d6e1f0637-label\" class=\"forminator-label\">Adjuntar c\u00f2pia de den\u00fancia davant les autoritats: <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-file-upload \" data-element=\"upload-1_6ac8d6e1f0637\"><input type=\"file\" name=\"upload-1\" id=\"forminator-field-upload-1_6ac8d6e1f0637\" class=\"forminator-input-file-required do-validate\" accept=\".jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.webp,.avif,.heic,.doc,.docx,.odt,.pages,.pdf,image\/jpeg,image\/gif,image\/png,image\/bmp,image\/tiff,image\/webp,image\/avif,image\/heic,application\/msword,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.oasis.opendocument.text,application\/vnd.apple.pages,application\/pdf\" tabindex=\"-1\"><button id=\"forminator-field-upload-1_6ac8d6e1f0637_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-1_6ac8d6e1f0637\">Escolliu fitxer<\/button><span data-empty-text=\"Cap fitxer escollit\">Cap fitxer escollit<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-10\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-10_6ac8d6e1f0637\" id=\"forminator-field-text-10_6ac8d6e1f0637-label\" class=\"forminator-label\">Conductor\/pilot:<\/label><input type=\"text\" name=\"text-10\" value=\"\" placeholder=\"\" id=\"forminator-field-text-10_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" aria-describedby=\"forminator-field-text-10_6ac8d6e1f0637-description\" \/><span id=\"forminator-field-text-10_6ac8d6e1f0637-description\" class=\"forminator-description\">(nom i cognoms)<\/span><\/div><\/div><div id=\"phone-2\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-2_6ac8d6e1f0637\" id=\"forminator-field-phone-2_6ac8d6e1f0637-label\" class=\"forminator-label\">Tel\u00e8fon:<\/label><input type=\"text\" name=\"phone-2\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-2_6ac8d6e1f0637\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" data-national_mode=\"disabled\" data-country=\"es\" data-validation=\"international\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-12\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-12_6ac8d6e1f0637\" id=\"forminator-field-text-12_6ac8d6e1f0637-label\" class=\"forminator-label\">Data de naixement:<\/label><input type=\"text\" name=\"text-12\" value=\"\" placeholder=\"\" id=\"forminator-field-text-12_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-11\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-11_6ac8d6e1f0637\" id=\"forminator-field-text-11_6ac8d6e1f0637-label\" class=\"forminator-label\">Data del perm\u00eds o t\u00edtol:<\/label><input type=\"text\" name=\"text-11\" value=\"\" placeholder=\"\" id=\"forminator-field-text-11_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/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_6ac8d6e1f0637\" id=\"forminator-field-textarea-2_6ac8d6e1f0637-label\" class=\"forminator-label\">Versi\u00f3 i circumst\u00e0ncies dels fets: <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-2\" placeholder=\"\" id=\"forminator-field-textarea-2_6ac8d6e1f0637\" class=\"forminator-textarea\" style=\"--forminator-textarea-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_6ac8d6e1f0637\" id=\"forminator-field-textarea-3_6ac8d6e1f0637-label\" class=\"forminator-label\">CLASSE DE DANYS (MATERIALS I PERSONALS) APRECIATS CAUSATS\/ SOFERTS I VALORACI\u00d3 aproximada DELS B\u00c9NS: <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-3\" placeholder=\"\" id=\"forminator-field-textarea-3_6ac8d6e1f0637\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" aria-describedby=\"forminator-field-textarea-3_6ac8d6e1f0637-description\" ><\/textarea><span id=\"forminator-field-textarea-3_6ac8d6e1f0637-description\" class=\"forminator-description\">RECOMANEM TREURE FOTOS DELS DANYS<\/span><\/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-radio-6-6ac8d6e1f0637-label\"><span id=\"forminator-radiogroup-radio-6-6ac8d6e1f0637-label\" class=\"forminator-label\">El causant dels danys \u00e9s un tercer?: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-6-label-1\" for=\"forminator-field-radio-6-1-6ac8d6e1f0637\" class=\"forminator-radio forminator-radio-inline\" title=\"S\u00ed\"><input type=\"radio\" name=\"radio-6\" value=\"one\" id=\"forminator-field-radio-6-1-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-6-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">S\u00ed<\/span><\/label><label id=\"forminator-field-radio-6-label-2\" for=\"forminator-field-radio-6-2-6ac8d6e1f0637\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-6\" value=\"two\" id=\"forminator-field-radio-6-2-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-6-label-2\" data-calculation=\"0\" checked=\"checked\" \/><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-4\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-4_6ac8d6e1f0637\" id=\"forminator-field-textarea-4_6ac8d6e1f0637-label\" class=\"forminator-label\">Dades del tercer causant: <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-4\" placeholder=\"\" id=\"forminator-field-textarea-4_6ac8d6e1f0637\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" aria-describedby=\"forminator-field-textarea-4_6ac8d6e1f0637-description\" ><\/textarea><span id=\"forminator-field-textarea-4_6ac8d6e1f0637-description\" class=\"forminator-description\">DADES DE L'ADVERS: NOM I COGNOMS, NIF,  DOMICILI, MATR\u00cdCULA, ETC., DADES ASSEGURADORA ADVERSA, DESCRIPCI\u00d3 DANYS ADVERS, DADES CONDUCTOR\/PILOT<\/span><\/div><\/div><\/div><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-radio-7-6ac8d6e1f0637-label\"><span id=\"forminator-radiogroup-radio-7-6ac8d6e1f0637-label\" class=\"forminator-label\">Vost\u00e8 ha causat danys a un tercer?: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-7-label-1\" for=\"forminator-field-radio-7-1-6ac8d6e1f0637\" class=\"forminator-radio forminator-radio-inline\" title=\"S\u00ed\"><input type=\"radio\" name=\"radio-7\" value=\"one\" id=\"forminator-field-radio-7-1-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-7-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">S\u00ed<\/span><\/label><label id=\"forminator-field-radio-7-label-2\" for=\"forminator-field-radio-7-2-6ac8d6e1f0637\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-7\" value=\"two\" id=\"forminator-field-radio-7-2-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-7-label-2\" data-calculation=\"0\" checked=\"checked\" \/><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-8\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-8_6ac8d6e1f0637\" id=\"forminator-field-textarea-8_6ac8d6e1f0637-label\" class=\"forminator-label\">DADES DELS TERCERS PERJUDICATS: <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-8\" placeholder=\"\" id=\"forminator-field-textarea-8_6ac8d6e1f0637\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" aria-describedby=\"forminator-field-textarea-8_6ac8d6e1f0637-description\" ><\/textarea><span id=\"forminator-field-textarea-8_6ac8d6e1f0637-description\" class=\"forminator-description\">DADES DEL TERCER PERJUDICAT: NOM I COGNOMS, NIF,  DOMICILI, MATR\u00cdCULA, ETC., DADES ASSEGURADORA TERCER PERJUDICAT, DESCRIPCI\u00d3 DANYS TERCER PERJUDICAT, DADES CONDUCTOR\/PILOT<\/span><\/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_6ac8d6e1f0637\" id=\"forminator-field-text-18_6ac8d6e1f0637-label\" class=\"forminator-label\">parentiu amb l&#039; assegurat i edat aproximada:<\/label><input type=\"text\" name=\"text-18\" value=\"\" placeholder=\"\" id=\"forminator-field-text-18_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><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-radio-2-6ac8d6e1f0637-label\"><span id=\"forminator-radiogroup-radio-2-6ac8d6e1f0637-label\" class=\"forminator-label\">LESIONATS: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-2-label-1\" for=\"forminator-field-radio-2-1-6ac8d6e1f0637\" class=\"forminator-radio forminator-radio-inline\" title=\"S\u00ed\"><input type=\"radio\" name=\"radio-2\" value=\"one\" id=\"forminator-field-radio-2-1-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-2-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">S\u00ed<\/span><\/label><label id=\"forminator-field-radio-2-label-2\" for=\"forminator-field-radio-2-2-6ac8d6e1f0637\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-2\" value=\"two\" id=\"forminator-field-radio-2-2-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-2-label-2\" data-calculation=\"0\" checked=\"checked\" \/><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=\"group-1\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">Dades lesionats:<\/label><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Afegir lesionat&quot;,&quot;remove_text&quot;:&quot;Eliminar lesionat&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"text-13\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-13_6ac8d6e1f0637\" id=\"forminator-field-text-13_6ac8d6e1f0637-label\" class=\"forminator-label\">Nom i Cognoms: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-13\" value=\"\" placeholder=\"\" id=\"forminator-field-text-13_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-30\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-30_6ac8d6e1f0637\" id=\"forminator-field-text-30_6ac8d6e1f0637-label\" class=\"forminator-label\">NIF\/NIE:<\/label><input type=\"text\" name=\"text-30\" value=\"\" placeholder=\"\" id=\"forminator-field-text-30_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" maxlength=\"12\" \/><span id=\"forminator-field-text-30_6ac8d6e1f0637-description\" class=\"forminator-description\"><span data-limit=\"12\" data-type=\"characters\">0 \/ 12<\/span><\/span><\/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_6ac8d6e1f0637\" id=\"forminator-field-text-16_6ac8d6e1f0637-label\" class=\"forminator-label\">Adre\u00e7a: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-16\" value=\"\" placeholder=\"\" id=\"forminator-field-text-16_6ac8d6e1f0637\" 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-6  codipostal\"><div class=\"forminator-field\"><label for=\"forminator-field-text-14_6ac8d6e1f0637\" id=\"forminator-field-text-14_6ac8d6e1f0637-label\" class=\"forminator-label\">Codi Postal:<\/label><input type=\"text\" name=\"text-14\" value=\"\" placeholder=\"\" id=\"forminator-field-text-14_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" maxlength=\"5\" \/><span id=\"forminator-field-text-14_6ac8d6e1f0637-description\" class=\"forminator-description\"><span data-limit=\"5\" data-type=\"characters\">0 \/ 5<\/span><\/span><\/div><\/div><div id=\"text-15\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-15_6ac8d6e1f0637\" id=\"forminator-field-text-15_6ac8d6e1f0637-label\" class=\"forminator-label\">Poblaci\u00f3: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-15\" value=\"\" placeholder=\"\" id=\"forminator-field-text-15_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-3\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-3_6ac8d6e1f0637\" id=\"forminator-field-phone-3_6ac8d6e1f0637-label\" class=\"forminator-label\">Tel\u00e8fon: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-3\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-3_6ac8d6e1f0637\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" data-national_mode=\"disabled\" data-country=\"es\" data-validation=\"international\" \/><\/div><\/div><div id=\"email-2\" class=\"forminator-field-email forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-2_6ac8d6e1f0637\" id=\"forminator-field-email-2_6ac8d6e1f0637-label\" class=\"forminator-label\">E-mail:<\/label><input type=\"email\" name=\"email-2\" value=\"\" placeholder=\"\" id=\"forminator-field-email-2_6ac8d6e1f0637\" class=\"forminator-input forminator-email--field\" data-required=\"\" aria-required=\"false\" autocomplete=\"email\" \/><\/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_6ac8d6e1f0637\" id=\"forminator-field-textarea-5_6ac8d6e1f0637-label\" class=\"forminator-label\">TIPUS DE LESI\u00d3:<\/label><textarea name=\"textarea-5\" placeholder=\"\" id=\"forminator-field-textarea-5_6ac8d6e1f0637\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/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_6ac8d6e1f0637\" id=\"forminator-field-text-19_6ac8d6e1f0637-label\" class=\"forminator-label\">Assist\u00e8ncia m\u00e8dica que va intervenir:<\/label><input type=\"text\" name=\"text-19\" value=\"\" placeholder=\"\" id=\"forminator-field-text-19_6ac8d6e1f0637\" 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_6ac8d6e1f0637\" id=\"forminator-field-text-20_6ac8d6e1f0637-label\" class=\"forminator-label\">Mitj\u00e0 utilitzat per al trasllat del lesionat:<\/label><input type=\"text\" name=\"text-20\" value=\"\" placeholder=\"\" id=\"forminator-field-text-20_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-21\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-21_6ac8d6e1f0637\" id=\"forminator-field-text-21_6ac8d6e1f0637-label\" class=\"forminator-label\">Centre m\u00e8dic al qual va ser traslladat:<\/label><input type=\"text\" name=\"text-21\" value=\"\" placeholder=\"\" id=\"forminator-field-text-21_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Afegir lesionat\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Eliminar lesionat\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/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-radio-3-6ac8d6e1f0637-label\"><span id=\"forminator-radiogroup-radio-3-6ac8d6e1f0637-label\" class=\"forminator-label\">TESTIMONIS: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-3-label-1\" for=\"forminator-field-radio-3-1-6ac8d6e1f0637\" class=\"forminator-radio forminator-radio-inline\" title=\"Si\"><input type=\"radio\" name=\"radio-3\" value=\"one\" id=\"forminator-field-radio-3-1-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-3-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Si<\/span><\/label><label id=\"forminator-field-radio-3-label-2\" for=\"forminator-field-radio-3-2-6ac8d6e1f0637\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-3\" value=\"two\" id=\"forminator-field-radio-3-2-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-3-label-2\" data-calculation=\"0\" checked=\"checked\" \/><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=\"group-3\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">Dades testimonis:<\/label><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Afegir testimoni&quot;,&quot;remove_text&quot;:&quot;Eliminar testimoni&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"text-28\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-28_6ac8d6e1f0637\" id=\"forminator-field-text-28_6ac8d6e1f0637-label\" class=\"forminator-label\">Nom i Cognoms: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-28\" value=\"\" placeholder=\"\" id=\"forminator-field-text-28_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-29\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-29_6ac8d6e1f0637\" id=\"forminator-field-text-29_6ac8d6e1f0637-label\" class=\"forminator-label\">NIF\/NIE:<\/label><input type=\"text\" name=\"text-29\" value=\"\" placeholder=\"\" id=\"forminator-field-text-29_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" maxlength=\"12\" \/><span id=\"forminator-field-text-29_6ac8d6e1f0637-description\" class=\"forminator-description\"><span data-limit=\"12\" data-type=\"characters\">0 \/ 12<\/span><\/span><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-27\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-27_6ac8d6e1f0637\" id=\"forminator-field-text-27_6ac8d6e1f0637-label\" class=\"forminator-label\">Adre\u00e7a: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-27\" value=\"\" placeholder=\"\" id=\"forminator-field-text-27_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-25\" class=\"forminator-field-text forminator-col forminator-col-6  codipostal\"><div class=\"forminator-field\"><label for=\"forminator-field-text-25_6ac8d6e1f0637\" id=\"forminator-field-text-25_6ac8d6e1f0637-label\" class=\"forminator-label\">Codi Postal:<\/label><input type=\"text\" name=\"text-25\" value=\"\" placeholder=\"\" id=\"forminator-field-text-25_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" maxlength=\"5\" \/><span id=\"forminator-field-text-25_6ac8d6e1f0637-description\" class=\"forminator-description\"><span data-limit=\"5\" data-type=\"characters\">0 \/ 5<\/span><\/span><\/div><\/div><div id=\"text-26\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-26_6ac8d6e1f0637\" id=\"forminator-field-text-26_6ac8d6e1f0637-label\" class=\"forminator-label\">Poblaci\u00f3: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-26\" value=\"\" placeholder=\"\" id=\"forminator-field-text-26_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-4\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-4_6ac8d6e1f0637\" id=\"forminator-field-phone-4_6ac8d6e1f0637-label\" class=\"forminator-label\">Tel\u00e8fon: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-4\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-4_6ac8d6e1f0637\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" data-national_mode=\"disabled\" data-country=\"es\" data-validation=\"international\" \/><\/div><\/div><div id=\"email-3\" class=\"forminator-field-email forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-3_6ac8d6e1f0637\" id=\"forminator-field-email-3_6ac8d6e1f0637-label\" class=\"forminator-label\">E-mail:<\/label><input type=\"email\" name=\"email-3\" value=\"\" placeholder=\"\" id=\"forminator-field-email-3_6ac8d6e1f0637\" class=\"forminator-input forminator-email--field\" data-required=\"\" aria-required=\"false\" autocomplete=\"email\" \/><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Afegir testimoni\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Eliminar testimoni\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/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-radio-4-6ac8d6e1f0637-label\"><span id=\"forminator-radiogroup-radio-4-6ac8d6e1f0637-label\" class=\"forminator-label\">VA INTERVENIR L&#039; AUTORITAT: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-4-label-1\" for=\"forminator-field-radio-4-1-6ac8d6e1f0637\" class=\"forminator-radio forminator-radio-inline\" title=\"S\u00ed\"><input type=\"radio\" name=\"radio-4\" value=\"one\" id=\"forminator-field-radio-4-1-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-4-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">S\u00ed<\/span><\/label><label id=\"forminator-field-radio-4-label-2\" for=\"forminator-field-radio-4-2-6ac8d6e1f0637\" class=\"forminator-radio forminator-radio-inline\" title=\"No\"><input type=\"radio\" name=\"radio-4\" value=\"two\" id=\"forminator-field-radio-4-2-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-4-label-2\" data-calculation=\"0\" checked=\"checked\" \/><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-7\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-7_6ac8d6e1f0637\" id=\"forminator-field-textarea-7_6ac8d6e1f0637-label\" class=\"forminator-label\">AUTORITAT\/JUTJAT QUE VA INTERVENIR:<\/label><textarea name=\"textarea-7\" placeholder=\"\" id=\"forminator-field-textarea-7_6ac8d6e1f0637\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-22\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-22_6ac8d6e1f0637\" id=\"forminator-field-text-22_6ac8d6e1f0637-label\" class=\"forminator-label\">Lloc de reparaci\u00f3:<\/label><input type=\"text\" name=\"text-22\" value=\"\" placeholder=\"\" id=\"forminator-field-text-22_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-23\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-23_6ac8d6e1f0637\" id=\"forminator-field-text-23_6ac8d6e1f0637-label\" class=\"forminator-label\">Persona de contacte per a valoraci\u00f3 pericial:<\/label><input type=\"text\" name=\"text-23\" value=\"\" placeholder=\"\" id=\"forminator-field-text-23_6ac8d6e1f0637\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-2\" class=\"forminator-field-upload forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-2_6ac8d6e1f0637\" id=\"forminator-field-upload-2_6ac8d6e1f0637-label\" class=\"forminator-label\">Aportaci\u00f3 de documents:<\/label><div class=\"forminator-multi-upload \" data-element=\"upload-2_6ac8d6e1f0637\" aria-describedby=\"forminator-field-upload-2_6ac8d6e1f0637-description\"><input type=\"file\" name=\"upload-2[]\" id=\"forminator-field-upload-2_6ac8d6e1f0637\" class=\"forminator-input-file forminator-field-upload-2_6ac8d6e1f0637-19324\" multiple=\"multiple\" data-method=\"ajax\" data-limit=\"5\" data-limit-message=\"You can upload a maximum of 5 files.\" data-size=\"20971520\" data-size-message=\"Maximum file size allowed is 20 MB. \"><div class=\"forminator-multi-upload-message\" aria-hidden=\"true\"><span class=\"forminator-icon-upload\" aria-hidden=\"true\"><\/span><p>Arrosegar i llan\u00e7ar (o) <a class=\"forminator-upload-file--forminator-field-upload-2_6ac8d6e1f0637\" href=\"#\" onclick=\"return false;\">Escolliu fitxers<\/a><\/p><\/div><\/div><span id=\"forminator-field-upload-2_6ac8d6e1f0637-description\" class=\"forminator-description\">(FULL DE DEN\u00daNCIA, DE DECLARACI\u00d3 AMISTOSA D'ACCIDENTS, DECLARACI\u00d3 DE TESTIMONIS, ETC.)<\/span><ul class=\"forminator-uploaded-files upload-container-upload-2_6ac8d6e1f0637\"><\/ul><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-10\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-10_6ac8d6e1f0637\" id=\"forminator-field-textarea-10_6ac8d6e1f0637-label\" class=\"forminator-label\">OBSERVACIONS:<\/label><textarea name=\"textarea-10\" placeholder=\"\" id=\"forminator-field-textarea-10_6ac8d6e1f0637\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" aria-describedby=\"forminator-field-textarea-10_6ac8d6e1f0637-description\" ><\/textarea><span id=\"forminator-field-textarea-10_6ac8d6e1f0637-description\" class=\"forminator-description\">EXPOSI EL QUE CONSIDERI D' INTER\u00c8S AL CAS.<\/span><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-19324--page-2\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-19324--page-2-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"2\"\n\t\t\t\tdata-label=\"SINISTRE\"\n\t\t\t\tdata-actual-label=\"CONTACTE\"\n\t\t\t\tdata-name=\"\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"html-2\" class=\"forminator-field-html forminator-col forminator-col-12 \"><div class=\"forminator-field forminator-merge-tags\" data-field=\"html-2\"><ul style=\"color: #0081c6\">\n<li>COM A CORRED\u00daRIA GESTIONEM EL SINISTRE PER VOST\u00c8 AMB L' ASSEGURADORA<\/li>\n<li>CORRESPON A L'ASSEGURADORA:\n<ul>\n<li>L' AVALUACI\u00d3 DELS DANYS<\/li>\n<li>L' ENVIAMENT DE PERIT<\/li>\n<\/ul>\n<\/li>\n<li>DURADA: ESTEM SUPEDITATS ALS TEMPS I RAPIDESA DE L' ASSEGURADORA<\/li>\n<li>INCID\u00c8NCIES: ESTEM AL SEU COSTAT PER ASSISTIR-LO<\/li>\n<\/ul><\/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-radio-5-6ac8d6e1f0637-label\"><span id=\"forminator-radiogroup-radio-5-6ac8d6e1f0637-label\" class=\"forminator-label\">PER A QUALSEVOL ACLARIMENT CONTACTIN VIA: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-5-label-1\" for=\"forminator-field-radio-5-1-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"E-MAIL\"><input type=\"radio\" name=\"radio-5\" value=\"one\" id=\"forminator-field-radio-5-1-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-5-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">E-MAIL<\/span><\/label><label id=\"forminator-field-radio-5-label-2\" for=\"forminator-field-radio-5-2-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"TEL\u00c8FON\"><input type=\"radio\" name=\"radio-5\" value=\"two\" id=\"forminator-field-radio-5-2-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-5-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">TEL\u00c8FON<\/span><\/label><label id=\"forminator-field-radio-5-label-3\" for=\"forminator-field-radio-5-3-6ac8d6e1f0637\" class=\"forminator-radio\" title=\"CORREU POSTAL\"><input type=\"radio\" name=\"radio-5\" value=\"CORREU-POSTAL\" id=\"forminator-field-radio-5-3-6ac8d6e1f0637\" aria-labelledby=\"forminator-field-radio-5-label-3\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">CORREU POSTAL<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-1\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-1_6ac8d6e1f0637\" id=\"forminator-field-consent-1_6ac8d6e1f0637-label\" class=\"forminator-label\">Consento \/ Consentim: <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-1_6ac8d6e1f0637__label\" class=\"forminator-checkbox forminator-consent\"><input type=\"checkbox\" name=\"consent-1\" id=\"forminator-field-consent-1_6ac8d6e1f0637\" value=\"checked\" aria-labelledby=\"forminator-field-consent-1_6ac8d6e1f0637-label\" aria-describedby=\"forminator-field-consent-1_6ac8d6e1f0637__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-1_6ac8d6e1f0637__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>Confirmo que accepto la <a rel=\"noopener\" href=\"#link-popup\">pol\u00edtica de privacitat<\/a> d'aquest lloc web per que puguin respondre la meva sol\u00b7licitud.<\/p><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row forminator-hidden\"><div id=\"hidden-1\" class=\"forminator-field-hidden  forminator-col-12 \"><input type=\"hidden\" id=\"hidden-1_6ac8d6e1f0637\" name=\"hidden-1\" value=\"\" \/><\/div><\/div><div class=\"forminator-row forminator-hidden\"><div id=\"hidden-2\" class=\"forminator-field-hidden  forminator-col-12 \"><input type=\"hidden\" id=\"hidden-2_6ac8d6e1f0637\" name=\"hidden-2\" value=\"\" \/><\/div><\/div><\/div><button class=\"forminator-button forminator-pagination-submit\" style=\"display: none;\" disabled>Enviar missatge<\/button><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"32def6196d\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index_beta.php\/wp-json\/wp\/v2\/pages\/3539\" \/><input type=\"hidden\" name=\"form_id\" value=\"19324\"><input type=\"hidden\" name=\"page_id\" value=\"3539\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/dunach.com\/index_beta.php\/comunicacio-sinistre\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"forminator-multifile-hidden\" class=\"forminator-multifile-hidden\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-27b059b elementor-widget elementor-widget-html\" data-id=\"27b059b\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<script type=\"text\/javascript\">\r\nwindow.addEventListener(\"load\", function() {\r\nconst cobertura = document.getElementsByName(\"text-1\");;\r\nconst nif = document.getElementsByName(\"text-24\");\r\nconst addr = document.getElementsByName(\"text-2\");\r\nconst cp = document.getElementsByName(\"text-3\");\r\nconst pobl = document.getElementsByName(\"text-4\");\r\nconst phon = document.getElementsByName(\"phone-1\");\r\nconst ema = document.getElementsByName(\"email-1\");\r\n\r\n\/\/ alternative is to use \"change\" - explained below\r\ncobertura[0].addEventListener(\"keyup\", buttonState);\r\n\r\nfunction buttonState() {\r\n    if (cobertura[0].value.toLowerCase() === \"broker\") {\r\n        nif[0].value = \"12345678A\";\r\n        addr[0].value = \"C\/ Nou, 123\";\r\n        cp[0].value = 17487;\r\n        pobl[0].value =\"Empuriabrava\";\r\n        phon[0].value = \"+34972450430\";\r\n        ema[0].value = \"broker@dunach.com\";\r\n    }}});\r\n<\/script>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-b00e29f\" data-id=\"b00e29f\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d2658ba elementor-widget elementor-widget-template\" data-id=\"d2658ba\" data-element_type=\"widget\" data-settings=\"{&quot;sticky&quot;:&quot;top&quot;,&quot;sticky_offset&quot;:330,&quot;sticky_effects_offset&quot;:200,&quot;sticky_parent&quot;:&quot;yes&quot;,&quot;sticky_on&quot;:[&quot;desktop&quot;,&quot;tablet&quot;,&quot;mobile&quot;],&quot;sticky_anchor_link_offset&quot;:0}\" data-widget_type=\"template.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-template\">\n\t\t\t\t\t<div data-elementor-type=\"section\" data-elementor-id=\"1965\" class=\"elementor elementor-1965\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-b7952de franja-lateral-contacte elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"b7952de\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9e7b5e4\" data-id=\"9e7b5e4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-68ab834 elementor-widget elementor-widget-spacer\" data-id=\"68ab834\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c897f95 elementor-align-center elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"c897f95\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-comments\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">voleu contactar-nos?<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-471adda elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"471adda\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-17957a5\" data-id=\"17957a5\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-079f24a elementor-widget__width-auto elementor-widget elementor-widget-heading\" data-id=\"079f24a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-heading-title elementor-size-default\">Oficina Empuriabrava \/ <br>Castell\u00f3 d'Emp\u00faries<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1758c20 elementor-widget elementor-widget-spacer\" data-id=\"1758c20\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-735138c elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"735138c\" 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\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xs\" href=\"tel:972450430\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-phone-alt\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">972 45 04 30<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cb1510d elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"cb1510d\" 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\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xs\" href=\"mailto:broker@dunach.com\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-envelope\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">broker@dunach.com<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cc2fd95 elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"cc2fd95\" 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\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xs\" href=\"https:\/\/www.google.com\/maps\/dir\/\/Du\u00f1ach+S.A.+Corredoria+d&#039;Assegurances,+Carrer+de+Sant+Mor\u00ed,+14,+Bajo,+17487+Empuriabrava,+Girona\/@42.241695,3.0877434,13z\/data=!3m1!4b1!4m8!4m7!1m0!1m5!1m1!1s0x12ba61b0ce87c3e5:0xf5316c2e78113760!2m2!1d3.1228485!2d42.2417004\" target=\"_blank\" rel=\"nofollow\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-map-marker-alt\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Com arribar<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-405aaab elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"405aaab\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4210322\" data-id=\"4210322\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-089ca2b elementor-widget__width-auto elementor-widget elementor-widget-heading\" data-id=\"089ca2b\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-heading-title elementor-size-default\">Oficina roses<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ae99ddc elementor-widget elementor-widget-spacer\" data-id=\"ae99ddc\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-68abc79 elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"68abc79\" 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\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xs\" href=\"tel:972257322\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-phone-alt\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">972 25 73 22<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-39bac28 elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"39bac28\" 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\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xs\" href=\"mailto:broker@dunach.com\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-envelope\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">broker@dunach.com<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-313117e elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"313117e\" 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\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xs\" 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