169 lines
8.6 KiB
PHP
169 lines
8.6 KiB
PHP
<?php
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session_start();
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if (!isset($_SESSION['personal_details'])) {
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header('Location: subscribe.php');
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exit;
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}
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if ($_SERVER['REQUEST_METHOD'] === 'POST') {
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$_SESSION['insurance_details'] = [
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'insuranceType' => filter_input(INPUT_POST, 'insuranceType', FILTER_SANITIZE_STRING),
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'carMake' => filter_input(INPUT_POST, 'carMake', FILTER_SANITIZE_STRING),
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'carModel' => filter_input(INPUT_POST, 'carModel', FILTER_SANITIZE_STRING),
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'carYear' => filter_input(INPUT_POST, 'carYear', FILTER_SANITIZE_STRING),
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'healthDependents' => filter_input(INPUT_POST, 'healthDependents', FILTER_SANITIZE_NUMBER_INT),
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'lifeCoverage' => filter_input(INPUT_POST, 'lifeCoverage', FILTER_SANITIZE_NUMBER_FLOAT, FILTER_FLAG_ALLOW_FRACTION),
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'homeType' => filter_input(INPUT_POST, 'homeType', FILTER_SANITIZE_STRING),
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];
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header('Location: subscribe-step3.php');
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exit;
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}
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$car_data = require __DIR__ . '/config/car_data.php';
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?>
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<!DOCTYPE html>
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<html lang="en">
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<head>
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<meta charset="UTF-8">
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<meta name="viewport" content="width=device-width, initial-scale=1.0">
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<title>Subscribe - SecureLife</title>
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<link href="https://cdn.jsdelivr.net/npm/bootstrap@5.3.2/dist/css/bootstrap.min.css" rel="stylesheet">
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<link rel="stylesheet" href="https://cdn.jsdelivr.net/npm/bootstrap-icons@1.11.3/font/bootstrap-icons.css">
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<link rel="preconnect" href="https://fonts.googleapis.com">
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<link rel="preconnect" href="https://fonts.gstatic.com" crossorigin>
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<link href="https://fonts.googleapis.com/css2?family=Inter:wght@400;500;700&display=swap" rel="stylesheet">
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<link rel="stylesheet" href="assets/css/custom.css?v=<?php echo time(); ?>">
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</head>
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<body>
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<header class="navbar navbar-expand-lg navbar-light bg-white shadow-sm">
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<div class="container">
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<a class="navbar-brand" href="index.php">SecureLife</a>
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</div>
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</header>
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<main class="container my-5">
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<div class="row justify-content-center">
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<div class="col-lg-8">
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<div class="card shadow-sm border-0" style="border-radius: 0.75rem;">
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<div class="card-body p-5">
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<h1 class="card-title text-center mb-2 fw-bold">Choose Your Coverage</h1>
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<p class="text-center text-muted mb-5">Step 2: Select your insurance plan and details</p>
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<form action="subscribe-step2.php" method="POST">
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<div class="mb-4">
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<label for="insuranceType" class="form-label fs-5">Insurance Type</label>
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<select class="form-select form-select-lg" id="insuranceType" name="insuranceType" required>
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<option value="" selected disabled>-- Select an insurance type --</option>
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<option value="Car">Car Insurance</option>
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<option value="Health">Health Insurance</option>
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<option value="Life">Life Insurance</option>
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<option value="Home">Home Insurance</option>
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</select>
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</div>
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<div id="carFields" class="dynamic-fields d-none border-top pt-4 mt-4">
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<div class="mb-3">
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<label for="carMake" class="form-label">Car Make</label>
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<select class="form-select" id="carMake" name="carMake">
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<option value="" selected disabled>-- Select Make --</option>
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<?php foreach (array_keys($car_data) as $make): ?>
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<option value="<?php echo $make; ?>"><?php echo $make; ?></option>
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<?php endforeach; ?>
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</select>
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</div>
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<div class="mb-3">
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<label for="carModel" class="form-label">Car Model</label>
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<select class="form-select" id="carModel" name="carModel" disabled>
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<option value="" selected disabled>-- Select Model --</option>
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</select>
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</div>
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<div class="mb-3">
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<label for="carYear" class="form-label">Year of Manufacture</label>
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<input type="date" class="form-control" id="carYear" name="carYear">
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</div>
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</div>
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<div id="healthFields" class="dynamic-fields d-none border-top pt-4 mt-4">
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<div class="mb-3">
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<label for="healthDependents" class="form-label">Number of Dependents</label>
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<input type="number" class="form-control" id="healthDependents" name="healthDependents" placeholder="e.g., 2">
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</div>
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</div>
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<div id="lifeFields" class="dynamic-fields d-none border-top pt-4 mt-4">
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<div class="mb-3">
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<label for="lifeCoverage" class="form-label">Desired Coverage Amount ($)</label>
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<input type="number" class="form-control" id="lifeCoverage" name="lifeCoverage" step="1000" placeholder="e.g., 500000">
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</div>
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</div>
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<div id="homeFields" class="dynamic-fields d-none border-top pt-4 mt-4">
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<div class="mb-3">
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<label for="homeType" class="form-label">Property Type</label>
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<select class="form-select" id="homeType" name="homeType">
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<option value="House">House</option>
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<option value="Apartment">Apartment</option>
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<option value="Condo">Condo</option>
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</select>
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</div>
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</div>
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<div class="d-flex justify-content-between mt-5">
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<a href="subscribe.php" class="btn btn-secondary btn-lg">← Go Back</a>
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<button type="submit" class="btn btn-primary-modern btn-lg">Next Step →</button>
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</div>
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</form>
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</div>
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</div>
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</div>
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</div>
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</main>
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<footer class="text-center py-4 mt-auto bg-dark text-white">
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<p class="mb-0">© <?php echo date("Y"); ?> SecureLife. All Rights Reserved.</p>
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</footer>
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<script src="https://cdn.jsdelivr.net/npm/bootstrap@5.3.2/dist/js/bootstrap.bundle.min.js"></script>
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<script>
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const carData = <?php echo json_encode($car_data); ?>;
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document.getElementById('insuranceType').addEventListener('change', function () {
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document.querySelectorAll('.dynamic-fields').forEach(function (el) {
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el.classList.add('d-none');
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});
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var selectedType = this.value;
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if (selectedType) {
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var fieldsetId = selectedType.toLowerCase() + 'Fields';
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var fieldset = document.getElementById(fieldsetId);
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if (fieldset) {
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fieldset.classList.remove('d-none');
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}
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}
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});
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document.getElementById('carMake').addEventListener('change', function() {
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const carModelSelect = document.getElementById('carModel');
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const selectedMake = this.value;
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// Clear existing options
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carModelSelect.innerHTML = '<option value="" selected disabled>-- Select Model --</option>';
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if (selectedMake && carData[selectedMake]) {
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carModelSelect.disabled = false;
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carData[selectedMake].forEach(function(model) {
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const option = document.createElement('option');
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option.value = model;
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option.textContent = model;
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carModelSelect.appendChild(option);
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});
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} else {
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carModelSelect.disabled = true;
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}
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});
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</script>
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</body>
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</html>
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