// JavaScript Document
function check_claiminput()
{
	if(document.claimonline.title.value == '')
	{	
		alert("Please select a title.");
		document.claimonline.title.focus();
		return false;
	}
	if(document.claimonline.name.value == '')
	{	
		alert("Please enter your name.");
		document.claimonline.name.focus();
		return false;
	}
	if(document.claimonline.email.value == '')
	{	
		alert("Please enter your email.");
		document.claimonline.email.focus();
		return false;
	}
	if(document.claimonline.email.value != '')
	{	
		var x = document.claimonline.email.value;
		var filter  = /^([a-zA-Z0-9_\.\-])+\@(([a-zA-Z0-9\-])+\.)+([a-zA-Z]{2,4})+$/;
		if (filter.test(x)==false)
		{	
			alert("Email Id Is Not Valid.");
			document.claimonline.email.select();
			return false;
		}
	}
	
	if(document.claimonline.phone.value == '')
	{	
		alert("Please enter your phone number.");
		document.claimonline.phone.focus();
		return false;
	}
	if(document.claimonline.phone.value!='')
	{
		var x = document.claimonline.phone.value;
		var filter  = /^([0-9\-])+$/;
		if (filter.test(x)==false)
		{	
			alert("Please enter a valid number.");
			document.claimonline.phone.focus();
			return false;
		}
	}
	
	
	
	
	/*document.claimonline.mode.value="insert_claim";
	document.claimonline.submit();*/
	
	xmlHttp=GetXmlHttpObject1();
	if(xmlHttp==null)
	{	alert ("Your browser does not support AJAX!"); 	
		return;    	
	}
	var title 		=  document.claimonline.title.value;
	var name 		=  document.claimonline.name.value;
	var surname		=  document.claimonline.surname.value;
	var postCode 	=  document.claimonline.postCode.value;
	var ukAddress 	=  document.claimonline.ukAddress.value;
	var phone 		=  document.claimonline.phone.value;
	var altPhone 	=  document.claimonline.altPhone.value;
	var email 		=  document.claimonline.email.value;
	var bestContactTime	=  document.claimonline.bestContactTime.value;
	var a_month 	=  document.claimonline.a_month.value;
	var a_day 		=  document.claimonline.a_day.value;
	var a_year 		=  document.claimonline.a_year.value;
	var accidentType =  document.claimonline.accidentType.value;
	var accidentBrief=  document.claimonline.accidentBrief.value;

	var url="http://www.leoclaims.co.uk/ajax/guest_ajax.php";
	url=url+"?title="+title;
	url=url+"&name="+name;
	url=url+"&surname="+surname;
	url=url+"&postCode="+postCode;
	url=url+"&ukAddress="+ukAddress;
	url=url+"&phone="+phone;
	url=url+"&altPhone="+altPhone;
	url=url+"&email="+email;
	url=url+"&bestContactTime="+bestContactTime;
	url=url+"&a_month="+a_month;
	url=url+"&a_day="+a_day;
	url=url+"&a_year="+a_year;
	url=url+"&accidentType="+accidentType;
	url=url+"&accidentBrief="+accidentBrief;
	url=url+"&action=claimonline";
	url=url+"&sid="+Math.random();
	xmlHttp.onreadystatechange=stateChangedClaim;
	xmlHttp.open("GET",url,true);
	xmlHttp.send(null);
}
function GetXmlHttpObject1()
{	var xmlHttp=null;
	try{  // Firefox, Opera 8.0+, Safari
  		  xmlHttp=new XMLHttpRequest();
  	}
	catch (e)
  	{   // Internet Explorer
  		try
    	{
    		xmlHttp=new ActiveXObject("Msxml2.XMLHTTP");
    	}
  		catch (e)
    	{
    		xmlHttp=new ActiveXObject("Microsoft.XMLHTTP");
    	}
  	}
	return xmlHttp;
 }
function stateChangedClaim() 
{ 
	if (xmlHttp.readyState==4)
	{
		if(xmlHttp.responseText != "")
		{
			//document.getElementById("showMessageClaim").style.display = '';
			document.claimonline.title.value = '';
			document.claimonline.name.value = '';
			document.claimonline.surname.value = '';
			document.claimonline.postCode.value = '';
			document.claimonline.ukAddress.value = '';
			document.claimonline.phone.value = '';
			document.claimonline.altPhone.value = '';
			document.claimonline.email.value = '';
			document.claimonline.bestContactTime.value = '';
			document.claimonline.a_month.value = '';
			document.claimonline.a_day.value = '';
			document.claimonline.a_year.value = '';
			document.claimonline.accidentType.value = '';
			document.claimonline.accidentBrief.value = '';
			//document.getElementById("guestMessageClaim").innerHTML=xmlHttp.responseText;
			document.claimonline.action='http://www.leoclaims.co.uk/thank-make-a-claim.html';
			document.claimonline.submit();
		}	
	}
}
function resetClaim()
{
	document.claimonline.title.value = '';
	document.claimonline.name.value = '';
	document.claimonline.surname.value = '';
	document.claimonline.postCode.value = '';
	document.claimonline.ukAddress.value = '';
	document.claimonline.phone.value = '';
	document.claimonline.altPhone.value = '';
	document.claimonline.email.value = '';
	document.claimonline.bestContactTime.value = '';
	document.claimonline.a_month.value = '';
	document.claimonline.a_day.value = '';
	document.claimonline.a_year.value = '';
	document.claimonline.accidentType.value = '';
	document.claimonline.accidentBrief.value = '';
}