diff --git a/app/Config/Routes.php b/app/Config/Routes.php
index d640d843..10fb373c 100755
--- a/app/Config/Routes.php
+++ b/app/Config/Routes.php
@@ -172,6 +172,7 @@ $routes->group("/client", ["filter" => "authMVC"], function ($routes) {
 
     $routes->group("others", ["filter" => "authMVC"], function ($routes) {
         $routes->post("create", "ClientController::createOtherTabContent");
+        $routes->post('check-duplicate', 'ClientController::validateDuplicateByClientBranch');
     });
 });
 
diff --git a/app/Controllers/ClientController.php b/app/Controllers/ClientController.php
index aae1390c..15df403f 100755
--- a/app/Controllers/ClientController.php
+++ b/app/Controllers/ClientController.php
@@ -132,6 +132,15 @@ class ClientController extends AdminController
 
     //--------------------------------------------------------------------------------------------------------
 
+    public function validateDuplicateByClientBranch()
+    {
+        $request = service('request');
+        $value = $request->getPost('value');
+        $clientId = $request->getPost('client_id');
+        $branchId = $request->getPost('branch_id');
+        $isDuplicate = $this->clientModel->isDuplicateByClientBranch($value, $clientId, $branchId);
+        return $this->response->setJSON(['isDuplicate' => $isDuplicate]);
+    }
     public function checkDuplicateTableFieldValue()
     {
         $table = $this->request->getPost('table');
diff --git a/app/Controllers/EmployeeRestController.php b/app/Controllers/EmployeeRestController.php
index 341bfcf2..1b7310b6 100755
--- a/app/Controllers/EmployeeRestController.php
+++ b/app/Controllers/EmployeeRestController.php
@@ -2868,14 +2868,14 @@ class EmployeeRestController extends AdminController
 
                 }else if($ClientPolicyValue['policy_type_id'] == 6)
                 { 
-                    $policyGroup = 'gpa';
+                    $policyGroup = 'other';
                     $data['ticket_type_id'] = 3;
                     $data['claim_subject'] = "Claim EDLI";
                     $data['sum_insured_label'] = "Sum Assured";
 
                 }else if($ClientPolicyValue['policy_type_id'] == 7)
                 { 
-                    $policyGroup = 'gpa';
+                    $policyGroup = 'other';
                     $data['ticket_type_id'] = 4;
                     $data['claim_subject'] = "Claim GTLI";
                     $data['sum_insured_label'] = "Sum Assured";
@@ -2969,9 +2969,6 @@ class EmployeeRestController extends AdminController
 
     function policyTermsFiter($terms , $type)
     {
-
-      
-    
         $gpa = [
             "sumInsured2" => "Sum Insured",
             "totalSumInsured" => "Total Sum Assured",
@@ -3021,8 +3018,6 @@ class EmployeeRestController extends AdminController
             "moderntreatmentsasperirdai" => "Modern Treatment "
         ];
 
-
-        
         $finalarray = [];
         if($type == 'gpa'){
             foreach ($gpa as $key => $value) {
@@ -3046,6 +3041,18 @@ class EmployeeRestController extends AdminController
                     $finalarray[$terms->gpa_special_condition_label[$i]] = $terms->gpa_special_condition_input[$i];
                 }
             }
+        }else if($type == 'other'){
+            foreach ($terms as $key => $value) {
+                if($key != "multiple_sum_insured" && $value != ""){
+                    $result = ucwords(str_replace('_', ' ', $key));
+                    $finalarray[$result] = $value;
+                }
+            }
+            if(isset(($terms->gpa_special_condition_label)) && is_array($terms->gpa_special_condition_label) && is_array($terms->gpa_special_condition_input)){
+                for ($i=0; $i < count($terms->gpa_special_condition_label); $i++) { 
+                    $finalarray[$terms->gpa_special_condition_label[$i]] = $terms->gpa_special_condition_input[$i];
+                }
+            }
         }else{
             foreach ($gmc as $key => $value) {
                 if(isset($terms->$key))
@@ -3070,9 +3077,7 @@ class EmployeeRestController extends AdminController
             }
         }
 
-
         return $finalarray;
-        
     }
 
 
diff --git a/app/Controllers/LeadsController.php b/app/Controllers/LeadsController.php
index 40afde50..59608e7e 100644
--- a/app/Controllers/LeadsController.php
+++ b/app/Controllers/LeadsController.php
@@ -138,7 +138,10 @@ class LeadsController extends BaseController
         $this->cause_of_death = [
             'natural_death' => 'Natural Death',
             'suicide'       => 'Suicide',
-            'accident'      => 'Accident'
+            'accident'      => 'Accident',
+            'cardiac_arrest' => 'Cardiac Arrest',
+            'septic_shock' => 'Septic shock',
+            'heart_attack' => 'Heart Attack',
         ];
 
         $this->member_data_excel_columns = [
@@ -2408,8 +2411,11 @@ class LeadsController extends BaseController
                 $row = 2;
                 foreach ($claim_details['finyear'] as $record) {
                     $col = 'A';
-                    foreach ($record as $value) {
+                    foreach ($record as $array_key => $value) {
                         $label = ucwords(str_replace('_', ' ', ($value ??  "")));
+                        if(in_array($array_key, ['sum_insured', 'claim_amount', 'settled'])){
+                            $label = formatIndianCurrency(intval($label));
+                        }
                         $sheet->setCellValue($col . $row, $label);
                         $col++;
                     }
@@ -2427,19 +2433,27 @@ class LeadsController extends BaseController
                 }
 
                 // Enable wrap text for all cells
-                $maxColLetter = chr(64 + count($headers)); // Last column letter
-                $sheet->getStyle("A2:{$maxColLetter}{$row}")->getAlignment()->setWrapText(true);
+                // $maxColLetter = chr(64 + count($headers)); // Last column letter
+                // $sheet->getStyle("A2:{$maxColLetter}{$row}")->getAlignment()->setWrapText(true);
 
-                // Optional: center vertically for neatness
-                $sheet->getStyle("A2:{$maxColLetter}{$row}")->getAlignment()->setVertical(\PhpOffice\PhpSpreadsheet\Style\Alignment::VERTICAL_CENTER);
+                // // Optional: center vertically for neatness
+                // $sheet->getStyle("A2:{$maxColLetter}{$row}")->getAlignment()->setVertical(\PhpOffice\PhpSpreadsheet\Style\Alignment::VERTICAL_CENTER);
 
-                // Optional: Make row height auto (helps when wrap text is on)
-                for ($i = 2; $i < $row; $i++) {
-                    $sheet->getRowDimension($i)->setRowHeight(-1);
-                }
+                $maxColLetter = chr(64 + count($headers));
+                $dataRange = "A1:{$maxColLetter}" . ($row - 1);
 
-            }
-        }
+                $sheet->getStyle($dataRange)->getAlignment()
+                    ->setWrapText(true)
+                    ->setHorizontal(\PhpOffice\PhpSpreadsheet\Style\Alignment::HORIZONTAL_CENTER)
+                    ->setVertical(\PhpOffice\PhpSpreadsheet\Style\Alignment::VERTICAL_CENTER);
+
+                            // Optional: Make row height auto (helps when wrap text is on)
+                            for ($i = 2; $i < $row; $i++) {
+                                $sheet->getRowDimension($i)->setRowHeight(-1);
+                            }
+
+                        }
+                    }
 
         // Save to temporary location
         $uploadFilePath = WRITEPATH . 'tmp/' . $filename;
diff --git a/app/Models/ClientModel.php b/app/Models/ClientModel.php
index 9abe8929..09db986d 100755
--- a/app/Models/ClientModel.php
+++ b/app/Models/ClientModel.php
@@ -226,5 +226,18 @@ class ClientModel extends Model
         return $result;
     }
 
+    public function isDuplicateByClientBranch($email, $clientId, $branchId)
+    {
+        $builder = $this->db->table('level_contacts lc')
+            ->select('lc.id')
+            ->join('client_branch cb', 'lc.ref_id = cb.id', 'left')
+            ->where('lc.email', $email)
+            ->where('lc.contact_type', 'client')
+            ->where('cb.client_id', $clientId)
+            ->where('lc.ref_id', $branchId)
+            ->get();
+
+        return $builder->getNumRows() > 0 ? true : false;
+    }
 }
 
diff --git a/app/Views/client_branch.php b/app/Views/client_branch.php
index f35d5f99..024c3741 100755
--- a/app/Views/client_branch.php
+++ b/app/Views/client_branch.php
@@ -198,7 +198,7 @@
                             <div class="form-group col-md-6">
                                 <label for="last_name">Email<span class="text-danger">*</span></label>
                                 <input value="" type="text" class="form-control" placeholder="Enter Contact Email"
-                                    name="email[]" id="email" data-parsley-trigger="change" data-parsley-type="email" onkeyup="validateInput(this, 'level_contacts', 'email', 'branchBtnSubmit')" required>
+                                    name="email[]" id="email" data-parsley-trigger="change" data-parsley-type="email"  onkeyup="validateDuplicateByClientBranch(this, 'branchBtnSubmit')" required>
                             </div>
                             <div class="form-group col-md-6">
                                 <label for="mobile">Mobile<span class="text-danger">*</span></label>
@@ -649,7 +649,7 @@ function appendContactHtml(contact = false, reset = false) {
                 <div class="form-row">
                     <div class="form-group col-md-6">
                         <label for="${uniqueId}_last_name">Email<span class="text-danger">*</span></label>
-                        <input value="${contact !== undefined && contact !== false ? contact.email : ''}" type="text" class="form-control" placeholder="Enter Contact Email" name="email[]" id="${uniqueId}_email" data-parsley-trigger="change" data-parsley-type="email" onkeyup="validateInput(this, 'level_contacts', 'email', 'branchBtnSubmit')" required>
+                        <input value="${contact !== undefined && contact !== false ? contact.email : ''}" type="text" class="form-control" placeholder="Enter Contact Email" name="email[]" id="${uniqueId}_email" data-parsley-trigger="change" data-parsley-type="email" onkeyup="validateDuplicateByClientBranch(this, 'branchBtnSubmit')" required>
                     </div>
                     <div class="form-group col-md-6">
                         <label for="${uniqueId}_mobile">Mobile<span class="text-danger">*</span></label>
@@ -972,6 +972,57 @@ function validateInput(input, table, field, submitButId){
 
 }
 
+function validateDuplicateByClientBranch(input, submitButId) {
+    let value = $(input).val().trim();
+    let clientId = $('#client_id_branch').val();
+    let branchId = $('#branch_id_primarykey').val();
+    console.log(`Ln968 cId: ${clientId} | bId: ${branchId}`);
+    
+    // Don't forgot be careful
+    // 1 Local duplication check (User entered)
+    let isLocalDuplicate = false;
+    $('input[name="email[]"]').each(function() {
+        if (this !== input && $(this).val().trim() === value && value !== '') {
+            isLocalDuplicate = true;
+            return false; // break loop
+        }
+    });
+
+    if (isLocalDuplicate) {
+        console.log(`r u n Local`);
+        toastr.warning("Email is duplicate!", 'WARNING');
+        $('#' + submitButId).prop('disabled', true);
+        return; // don’t call server if duplicate in UI
+    }
+    
+    // Don't forgot be careful
+    // 2 Server-side duplicate check (DB)
+    if (!isLocalDuplicate && value !== '') {
+        console.log(`r u n Server`);
+        $.ajax({
+            url: '<?= base_url("client/others/check-duplicate") ?>',
+            type: 'POST',
+            data: { 
+                client_id: clientId,
+                branch_id: branchId,
+                value: value
+            },
+            dataType: 'json',
+            success: function(response) {
+                if (response.isDuplicate) {
+                    toastr.warning("Email already exists!", 'WARNING');
+                    $('#' + submitButId).prop('disabled', true);
+                } else {
+                    $('#' + submitButId).prop('disabled', false);
+                }
+            },
+            error: function(xhr, status, error) {
+                console.error('AJAX Error:', error);
+            }
+        });
+    }
+}
+
 function getContactsData() {
     const contacts = [];
 
diff --git a/app/Views/leads_form.php b/app/Views/leads_form.php
index 12ef9a30..52902934 100644
--- a/app/Views/leads_form.php
+++ b/app/Views/leads_form.php
@@ -1862,6 +1862,7 @@
         let claimData = [];
 
         $(".claim-row").each(function() {
+
             let year = $(this).find("[name='first_year[]']").val();
             let claimAmount = $(this).find("[name='first_claim_amount[]']").val();
             let claimStatus = $(this).find("[name='first_claim_status[]']").val();
@@ -1869,13 +1870,22 @@
             let causeOfDeath = $(this).find("[name='first_cause_of_death[]']").val();
             let deathDate = $(this).find("[name='first_death_date[]']").val();
 
+            let emp_id = $(this).find("[name='emp_id[]']").val();
+            let emp_name = $(this).find("[name='emp_name[]']").val();
+            let gender = $(this).find("[name='gender[]']").val();
+            let designation = $(this).find("[name='designation[]']").val();
+            let sum_insured = $(this).find("[name='sum_insured[]']").val();
+
             claimData.push({
                 "year": year,
-                "claim_amount": claimAmount,
-                "status": claimStatus,
-                "claim_type": claimType,
+                "emp_id": emp_id,
+                "emp_name": emp_name,
+                "gender": gender,
+                "designation": designation,
+                "sum_insured": sum_insured,
+                "death_date": deathDate,
                 "cause_of_death": causeOfDeath,
-                "death_date": deathDate
+                "settled": claimAmount,
             });
         });
 
@@ -1893,6 +1903,93 @@
 
     //-----------------------------------------------------------------------------------------------------------
 
+    // do not remove this
+    // function appendThreeYearsClaims(count) {
+
+    //     // let count = $('#appendAreaForClaim').data('count'); 
+    //     console.log("count", count);
+
+    //     let policy_type_id = $('#policy_type_id_' + count).val()
+    //     console.log('policy_type_id', policy_type_id);
+
+    //     console.log('claimIndex from parent', claimIndex);
+    //     let increment = claimIndex;
+
+    //     let claimsFields = `
+    //             <div class="row claim-row">
+
+    //                 <div class="form-group col-md-2">
+    //                     <label for="first_year_${increment}">Year<span class="text-danger">*</span></label>
+    //                     <select class="form-control first_year_" id="first_year_${increment}" name="first_year[]">
+    //                         <option value="">Select Year</option>
+    //                         <?php foreach ($lastFiveYears as $year) {echo "<option value='$year'>$year</option>";} ?>
+    //                     </select>
+    //                 </div>
+    //                 <div class="form-group col-md-2">
+    //                     <label for="first_claim_amount_${increment}">Claim/Settled Amount<span class="text-danger">*</span></label>
+    //                     <input type="text" class="form-control" id="first_claim_amount_${increment}" name="first_claim_amount[]">
+    //                 </div>
+    //                 <div class="form-group col-md-2">
+    //                     <label for="first_claim_status_${increment}">Claim Status<span class="text-danger">*</span></label>
+    //                     <input type="text" class="form-control" id="first_claim_status_${increment}" name="first_claim_status[]">
+    //                 </div>
+    //                 <div class="form-group col-md-2 lifeClaimFields" style="display:none;">
+    //                     <label for="first_cause_of_death_${increment}">Nature/Cause Of Death <span class="text-danger">*</span></label>
+    //                     <select class="form-control" id="first_cause_of_death_${increment}" name="first_cause_of_death[]">
+    //                         <option value="">Select Cause of Death</option>
+    //                         <?php foreach ($causeOfDeath as $cause => $death_value) {echo "<option value='$cause'>$death_value</option>";} ?>
+    //                     </select>
+    //                 </div>
+    //                 <div class="form-group col-md-2 lifeClaimFields" style="display:none;">
+    //                     <label for="first_death_date_${increment}">Date of Death<span class="text-danger">*</span></label>
+    //                     <input type="text" class="form-control" id="first_death_date_${increment}" name="first_death_date[]">
+    //                 </div>
+    //                 <div class="form-group col-md-2 gpaClaimFileds" style="display:none;">
+    //                     <label for="claim_type_${increment}">Claim Type<span class="text-danger">*</span></label>
+    //                     <select class="form-control" id="claim_type_${increment}" name="claim_type[]">
+    //                         <option value="">Select Claim Type</option>
+    //                         <?php foreach ($gpaClaimType as $claimType => $claim_value) {echo "<option value='$claimType'>$claim_value</option>";} ?>
+    //                     </select>
+    //                 </div>
+    //                 <div class="form-group col-md-2">
+    //                     <div class="" style="position: relative; top: 28px; float: right; text-align: end;">
+    //                         <a class="btn btn-danger waves-effect waves-light" onclick="removeClaim(this, ${count})">x</a>
+    //                         <a class="btn btn-primary waves-effect waves-light mr-1" onclick="appendThreeYearsClaims(${count})">+</a>
+    //                     </div>
+    //                 </div>
+    //             </div>
+    //         `;
+
+    //     // Append new claim fields
+    //     let referenceDiv = document.getElementById('appendAreaForClaim_' + count);
+
+    //     if (referenceDiv) {
+    //         referenceDiv.insertAdjacentHTML('beforeend', claimsFields);
+    //     } else {
+    //         console.error('Element not found: appendAreaForClaim_' + count);
+    //     }
+
+    //     // Increment claim index
+    //     console.log("claim index " + claimIndex);
+    //     claimIndex++;
+    //     console.log("after claim index " + claimIndex);
+
+    //     if (policy_type_id == 1) {
+    //         $('.gpaClaimFileds').show();
+    //         $('.lifeClaimFields').hide();
+    //     } else if (policy_type_id == 6 || policy_type_id == 7) {
+    //         $('.gpaClaimFileds').hide();
+    //         $('.lifeClaimFields').show();
+    //     }
+
+    //     // Initialize Select2 for the newly added fields
+    //     $("#first_year_" + increment).select2();
+    //     $("#claim_type_" + increment).select2();
+    //     $("#first_cause_of_death_" + increment).select2();
+
+    //     toggleRequiredFields();
+    // }
+
     function appendThreeYearsClaims(count) {
 
         // let count = $('#appendAreaForClaim').data('count'); 
@@ -1916,15 +2013,46 @@
                             } ?>
                         </select>
                     </div>
+
                     <div class="form-group col-md-2">
-                        <label for="first_claim_amount_${increment}">Claim/Settled Amount<span class="text-danger">*</span></label>
-                        <input type="text" class="form-control" id="first_claim_amount_${increment}" name="first_claim_amount[]">
+                        <label for="emp_id_${increment}">Emp ID<span class="text-danger">*</span></label>
+                        <input type="text" class="form-control" id="emp_id_${increment}" name="emp_id[]">
                     </div>
+                    
+                    
                     <div class="form-group col-md-2">
-                        <label for="first_claim_status_${increment}">Claim Status<span class="text-danger">*</span></label>
-                        <input type="text" class="form-control" id="first_claim_status_${increment}" name="first_claim_status[]">
+                        <label for="emp_name_${increment}">Employee Name<span class="text-danger">*</span></label>
+                        <input type="text" class="form-control" id="emp_name_${increment}" name="emp_name[]">
                     </div>
-                    <div class="form-group col-md-2 lifeClaimFields" style="display:none;">
+                    
+                    <div class="form-group col-md-2">
+                        <label for="gender_${increment}">Gender<span class="text-danger">*</span></label>
+                        <select class="form-control" id="gender_${increment}" name="gender[]">
+                            <option value="">Select Gender</option>
+                            <option value="Female">Female</option>
+                            <option value="Male">Male</option>       
+                        </select>
+                    </div>	
+                    
+                    <div class="form-group col-md-2">
+                        <label for="designation_${increment}">Designation <span class="text-danger">*</span></label>
+                        <input type="text" class="form-control" id="designation_${increment}" name="designation[]">
+                    </div>
+                    
+                    <div class="form-group col-md-2">
+                        <label for="sum_insured_${increment}">Sum Insured <span class="text-danger">*</span></label>
+                        <input type="text" class="form-control" id="sum_insured_${increment}" name="sum_insured[]">
+                    </div>
+
+                    <div class="form-group col-md-2">
+                        <label for="first_death_date_${increment}">Date of Death<span class="text-danger">*</span></label>
+                        <div class="input-icon">
+                            <input type="text" class="form-control death_date flatpickr-date" id="first_death_date_${increment}" name="first_death_date[]" autocomplete="off">
+                            <i class="mdi mdi-calendar-blank-outline additional-icon"></i>
+                        </div>
+                    </div>
+
+                    <div class="form-group col-md-2">
                         <label for="first_cause_of_death_${increment}">Nature/Cause Of Death <span class="text-danger">*</span></label>
                         <select class="form-control" id="first_cause_of_death_${increment}" name="first_cause_of_death[]">
                             <option value="">Select Cause of Death</option>
@@ -1933,11 +2061,18 @@
                             } ?>
                         </select>
                     </div>
-                    <div class="form-group col-md-2 lifeClaimFields" style="display:none;">
-                        <label for="first_death_date_${increment}">Date of Death<span class="text-danger">*</span></label>
-                        <input type="text" class="form-control" id="first_death_date_${increment}" name="first_death_date[]">
+
+                    <div class="form-group col-md-2">
+                        <label for="first_claim_amount_${increment}">Claim/Settled Amount<span class="text-danger">*</span></label>
+                        <input type="text" class="form-control" id="first_claim_amount_${increment}" name="first_claim_amount[]">
                     </div>
-                    <div class="form-group col-md-2 gpaClaimFileds" style="display:none;">
+
+                    <!-- <div class="form-group col-md-2">
+                        <label for="first_claim_status_${increment}">Claim Status<span class="text-danger">*</span></label>
+                        <input type="text" class="form-control" id="first_claim_status_${increment}" name="first_claim_status[]">
+                    </div> -->
+                    
+                    <!-- <div class="form-group col-md-2 gpaClaimFileds" style="display:none;">
                         <label for="claim_type_${increment}">Claim Type<span class="text-danger">*</span></label>
                         <select class="form-control" id="claim_type_${increment}" name="claim_type[]">
                             <option value="">Select Claim Type</option>
@@ -1945,7 +2080,8 @@
                                 echo "<option value='$claimType'>$claim_value</option>";
                             } ?>
                         </select>
-                    </div>
+                    </div> -->
+                    
                     <div class="form-group col-md-2">
                         <div class="" style="position: relative; top: 28px; float: right; text-align: end;">
                             <a class="btn btn-danger waves-effect waves-light" onclick="removeClaim(this, ${count})">x</a>
@@ -1981,10 +2117,18 @@
         $("#first_year_" + increment).select2();
         $("#claim_type_" + increment).select2();
         $("#first_cause_of_death_" + increment).select2();
+        $("#gender_" + increment).select2();
+
+        flatpickr('.flatpickr-date', {
+            dateFormat: 'd-m-Y', // Example format: 11-10-2025
+            allowInput: true,    // Allow manual typing
+            maxDate: 'today',    // Optional: disable future dates
+        });
 
         toggleRequiredFields();
     }
 
+
     function removeClaim(btn, count) {
         const container = document.getElementById('appendAreaForClaim_' + count);
         const rows = container.querySelectorAll('.claim-row');
@@ -2108,6 +2252,10 @@
                 $(this).find('.form-group').each(function() {
                     var input = $(this).find('input, select');
 
+                    if (input.attr('name') === "gender[]") {
+                        return;
+                    }
+
                     if (input.length === 0) {
                         console.warn('No input/select fields found in:', this);
                         return;
diff --git a/app/Views/leads_form_handler.php b/app/Views/leads_form_handler.php
index 477e610b..cb17bb22 100644
--- a/app/Views/leads_form_handler.php
+++ b/app/Views/leads_form_handler.php
@@ -393,7 +393,6 @@ if (isset($selected_lead_type)) {
             }
         });
 
-
         $('#client_branch_id').change(function() {
 
             let client_branch_id = $(this).val();
diff --git a/app/Views/rfq/gpa.php b/app/Views/rfq/gpa.php
index 70abf90a..955b5851 100644
--- a/app/Views/rfq/gpa.php
+++ b/app/Views/rfq/gpa.php
@@ -37,14 +37,15 @@
 <hr>
 
 <?php if(isset($lead_edit_data)) { ?>
-
     <div class="form-row" id="appendAreaForClaim_1">
         <?php 
 
         $claims = !empty($lead_edit_data['fin_years_claims_array']) ? $lead_edit_data['fin_years_claims_array'] : [ ['year' => '', 'claim_amount' => '', 'status' => '', 'claim_type' => '', 'cause_of_death' => '', 'death_date' => ''] ];
 
         foreach ($claims as $key => $value) { ?> 
+
             <div class="row claim-row">
+
                 <div class="form-group col-md-2">
                     <label for="first_year">Year<span class="text-danger">*</span></label>
                     <select class="form-control first_year_" id="first_year" name="first_year[]">
@@ -55,15 +56,42 @@
                         } ?>
                     </select>
                 </div>
+
                 <div class="form-group col-md-2">
-                    <label for="first_claim_amount">Claim/Settled Amount<span class="text-danger">*</span></label>
-                    <input type="text" class="form-control" id="first_claim_amount" name="first_claim_amount[]" value="<?= htmlspecialchars($value['claim_amount']) ?>">
+                    <label for="emp_id">Emp ID<span class="text-danger">*</span></label>
+                    <input type="text" class="form-control" id="emp_id" name="emp_id[]" value="<?= htmlspecialchars(isset($value['emp_id']) ? $value['emp_id'] :  '-' ) ?>">
                 </div>
+                                
                 <div class="form-group col-md-2">
-                    <label for="first_claim_status">Claim Status<span class="text-danger">*</span></label>
-                    <input type="text" class="form-control" id="first_claim_status" name="first_claim_status[]" value="<?= htmlspecialchars($value['status']) ?>">
+                    <label for="emp_name">Employee Name<span class="text-danger">*</span></label>
+                    <input type="text" class="form-control" id="emp_name" name="emp_name[]" value="<?= htmlspecialchars(isset($value['emp_name']) ? $value['emp_name'] :  '-' ) ?>">
                 </div>
-                <div class="form-group col-md-2 lifeClaimFields" style="display:none;">
+                
+                <div class="form-group col-md-2">
+                    <label for="gender">Gender<span class="text-danger">*</span></label>
+                    <select class="form-control" id="gender" name="gender[]">
+                        <option value="">Select Gender</option>
+                        <option value="Female" <?= htmlspecialchars(isset($value['gender']) && $value['gender'] == "" ?  'selected' : "Female" ) ?> >Female</option>
+                        <option value="Male" <?= htmlspecialchars(isset($value['gender']) && $value['gender'] == "" ?  'selected' : "Male" ) ?> >Male</option>       
+                    </select>
+                </div>	
+                
+                <div class="form-group col-md-2">
+                    <label for="designation">Designation <span class="text-danger">*</span></label>
+                    <input type="text" class="form-control" id="designation" name="designation[]" value="<?= htmlspecialchars(isset($value['designation']) ? $value['designation'] :  '-' ) ?>">
+                </div>
+                
+                <div class="form-group col-md-2">
+                    <label for="sum_insured">Sum Insured <span class="text-danger">*</span></label>
+                    <input type="text" class="form-control" id="sum_insured" name="sum_insured[]" value="<?= htmlspecialchars(isset($value['sum_insured']) ? $value['sum_insured'] :  '-' ) ?>">
+                </div>
+
+                <div class="form-group col-md-2">
+                    <label for="first_death_date">Date of Death<span class="text-danger">*</span></label>
+                    <input type="text" class="form-control flatpickr-date" id="first_death_date" name="first_death_date[]" value="<?= htmlspecialchars($value['death_date']) ?>" autocomplete="off">
+                </div>
+
+                <div class="form-group col-md-2">
                     <label for="first_cause_of_death">Nature/Cause Of Death <span class="text-danger">*</span></label>
                     <select class="form-control" id="first_cause_of_death" name="first_cause_of_death[]">
                         <option value="">Select Cause of Death</option>
@@ -73,26 +101,37 @@
                         } ?>
                     </select>
                 </div>
-                <div class="form-group col-md-2 lifeClaimFields" style="display:none;">
-                    <label for="first_death_date">Date of Death<span class="text-danger">*</span></label>
-                    <input type="text" class="form-control" id="first_death_date" name="first_death_date[]" value="<?= htmlspecialchars($value['death_date']) ?>">
+
+                <div class="form-group col-md-2">
+                    <label for="first_claim_amount">Claim/Settled Amount<span class="text-danger">*</span></label>
+                    <input type="text" class="form-control" id="first_claim_amount" name="first_claim_amount[]" value="<?= htmlspecialchars(isset($value['claim_amount']) ? $value['claim_amount'] : ( isset($value['settled']) ? $value['settled'] : '-' )) ?>">
                 </div>
-                <div class="form-group col-md-2 gpaClaimFileds" style="display:none;">
+
+                <!-- <div class="form-group col-md-2">
+                    <label for="first_claim_status">Claim Status<span class="text-danger">*</span></label>
+                    <input type="text" class="form-control" id="first_claim_status" name="first_claim_status[]" value="<?php //htmlspecialchars($value['status']) ?>">
+                </div> -->
+
+                <!-- <div class="form-group col-md-2 gpaClaimFileds" style="display:none;">
                     <label for="claim_type">Claim Type<span class="text-danger">*</span></label>
                     <select class="form-control" id="claim_type" name="claim_type[]">
                         <option value="">Select Claim Type</option>
-                        <?php foreach ($gpaClaimType as $claimType => $claim_value) {
-                            $selected = ($claimType == $value['claim_type']) ? 'selected' : '';
-                            echo "<option value='$claimType' $selected>$claim_value</option>";
-                        } ?>
+                        <?php 
+                        // foreach ($gpaClaimType as $claimType => $claim_value) {
+                        //     $selected = ($claimType == $value['claim_type']) ? 'selected' : '';
+                        //     echo "<option value='$claimType' $selected>$claim_value</option>";
+                        // } 
+                        ?>
                     </select>
-                </div>
+                </div> -->
+
                 <div class="form-group col-md-2">
                     <div class="" style="position: relative; top: 28px; float: right; text-align: end;">
                         <a class="btn btn-danger waves-effect waves-light" onclick="removeClaim(this, 1)">x</a>
                         <a class="btn btn-primary waves-effect waves-light mr-1" onclick="appendThreeYearsClaims(1)">+</a>
                     </div>
                 </div>
+
             </div>
         <?php } ?>
     </div>
@@ -100,3 +139,13 @@
     <div class="form-row" id="appendAreaForClaim"></div>
 <?php } ?>
 
+<script>
+
+flatpickr('.flatpickr-date', {
+    dateFormat: 'd-M-Y', // Example format: 11-10-2025
+    allowInput: true,    // Allow manual typing
+    maxDate: 'today',    // Optional: disable future dates
+});
+
+</script>
+