claims.fscs.org.uk Open in urlscan Pro
141.226.98.25  Public Scan

Form analysis
3 forms found in the DOM

POST /Account/Login

<form action="/Account/Login" autocomplete="off" class="loginForm" method="post" novalidate="novalidate">
  <h2 class="col-12">Return to my claim</h2>
  <input name="__RequestVerificationToken" type="hidden" value="MHQy3KvxlN-WnEVX-bBBCRhCtQY1IcgLSA2WXJOwfgD1sfFozGlnGCPVF3ffBhVGEUyZCI_DKay0j-GEm5EGAkcnMPwDQ7xD8UTZPUwsoi41">
  <div id="error-container" class="validation-summary-valid" data-valmsg-summary="true" tabindex="-1" aria-label="Please resolve the issue below" aria-live="Off">
    <div class="row px-0 mb0">
      <div class="errorDiv col-12 mb-3" aria-atomic="true">
        <div class="errorsHeader h4">Please resolve the issue below</div>
        <ul class="error-list" role="list">
        </ul>
      </div>
      <div class="clearfix"></div>
    </div>
  </div>
  <div class="clearfix"></div>
  <div class="col-12 same-heights">
    <div class="form-group">
      <label class="control-label" for="UserName">Email</label>
      <input autocomplete="off" class="form-control" data-val="true" data-val-regex="The Email field should be a valid email address"
        data-val-regex-pattern="(?:[A-Za-z0-9!#$%&amp;'*+/=?^_`{|}~-]+(?:\.[A-Za-z0-9!#$%&amp;'*+/=?^_`{|}~-]+)*|&quot;(?:[\x01-\x08\x0b\x0c\x0e-\x1f\x21\x23-\x5b\x5d-\x7f]|\\[\x01-\x09\x0b\x0c\x0e-\x7f])*&quot;)@(?:(?:[A-Za-z0-9](?:[A-Za-z0-9-_]*[A-Za-z0-9])?\.)+[A-Za-z0-9](?:[A-Za-z0-9-]*[A-Za-z0-9])?|\[(?:(?:25[0-5]|2[0-4][0-9]|[01]?[0-9][0-9]?)\.){3}(?:25[0-5]|2[0-4][0-9]|[01]?[0-9][0-9]?|[A-Za-z0-9-]*[A-Za-z0-9]:(?:[\x01-\x08\x0b\x0c\x0e-\x1f\x21-\x5a\x53-\x7f]|\\[\x01-\x09\x0b\x0c\x0e-\x7f])+)\])"
        data-val-required="Please enter your account email address" id="UserName" name="UserName" tabindex="0" type="email" value="">
      <span autocomplete="off" class="field-validation-valid inline-validation" data-valmsg-for="UserName" data-valmsg-replace="true" role="alert"></span>
    </div>
  </div>
  <div class="col-12 same-heights">
    <div class="form-group">
      <label class="control-label" for="Password">Password</label>
      <a class="pull-right" href="/Account/RecoverUserAccount">Forgot Password</a>
      <input autocomplete="off" class="form-control" data-val="true" data-val-length="The password must be no more than 100 characters" data-val-length-max="100" data-val-required="Please enter your account password" id="Password" name="Password"
        tabindex="0" type="password">
      <span class="field-validation-valid inline-validation" data-valmsg-for="Password" data-valmsg-replace="true" role="alert"></span>
    </div>
  </div>
  <div class="col-12">
    <div class="form-group sign-in-form">
      <input type="submit" id="loginbtnSubmit" value="Sign in" class="btn btn-default">
    </div>
  </div>
</form>

<form class="form application-claim-extend-form no-scroll-on-validation" novalidate="novalidate">
  <div class="modal-body">
    <div id="error-container" class="validation-summary-valid" data-valmsg-summary="true" tabindex="-1" aria-label="Please resolve the issue below" aria-live="Off">
      <div class="row px-0 mb0">
        <div class="errorDiv col-12 mb-3" aria-atomic="true">
          <div class="errorsHeader h4">Please resolve the issue below</div>
          <ul class="error-list" role="list">
          </ul>
        </div>
        <div class="clearfix"></div>
      </div>
    </div>
    <div class="form-group hidden">
      <label class="control-label">Date extended to: </label>
      <label class="uncontrol-label"> 13/09/2021 </label>
    </div>
    <div class="form-group hidden">
      <label class="control-label">Reason for extending claim</label>
      <div>
        <p>Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.</p>
      </div>
    </div>
    <input type="hidden" name="selectedApplicationId" class="selectedApplicationId" value="">
    <div class="form-group input-group">
      <label for="extendApplicationDate" class="w-100">Choose your preferred date</label>
      <input id="extendApplicationDate" name="extendApplicationDate" type="text" class="form-control date-picker-fscs" placeholder="DD/MM/YYYY" data-provide="datepicker" data-date-container="#extendApplicationForm" autocomplete="off" data-val="true"
        data-val-required="The preferred date field is required" data-val-regex="The preferred date field is not valid"
        data-val-regex-pattern="^(?:(?:31(\/|-|\.)(?:0?[13578]|1[02]))\1|(?:(?:29|30)(\/|-|\.)(?:0?[13-9]|1[0-2])\2))(?:(?:1[6-9]|[2-9]\d)?\d{2})$|^(?:29(\/|-|\.)0?2\3(?:(?:(?:1[6-9]|[2-9]\d)?(?:0[48]|[2468][048]|[13579][26])|(?:(?:16|[2468][048]|[3579][26])00))))$|^(?:0?[1-9]|1\d|2[0-8])(\/|-|\.)(?:(?:0?[1-9])|(?:1[0-2]))\4(?:(?:1[6-9]|[2-9]\d)?\d{2})$">
      <div class="input-group-append">
        <span class="input-group-text">
          <i class="fa fa-calendar"></i>
        </span>
      </div>
      <div autocomplete="off" class="w-100 field-validation-error" data-valmsg-for="extendApplicationDate" data-valmsg-replace="true"></div>
    </div>
    <div class="form-group">
      <label for="">Reason for extending claim date</label>
      <textarea id="extendApplicationReason" name="extendApplicationReason" class="form-control" rows="3" maxlength="255" data-val="true" data-val-required="The reason for extending claim date is required"></textarea>
      <span autocomplete="off" class="field-validation-error" data-valmsg-for="extendApplicationReason" data-valmsg-replace="true" role="alert"></span>
    </div>
  </div>
  <div class="modal-footer">
    <button type="submit" class="btn btn-primary">SAVE</button>
    <button type="button" id="claimExtendCancelBtn" class="btn btn-secondary" data-dismiss="modal">CANCEL</button>
  </div>
</form>

<form class="form application-claim-reopen-form no-scroll-on-validation" novalidate="novalidate">
  <div class="modal-body">
    <div id="error-container" class="validation-summary-valid" data-valmsg-summary="true" tabindex="-1" aria-label="Please resolve the issue below" aria-live="Off">
      <div class="row px-0 mb0">
        <div class="errorDiv col-12 mb-3" aria-atomic="true">
          <div class="errorsHeader h4">Please resolve the issue below</div>
          <ul class="error-list" role="list">
          </ul>
        </div>
        <div class="clearfix"></div>
      </div>
    </div>
    <input type="hidden" name="selectedApplicationId" class="selectedApplicationId" value="">
    <div class="form-group input-group">
      <label for="reopenApplicationDate" class="w-100">Choose your preferred date</label>
      <input id="reopenApplicationDate" name="reopenApplicationDate" type="text" class="form-control date-picker-fscs" placeholder="DD/MM/YYYY" data-provide="datepicker" autocomplete="off" data-val="true"
        data-val-required="The preferred date field is required" data-val-regex="The preferred date field is not valid"
        data-val-regex-pattern="^(?:(?:31(\/|-|\.)(?:0?[13578]|1[02]))\1|(?:(?:29|30)(\/|-|\.)(?:0?[13-9]|1[0-2])\2))(?:(?:1[6-9]|[2-9]\d)?\d{2})$|^(?:29(\/|-|\.)0?2\3(?:(?:(?:1[6-9]|[2-9]\d)?(?:0[48]|[2468][048]|[13579][26])|(?:(?:16|[2468][048]|[3579][26])00))))$|^(?:0?[1-9]|1\d|2[0-8])(\/|-|\.)(?:(?:0?[1-9])|(?:1[0-2]))\4(?:(?:1[6-9]|[2-9]\d)?\d{2})$">
      <div class="input-group-append">
        <span class="input-group-text">
          <i class="fa fa-calendar"></i>
        </span>
      </div>
      <div autocomplete="off" class="w-100 field-validation-error" data-valmsg-for="reopenApplicationDate" data-valmsg-replace="true"></div>
    </div>
    <div class="form-group">
      <label for="">Reason for re-opening claim date</label>
      <textarea id="reopenApplicationReason" name="reopenApplicationReason" class="form-control" rows="3" maxlength="255" data-val="true" data-val-required="The reason for re-opening claim date is required"></textarea>
      <span autocomplete="off" class="field-validation-error" data-valmsg-for="reopenApplicationReason" data-valmsg-replace="true" role="alert"></span>
    </div>
  </div>
  <div class="modal-footer">
    <button type="submit" class="btn btn-primary">SAVE</button>
    <button type="button" id="claimReopenCancelBtn" class="btn btn-secondary" data-dismiss="modal">CANCEL</button>
  </div>
</form>

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notice has been updated. This website uses cookies. By using the FSCS website,
you consent to the use of cookies in accordance with our cookie policy. You can
change your browser settings to disable cookies at any time but if you do so,
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using the FSCS website, you consent to the use of cookies in accordance with our
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