20240808.countrybankers.com Open in urlscan Pro
2a02:4780:6:1466:0:e0e:757d:10  Public Scan

Form analysis
3 forms found in the DOM

POST

<form method="POST" enctype="multipart/form-data" action="" id="fb_form_51-0" class="et_pb_contact fb_form   disable_submit_for_required hide_until_loaded" data-ajax-btn="Processing" data-ajax-hide-sub="on" style="" novalidate="novalidate">
  <h3 class="form-title">Request for quotation</h3>
  <div class="divi-form-wrapper">
    <div class="et_pb_module de_fb_form_field de_fb_form_field_0_tb_header grid_et_pb_column_4_4_12 dfb_radio_default et_pb_column_4_4 et_pb_column last-item">
      <div class="et_pb_module_inner">
        <div id="de_fb_products_wrapper" class="field_wrapper search_filter_cont " data-count="100" "="">
								<p class=" et_pb_contact_field" data-type="select">
          <input type="hidden" name="field_title[]" value="Products &amp; Services"><input type="hidden" name="field_name[]" value="de_fb_products"><input type="hidden" name="field_id[]" value="de_fb_products"><select
            class="divi-form-builder-field select-field et_pb_contact_select " required="" name="de_fb_products" data-field_type="select" data-msg-required="This field is required." id="de_fb_products">
            <option value="" disabled="" selected="">Choose your insurance product</option>
            <option value="Alalay sa Buhay Family">Alalay sa Buhay Family</option>
            <option value="Alalay sa Buhay">Alalay sa Buhay</option>
            <option value="Bonds">Bonds</option>
            <option value="Contractors All Risk Insurance">Contractors All Risk Insurance</option>
            <option value="Alalay sa Buhay for Seniors">Alalay sa Buhay for Seniors</option>
            <option value="CB Ipon">CB Ipon</option>
            <option value="Creditors Group Life">Creditors Group Life</option>
            <option value="CB Kalinga">CB Kalinga</option>
            <option value="Comprehensive General Liability">Comprehensive General Liability</option>
            <option value="Kalinga sa Pandemya">Kalinga sa Pandemya</option>
            <option value="Money, Security &amp; Payroll Insurance">Money, Security &amp; Payroll Insurance</option>
            <option value="Mortgage Redemption Insurance">Mortgage Redemption Insurance</option>
            <option value="Personal Accident Insurance">Personal Accident Insurance</option>
            <option value="Motorcar Insurance">Motorcar Insurance</option>
          </select> </p>
        </div>
      </div>
    </div>
    <div class="et_pb_module de_fb_form_field de_fb_form_field_1_tb_header grid_et_pb_column_4_4_12 dfb_radio_default et_pb_column_4_4 et_pb_column last-item">
      <div class="et_pb_module_inner">
        <div id="de_fb_name_wrapper" class="field_wrapper search_filter_cont " data-count="100" "="">
								<p class=" et_pb_contact_field" data-type="input">
          <input type="hidden" name="field_title[]" value="Name"><input type="hidden" name="field_name[]" value="de_fb_name"><input type="hidden" name="field_id[]" value="de_fb_name"> <input type="text" name="de_fb_name" id="de_fb_name"
            placeholder="Name*" class="divi-form-builder-field input-field " required="" value="" data-msg-required="This field is required." data-required_position="bottom" autocomplete="on">
          </p>
        </div>
      </div>
    </div>
    <div class="et_pb_module de_fb_form_field de_fb_form_field_2_tb_header grid_et_pb_column_4_4_12 dfb_radio_default et_pb_column_4_4 et_pb_column last-item">
      <div class="et_pb_module_inner">
        <div id="de_fb_email_wrapper" class="field_wrapper search_filter_cont " data-count="100" "="">
								<p class=" et_pb_contact_field" data-type="email">
          <input type="hidden" name="field_title[]" value="Email"><input type="hidden" name="field_name[]" value="de_fb_email"><input type="hidden" name="field_id[]" value="de_fb_email"> <input type="email" name="de_fb_email" id="de_fb_email"
            placeholder="Email*" class="divi-form-builder-field input-field " required="" value="" data-msg-required="This field is required." data-required_position="bottom" data-msg-email="Please input correct email address." autocomplete="on">
          </p>
        </div>
      </div>
    </div>
    <div class="et_pb_module de_fb_form_field de_fb_form_field_3_tb_header grid_et_pb_column_4_4_12 dfb_radio_default et_pb_column_4_4 et_pb_column last-item">
      <div class="et_pb_module_inner">
        <div id="de_fb_mobile_wrapper" class="field_wrapper search_filter_cont " data-count="100" "="">
								<p class=" et_pb_contact_field" data-type="input">
          <input type="hidden" name="field_title[]" value="Mobile No."><input type="hidden" name="field_name[]" value="de_fb_mobile"><input type="hidden" name="field_id[]" value="de_fb_mobile"> <input type="text" name="de_fb_mobile" id="de_fb_mobile"
            placeholder="Mobile No." class="divi-form-builder-field input-field " value="" autocomplete="on">
          </p>
        </div>
      </div>
    </div>
    <div class="et_pb_module de_fb_form_field de_fb_form_field_4_tb_header grid_et_pb_column_4_4_12 dfb_radio_default et_pb_column_4_4 et_pb_column last-item">
      <div class="et_pb_module_inner">
        <div id="de_fb_message_wrapper" class="field_wrapper search_filter_cont " data-count="100" "="">
								<p class=" et_pb_contact_field" data-type="text">
          <input type="hidden" name="field_title[]" value="Message"><input type="hidden" name="field_name[]" value="de_fb_message"><input type="hidden" name="field_id[]" value="de_fb_message"> <textarea name="de_fb_message" id="de_fb_message"
            class="divi-form-builder-field textarea-field" required="" placeholder="Message*" rows="8" data-msg-required="This field is required." data-required_position="bottom" autocomplete="on"></textarea>
          </p>
        </div>
      </div>
    </div>
  </div>
  <input type="hidden" value="51-0" name="form_key">
  <div class="et_contact_bottom_container">
    <div class="submit-container">
      <script src="https://www.google.com/recaptcha/api.js?render=6Ld3diInAAAAAHxGWLT-pH1fsCcd3v7tvnJNMRRX"></script>
      <input type="hidden" id="recaptcha_token" name="recaptcha_token" value="">
      <script>
        jQuery(document).ready(function($) {
          jQuery("#fb_form_51-0").submit(function(e) {
            e.preventDefault();
            $(this).find('.divi-form-submit').prop('disabled', true);
            var required_check = true;
            var form = jQuery(this);
            let required_fields = $('.required', form);
            if (required_fields.length > 0) {
              $.each(required_fields, function(index, element) {
                $(this).closest('.et_pb_contact_field').parent().find('.error').remove();
                if (!$(this).closest('.de_fb_form_field').hasClass('condition-hide')) {
                  var field_type = $(this).closest('.et_pb_contact_field').data('type');
                  if (field_type == 'checkbox' || field_type == 'radio') {
                    if (jQuery(this).find('input:checked').length == 0) {
                      required_check = false;
                    }
                  } else if (field_type == 'file' || field_type == 'image') {
                    var value_field_id = jQuery(this).find('input.upload_field').attr('id') + '_value';
                    if (jQuery(this).find('.files .template-upload').length == 0 && jQuery(this).find('#' + value_field_id).val() == "") {
                      required_check = false;
                    }
                  } else {
                    if (jQuery(this).val() == '') {
                      required_check = false;
                    }
                  }
                  if (!required_check) {
                    var required_message = $(this).attr('data-required_message');
                    var required_message_pos = $(this).attr('data-required_position');
                    if (required_message_pos == 'top') {
                      $(this).closest('.et_pb_contact_field').before('<p class="error">' + required_message + '</p>');
                    } else {
                      $(this).closest('.et_pb_contact_field').after('<p class="error">' + required_message + '</p>');
                    }
                  }
                }
              });
              if (!required_check) {
                $('html, body').animate({
                  scrollTop: form.offset().top - 10
                }, 300);
                form.find('.divi-form-submit').removeProp('disabled');
                form.find('.divi-form-submit').removeAttr('disabled');
              }
            }
            var validation_result = form.valid();
            if (!validation_result) {
              e.preventDefault();
              //Here we check for an icon related to this input and we retrieve it to move it to correct place
              //since validate function places the label before the icon -
              let inputs_error = $('.input-field.error', form);
              inputs_error.each(function() {
                let input = $(this);
                let parent = input.parent();
                let label = $('label.error', parent).first();
                let icon = $('.dfb_input_icon', parent).first();
                if (icon.length) {
                  if (input.next().is(label)) {
                    label.detach().appendTo(parent.parent());
                  }
                }
              });
              $(this).find('.divi-form-submit').removeProp('disabled');
              $(this).find('.divi-form-submit').removeAttr('disabled');
              return false;
            }
            if ($(this).find('.signature-field').length > 0) {
              $.each($(this).find('.signature-field'), function(i) {
                var field_id = $(this).find('input').attr('id');
                $("#" + field_id).val(fb_signature.signature_objs['signaturePad_' + field_id].toDataURL());
              });
            }
            if (required_check) {
              grecaptcha.ready(function() {
                grecaptcha.execute('6Ld3diInAAAAAHxGWLT-pH1fsCcd3v7tvnJNMRRX', {
                  action: 'submit'
                }).then(function(token) {
                  jQuery("#recaptcha_token").val(token);
                  if (form.find('.file_preview_container .template-upload').length > 0) {
                    e.preventDefault();
                    de_fb_ajax_files_upload(form);
                  } else {
                    if (form.find('.divi-form-submit').hasClass('de_fb_ajax_submit')) {
                      de_fb_ajax_form_submit(form[0]);
                      e.preventDefault();
                    } else {
                      jQuery("#fb_form_51-0").unbind('submit').submit();
                    }
                  }
                });
              });
            } else {
              e.preventDefault();
            }
            $(this).find('.divi-form-submit').removeProp('disabled');
            $(this).find('.divi-form-submit').removeAttr('disabled');
          });
        });
      </script>
      <button class="divi-form-submit et_pb_button de_fb_ajax_submit" type="submit">Submit</button>
      <input type="hidden" name="form_type" value="contact">
      <input type="hidden" name="divi-form-submit" value="yes">
      <input type="hidden" name="form_id" value="">
    </div>
  </div>
</form>

POST

<form method="POST" enctype="multipart/form-data" action="" id="fb_form_51-1" class="et_pb_contact fb_form   disable_submit_for_required hide_until_loaded" data-ajax-btn="Processing" data-ajax-hide-sub="on" style="" novalidate="novalidate">
  <h3 class="form-title">Request for quotation</h3>
  <div class="divi-form-wrapper">
    <div class="et_pb_module de_fb_form_field de_fb_form_field_0_tb_footer grid_et_pb_column_4_4_12 dfb_radio_default et_pb_column_4_4 et_pb_column last-item">
      <div class="et_pb_module_inner">
        <div id="de_fb_products_wrapper" class="field_wrapper search_filter_cont " data-count="100" "="">
								<p class=" et_pb_contact_field" data-type="select">
          <input type="hidden" name="field_title[]" value="Products &amp; Services"><input type="hidden" name="field_name[]" value="de_fb_products"><input type="hidden" name="field_id[]" value="de_fb_products"><select
            class="divi-form-builder-field select-field et_pb_contact_select " required="" name="de_fb_products" data-field_type="select" data-msg-required="This field is required." id="de_fb_products">
            <option value="" disabled="" selected="">Choose your insurance product</option>
            <option value="Alalay sa Buhay Family">Alalay sa Buhay Family</option>
            <option value="Alalay sa Buhay">Alalay sa Buhay</option>
            <option value="Bonds">Bonds</option>
            <option value="Contractors All Risk Insurance">Contractors All Risk Insurance</option>
            <option value="Alalay sa Buhay for Seniors">Alalay sa Buhay for Seniors</option>
            <option value="CB Ipon">CB Ipon</option>
            <option value="Creditors Group Life">Creditors Group Life</option>
            <option value="CB Kalinga">CB Kalinga</option>
            <option value="Comprehensive General Liability">Comprehensive General Liability</option>
            <option value="Kalinga sa Pandemya">Kalinga sa Pandemya</option>
            <option value="Money, Security &amp; Payroll Insurance">Money, Security &amp; Payroll Insurance</option>
            <option value="Mortgage Redemption Insurance">Mortgage Redemption Insurance</option>
            <option value="Personal Accident Insurance">Personal Accident Insurance</option>
            <option value="Motorcar Insurance">Motorcar Insurance</option>
          </select> </p>
        </div>
      </div>
    </div>
    <div class="et_pb_module de_fb_form_field de_fb_form_field_1_tb_footer grid_et_pb_column_4_4_12 dfb_radio_default et_pb_column_4_4 et_pb_column last-item">
      <div class="et_pb_module_inner">
        <div id="de_fb_name_wrapper" class="field_wrapper search_filter_cont " data-count="100" "="">
								<p class=" et_pb_contact_field" data-type="input">
          <input type="hidden" name="field_title[]" value="Name"><input type="hidden" name="field_name[]" value="de_fb_name"><input type="hidden" name="field_id[]" value="de_fb_name"> <input type="text" name="de_fb_name" id="de_fb_name"
            placeholder="Name*" class="divi-form-builder-field input-field " required="" value="" data-msg-required="This field is required." data-required_position="bottom" autocomplete="on">
          </p>
        </div>
      </div>
    </div>
    <div class="et_pb_module de_fb_form_field de_fb_form_field_2_tb_footer grid_et_pb_column_4_4_12 dfb_radio_default et_pb_column_4_4 et_pb_column last-item">
      <div class="et_pb_module_inner">
        <div id="de_fb_email_wrapper" class="field_wrapper search_filter_cont " data-count="100" "="">
								<p class=" et_pb_contact_field" data-type="email">
          <input type="hidden" name="field_title[]" value="Email"><input type="hidden" name="field_name[]" value="de_fb_email"><input type="hidden" name="field_id[]" value="de_fb_email"> <input type="email" name="de_fb_email" id="de_fb_email"
            placeholder="Email*" class="divi-form-builder-field input-field " required="" value="" data-msg-required="This field is required." data-required_position="bottom" data-msg-email="Please input correct email address." autocomplete="on">
          </p>
        </div>
      </div>
    </div>
    <div class="et_pb_module de_fb_form_field de_fb_form_field_3_tb_footer grid_et_pb_column_4_4_12 dfb_radio_default et_pb_column_4_4 et_pb_column last-item">
      <div class="et_pb_module_inner">
        <div id="de_fb_mobile_wrapper" class="field_wrapper search_filter_cont " data-count="100" "="">
								<p class=" et_pb_contact_field" data-type="input">
          <input type="hidden" name="field_title[]" value="Mobile No."><input type="hidden" name="field_name[]" value="de_fb_mobile"><input type="hidden" name="field_id[]" value="de_fb_mobile"> <input type="text" name="de_fb_mobile" id="de_fb_mobile"
            placeholder="Mobile No." class="divi-form-builder-field input-field " value="" autocomplete="on">
          </p>
        </div>
      </div>
    </div>
    <div class="et_pb_module de_fb_form_field de_fb_form_field_4_tb_footer grid_et_pb_column_4_4_12 dfb_radio_default et_pb_column_4_4 et_pb_column last-item">
      <div class="et_pb_module_inner">
        <div id="de_fb_message_wrapper" class="field_wrapper search_filter_cont " data-count="100" "="">
								<p class=" et_pb_contact_field" data-type="text">
          <input type="hidden" name="field_title[]" value="Message"><input type="hidden" name="field_name[]" value="de_fb_message"><input type="hidden" name="field_id[]" value="de_fb_message"> <textarea name="de_fb_message" id="de_fb_message"
            class="divi-form-builder-field textarea-field" required="" placeholder="Message*" rows="8" data-msg-required="This field is required." data-required_position="bottom" autocomplete="on"></textarea>
          </p>
        </div>
      </div>
    </div>
  </div>
  <input type="hidden" value="51-1" name="form_key">
  <div class="et_contact_bottom_container">
    <div class="submit-container">
      <script src="https://www.google.com/recaptcha/api.js?render=6Ld3diInAAAAAHxGWLT-pH1fsCcd3v7tvnJNMRRX"></script>
      <input type="hidden" id="recaptcha_token" name="recaptcha_token" value="">
      <script>
        jQuery(document).ready(function($) {
          jQuery("#fb_form_51-1").submit(function(e) {
            e.preventDefault();
            $(this).find('.divi-form-submit').prop('disabled', true);
            var required_check = true;
            var form = jQuery(this);
            let required_fields = $('.required', form);
            if (required_fields.length > 0) {
              $.each(required_fields, function(index, element) {
                $(this).closest('.et_pb_contact_field').parent().find('.error').remove();
                if (!$(this).closest('.de_fb_form_field').hasClass('condition-hide')) {
                  var field_type = $(this).closest('.et_pb_contact_field').data('type');
                  if (field_type == 'checkbox' || field_type == 'radio') {
                    if (jQuery(this).find('input:checked').length == 0) {
                      required_check = false;
                    }
                  } else if (field_type == 'file' || field_type == 'image') {
                    var value_field_id = jQuery(this).find('input.upload_field').attr('id') + '_value';
                    if (jQuery(this).find('.files .template-upload').length == 0 && jQuery(this).find('#' + value_field_id).val() == "") {
                      required_check = false;
                    }
                  } else {
                    if (jQuery(this).val() == '') {
                      required_check = false;
                    }
                  }
                  if (!required_check) {
                    var required_message = $(this).attr('data-required_message');
                    var required_message_pos = $(this).attr('data-required_position');
                    if (required_message_pos == 'top') {
                      $(this).closest('.et_pb_contact_field').before('<p class="error">' + required_message + '</p>');
                    } else {
                      $(this).closest('.et_pb_contact_field').after('<p class="error">' + required_message + '</p>');
                    }
                  }
                }
              });
              if (!required_check) {
                $('html, body').animate({
                  scrollTop: form.offset().top - 10
                }, 300);
                form.find('.divi-form-submit').removeProp('disabled');
                form.find('.divi-form-submit').removeAttr('disabled');
              }
            }
            var validation_result = form.valid();
            if (!validation_result) {
              e.preventDefault();
              //Here we check for an icon related to this input and we retrieve it to move it to correct place
              //since validate function places the label before the icon -
              let inputs_error = $('.input-field.error', form);
              inputs_error.each(function() {
                let input = $(this);
                let parent = input.parent();
                let label = $('label.error', parent).first();
                let icon = $('.dfb_input_icon', parent).first();
                if (icon.length) {
                  if (input.next().is(label)) {
                    label.detach().appendTo(parent.parent());
                  }
                }
              });
              $(this).find('.divi-form-submit').removeProp('disabled');
              $(this).find('.divi-form-submit').removeAttr('disabled');
              return false;
            }
            if ($(this).find('.signature-field').length > 0) {
              $.each($(this).find('.signature-field'), function(i) {
                var field_id = $(this).find('input').attr('id');
                $("#" + field_id).val(fb_signature.signature_objs['signaturePad_' + field_id].toDataURL());
              });
            }
            if (required_check) {
              grecaptcha.ready(function() {
                grecaptcha.execute('6Ld3diInAAAAAHxGWLT-pH1fsCcd3v7tvnJNMRRX', {
                  action: 'submit'
                }).then(function(token) {
                  jQuery("#recaptcha_token").val(token);
                  if (form.find('.file_preview_container .template-upload').length > 0) {
                    e.preventDefault();
                    de_fb_ajax_files_upload(form);
                  } else {
                    if (form.find('.divi-form-submit').hasClass('de_fb_ajax_submit')) {
                      de_fb_ajax_form_submit(form[0]);
                      e.preventDefault();
                    } else {
                      jQuery("#fb_form_51-1").unbind('submit').submit();
                    }
                  }
                });
              });
            } else {
              e.preventDefault();
            }
            $(this).find('.divi-form-submit').removeProp('disabled');
            $(this).find('.divi-form-submit').removeAttr('disabled');
          });
        });
      </script>
      <button class="divi-form-submit et_pb_button de_fb_ajax_submit" type="submit">Submit</button>
      <input type="hidden" name="form_type" value="contact">
      <input type="hidden" name="divi-form-submit" value="yes">
      <input type="hidden" name="form_id" value="">
    </div>
  </div>
</form>

POST

<form method="post">
  <div class="et_pb_newsletter_result et_pb_newsletter_error"></div>
  <div class="et_pb_newsletter_result et_pb_newsletter_success">
    <h2>Success!</h2>
  </div>
  <div class="et_pb_newsletter_fields">
    <p class="et_pb_newsletter_field et_pb_contact_field_last et_pb_contact_field_last_tablet et_pb_contact_field_last_phone">
      <label class="et_pb_contact_form_label" for="et_pb_signup_email" style="display: none;">Email</label>
      <input id="et_pb_signup_email" class="input" type="text" placeholder="Email" name="et_pb_signup_email">
    </p>
    <p class="et_pb_newsletter_button_wrap">
      <a class="et_pb_newsletter_button et_pb_button" href="#" data-icon="$">
							<span class="et_subscribe_loader"></span>
							<span class="et_pb_newsletter_button_text">Subscribe</span>
						</a>
    </p>
  </div>
  <input type="hidden" value="mailchimp" name="et_pb_signup_provider">
  <input type="hidden" value="51d56005c5" name="et_pb_signup_list_id">
  <input type="hidden" value="undefined" name="et_pb_signup_account_name">
  <input type="hidden" value="true" name="et_pb_signup_ip_address"><input type="hidden" value="743b0f02d310978f2d3ae956e84f5e7b" name="et_pb_signup_checksum">
</form>

Text Content

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ABOUT US


KAPAG SIGURADO, HINDI KABADO!  – COUNTRY BANKERS

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WHAT WE PROVIDE

Protect what matters most to you with our comprehensive insurance products.
Whether you’re looking for coverage for your family, home, car, or business,
we’ve got you covered.

CREDITOR’S GROUP LIFE (CGL)

This special plan caters to all lending institutions. It protects lending
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MORTGAGE REDEMPTION INSURANCE (MRI)

It protects all lending businesses by assuming payment of the deceased debtor’s
loan.

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MICRO INSURANCE

The most comprehensive family insurance program for groups of 500+ members from
MFIs, rural/thrift banks, co-ops, and NGOs.

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MOTORCAR INSURANCE

Protect your vehicle and your peace of mind with our reliable car insurance
coverage. From accidents to theft, our insurance coverage has you covered.

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BONDS / SURETY

Surety bonds are a crucial aspect of many industries, from construction to
finance. They offer financial security and peace of mind to both parties
involved in a contract.

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FIRE INSURANCE

Protect your home and belongings from unexpected fires and other natural
calamities with our comprehensive fire insurance coverage.

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DON’T WAIT UNTIL IT’S TOO LATE.

Get insured now and have peace of mind knowing that you’re covered in case of
unexpected events.

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EVENTS AND ARTICLES


LATEST NEWS

Get the most recent and up-to-date information about Country Bankers Insurance
Group.


CBIG 2023 MID-YEAR REVIEW

Jul 8, 2023 | Country Bankers Insurance, Country Bankers Life

The mid-year review of Country Bankers Insurance Group (CBIG) was held in Seda
Nuvali, Santa Rosa Laguna on June 28-29. This is a crucial event that allows the
organization to assess its performance so far and make necessary adjustments for
the remainder of the year....

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REVIVING THE SPIRIT: A SPECTACULAR COMEBACK OF THE COMPANY TEAM-BUILDING AFTER A
3-YEAR HIATUS DUE TO COVID-19

Jul 8, 2023 | Country Bankers Insurance, Country Bankers Life

We are thrilled to share some exciting news that will reignite the spark of joy
and camaraderie among our incredible team. After a long and unavoidable hiatus
of three years due to the challenging times of the COVID-19 pandemic, our
much-anticipated company outing...

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CBLIC INTRODUCES KALINGA SA PANDEMYA

Jul 7, 2023 | Country Bankers Life

A one-year Term Insurance protection for individual for COVID related cause of
death. For ages 13 – 70 years old No medical examinations required (but with
health declaration upon application.) Quarantine Care – pays an insured
equivalent 14 days quarantine upon...

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NOT SURE WHAT YOU NEED?

Are you feeling uncertain about what kind of insurance coverage you need? It’s a
common problem, and there are many options to consider.  Contact Us & We gladly
help you.

Get in Touch

Address: 648 Kalaw Avenue, Ermita Manila
Life : 8523-8611 to 18
Nonlife: 8524-0621 to 23

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