@extends('master')
@section('title')
Reclamo - gastos medicos
@endsection
@section('breadcrumb')
<li class="breadcrumb-item">
        <a href="{{url('/claims/list')}}">
        <i class="bi bi-file-earmark-medical"></i>
            Reclamos
        </a>
    </li>
    <li class="breadcrumb-item">
    <a href="{{url('/claims/create-list')}}">
        <i class="bi bi-file-earmark-medical"></i>
            Edicion reclamo
        </a>
    </li>
@endsection
@section('link')
<link rel="stylesheet" href="{{url('/static/css/select2.min.css?v='.time())}}">
@endsection
@section('body')
    <div class="col wrapper  ">

        <div class="row">
            <div class=" col-12 mtop16  mb-5">
                <div class="row">
                        <div class=" col-12 ">
                            <div class="panel myshadow">
                                <div class="mypanel">
                                    <div class="title mb-3">
                                        <p><i class="bi bi-plus-circle"></i> Edicion Reclamo Daños</p>
                                    </div>
                                    <form action="{{url('/claims/edit-damage/'.$claim->id)}}" method="POST" class="my-forms" enctype="multipart/form-data">
                                        @csrf
                                        <div class="row">
                                            <!-- Información del Reclamo -->
                                            <div class="col-lg-4 col-md-4 col-sm-12 mtop16">
                                                <h5>Información del Reclamo</h5>
                                                <table class="table table-bordered">
                                                    <tbody>
                                                        <tr>
                                                            <th>ID Gestión</th>
                                                            <td><a target="_blank" href="{{url('/tickets/edit/'.$claim->ticket_id)}}">NG-{{ $claim->ticket_id }}</a></td>
                                                        </tr>
                                                        <tr>
                                                            <th>Póliza</th>
                                                            <td>{{ $claim->policy->policy_id ?? 'N/A' }}</td>
                                                        </tr>
                                                        <tr>
                                                            <th>Cliente</th>
                                                            <td><a target="_blank" href="{{url('/clients/profile/'.$claim->policy->getClient->id)}}">{{getClientName($claim->policy->getClient)}}</a></td>
                                                        </tr>
                                                        <tr>
                                                            <th>Asegurado</th>
                                                            <td>
                                                                {{ $claim->policyInsurerVehicle ? $claim->policyInsurerVehicle->engine .' - '. $claim->policyInsurerVehicle->brand : $claim->policyInsurerDamage->name }}
                                                            </td>
                                                        </tr>
                                                        <tr>
                                                            <th>Aseguradora</th>
                                                            <td>{{ $claim->insurance->name ?? 'N/A' }}</td>
                                                        </tr>
                                                        <tr>
                                                            <th>Ramo</th>
                                                            <td>{{ $claim->insuranceInsurer->name }}</td>
                                                        </tr>
                                                    </tbody>
                                                </table>
                                            </div>

                                            @if ($claim->status != 99)
                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <select class="form-select" id="status" name="status">
                                                            @foreach(damageClaimsStatuses() as $key => $value)
                                                                <option value="{{$key}}" @if($claim->status == $key) selected @endif>{{$value}}</option>
                                                            @endforeach
                                                        </select>
                                                        <label for="status">Estado del Reclamo</label>
                                                    </div>
                                                </div>
                                            @endif

                                            <!-- Inputs ocultos -->
                                            <input value="{{$claim->insurer->id ?? old('insurer_id_hidden')}}" type="hidden" class="form-control" id="insurer_id_hidden" name="insurer_id_hidden">
                                            <input value="{{$claim->policy->id ?? old('policy_id_hidden')}}" type="hidden" class="form-control" id="policy_id_hidden" name="policy_id_hidden">
                                            <input value="{{$claim->client->id ?? old('client_id_hidden')}}" type="hidden" class="form-control" id="client_id_hidden" name="client_id_hidden">
                                            <input value="{{$claim->insurer->id ?? old('insurance_id_hidden')}}" type="hidden" class="form-control" id="insurance_id_hidden" name="insurance_id_hidden">
                                            <input value="{{$claim->policy->branch_id ?? old('ramo_id_hidden')}}" type="hidden" class="form-control" id="ramo_id_hidden" name="ramo_id_hidden">
                                            <input value="{{$claim->product_type ?? old('product_type')}}" type="hidden" class="form-control" id="product_type" name="product_type">
                                            <input value="{{$claim->claim_type ?? 3}}" type="hidden" class="form-control" id="claim_type" name="claim_type">

                                            <!-- Información del Reclamo -->
                                                <small class="my-2">Información del Reclamo</small>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{$claim->claim_number ?? old('claim_number')}}" required type="text" class="form-control" id="claim_number" name="claim_number">
                                                        <label for="claim_number">Número de Reclamo</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{$claim->date_infinity_receive ?? old('date_infinity_receive')}}" type="date" class="form-control" id="date_infinity_receive" name="date_infinity_receive">
                                                        <label for="date_infinity_receive">Fecha Recibido en Infinity</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{$claim->incident_date ?? old('incident_date')}}" required type="date" class="form-control" id="incident_date" name="incident_date">
                                                        <label for="incident_date">Fecha del Siniestro</label>
                                                    </div>
                                                </div>

                                                <!-- Valores Monetarios -->
                                                <small class="my-2">Valores Monetarios</small>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{$claim->compensation_value ?? old('compensation_value')}}" type="number" step="0.01" class="form-control" id="compensation_value" name="compensation_value">
                                                        <label for="compensation_value">Valor de la Compensación</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{$claim->own_damage_value ?? old('own_damage_value')}}" type="number" step="0.01" class="form-control" id="own_damage_value" name="own_damage_value">
                                                        <label for="own_damage_value">Valor de Daños Propios</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{$claim->third_party_damage_value ?? old('third_party_damage_value')}}" type="number" step="0.01" class="form-control" id="third_party_damage_value" name="third_party_damage_value">
                                                        <label for="third_party_damage_value">Valor de Daños a Terceros</label>
                                                    </div>
                                                </div>

                                                <!-- Deducibles -->
                                                <small class="my-2">Deducibles</small>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{$claim->deductible_paid_deductible_1 ?? old('deductible_paid_deductible_1')}}" type="date" class="form-control" id="deductible_paid_deductible_1" name="deductible_paid_deductible_1">
                                                        <label for="deductible_paid_deductible_1">Deducible Pagado 1</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{$claim->deductible_paid_deductible_2 ?? old('deductible_paid_deductible_2')}}" type="date" class="form-control" id="deductible_paid_deductible_2" name="deductible_paid_deductible_2">
                                                        <label for="deductible_paid_deductible_2">Deducible Pagado 2</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{$claim->deductible_paid_deductible_3 ?? old('deductible_paid_deductible_3')}}" type="date" class="form-control" id="deductible_paid_deductible_3" name="deductible_paid_deductible_3">
                                                        <label for="deductible_paid_deductible_3">Deducible Pagado 3</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{$claim->deductible_paid_value_1 ?? old('deductible_paid_value_1')}}" type="number" step="0.01" class="form-control" id="deductible_paid_value_1" name="deductible_paid_value_1">
                                                        <label for="deductible_paid_value_1">Valor del Deducible 1</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{$claim->deductible_paid_value_2 ?? old('deductible_paid_value_2')}}" type="number" step="0.01" class="form-control" id="deductible_paid_value_2" name="deductible_paid_value_2">
                                                        <label for="deductible_paid_value_2">Valor del Deducible 2</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{$claim->deductible_paid_value_3 ?? old('deductible_paid_value_3')}}" type="number" step="0.01" class="form-control" id="deductible_paid_value_3" name="deductible_paid_value_3">
                                                        <label for="deductible_paid_value_3">Valor del Deducible 3</label>
                                                    </div>
                                                </div>

                                                <small class="my-2">Detalles Adicionales</small>

                                                <div class="col-lg-6 col-md-6 col-sm-6 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <textarea class="form-control" id="pending_case_details" name="pending_case_details" rows="4">{{ $claim->pending_case_details ?? old('pending_case_details') }}</textarea>
                                                        <label for="pending_case_details">Detalles del Caso Pendiente</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <select class="form-select" id="settlement_status_id" name="settlement_status_id">
                                                            <option value="">Seleccionar Estado del Finiquito</option>
                                                            <option value="1" @if(($claim->settlement_status_id ?? old('settlement_status_id')) == 1) selected @endif>FINIQUITO ENVIADO AL CLIENTE</option>
                                                            <option value="2" @if(($claim->settlement_status_id ?? old('settlement_status_id')) == 2) selected @endif>FINIQUITO FIRMADO POR CLIENTE</option>
                                                            <option value="3" @if(($claim->settlement_status_id ?? old('settlement_status_id')) == 3) selected @endif>FINIQUITO PENDIENTE CIA</option>
                                                        </select>
                                                        <label for="settlement_status_id">Estado del Finiquito</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{ $claim->case_closure_date ?? old('case_closure_date') }}" type="date" class="form-control" id="case_closure_date" name="case_closure_date">
                                                        <label for="case_closure_date">Fecha de Cierre del Caso</label>
                                                    </div>
                                                </div>

                                                <small class="my-2">Información Adicional del Reclamo</small>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{ $claim->claim_reference_number ?? old('claim_reference_number') }}" type="text" class="form-control" id="claim_reference_number" name="claim_reference_number">
                                                        <label for="claim_reference_number">N. Reclamo CIA</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <select required class="form-select" id="incident_type" name="incident_type">
                                                            <option value="">Seleccionar tipo de siniestro</option>
                                                            @foreach (incidentTypes() as $typeId => $typeName)
                                                            <option value="{{ $typeId }}" @if(($claim->incident_type ?? old('incident_type')) == $typeId) selected @endif>{{ $typeName }}</option>
                                                            @endforeach
                                                        </select>
                                                        <label for="incident_type">Tipo de Siniestro</label>
                                                    </div>
                                                </div>

                                                <small class="my-2">Audiencia</small>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{ $claim->hearing_date ?? old('hearing_date') }}" type="date" class="form-control" id="hearing_date" name="hearing_date">
                                                        <label for="hearing_date">Fecha de Audiencia</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{ $claim->driver_comments ?? old('driver_comments') }}" type="text" class="form-control" id="driver_comments" name="driver_comments">
                                                        <label for="driver_comments">Motorista</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{ $claim->report_delivery_date ?? old('report_delivery_date') }}" type="date" class="form-control" id="report_delivery_date" name="report_delivery_date">
                                                        <label for="report_delivery_date">Fecha de Entrega del Parte</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{ $claim->hearing_verdict ?? old('hearing_verdict') }}" type="text" class="form-control" id="hearing_verdict" name="hearing_verdict">
                                                        <label for="hearing_verdict">Culpables o No Culpables Audiencia de DNVT</label>
                                                    </div>
                                                </div>

                                                <div class="col-lg-4 col-md-4 col-sm-4 col-12 mb-2">
                                                    <div class="form-floating">
                                                        <input value="{{ $claim->notification_date ?? old('notification_date') }}" type="date" class="form-control" id="notification_date" name="notification_date">
                                                        <label for="notification_date">Fecha de Notificación CIA</label>
                                                    </div>
                                                </div>

                                        </div>

                                        <button class="btn btn-success send-form mt-5" type="submit">Actualizar Reclamo</button>
                                    </form>

                                </div>
                            </div>
                        </div>
                </div>
            </div>

        </div>
    </div>


@endsection

@section('script')
<script src="{{url('/static/js/select2.min.js?v='.time())}}"></script>

<script src="{{url('/static/js/claim_creation.js?v='.time())}}"></script>
<script>
    $(document).ready(function() {

        $('.js-pick-ticket-id').select2().on('change', function(){
            getInfoClaimsFromTicket(this.value);
        });
    });

</script>

@endsection