www.ubench.com
Open in
urlscan Pro
81.246.77.232
Public Scan
URL:
https://www.ubench.com/ubench/xhtml/claims/declaration/declarationOverview.xhtml?values=ZNctO5DIsOQ7KuiouVhri7Qf8Z_f2Zj...
Submission: On May 11 via api from CH — Scanned from DE
Submission: On May 11 via api from CH — Scanned from DE
Form analysis 2 forms found in the DOM
Name: damageDeclarationForm — POST /ubench/xhtml/claims/declaration/declarationOverview.xhtml
<form id="damageDeclarationForm" name="damageDeclarationForm" method="post" action="/ubench/xhtml/claims/declaration/declarationOverview.xhtml" class="mainform ui-fluid" enctype="multipart/form-data">
<input type="hidden" name="damageDeclarationForm" value="damageDeclarationForm">
<div id="damageDeclarationForm:fleetLogo" class="ui-outputpanel ui-widget fleetLogo">
<img class="logoOnlineDeclaration" src="https://www.ubench.com/ubench/display?values=s18GwwOBqRKP5JnRylZH_lT-0AoEh72pDDJGEVGpHZfAFHMicOnxTg%0D%0A" style="margin: auto auto auto 0;max-height:100px;">
</div>
<table id="damageDeclarationForm:j_idt44" class="ui-panelgrid ui-widget fullWidth" role="grid">
<tbody>
<tr class="ui-widget-content" role="row">
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-12 fullWidth">
<div id="damageDeclarationForm:tabview" class="ui-tabs ui-widget ui-widget-content ui-corner-all ui-hidden-container ui-tabs-top" data-widget="widget_damageDeclarationForm_tabview">
<ul class="ui-tabs-nav ui-helper-reset ui-widget-header ui-corner-all" role="tablist">
<li class="ui-tabs-header ui-state-default ui-corner-top" role="tab" aria-expanded="false" aria-selected="false" data-index="0" tabindex="0"><a href="#damageDeclarationForm:tabview:declaration" tabindex="-1">Déclaration</a></li>
<li class="ui-tabs-header ui-state-default ui-corner-top" role="tab" aria-expanded="false" aria-selected="false" data-index="1" tabindex="0"><a href="#damageDeclarationForm:tabview:status" tabindex="-1">Progrès du dossier</a></li>
</ul>
<div class="ui-tabs-panels">
<div id="damageDeclarationForm:tabview:declaration" class="ui-tabs-panel ui-widget-content ui-corner-bottom ui-helper-hidden" role="tabpanel" aria-hidden="true" data-index="0">
<div id="damageDeclarationForm:tabview:j_idt45" class="ui-panelgrid ui-widget no-padding">
<div id="damageDeclarationForm:tabview:j_idt45_content" class="ui-panelgrid-content ui-widget-content ui-grid ui-grid-responsive">
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-6 fullWidth ui-g-12 ui-md-6">
<div id="damageDeclarationForm:tabview:j_idt46" class="ui-panelgrid ui-widget borderlessTable no-padding">
<div id="damageDeclarationForm:tabview:j_idt46_content" class="ui-panelgrid-content ui-widget-content ui-grid ui-grid-responsive">
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-4 ui-g-12 ui-md-6"><label id="damageDeclarationForm:tabview:j_idt47" class="ui-outputlabel ui-widget ubcustom label " style="">Plaque</label></div>
<div class="ui-panelgrid-cell ubi-grid-col-8 fullWidth ui-g-12 ui-md-6"><span id="damageDeclarationForm:tabview:licenseplate" class="value">VL4425</span></div>
</div>
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-4 ui-g-12 ui-md-6"><label id="damageDeclarationForm:tabview:j_idt48" class="ui-outputlabel ui-widget ubcustom label " style="">Nom</label></div>
<div class="ui-panelgrid-cell ubi-grid-col-8 fullWidth ui-g-12 ui-md-6"><span id="damageDeclarationForm:tabview:drivername" class="value">CAR, POOL 2 (♂)</span></div>
</div>
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-4 ui-g-12 ui-md-6"><label id="damageDeclarationForm:tabview:j_idt49" class="ui-outputlabel ui-widget ubcustom label " style="">Adresse</label></div>
<div class="ui-panelgrid-cell ubi-grid-col-8 fullWidth ui-g-12 ui-md-6">
<div id="damageDeclarationForm:tabview:j_idt50" class="ui-outputpanel ui-widget"><span id="damageDeclarationForm:tabview:address" class="value" style="display:block;">UBS Europe SE, Avenue J.F Kennedy</span><span
id="damageDeclarationForm:tabview:city" style="display:block;">2010 LUXEMBOURG</span><span id="damageDeclarationForm:tabview:country" style="display:block;">Luxembourg</span></div>
</div>
</div>
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-4 ui-g-12 ui-md-6"><span id="damageDeclarationForm:tabview:safAttachmentName"></span></div>
</div>
</div>
</div>
</div>
<div class="ui-panelgrid-cell ubi-grid-col-6 fullWidth ui-g-12 ui-md-6">
<div id="damageDeclarationForm:tabview:j_idt57" class="ui-panelgrid ui-widget borderlessTable">
<div id="damageDeclarationForm:tabview:j_idt57_content" class="ui-panelgrid-content ui-widget-content ui-grid ui-grid-responsive">
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-4 ui-g-12 ui-md-6"><label id="damageDeclarationForm:tabview:j_idt58" class="ui-outputlabel ui-widget ubcustom label " style="">Date de sinistre</label></div>
<div class="ui-panelgrid-cell ubi-grid-col-8 fullWidth ui-g-12 ui-md-6"><span id="damageDeclarationForm:tabview:accidentdate">Apr 25, 2022</span></div>
</div>
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-4 ui-g-12 ui-md-6"><label id="damageDeclarationForm:tabview:j_idt59" class="ui-outputlabel ui-widget ubcustom label " style="">Premier impact</label></div>
<div class="ui-panelgrid-cell ubi-grid-col-8 fullWidth ui-g-12 ui-md-6"><span id="damageDeclarationForm:tabview:firsthit">Avant</span></div>
</div>
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-4 ui-g-12 ui-md-6"><label id="damageDeclarationForm:tabview:j_idt60" class="ui-outputlabel ui-widget ubcustom label " style="">Lieu du sinistre</label></div>
<div class="ui-panelgrid-cell ubi-grid-col-8 fullWidth ui-g-12 ui-md-6">
<div id="damageDeclarationForm:tabview:j_idt61" class="ui-outputpanel ui-widget"><span id="damageDeclarationForm:tabview:accidentlocation">autoroute</span> Belgique</div>
</div>
</div>
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-4 ui-g-12 ui-md-6"><label id="damageDeclarationForm:tabview:j_idt66" class="ui-outputlabel ui-widget ubcustom label " style="">Tiers</label></div>
<div class="ui-panelgrid-cell ubi-grid-col-8 fullWidth ui-g-12 ui-md-6">
<div id="damageDeclarationForm:tabview:thirdpartyPresent:yesNo" class="ui-outputpanel ui-widget"><span class="fa fa-times times-color" title=""> </span></div>
</div>
</div>
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-4 ui-g-12 ui-md-6"><label id="damageDeclarationForm:tabview:j_idt72" class="ui-outputlabel ui-widget ubcustom label " style="">Police</label></div>
<div class="ui-panelgrid-cell ubi-grid-col-8 fullWidth ui-g-12 ui-md-6">
<div id="damageDeclarationForm:tabview:policePresent:yesNo" class="ui-outputpanel ui-widget"><span class="fa fa-times times-color" title=""> </span></div>
</div>
</div>
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-4 ui-g-12 ui-md-6"><label id="damageDeclarationForm:tabview:j_idt80" class="ui-outputlabel ui-widget ubcustom label " style="">Témoins</label></div>
<div class="ui-panelgrid-cell ubi-grid-col-8 fullWidth ui-g-12 ui-md-6">
<div id="damageDeclarationForm:tabview:witnessPresent:yesNo" class="ui-outputpanel ui-widget"><span class="fa fa-times times-color" title=""> </span></div>
</div>
</div>
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-4 ui-g-12 ui-md-6"><label id="damageDeclarationForm:tabview:j_idt86" class="ui-outputlabel ui-widget ubcustom label " style="">Blessé(s)</label></div>
<div class="ui-panelgrid-cell ubi-grid-col-8 fullWidth ui-g-12 ui-md-6">
<div id="damageDeclarationForm:tabview:j_idt87" class="ui-outputpanel ui-widget">
<div id="damageDeclarationForm:tabview:woundedPresent:yesNo" class="ui-outputpanel ui-widget"><span class="fa fa-times times-color" title=""> </span></div>
</div>
</div>
</div>
<div class="ui-g">
<div class="ui-panelgrid-cell ubi-grid-col-4 ui-g-12 ui-md-6"><label id="damageDeclarationForm:tabview:j_idt96" class="ui-outputlabel ui-widget ubcustom label " style="">Carrossier</label></div>
<div class="ui-panelgrid-cell ubi-grid-col-8 fullWidth ui-g-12 ui-md-6"><span id="damageDeclarationForm:tabview:repairer">AUTOGLAS Luxbg.</span></div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div id="damageDeclarationForm:tabview:j_idt112" class="ui-panelgrid ui-widget no-padding">
<div id="damageDeclarationForm:tabview:j_idt112_content" class="ui-panelgrid-content ui-widget-content ui-grid ui-grid-responsive"></div>
</div>
</div>
<div id="damageDeclarationForm:tabview:status" class="ui-tabs-panel ui-widget-content ui-corner-bottom ui-helper-hidden" role="tabpanel" aria-hidden="true" data-index="1">
<h2>Progrès du dossier - 22901308 (VL4425)</h2>Pour un service optimal vous trouvez ci-dessus toute information importante concernant la réparation de votre voiture<br>
<strong>AUDI A6 45 TDI QUATTRO</strong>
<div id="damageDeclarationForm:tabview:j_idt126" class="ui-outputpanel ui-widget panel fullWidth">
<table id="damageDeclarationForm:tabview:claimProgressTable" class="ui-panelgrid ui-widget borderlessTable no-padding fullWidth" role="grid">
<tbody>
<tr class="ui-widget-content ui-panelgrid-even" role="row">
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-3">
<h3>Carrossier</h3>
</td>
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-9 fullWidth"></td>
</tr>
<tr class="ui-widget-content ui-panelgrid-odd" role="row">
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-3"><label id="damageDeclarationForm:tabview:j_idt135" class="ui-outputlabel ui-widget ubcustom label " style="">Nom</label></td>
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-9 fullWidth"><span class="value">AUTOGLAS Luxbg.</span></td>
</tr>
<tr class="ui-widget-content ui-panelgrid-even" role="row">
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-3"><label id="damageDeclarationForm:tabview:j_idt140" class="ui-outputlabel ui-widget ubcustom label " style="">Adresse</label></td>
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-9 fullWidth"><span class="value">Rue de Luxembourg, 43, L-8077 BERTRANGE, Luxembourg</span></td>
</tr>
<tr class="ui-widget-content ui-panelgrid-odd" role="row">
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-3"><label id="damageDeclarationForm:tabview:j_idt145" class="ui-outputlabel ui-widget ubcustom label " style="">Tél.</label></td>
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-9 fullWidth"><span class="value">0035290150</span></td>
</tr>
<tr class="ui-widget-content ui-panelgrid-even" role="row">
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-3"><label id="damageDeclarationForm:tabview:j_idt150" class="ui-outputlabel ui-widget ubcustom label " style="">E-mail</label></td>
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-9 fullWidth">
<a class="value" href="mailto:info@autoglas.lu">info@autoglas.lu</a>
</td>
</tr>
<tr class="ui-widget-content ui-panelgrid-odd" role="row">
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-3"><label id="damageDeclarationForm:tabview:j_idt157" class="ui-outputlabel ui-widget ubcustom label " style="">Itinéraire</label></td>
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-9 fullWidth">
<a target="map" title="Itinéraire" class="value" href="https://maps.google.com/?saddr=UBS Europe SE, Avenue J.F Kennedy,LUXEMBOURG&daddr=Rue de Luxembourg, 43,BERTRANGE"><span class="directions fa fa-location-arrow"></span>
</a>
</td>
</tr>
<tr class="ui-widget-content ui-panelgrid-odd" role="row">
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-3">
<h3>Réparation</h3>
</td>
<td role="gridcell" class="ui-panelgrid-cell ubi-grid-col-9 fullWidth"></td>
</tr>
<tr class="ui-widget-content ui-panelgrid-even" role="row">
<td role="gridcell" class="ui-panelgrid-cell" colspan="2">
<div class="progress-bar">
<div class="state active">
<div class="icon fa "></div><span class="date">11-05-2022 08:00</span>
<div class="label">Inspection</div>
</div>
<div class="state active">
<div class="icon fa "></div><span class="date">11-05-2022 08:00</span>
<div class="label">Début de la réparation</div>
</div>
<div class="state active">
<div class="icon fa "></div><span class="date">11-05-2022 12:00</span>
<div class="label">Date de fin prévue</div>
</div>
<div class="state active">
<div class="icon fa "></div><span class="date">11-05-2022 14:23</span>
<div class="label">Fin de la réparation</div>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
</div>
</div><input type="hidden" id="damageDeclarationForm:tabview_activeIndex" name="damageDeclarationForm:tabview_activeIndex" value="2" autocomplete="off">
</div>
</td>
</tr>
</tbody>
</table><input type="hidden" name="javax.faces.ViewState" id="j_id1:javax.faces.ViewState:0" value="-821762162110498397:8522105071048254524" autocomplete="off">
</form>Name: footerform — POST /ubench/xhtml/claims/declaration/declarationOverview.xhtml
<form id="footerform" name="footerform" method="post" action="/ubench/xhtml/claims/declaration/declarationOverview.xhtml" enctype="application/x-www-form-urlencoded">
<input type="hidden" name="footerform" value="footerform">
<div id="footerform:j_idt260" class="ui-outputpanel ui-widget onlineDeclarationLocales">
<div id="footerform:j_idt261" class="ui-selectonebutton ui-buttonset ui-widget ui-corner-all ui-buttonset-3">
<div class="ui-button ui-widget ui-state-default ui-button-text-only ui-corner-left ui-state-active" tabindex="0"><input id="footerform:j_idt261:0" name="footerform:j_idt261" type="radio" value="fr" class="ui-helper-hidden-accessible"
tabindex="-1" aria-label="FR" checked="checked"><span class="ui-button-text ui-c">FR</span></div>
<div class="ui-button ui-widget ui-state-default ui-button-text-only" tabindex="0"><input id="footerform:j_idt261:1" name="footerform:j_idt261" type="radio" value="en" class="ui-helper-hidden-accessible" tabindex="-1" aria-label="EN"><span
class="ui-button-text ui-c">EN</span></div>
<div class="ui-button ui-widget ui-state-default ui-button-text-only ui-corner-right" tabindex="0"><input id="footerform:j_idt261:2" name="footerform:j_idt261" type="radio" value="de" class="ui-helper-hidden-accessible" tabindex="-1"
aria-label="DE"><span class="ui-button-text ui-c">DE</span></div>
</div>
</div><input type="hidden" name="javax.faces.ViewState" id="j_id1:javax.faces.ViewState:1" value="-821762162110498397:8522105071048254524" autocomplete="off">
</form>Text Content
* Déclaration * Progrès du dossier Plaque VL4425 Nom CAR, POOL 2 (♂) Adresse UBS Europe SE, Avenue J.F Kennedy2010 LUXEMBOURGLuxembourg Date de sinistre Apr 25, 2022 Premier impact Avant Lieu du sinistre autoroute Belgique Tiers Police Témoins Blessé(s) Carrossier AUTOGLAS Luxbg. PROGRÈS DU DOSSIER - 22901308 (VL4425) Pour un service optimal vous trouvez ci-dessus toute information importante concernant la réparation de votre voiture AUDI A6 45 TDI QUATTRO CARROSSIER NomAUTOGLAS Luxbg.AdresseRue de Luxembourg, 43, L-8077 BERTRANGE, LuxembourgTél.0035290150E-mail info@autoglas.luItinéraire RÉPARATION 11-05-2022 08:00 Inspection 11-05-2022 08:00 Début de la réparation 11-05-2022 12:00 Date de fin prévue 11-05-2022 14:23 Fin de la réparation FR EN DE