www.adityabirlacapital.com Open in urlscan Pro
13.126.162.195  Public Scan

Form analysis
1 forms found in the DOM

Name: call_form —

<form name="call_form" id="callUsForm" ng-class="{'form-error':showErrors}" class="ng-pristine ng-invalid ng-invalid-required ng-valid-pattern ng-valid-minlength ng-valid-maxlength">
  <div class="textbox leadformh">
    <input class="helpinputbox help-email-icon ng-pristine ng-untouched ng-valid ng-empty" name="name" ng-model="authmob.FIRSTNAME" placeholder="Name" valid-name="">
    <!-- ngIf: call_form.name.$error.required -->
  </div>
  <div class="textbox leadformh">
    <input class="helpinputbox help-mob-icon ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required ng-valid-pattern ng-valid-minlength ng-valid-maxlength" name="phone" placeholder="Mobile Number" valid-number="" maxlength="10"
      ng-model="authmob.MOBILE" required="" minlength="10" ng-pattern="/^[6789]\d{9}$/">
    <!-- ngIf: call_form.phone.$error.required --><span class="error-help-txt errorPhone ng-scope" ng-if="call_form.phone.$error.required">Please enter mobile no</span><!-- end ngIf: call_form.phone.$error.required -->
    <!-- ngIf: (!call_form.phone.$error.minlength && call_form.phone.$error.pattern) || call_form.phone.showError -->
    <!-- ngIf: call_form.phone.$error.minlength -->
  </div>
  <input type="hidden" name="key" value="s8KJBUKVV7rC6hun3+Ys3w==" autocomplete="off">
  <input type="hidden" name="id" value="889" autocomplete="off">
  <input type="hidden" name="ipaddress" autocomplete="off">
  <input type="hidden" name="location" autocomplete="off">
  <div class="textbox leadformh">
    <div class="floatcheck">
      <span class="error-help-txt errorTick" style="display:none">*</span>
      <input type="checkbox" class="helpcheckbox ng-pristine ng-untouched ng-valid ng-not-empty" ng-model="chkAuth" name="txtHelpCheck" id="txtHelpCheck" disabled="true">
    </div>
    <p class="desctxt">I authorize ABHICL and associate partners to contact me through me email/call/SMS. This will override registry on the DNCR</p>
  </div>
  <div class="textbox leadformh textparaStyle">
    <p>You will get a call immediately from us connecting our agent.</p>
  </div>
  <div class="textbox sub-buttons text-center" style="min-height:auto">
    <button type="button" class="cp-common-btn" name="txtSubmit" id="txtSubmit" ng-click="btnHelpBuy(authmob,call_form.$invalid,'call' ,'click-to-call')">Click to Call</button>
  </div>
</form>

Text Content

HEALTH INSURANCE
Aditya Birla Health Insurance Co. Limited







This channel is for buying assistance.
For service query please call 1800-270-7000


Please enter mobile no
*

I authorize ABHICL and associate partners to contact me through me
email/call/SMS. This will override registry on the DNCR

You will get a call immediately from us connecting our agent.

Click to Call



Request for Support

CONNECT WITH OUR EXPERTS

+91
Please provide your contact details for our Experts to Assist you.
CancelConnect


SHARE WITH OTHERS


Anyone with the link can guide youCopy link


*Your personal information will be masked and will not be shared with anyone.


Done

MAKE A SELECTION


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DenyProceed
Chat with the Agent Revoke edit access Show agent details

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End Session

FEEDBACK



On a scale of 1-10, how likely are you to recommend Cobrowse to a friend or
colleague?

012345678910
No ThanksSubmit

CONNECT WITH OUR EXPERTS

Our Customer Support Agent will be connecting with you shortly. Please wait.
OK

CONNECT WITH OUR EXPERTS

We would like to assist you in filling your form. By clicking 'Allow' our
Customer Service Agent will be able to see your screen and assist you. Please
don't worry, your personal data is safe and will not be visible to our Agent
CancelAllow

CONNECT WITH OUR EXPERTS

Our Customer Service Agent would like to meet you through video conferencing. By
clicking 'Connect' our Customer Service Agent and you will be connected on a
video conferencing.
DeclineConnect

VIDEO CALL


NoYes

AUDIO CALL


NoYes

CO-BROWSING ALERT*

--------------------------------------------------------------------------------

Upon clicking on Pay button, you will be directed to payment gateway page to
complete your transaction. For your security reasons, please note your
co-browsing session will be paused during this session and our sales agent will
not be able to view your details.


Ok

CONNECT WITH OUR EXPERTS


OK
Our Customer Service Agent has requested Edit Access to help you in filling the
form. You can revoke edit access from the navigation bar. Would you like to
allow?
DenyAllow
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AGENT DETAILS


You are connected to an official agent
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