customer_4711.xmlpre-filled
DATA
- NameJohn Smith
- Policy numberCAR-2026-4711
- Emailjohn@sample.com
RETURNED FROM THE FORM
- Date of loss12/10/2026empty
- Place of lossEisenstadtempty
- IBANAT61 1904 3002 3457 3201empty
Sample Insurance Ltd
BIU+ FieldRuleConditionRole: case worker
Sample Insurance Ltd
Motor claim report
Online form · draft in WYSIWYG mode
John Smith
CAR-2026-4711
john@sample.com
DD/MM/YYYY12/10/2026
Enter placeEisenstadt
AT__ ____ ____ ____ ____
YesNo
If “Yes”: injured persons and medical report upload appear dynamically
9:415G
Motor claim reportStep 2 of 3 · Details of the loss
John Smith
CAR-2026-4711
12/10/2026
Eisenstadt
AT61 1904 3002 345AT61 1904 3002 3457 3201
IBAN incomplete – please check
Tip: your IBAN is on your bank card.
YesNo
Claim submitted
Submit
Sample Insurance Ltd
Motor claim report
The same document, now complete
| Name | John Smith |
| Policy number | CAR-2026-4711 |
| john@sample.com | |
| Date of loss | 12/10/2026 |
| Place of loss | Eisenstadt |
| IBAN | AT61 1904 3002 3457 3201 |
| Personal injury | No |
Sample Insurance LtdPage 1 of 1
PDFMotor claim report
Customer portalStatus & documents
Emailwith PDF attached
PDF-Downloadaccessible to PDF/UA
XML dataData source
→To the customerConfirmation as PDF
←Back into the XMLfor further digital processing
Data from the core system – pre-filled
Pre-filling · rights & roles · dynamic fields
Responsive on any device · hints · error messages · guided input
Data back to the business application for further processing