View In:   ArcGIS Online Map Viewer

Name: Damage_Claim_Intake_Form

Display Field: objectid

Type: Feature Layer

Geometry Type: esriGeometryPoint

Description:

Service Item Id: 6ce8d78f54164d28b5226f82ceb707ca

Copyright Text:

Default Visibility: true

MaxRecordCount: 1000

MaxSelectionCount: 0

Supported Query Formats: JSON, geoJSON, PBF

Min Scale: 0.0

Max Scale: 0.0

Supports Advanced Queries: true

Supports Statistics: true

Use Standardized Queries: true

Supports ValidateSQL: true

Supports Calculate: true

Extent:

XMin: -180.0
YMin: -90.0
XMax: 180.0
YMax: 90.0
Spatial Reference: 4326  (0)  LatestVCSWkid(0)

Drawing Info:

Renderer:
Unique Value Renderer:
Field 1: claimstatus
Field 2: N/A
Field 3: N/A
Field Delimiter: N/A
Default Symbol:
N/A
Default Label: N/A
UniqueValueInfos:
• Value: Assigned
  Label: Assigned
  Description: N/A
  Symbol:
  Style: esriSMSCircle
  Color: [237, 81, 81, 255]
  Size: 6.0
  Angle: 0.0
  XOffset: 0
  YOffset: 0
  Outline:
  [153, 153, 153, 64] Width: 0
• Value: Received
  Label: Received
  Description: N/A
  Symbol:
  Style: esriSMSCircle
  Color: [20, 158, 206, 255]
  Size: 6.0
  Angle: 0.0
  XOffset: 0
  YOffset: 0
  Outline:
  [153, 153, 153, 64] Width: 0
• Value: Expired - No Response
  Label: Expired - No Response
  Description: N/A
  Symbol:
  Style: esriSMSCircle
  Color: [167, 198, 54, 255]
  Size: 6.0
  Angle: 0.0
  XOffset: 0
  YOffset: 0
  Outline:
  [153, 153, 153, 64] Width: 0
• Value: Closed
  Label: Closed
  Description: N/A
  Symbol:
  Style: esriSMSCircle
  Color: [158, 85, 156, 255]
  Size: 6.0
  Angle: 0.0
  XOffset: 0
  YOffset: 0
  Outline:
  [153, 153, 153, 64] Width: 0
• Value: Needs More Information
  Label: Needs More Information
  Description: N/A
  Symbol:
  Style: esriSMSCircle
  Color: [252, 146, 31, 255]
  Size: 6.0
  Angle: 0.0
  XOffset: 0
  YOffset: 0
  Outline:
  [153, 153, 153, 64] Width: 0
• Value: Redirect
  Label: Redirect
  Description: N/A
  Symbol:
  Style: esriSMSCircle
  Color: [255, 222, 62, 255]
  Size: 6.0
  Angle: 0.0
  XOffset: 0
  YOffset: 0
  Outline:
  [153, 153, 153, 64] Width: 0
Transparency: 0
Labeling Info:

Feature Draw Order:

N/A

Advanced Query Capabilities:

Supports Statistics: true
Supports OrderBy: true
Supports Distinct: true
Supports Pagination: true
Supports TrueCurve: false
Supports Returning Query Extent: true
Supports Query With Distance: true
Supports Sql Expression: true
Supports Query With ResultType: true
Supports Returning Geometry Centroid: false
Supports Binning LOD: true
Supports Query With LOD Spatial Reference: true
Supports Percentile Statistics: true
Supports Having Clause: true
Supports Count Distinct: true
Supports Time Relation: false
Supports Sql Format: false
Supports Query Analytic: true
Supports Query With Current User: true

HasZ: false

HasM: false

Has Attachments: true

HTML Popup Type: esriServerHTMLPopupTypeAsHTMLText

Type ID Field: claimstatus

Fields:

• objectid ( nullable: false, editable: false, defaultValue: null, length: 4, alias: ObjectID, type: esriFieldTypeOID )
• globalid ( nullable: false, editable: false, defaultValue: null, length: 38, alias: GlobalID, type: esriFieldTypeGlobalID )
• uniquerowid ( nullable: true, editable: true, defaultValue: null, length: 38, alias: RowID, type: esriFieldTypeGUID )
• name ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Your Name (first and last):, type: esriFieldTypeString )
• city ( nullable: true, editable: true, defaultValue: null, length: 255, alias: City:, type: esriFieldTypeString )
• state_abbr ( nullable: true, editable: true, defaultValue: null, length: 255, alias: State:, type: esriFieldTypeString , Coded Values: [AL: AL] , [AK: AK] , [AZ: AZ] , ...47 more... )
• zip ( nullable: true, editable: true, defaultValue: null, alias: Zip Code:, type: esriFieldTypeInteger )
• email ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Email Address:, type: esriFieldTypeString )
• phone ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Phone Number:, type: esriFieldTypeString )
• preferred_comm ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Preferred method of communication:, type: esriFieldTypeString , Coded Values: [Phone: Phone] , [Email: Email] )
• datetime ( nullable: true, editable: true, defaultValue: null, precision: 1, length: 29, alias: Date and Time of Incident:, type: esriFieldTypeDate )
• claim_type ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Type of Claim:, type: esriFieldTypeString , Coded Values: [Vehicle: Vehicle] , [Property: Property] )
• claim_subtype ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Type of Damage:, type: esriFieldTypeString )
• other ( nullable: true, editable: true, defaultValue: null, length: 255, alias: If other, please describe:, type: esriFieldTypeString )
• damage_description ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Please provide a detailed description of the damage to your vehicle or property:, type: esriFieldTypeString )
• vehicle_make ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Vehicle Make:, type: esriFieldTypeString )
• vehicle_model ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Vehicle Model:, type: esriFieldTypeString )
• vehicle_year ( nullable: true, editable: true, defaultValue: null, alias: Vehicle Year:, type: esriFieldTypeInteger )
• license_plate ( nullable: true, editable: true, defaultValue: null, length: 255, alias: License Plate:, type: esriFieldTypeString )
• contact_ems ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Did you contact the police or emergency services?, type: esriFieldTypeString , Coded Values: [yes: Yes] , [no: No] )
• direction ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Please describe direction of travel:, type: esriFieldTypeString )
• injuries ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Did you sustain any injuries during this incident?, type: esriFieldTypeString , Coded Values: [yes: Yes] , [no: No] )
• injuries_description ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Please describe injuries:, type: esriFieldTypeString )
• constzone ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Did the damage occur in a construction zone?, type: esriFieldTypeString , Coded Values: [yes: Yes] , [no: No] )
• constzone_contractor ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Please provide the contractor name if known:, type: esriFieldTypeString )
• description ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Please provide a detailed description of the incident in which alleged damage occurred:, type: esriFieldTypeString )
• fraud_disclaimer ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Insurance Fraud Acknowledgment:, type: esriFieldTypeString , Coded Values: [Fraud: It is a crime to present a written statement or representation in connection with a civil claim asserted for recovery of damages for personal or bodily injuries or property damage; and knowing that the statement or representation contains false, incomplete, or fraudulent information concerning any fact or thing material to the claim. § 76-6-521 Fraudulent insurance act.] )
• acknowledgement ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Please confirm the following:, type: esriFieldTypeString , Coded Values: [Confirm: I confirm that all information in this form is accurate and true to the best of my knowledge.] )
• loc_y ( nullable: true, editable: true, defaultValue: null, length: 255, alias: loc_y, type: esriFieldTypeString )
• loc_x ( nullable: true, editable: true, defaultValue: null, length: 255, alias: loc_x, type: esriFieldTypeString )
• randh_url ( nullable: true, editable: true, defaultValue: null, length: 255, alias: randh_url, type: esriFieldTypeString )
• randh_json ( nullable: true, editable: true, defaultValue: null, length: 255, alias: JSON Response, type: esriFieldTypeString )
• route ( nullable: true, editable: true, defaultValue: null, length: 255, alias: route, type: esriFieldTypeString )
• measure ( nullable: true, editable: true, defaultValue: null, length: 255, alias: measure, type: esriFieldTypeString )
• created_user ( nullable: true, editable: false, defaultValue: null, length: 255, alias: created_user, type: esriFieldTypeString )
• created_date ( nullable: true, editable: false, defaultValue: null, precision: 1, length: 29, alias: created_date, type: esriFieldTypeDate )
• last_edited_user ( nullable: true, editable: false, defaultValue: null, length: 255, alias: last_edited_user, type: esriFieldTypeString )
• last_edited_date ( nullable: true, editable: false, defaultValue: null, precision: 1, length: 29, alias: last_edited_date, type: esriFieldTypeDate )
• address ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Address:, type: esriFieldTypeString )
• claimstatus ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Claim Status:, type: esriFieldTypeString , Coded Values: [Received: Received] , [Needs More Information: Needs More Information] , [Redirect: Redirect] , ...3 more... )
• assignedto ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Assigned To:, type: esriFieldTypeString )
• notes ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Notes:, type: esriFieldTypeString )
• privateinsurance ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Have you filed a claim with your homeowner's or auto insurance?, type: esriFieldTypeString , Coded Values: [yes: Yes] , [no: No] )
• insuranceclaim2 ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Insurance claim information:, type: esriFieldTypeString )
• shedjson ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Shed JSON response, type: esriFieldTypeString )
• stationnum ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Station Number, type: esriFieldTypeString )
• isstateroute ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Is the point on a state route, type: esriFieldTypeString )
• routenote ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Looks like the route you chose is not a state route - please contact your local municipality. If you feel this is incorrect, please continue filling out the claim form., type: esriFieldTypeString )
• assignedsub ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Assigned To Project/Company:, type: esriFieldTypeString )
• generaldisclaimer ( nullable: true, editable: true, defaultValue: null, length: 256, alias: General Disclaimer, type: esriFieldTypeString )
• requiredquestions ( nullable: true, editable: true, defaultValue: null, length: 256, alias: Fields marked with an asterisk are required, and you will not be able to submit a claim if they are left blank., type: esriFieldTypeString )
• instructions ( nullable: true, editable: true, defaultValue: null, length: 256, alias: Instructions, type: esriFieldTypeString )
• snowplow ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Did the incident involve a snow plow?, type: esriFieldTypeString , Coded Values: [yes: Yes] , [no: No] )
• snowplow_info ( nullable: true, editable: true, defaultValue: null, length: 255, alias: If yes, did you get any information about the plow?, type: esriFieldTypeString )
• text1 ( nullable: true, editable: true, defaultValue: null, length: 255, alias: text1, type: esriFieldTypeString )
• policenum ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Please provide the case number, if known:, type: esriFieldTypeString )
• protectedrecords ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Protected Records Classification Notice; please acknowledge the following:, type: esriFieldTypeString , Coded Values: [Confirm: The data collected through this claims intake system including; any associated attachments, file uploads, and derivative data analytics-based information constitute records are part of a protected loss occurrence investigation that may be used for the purpose of identifying, evaluating, or planning the safety enhancement of potential accident sites or hazardous roadway conditions. As such, all associated records are expressly protected against public records release, discovery, and admission per Utah GRAMA - § 63G-2-305(24) and 23 U.S. Code § 407.] )
• datadisclaimer ( nullable: true, editable: true, defaultValue: null, length: 255, alias: Data Subject Disclosures - § 63G-2-601(2)(a); please acknowledge the following:, type: esriFieldTypeString , Coded Values: [Data: (i) Data Collection Need: The Utah Department of Transportation (UDOT) collects claims-related data in order to conduct loss occurrence investigations, facilitate claims adjusting processes, and support the resolution of claim-related disputes. (ii) Limited Use Purpose: This data will be used to investigate reported loss occurrence claims, facilitate the claims adjusting process, assign, tender, and convey claims information and records to appropriate parties that have a specific loss mitigation role directed towards the resolution of a submitted claim. This data will also be used to facilitate ongoing communication and engagement with the claimant. In addition, redacted or de-identified data may be employed to support transportation research, improve the effectiveness of staff training, aid in proactive loss mitigation efforts, and improve longitudinal program performance outcomes. This data is protected against public information releases under Utah GRAMA (§ 63G-2-305(24)) and 23 U.S. Code § 407. It will not be shared, monetized, or otherwise sold to any third-party with data brokering or other commercialization-related interests. (iii) Refusal to Provide Data: A claimant cannot submit a claim without providing sufficient information to complete the claims intake system screens. UDOT will not process partial or incomplete damage claim reports. UDOT does, however, apply a data minimization principle and purposefully narrows structured data collection screens to the minimum the fields necessary to responsibly facilitate core program and process transactions. (iv) Classes of Persons and Governmental Entities Share/Receive Information: This data may be shared with specific UDOT employees that have an essential role in the claims data processing, prevention, mitigation, optimization, and resolution process. This data may also be shared with specific insurance carriers, UDOT contractors, UDOT consultants, state-level executive branch agencies, and others parties that fall within the scope of the expressed limited use purpose.] )
• statusclosed ( nullable: true, editable: true, defaultValue: null, length: 256, alias: Closed Claim - reason:, type: esriFieldTypeString )
• pothole_known ( nullable: true, editable: true, defaultValue: null, length: 10, alias: Known Pothole, type: esriFieldTypeString )
• pothole_action ( nullable: true, editable: true, defaultValue: null, length: 10, alias: Pothole Action, type: esriFieldTypeString )

Types:

ID: Assigned
Name: Assigned
Domains:
None
Templates:
• Name: Assigned
  Description:
  Prototype:
  injuries_description: null
  instructions: null
  acknowledgement: null
  notes: null
  injuries: null
  damage_description: null
  protectedrecords: null
  isstateroute: null
  fraud_disclaimer: null
  datetime: null
  generaldisclaimer: null
  constzone_contractor: null
  loc_x: null
  pothole_known: null
  loc_y: null
  privateinsurance: null
  zip: null
  vehicle_make: null
  claimstatus: Assigned
  shedjson: null
  snowplow: null
  claim_type: null
  policenum: null
  claim_subtype: null
  routenote: null
  route: null
  measure: null
  insuranceclaim2: null
  phone: null
  text1: null
  name: null
  snowplow_info: null
  preferred_comm: null
  other: null
  city: null
  vehicle_model: null
  description: null
  constzone: null
  uniquerowid: null
  randh_url: null
  contact_ems: null
  email: null
  direction: null
  address: null
  assignedsub: null
  assignedto: null
  statusclosed: null
  datadisclaimer: null
  license_plate: null
  randh_json: null
  stationnum: null
  vehicle_year: null
  state_abbr: null
  requiredquestions: null
  
  Drawing Tool: N/A

---

ID: Received
Name: Received
Domains:
None
Templates:
• Name: Received
  Description:
  Prototype:
  injuries_description: null
  instructions: null
  acknowledgement: null
  notes: null
  injuries: null
  damage_description: null
  protectedrecords: null
  isstateroute: null
  fraud_disclaimer: null
  datetime: null
  generaldisclaimer: null
  constzone_contractor: null
  loc_x: null
  pothole_known: null
  loc_y: null
  privateinsurance: null
  zip: null
  vehicle_make: null
  claimstatus: Received
  shedjson: null
  snowplow: null
  claim_type: null
  policenum: null
  claim_subtype: null
  routenote: null
  route: null
  measure: null
  insuranceclaim2: null
  phone: null
  text1: null
  name: null
  snowplow_info: null
  preferred_comm: null
  other: null
  city: null
  vehicle_model: null
  description: null
  constzone: null
  uniquerowid: null
  randh_url: null
  contact_ems: null
  email: null
  direction: null
  address: null
  assignedsub: null
  assignedto: null
  statusclosed: null
  datadisclaimer: null
  license_plate: null
  randh_json: null
  stationnum: null
  vehicle_year: null
  state_abbr: null
  requiredquestions: null
  
  Drawing Tool: N/A

---

ID: Expired - No Response
Name: Expired - No Response
Domains:
None
Templates:
• Name: Expired - No Response
  Description:
  Prototype:
  injuries_description: null
  instructions: null
  acknowledgement: null
  notes: null
  injuries: null
  damage_description: null
  protectedrecords: null
  isstateroute: null
  fraud_disclaimer: null
  datetime: null
  generaldisclaimer: null
  constzone_contractor: null
  loc_x: null
  pothole_known: null
  loc_y: null
  privateinsurance: null
  zip: null
  vehicle_make: null
  claimstatus: Expired - No Response
  shedjson: null
  snowplow: null
  claim_type: null
  policenum: null
  claim_subtype: null
  routenote: null
  route: null
  measure: null
  insuranceclaim2: null
  phone: null
  text1: null
  name: null
  snowplow_info: null
  preferred_comm: null
  other: null
  city: null
  vehicle_model: null
  description: null
  constzone: null
  uniquerowid: null
  randh_url: null
  contact_ems: null
  email: null
  direction: null
  address: null
  assignedsub: null
  assignedto: null
  statusclosed: null
  datadisclaimer: null
  license_plate: null
  randh_json: null
  stationnum: null
  vehicle_year: null
  state_abbr: null
  requiredquestions: null
  
  Drawing Tool: N/A

---

ID: Closed
Name: Closed
Domains:
None
Templates:
• Name: Closed
  Description:
  Prototype:
  injuries_description: null
  instructions: null
  acknowledgement: null
  notes: null
  injuries: null
  damage_description: null
  protectedrecords: null
  isstateroute: null
  fraud_disclaimer: null
  datetime: null
  generaldisclaimer: null
  constzone_contractor: null
  loc_x: null
  pothole_known: null
  loc_y: null
  privateinsurance: null
  zip: null
  vehicle_make: null
  claimstatus: Closed
  shedjson: null
  snowplow: null
  claim_type: null
  policenum: null
  claim_subtype: null
  routenote: null
  route: null
  measure: null
  insuranceclaim2: null
  phone: null
  text1: null
  name: null
  snowplow_info: null
  preferred_comm: null
  other: null
  city: null
  vehicle_model: null
  description: null
  constzone: null
  uniquerowid: null
  randh_url: null
  contact_ems: null
  email: null
  direction: null
  address: null
  assignedsub: null
  assignedto: null
  statusclosed: null
  datadisclaimer: null
  license_plate: null
  randh_json: null
  stationnum: null
  vehicle_year: null
  state_abbr: null
  requiredquestions: null
  
  Drawing Tool: N/A

---

ID: Needs More Information
Name: Needs More Information
Domains:
None
Templates:
• Name: Needs More Information
  Description:
  Prototype:
  injuries_description: null
  instructions: null
  acknowledgement: null
  notes: null
  injuries: null
  damage_description: null
  protectedrecords: null
  isstateroute: null
  fraud_disclaimer: null
  datetime: null
  generaldisclaimer: null
  constzone_contractor: null
  loc_x: null
  pothole_known: null
  loc_y: null
  privateinsurance: null
  zip: null
  vehicle_make: null
  claimstatus: Needs More Information
  shedjson: null
  snowplow: null
  claim_type: null
  policenum: null
  claim_subtype: null
  routenote: null
  route: null
  measure: null
  insuranceclaim2: null
  phone: null
  text1: null
  name: null
  snowplow_info: null
  preferred_comm: null
  other: null
  city: null
  vehicle_model: null
  description: null
  constzone: null
  uniquerowid: null
  randh_url: null
  contact_ems: null
  email: null
  direction: null
  address: null
  assignedsub: null
  assignedto: null
  statusclosed: null
  datadisclaimer: null
  license_plate: null
  randh_json: null
  stationnum: null
  vehicle_year: null
  state_abbr: null
  requiredquestions: null
  
  Drawing Tool: N/A

---

ID: Redirect
Name: Redirect
Domains:
None
Templates:
• Name: Redirect
  Description:
  Prototype:
  injuries_description: null
  instructions: null
  acknowledgement: null
  notes: null
  injuries: null
  damage_description: null
  protectedrecords: null
  isstateroute: null
  fraud_disclaimer: null
  datetime: null
  generaldisclaimer: null
  constzone_contractor: null
  loc_x: null
  pothole_known: null
  loc_y: null
  privateinsurance: null
  zip: null
  vehicle_make: null
  claimstatus: Redirect
  shedjson: null
  snowplow: null
  claim_type: null
  policenum: null
  claim_subtype: null
  routenote: null
  route: null
  measure: null
  insuranceclaim2: null
  phone: null
  text1: null
  name: null
  snowplow_info: null
  preferred_comm: null
  other: null
  city: null
  vehicle_model: null
  description: null
  constzone: null
  uniquerowid: null
  randh_url: null
  contact_ems: null
  email: null
  direction: null
  address: null
  assignedsub: null
  assignedto: null
  statusclosed: null
  datadisclaimer: null
  license_plate: null
  randh_json: null
  stationnum: null
  vehicle_year: null
  state_abbr: null
  requiredquestions: null
  
  Drawing Tool: N/A

---

Relationships:

• Damage_Claim_Intake_Form_PhotoRepeat (0) -- Related To: PhotoRepeat (1)

Capabilities: Query

Sync Can Return Changes: true

Is Data Versioned: false

Supports Rollback On Failure: true

Supports ApplyEdits With Global Ids: false

Supports ApplyEdits By Upload Id: true

Edit Fields Info:

• Creation Date Field: created_date
• Creator Field: created_user
• Edit Date Field: last_edited_date
• Editor Field: last_edited_user

Ownership Based Access Control:

• Allow Others to Update: false
• Allow Others to Delete: false
• Allow Others to Query: false

Supports Query With Historic Moment: false

Supports Coordinates Quantization: true

Child Resources:

Supported Operations:   Query   Query Attachments   Query Analytic   Query Top Features   Query Related Records   Query Bins   Append   Validate SQL   Generate Renderer   Return Updates   Metadata   Update Metadata