diff --git a/src/layouts/insurance-details/insurance-details.vue b/src/layouts/insurance-details/insurance-details.vue
index 67670b9cc..3fdfffbdf 100644
--- a/src/layouts/insurance-details/insurance-details.vue
+++ b/src/layouts/insurance-details/insurance-details.vue
@@ -1,3 +1,4 @@
+
 <template>
     <Form @submit="onSubmit" @invalid-submit="onInvalidSubmit" ref="theForm" v-slot="{ meta }">
         <loadingModal ref="loadingModal" />
@@ -39,7 +40,16 @@
                         format="MM/dd/yyyy"
                         modelType="MM/dd/yyyy"
                         :enableTimePicker="false"
-                        :clearable="false" />
+                        :clearable="false"
+                        :textInput="true" />
+
+                    <textboxQuestion
+                        v-if="displayClaimNumber"
+                        isRequired
+                        class="mb-4"
+                        cmsWidgetName="ClaimNumberWidget"
+                        v-model="claimNumber"
+                        inputId="claimNumber" />
 
                     <dropdownQuestion
                         isRequired
@@ -89,6 +99,7 @@
                         :options="stateOptions"
                         validationRules="state-required"
                         autocomplete="address-level1"
+                        placeHolderText="Select State"
                         :labelBold="true" />
 
                     <textboxQuestion
@@ -157,6 +168,7 @@ export default {
             city: this.getCityFromStore(),
             policyState: this.getPolicyStateFromStore(),
             policyZip: this.getPolicyZipFromStore(),
+            claimNumber: this.getClaimNumberFromStore(),
         };
     },
     components: {
@@ -186,6 +198,14 @@ export default {
     },
 
     computed: {
+        displayClaimNumber() {
+            const order = store.getters.order;
+            // Kentucky Farm Bureau
+            if (order.payment?.parentAccountNumber.toString() === "223499") {
+                return true;
+            }
+            return false;
+        },
         stateOptions() {
             return stateOptions;
         },
@@ -231,6 +251,9 @@ export default {
         getPolicyZipFromStore() {
             return store.getters.order.policy.zipCode ?? "";
         },
+        getClaimNumberFromStore() {
+            return store.getters.order.policy.claimNumber ?? "";
+        },
         backButtonAction() {
             this.$router.navigateWithoutSaving(
                 this.navigationScenarios.CLICKED_BACK,
@@ -247,6 +270,7 @@ export default {
                     city: this.city,
                     state: this.policyState,
                     zipCode: this.policyZip,
+                    claimNumber: this.claimNumber,
                 },
                 false
             );
diff --git a/src/store/index.js b/src/store/index.js
index a58200a96..4f729efa3 100644
--- a/src/store/index.js
+++ b/src/store/index.js
@@ -170,6 +170,7 @@ const getDefaultState = () => {
                 currentDeductible: 0,
                 originalDeductible: 0,
                 policyNumber: null,
+                claimNumber: null,
                 isItac: false,
                 additionalAuthFlag: null,
                 isNoComp: false,
@@ -355,6 +356,9 @@ export const mutations = {
     updateZipCode(state, zipCode) {
         state.order.policy.zipCode = zipCode;
     },
+    updateClaimNumber(state, claimNumber) {
+        state.order.policy.claimNumber = claimNumber;
+    },
     updateIsClaimAndCoverage(state, isClaimAndCoverage) {
         state.order.payment.isClaimAndCoverage = isClaimAndCoverage;
     },
@@ -523,6 +527,7 @@ export const mutations = {
             state.order.policy.city = insuranceDetails.city;
             state.order.policy.state = insuranceDetails.state;
             state.order.policy.zipCode = insuranceDetails.zipCode;
+            state.order.policy.claimNumber = insuranceDetails.claimNumber;
         }
     },
     updateDamageDetails(state, damageDetails) {