Process a claim on a child coverage factoring in the limit balances of the coverages above it in the hierarchy, and track limit consumption at all levels. Send richer contextual data to your custom calculation logic for adjustments and limit tracking. Pay multiple amounts across coverages for a claim in a single batch request.
- Process Claims on Child Coverages with Hierarchical Limit Consumption
Adjust the payout for a claim on a child coverage based on the currency and count limit balances for the related coverages up the hierarchy. Apply the deductible, copay, coinsurance, and out-of-pocket maximum for the child coverage. When you finalize the payment, deduct the payout from limit balances at each level of the coverage hierarchy and accurately track consumption. - Use More Contextual Data in Claims Adjustment and Policy Limit Calculations
Pass contextual details, such as network type and discount codes, into your custom calculation logic for adjusting the claim amount or tracking policy limit consumption. Previously, you could send only the claimed amount, adjusted amount, and the count limit to your calculation logic. - Pay Multiple Claim Amounts in a Batch
Process multiple claim amounts across coverages in a claim as an asynchronous batch. Payment succeeds for amounts that meet coverage and policy limits and fails for amounts that exceed the limits. When the batch processing is complete, you get a notification about whether the payments succeeded or failed. Previously, you paid one claim amount at a time. - New and Changed Connect REST APIs in Insurance Claims Management
Use the new property in insurance to process policy limits for specific payment detail records associated with loss items during claim processing. Specify business-specific additional details when calculating the adjusted amount for a claim loss item or recalculating the adjusted amount for an existing claim coverage payment detail record. Improve claim settlement efficiency by processing payments in bulk for large volumes of Claim Coverage Payment Detail (CCPD) records. - New and Changed Invocable Actions in Insurance Claims Management
Specify business-specific additional standard or custom fields when you calculate or recalculate the adjusted amounts for a claim loss item. Accelerate claims settlement efficiency by processing payments in bulk for a large volume of Claim Coverage Payment Detail (CCPD) records.