This API uses the default Expression Set Executable Template to perform the calculation and applies the standard policy rules, such as deductibles, co-pays, co-insurance, and limits to an initial claimed amount. You can either extend the executable template to create a custom Expression Set or create an Integration Procedure to include custom calculations.
The API uses the claimedAmount, claimId, and claimCoverageId as input, and returns the final adjustedAmount along with the generated data for Claim Coverage Payment Adjustments (CCPAs) and Insurance Policy Limit Tracking (IPLT) records. This API only returns the data; it doesn't save them in database.
Resource
{claimId} and {coverageId} are placeholders.
/connect/insurance/claims/{claimId}/coverages/{coverageId}/calculate-adjustments
Resource Example
Replace {yourInstance} with the My Domain name of your Salesforce org.
https://{yourInstance}.salesforce.com/services/data/v68.0/connect/insurance/claims/0Zkxx000000001dEAA/coverages/0kPxx000000002fEAA/calculate-adjustments
Available Version
65.0PATCH is available in version 66.0 and later.
HTTP Methods
POST, PATCH
Path Parameter for POST and PATCH
| Parameter Name | Type | Description | Required or Optional | Available Version |
|---|---|---|---|---|
| claimId | String | ID of the claim for which the payment adjustments must be calculated. | Required | 65.0 |
| coverageId | String | ID of the claim coverage record. | Required | 65.0 |
Request Body for POST
Calculate adjustments during the creation of a Loss item.
JSON Example
{
"additionalFields": {
"LimitUnitOfMeasure": "Visits",
"LimitUnitCount": 2,
"Network_Type__c": "Car Rental Network",
"Claimant_Phone__c": "123456789",
"Claimant_Email__c": "test@email.com",
"Discount_Percent__c": 50,
"EditedDateTime__c": "2026-03-25T11:50:00.000Z",
"IsPaid__c": false
},
"benefitName": "Car Rental",
"claimedAmount": 1500
}
Properties
| Name | Type | Description | Required or Optional | Available Version |
|---|---|---|---|---|
| additionalFields | String | Additional standard or custom fields to calculate the adjusted amount for a loss item. | Optional | 67.0 |
| benefitName | String | Name of the specific benefit or sub-coverage that's associated with the coverage, as defined in the product attribute mapping. | Optional | 66.0 |
| claimedAmount | Double | Amount requested by the claimant when submitting the loss. | Required | 65.0 |
Request Body for PATCH
Recalculate adjustments for an existing payment detail.
JSON Example
{
"additionalFields": {
"LimitUnitOfMeasure": "Visits",
"LimitUnitCount": 2,
"Network_Type__c": "Car Rental Network",
"Claimant_Phone__c": "123456789",
"Claimant_Email__c": "test@email.com",
"Discount_Percent__c": 50,
"EditedDateTime__c": "2026-03-25T11:50:00.000Z",
"IsPaid__c": false
},
"claimedAmount": 1200,
"paymentDetailId": "0l2xx0000000001CAA"
}
Properties
| Name | Type | Description | Required or Optional | Available Version |
|---|---|---|---|---|
| additionalFields | String | Additional standard or custom fields to recalculate the adjusted amount for an existing payment detail record. | Optional | 67.0 |
| claimedAmount | Double | Amount requested by the claimant when submitting the loss. | Optional | 66.0 |
| paymentDetailId | String | ID of the claim coverage payment detail for recalculating adjustments. | Optional | 66.0 |