Learn more about the available Insurance Claims API.
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Bulk Pay Claim Coverage Payment Details (POST)
Initiate asynchronous payment processing for claim coverage payment detail records in bulk. Specify the claim coverage payment detail IDs you want to process for payment, and the API validates access, enqueues work, and returns an identifier you can use to track the bulk job. -
Calculate or Recalculate Adjustments (POST, PATCH)
Calculate adjustments for a new loss item (POST) or recalculate adjustments for an existing payment detail record (PATCH) under a claim coverage. -
Cancel Claim Coverage Payment Detail (POST)
Cancel payment for a claim coverage payment detail record. -
Check Financial Authority (POST)
Check whether the current user has sufficient financial authority to approve a claim coverage payment detail. The API matches a User Financial Authority (UFA) record to the payment detail’s product and financial type, compares the adjusted amount to the user’s maximum approval amount, and sets the payment detail status to Pending Authority when the limit is exceeded and a manager is available. -
Claim (POST)
Create a claim. -
Claim (GET, PATCH)
Get or update a claim record and its associated claim items and participants. -
Claim Coverage (POST)
Create a claim coverage record for the specified claim. -
Claim Coverage (PATCH)
Update a specific claim coverage record. -
Claim Coverage Payment Detail (POST)
Create a claim coverage payment detail record. This also generates the related records for the Insurance Policy Limit Tracking and Claim Coverage Payment Adjustment records if applicable. -
Claim Coverage Payment Detail Edit (PATCH)
Update an existing Claim Coverage Payment Detail (CCPD) record for both loss and expense types. -
Delete Claim Coverage Payment Detail (POST)
Remove unpaid claim coverage payment details by updating the status to Deleted. The API reverses the insurance policy limit tracking data to roll back consumption for the type Loss. -
Field Set Fields (GET)
Get the fields of a field set by the field set ID and object name. -
Policy Limits (POST)
Create insurance policy limit records for the specified policy based on its defined product attributes and coverages. -
Insurance Policy Limit Current Standings (POST)
Get the calculated current standings (consumption status) for all applicable insurance policy limits. This API retrieves standings based on the policy, claim, claim coverage as well as policy coverage, insurance policy participant, and insurance policy asset. -
Pay Claim Coverage Payment Detail (POST)
Process the payment for a claim coverage payment detail record. -
Pay Ex Gratia Claim Coverage Payment Detail (POST)
Process a discretionary ex gratia payment for a claim coverage payment detail, enabling payment even when coverage or policy limits are exceeded. -
Process Policy Limits (POST)
Process the policy limits for a loss item in a claim by using the current standings of the insurance policy limits. -
Verify Policy Coverage (POST)
Verify the applicability of a policy coverage for a specified loss date under an insurance policy, so that only eligible coverages are processed for claims.