Retrieving policy information

During the initial POST of a draft claim, ClaimCenter copies information about the relevant policy from the Policy Administration System into ClaimCenter. This information is a snapshot of the policy as it existed on the claim's loss date.

The Policy Administration System is considered the System of Record for policy information. Consequently, for verified policies, you cannot edit policy information in ClaimCenter through the system APIs. (The user interface does allow you to edit policy information, though this causes the policy to become unverified. For more information on unverified policies, refer to the Application Guide.)

The system APIs include several endpoints that let you view policy information.

Summary of the policy endpoints

The information returned by the following endpoints comes from the ClaimCenter snapshot of the policy. It does not come directly from the Policy Administration System.

The policy itself

The following endpoint returns information that is directly on the policy resource, such as effective date, expiration date, policy number and policy type:

  • /claims/{claimId}/policy

Risk units

A risk unit is a thing covered by the policy (other than the policyholder and any additional insureds). The type of risk units on a policy vary based on the type of policy. For example:

  • On a personal auto policy or commercial auto policy, risk units are typically vehicles.
  • On a homeowner's policy, risk units are typically dwellings, other structures on the property (fences, sheds), or items of value in the home (electronics, jewelry).

The following endpoints return information about the risk units on the policy:

  • /claims/{claimId}/policy/location-based-risk-units
  • /claims/{claimId}/policy/location-based-risk-units/{locationBasedRiskUnitId}
  • /claims/{claimId}/policy/vehicle-risk-units
  • /claims/{claimId}/policy/vehicle-risk-units/{vehicleRiskUnitId}

Coverages

There are two types of coverages on a policy: policy-level coverages and risk unit coverages.

  • A policy-level coverage is a coverage that typically covers the policyholder or other additional insureds listed on the policy.
    • For example, personal auto policies typically come with a "Liability - Bodily Injury and Property Damage" coverage. This covers any damage to other people or other properties that is caused by the policyholder (or the additional insureds) while driving a vehicle. It does not matter which vehicle the policyholder was driving. The coverage applies to the policyholder.
  • A risk unit coverage is a coverage that covers an associated risk unit.
    • For example, every vehicle listed on a personal auto policy typically comes with a "Collision" coverage. This covers damage done to the associated vehicle. Suppose there is a policy with two vehicles and only the first vehicle has collision coverage. If the second vehicle is involved in a collision, the policyholder will not be able to file a claim for damages done to the second vehicle.

The following endpoints return information about the policy-level coverages on the policy:

  • /claims/{claimId}/policy/coverages
  • /claims/{claimId}/policy/coverages/{coverageId}

The following endpoints return information about the risk units on the policy. This includes the risk unit coverages attached to each risk unit:

  • /claims/{claimId}/policy/location-based-risk-units
  • /claims/{claimId}/policy/location-based-risk-units/{locationBasedRiskUnitId}
  • /claims/{claimId}/policy/vehicle-risk-units
  • /claims/{claimId}/policy/vehicle-risk-units/{vehicleRiskUnitId}

Locations

A location is a physical place listed on a policy. The ways in which locations are used vary based on the type of policy. For example:

  • On a personal auto policy, a location can be used to identify where a vehicle is garaged.
  • On a homeowner's policy, a location can be used to identify where the home is located.

The following endpoints return information about the locations on the policy:

  • /claims/{claimId}/policy/locations
  • /claims/{claimId}/policy/locations/{locationId}

Endorsements

An endorsement is a physical document detailing some aspect of the policy. Occasionally, an endorsement can become relevant to claims processing. Endorsements are also referred to as forms.

For example, suppose a home owner elects to get a homeowner's policy for a home that is in a flood zone. The insurer attaches an endorsement to the policy that excludes any damage caused by flooding. Later, the home owner files a claim for damage caused by a flood. When determining if payment will be made on the claim, the adjuster needs to see if the policy included a flood damage exclusion endorsement.

The following endpoints return information about the endorsements on the policy:

  • /claims/{claimId}/policy/endorsements
  • /claims/{claimId}/policy/endorsements/{endorsementId}