Identifying the ClaimContact

There are several ways you can add ClaimContact information to a claim. You can:

  • Create a new ClaimContact and specify its role
  • Specify a role for a contact that is on the policy in the Policy Administration System
  • Specify a role for a ClaimContact that is already on the claim

Each of these approaches uses a different property to identify the ClaimContact.

Creating a new ClaimContact and specifying its role

You can create a new ClaimContact and specify its role in the same payload using request inclusion. When using this approach, you identify the ClaimContact by refid. For more information on this approach, see Request inclusion.

The following example is the payload for a PATCH to an existing claim with id cc:402. This PATCH creates a new ClaimContact and sets the claim's reporter to that ClaimContact. Note that the value used for refid, "newContact", is arbitrary. Any value could be used so long as the same value is used for the reporter's refid in the data section and the refid in the included ClaimContact section.

PATCH /claim/v1/claim/cc:402

{
  "data": {
    "attributes": {
      "reporter": {
        "refid": "newContact"
      }
    }
  },
  "included": {
    "ClaimContact": [
      {
        "refid": "newContact",
        "attributes": {
            "contactSubtype": "Person",
            "firstName": "Carol",
            "lastName": "Daniels"
        },
        "method": "post",
        "uri": "/claim/v1/claims/cc:402/contacts"
      }   
    ]
  }
}

Specifying a role for a ClaimContact that is already on the claim

When a ClaimContact is created in ClaimCenter, it is assigned an id. This value is the ClaimContact's Public ID in ClaimCenter.

ClaimContact roles can be specified using the id field. This is useful when the caller application is constructing the payload for a PATCH to an existing claim, the ClaimContact already exists on the claim, and the caller application knows the value of the ClaimContact's id.

The following example is the payload for a PATCH to an existing claim. This PATCH sets the Claim's reporter to the ClaimContact whose id is cc:202.

{
  "data": {
    "attributes": {
      "reporter": {
        "id": "cc:202"
      }
    }
  }
}

Specifying a role for a contact that is on the policy

When a draft claim is initially POSTed to ClaimCenter, information on the policy is copied from the Policy Administration System to ClaimCenter. This typically includes contacts listed on the policy.

Policy system IDs

One of the policy contact attributes that is copied to ClaimCenter is the contact's policy system ID. Policy system ID is a value that uniquely identifies a given type of object on the policy. For example, on a given policy, every contact's policy system ID must be used by only one contact.

The value that is used as the policy system ID is determined by the integration code that copies the policy information over to ClaimCenter. This code is written during implementation and will be different for each insurer and each Policy Administration System. A policy system ID is not required to be unique across the entire Policy Administration System. But, it is required to be unique across all instances of the given type of object on a given policy.

Specifying roles by policy system ID

In the system APIs, the name of the policy system ID field is policySystemId. Specifying roles through policySystemId is useful in the following circumstances:

  • The caller application is constructing the payload for the initial POST /claims and wants to include an existing ClaimContact and its role in the payload. At this point, the policy information (including policy contacts) have not yet been copied to ClaimCenter. Therefore, the relevant contact does not yet have a ClaimCenter ID.
  • The caller application is constructing the payload for a PATCH to an existing draft or open claim. The application knows the policy system ID from a previous call to the Policy Administration System, and it does not want to execute a separate GET to retrieve the ClaimCenter ID. Therefore, it identifies the ClaimContact by policy system ID.
Note: All resource field names are case-sensitive. Unlike refid and id, which use lower-case i's, policySystemId uses an upper-case I.

The following example is the payload for a PATCH to an existing claim. This PATCH sets the Claim's reporter to the ClaimContact whose policy system ID is ab:0001-1.

{
  "data": {
    "attributes": {
      "reporter": {
        "policySystemId": "ab:0001-1"
      }
    }
  }
}