Graph-based policy retrieval

At the start of the FNOL process, the user who is creating the claim must identify the relevant policy. A subset of information about the policy is then copied to ClaimCenter to support adjudication.

When executing FNOL through the ClaimCenter user interface, this operation involves two actions:

  • Policy search - The user provides information about the desired policy, such as policy number or name of the insured. ClaimCenter queries the Policy Administration System (PAS). Finally, ClaimCenter provides a list of Policy Summary information for all policies meeting the criteria.

  • Policy retrieval - The user then selects the Policy Summary corresponding to the desired policy. ClaimCenter retrieves a more complete copy of the policy corresponding to the selected summary.

When executing FNOL through an integration point, the third-party system typically interacts with the PAS directly to identify the desired policy without executing a user-involved policy search. This is then followed by policy retrieval, in which ClaimCenter retrieves a more complete copy of the policy corresponding to the policy identified by the third-party system.

For a more complete discussion of policy search and retrieval functionality, see the Plugins, Prebuilt Integrations, and SOAP APIs.

Policy search and retrieve can be one of the more time-consuming integration points to implement. The implementation of this logic can be simplified by Cloud API. Cloud API has schemas for Policy and its child objects. Cloud API uses these schemas to convert policy information into JSON payloads that adhere to the schema structure. If an integration point is able to provide policy information from a PAS that is JSON-formatted and adheres to the Cloud API Policy graph schema, Cloud API can convert that JSON into a Policy entity and save it to the ClaimCenter database.

This topic describes how to implement graph-based policy retrieval. This topic assumes you are familiar with traditional policy search and retrieval functionality as described in the Plugins, Prebuilt Integrations, and SOAP APIs.