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Insurance
InsClaimItemService:add

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InsClaimItemService:add

Use this service to add a claim line item to a specified claim item object.

This service can create either a Loss type claim line item or an Expense type claim line item, depending on which options get inputs.

Note
Note

If the service receives inputs for both Loss and Expense type claim line items, it creates a Loss type claim line item.

Class: InsClaimItemService

Method: add

How It works

The service uses object interface field names as default input and output for common fields in both Vlocity (ClaimLineItem__c) and Salesforce FSC (ClaimCoveragePaymentDetail) data models.

  • Takes the claimId and gets the claim record, the associated policy record, and attribute values for both the claim and the policy.

  • If type = Loss, calls the InsPolicyTermsService: process service.

    This service calculates all insured obligation amounts (copay/coinsurance, deductible, and out-of-pocket max.)

    If type = Expense, skips to step 3.

  • Saves the claim line item.

    If type = Expense, it is the last step the service takes.

  • Converts the list of insured obligation amounts returned in step 2 into child records of the claim line item as Line Adjustments record type.

    Note
    Note

    Out of pocket max is not saved as a line adjustment.

  • Saves the line adjustments.

  • Saves the insured obligation amounts and out-of-pocket max as AssetTermTrackingEntry records.

Remote Options

Option

Description

claimId

Required.

The Id of the claim the service adds a line item to.

claimCoverageId

Required.

The Id of the coverage the service uses to create this claim line item.

type

Loss or Expense

The type of claim line item to be created.

additionalInput

Required.

JSON of possible additional input to be saved in the Claim Line Item record or to be used in the coverage/total coverage calculation formula. It must have the following inputs:

  • ClaimLineItem.claimAmount

  • ClaimLineItem.recipientId

Uses interface field names in the input and output for common fields in Vlocity ClaimLineItem__c and Salesforce FSC ClaimCoveragePaymentDetail data models. For details, see the next table.

Any Vlocity or customer-created custom field you enter for the value of this option must follow this format, including the fully qualified field API name:

{

"ClaimLineItem.<fully qualified name / field API name>": "some random value",

"ClaimLineItem.Customer_Custom_Field__c" : "some other random value" // customer added field

}

Attributes prefixed with ClaimLineItem that have claim line item's API are saved to the claim line item that is created.

This JSON can also include values that calculates the claim line item's coverage amount, if the new claim line item is a Loss.

If a coverage amount or an adjusted amount or a claim amount are passed in this JSON, this service returns these amounts. It won’t recalculate them.

If not listed in this table, use the fully qualified name of the field.

User Interface Field Name

Common Fields in Vlocity ClaimLineItem__c and Salesforce FSC ClaimCoveragePaymentDetail Data Models

ClaimLineItem.name

Use for ClaimLineItem__c.Name and ClaimCoveragePaymentDetail.Name

ClaimLineItem.claimAmount

Use for ClaimLineItem__c.ClaimAmount__c  and ClaimCoveragePaymentDetail.ClaimedAmount

ClaimLineItem.description

Use for ClaimLineItem__c.Description__c and ClaimCoveragePaymentDetail.Description

ClaimLineItem.recipientId

Use for ClaimLineItem__c.PayeeAcccountId__c, ClaimLineItem__c.PayeeContactId__c, ClaimLineItem.PayeeAccountId__c__c, and ClaimCoveragePaymentDetail.ClaimParticipantRecipientId

ClaimLineItem.benefitType

Use for ClaimLineItem__c.BenefitType__c and ClaimCoveragePaymentDetail.BenefitName

ClaimLineItem.reserveAmount

Use for ClaimLineItem__c.ReserveAmount__c  and ClaimCoveragePaymentDetail.ClaimCoverageReserveDetailId.ReserveAmount

ClaimLineItem.status

Use for ClaimLineItem__c.Status__c and ClaimCoveragePaymentDetail.Status

ClaimLineItem.type

Use for ClaimLineItem__c.Type__c and ClaimCoveragePaymentDetail.Type

ClaimLineItem.unitCount

Use for ClaimLineItem__c.Quantity__c and ClaimCoveragePaymentDetail.LimitUnitCount

ClaimLineItem.uom

Use for ClaimCoveragePaymentDetail.LimitUnitOfMeasure

ClaimLineItem.currencyIsoCode

Use for ClaimLineItem__c.CurrencyIsoCode and ClaimCoveragePaymentDetail.CurrencyIsoCode

Input JSON

This service can take an optional additionalInput JSON that adds additional data to the claim line item.

Here's the format of the input JSON:

{ 
	"claimId: <Id>,
	"claimCoverageId: <Id>,
	"type": "Loss",
	"additionalInput": {
		"ClaimLineItem." + <fully qualified fieldname>: <values>, 
		"ClaimLineItem.claimAmount": <decimal> // example
		"ClaimLineItem.recipientId": <id> // example
		...	
		// other claim line item fields that need to be saved.
	}
}

And here's an example of an input JSON:

{ 
	"claimId": "01t000000000000001",
	"claimCoverageId": "01t000000000000002",
	"type": "Loss",
	"additionalInput": {
		"ClaimLineItem.claimAmount": 500
		"ClaimLineItem.description": "line item description"
		"ClaimLineItem.recipientId": "01t000000000000003"
	}
}

Output JSON

Here's the format of the output JSON:

{  
   	"adjustedAmount": <decimal>,
	"claimItemId": <id>, // if add/update,
	"claimItem" : {
		"adjustedAmount" : <decimal>,
		"description" : <string>,
		...
	}
	"childClaimItems": [
		{
			"adjustedAmount" : <decimal>,
			"adjustmentReason" : <string>
		}
	]
}
Note
Note

The childClaimItems node is applicable only when type = Loss.

Here's an example of an output JSON:

{  
   	"adjustedAmount": 200,
	"claimItemId": "01t000000000000004", // if add/update,
	"claimItem" : {
		"adjustedAmount" : 200,
		"description" : <string>
	},
	"childClaimItems": [
		{
			"adjustedAmount" : 200,
			"adjustmentReason" : "Deductible"
		},
		
		{
			"adjustedAmount" : 100,
			"adjustmentReason" : "Coinsurance"
		}
	]
}
 
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