Claims Management
We have opened up our Claims Management function through APIs. You can get access to our full claims life cycle through the Claims Management suite.
Highlights of Claims Management API
Lodge Claim
Lodge claim with all member and account details,a long with claim incident details (illness, injury, accident, disability or death).
ApplicationInformation:
type: object
properties:
arn:
type: string
description: The id of the memberLodge Short Form claim & request tele interview
Lodge short version of above with minimal information to start conversation with member, along with a request to book tele-interview. TAL will coordinate all other details by contacting member to complete claims lodgement.
MemberDetailsResponse:
type: object
required:
- messageID
- messageDateTime
- fund
- plan
- memberDetails
- policyDetailsRequest Additional Requirement
As part of claims process, additional information e.g. medical reports etc needs to be requested from member.
employerDetails:
type: object
properties:
employerName:
type: string
description: The name of the employee.
example: '33'Update requirements
Provide requested requirement as per above.
ResponseHeader:
type: object
properties:
correlationId:
type: stringStatus updates
Status changes on claims are notified as it moves from one stage to another through the claims assesment process. This can be used for either updating workflow/ registry or for follow-ups with member.
ClaimsOutcomeClaimDetails:
type: object
properties:
externalId:
type: string
description: The external id.
example: 123456ABC
claimId:
type: stringOutcome Notification
Outcome for claims assesment.
ClaimDetails:
type: object
properties:
type:
type: string
description: The type of Claim.
example: Death
enum:Payment Status
Provides status/schedule of payments sent to member directly (applicable only for Income Protection).
Premiums:
type: object
properties:
coverType:
type: string
description: Cover Type.
example: 'Death'