BriteCore combines claims administration functionality and business process management (BPM) support for the entire claims process. From open to close, agents and adjusters work collaboratively and efficiently within BriteCore to process first notices of loss (FNOL), establish reserves, upload reports, issue payments, and settle claims.
This tutorial will guide you through filing and updating a new claim (creating and submitting an FNOL), as well as retrieving claims-related information.
Note: For auto-related policy information, refer to the BriteClaims tutorial.
Key concepts
- Additional interest: A person or company that owns a portion of the risk, such as a mortgagor for a home or building or a lessor for a vehicle.
- Additional interest: A person or company that owns a portion of the risk, such as a mortgagor for a home or building or a lessor for a vehicle.
- Adjuster – primary: The initial adjuster assigned to manage the claim file after FNOL, and who is ultimately responsible for the overall management of the claim. These adjusters are usually internal adjusters.
- Agent (producer, broker, MGA, GA): The party that represents the insurance company in the sale of an insurance policy to an insured.
- Allocated loss adjustment expenses (ALAE): ALAE are part of an insurer’s expense reserves that are attributed to the processing of a specific insurance claim.
- Attorney – defense: Represents the insurance carrier.
- Attorney – plaintiff: Represents the insured or claimant.
- Batch processing: Batch processing is typically performed by the accounting/finance team. This process batches, validates, and releases eligible payments for issuance (check printing or other payment delivery methods). From a business standpoint, a processed payment is an official financial transaction recorded on the claim.
- Bifurcation: When a court requires a claim to be separated into two parts.
- Carrier/insurance company: The financially responsible party to compensate a claimant for their loss by repairing/restoring, replacing, or healing the claimant’s property or person.
- Catastrophe (CAT): A catastrophe is a large-magnitude loss that affects a broad region, causing property damage and/or loss of life. Perils often include earthquakes, tornadoes, wind, hurricanes, floods, tsunamis, hailstorms, fires, etc. A catastrophe can include multiple perils. Local or federal government will issue a CAT number or code to define the affected geographic region and period of time (duration) that caused the damage. Claims are associated with this CAT and an insurer may submit damages to their reinsurance policy.
- Claim: The reporting of an occurrence of an accident that damaged property or injured people listed on an insurance policy.
- Claim number: The number given to the claim file at the time of FNOL.
- Claimant: Every involved party with an exposure on a claim requesting compensation from the insurance company by virtue of the insurance policy to repair/restore, replace, property or heal a person; can include named persons listed on the policy (insureds).
- Claimant – first party: People who aren’t listed on the policy, but can claim first party coverages; in some cases, they can also be considered insureds, such as a passenger in the insured vehicle who isn’t listed on the policy.
- Claimant – third party: People or organizations taht make claims against an insured under liability coverage types.
- Coverage: The name of the specific type of insurance placed on a risk if it is damaged/injured by certain perils, including the maximum financial benefit to be paid to the claimant to repair/restore, replace, or heal the risk.
- Estimate: The amount provided by a vendor that they need to repair/restore damaged property.
- Exposure: The combination of a claimant, risk, and coverage that has emerged as a result of a claim.
- Feature: Another term for exposure.
- First notice of loss (FNOL): FNOL is the initial reporting of the claim to the insurance company by the insured, third-party claimant, or agent.
- Indemnification: A contractual agreement in which one party (the insurer or insurance carrier) guarantees compensation for actual or potential losses or damages sustained by another party (the insured or claimant).
- Insureds: Named persons or organizations listed on the policy.
- Limits: The claims system will need to enforce limits provided from the policy so payments don’t exceed the limits, unless approved by a supervisor. Limits coming from the policy will vary by line of business, but often include limits by policy, coverage, and risk.
- Loss:The basis of a claim for damages under the terms of an insurance policy.
- Payee: Payments are made to a payee. A payee can be an insured, claimant, vendor, representative of a claimant, or additional interest
- Payment: Money that is paid to the Insured, third-party claimant, or vendors to repair/restore, replace, or heal the risk.
- Peril: Causes of the claim. Examples include wind, fire, water, earthquake, etc.
- Risk: The item listed on the insurance policy for which insurance has been purchased (vehicle, house, equipment, business, personal injury). Risks can also be third party, property, or person.
- Salvage: When an item such as a vehicle is declared a total loss, the item may be sold for parts. Monies recovered from the salvage of the vehicle will be applied to the claim financials to reduce the net incurred.
- Settlement: The total amount of money an insurer is willing to pay for damages to property or recovery/restitution of health and loss of wages for an injured party.
- Subrogation: If there are persons or companies that are partially or fully at fault for the occurrence or accident, the adjuster will attempt to recover funds from those parties.
- Total loss: Total loss may be declared when the estimated damages to repair an item such as a car are above a designated percentage of the replacement value for the item.
- Unallocated loss adjustment expenses (ULAE): Expenses associated with ULAE are more general than ALAE and may include overhead, investigations, and salaries. Insurers that use in-house employees for field adjustments would report that expense as a ULAE.
- Vendor: A party that is paid for services provided associated with a claim.
Create and update an FNOL and retrieve related information
Step 1: Get a security token
You will need to request an ID and Secret to use OAuth 2.0.
For more information, refer to How do I get started?
Step 2: Search policies
Pass a string to the Search endpoint to retrieve a list of matching policies.
Sample request
curl --location --request POST '/api/v2/policies/search' \
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Sample response
"FlatCancel",
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Step 3: Retrieve your policy summary
Use retrieve_policy_terms to obtain the details of your policy. policy_number and policy_id are required.
Sample request
curl --location --request POST '/api/v2/policies/retrieve_policy_terms' \
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Sample response
{
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Step 4: Retrieve property and photos
The get_property_information_and_photos retrieves the property data. You need the property_id parameter from step 3.
Sample request
curl --location --request POST '/api/v2/insured/get_property_information_and_photos' \
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Sample response
{
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Step 5: File a new claim
Use the new_claim_information endpoint to file a new claim. You will need to pass the following parameters:
'{"policy_id": "{{policy_id}}","property_id": "{{property_id}}"}' |
Sample request
curl --location --request POST '/api/v2/insured/new_claim_information' \--header 'Content-Type: application/json' \--headers 'authorization: enter your access token here' \--data-raw '{"policy_id": "{{policy_id}}","property_id": "{{property_id}}"}' |
Sample response
{
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Step 6: Update the claim
The update_claim endpoint updates an existing claim. Pass a JSON object with the update details:
{"claim_id": "{{claim_id}}","loss_date": "2019-10-31","description": "The front fell off","additional_information": {"Insured Contact Number": "+1 (650) 321-1234","arbitrary id": "0fe6a7bf-bca7-4757-825c-7cc9bf90cfc0"}} |
Sample request
curl --location --request POST '/api/v2/insured/update_claim' \
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Sample response
{
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Step 7: Upload a claim photo
The upload_property_or_claim_photo endpoint uploads a claim/property user’s photo. Required parameters include:
{file_type : str, requiredeither one of 'properties' or 'claims'reference_id : str, requiredreference id pointing to claim or property id related to filephoto_as_base64 : basestring, requiredphoto as a data URI string -- ex: 'data:image/filename : str, requiredoriginal filename of uploaded file (include the extension, e.g. picture.jpg)mimetype : strmimetype of uploaded file |
Sample request
curl --location --request POST '/api/v2/insured/upload_property_or_claim_photo' \
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Sample response
{
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Step 8: Submit a claim
The submit_claim endpoint submits the claim that was just updated. Pass the claim_id.
Sample request
curl --location --request POST '/api/v2/insured/submit_claim' \
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Sample response
{
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Step 9: Retrieve claim details
Use get_claim to retrieve claim details. Pass the claim_id.
Sample request
curl --location --request POST '/api/v2/claims/get_claim' \
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Sample response
{
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Step 10: Retrieve claims attachments
The get_attachment_file_list endpoint retrieves related documents list. Pass a JSON object with the following details:
{
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Sample request
curl --location --request POST '/api/v2/attachments/get_attachments_file_list' \
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Sample response
{
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Step 11: Retrieve a specific document
Use the get_attachment endpoint to retrieve a specific deliverable.
Note: The endpoint returns a Base64 encoded payload of your PDF. You need the
file_idfor the attachment.
Sample request
curl --location --request POST '/api/v2/deliverables/get_attachment' \
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Sample response
{
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Step 12: Retrieve notes related to the claim
The retreiveNotes endpoint returns a JSON string containing the notes matching the search string entered by the user or null. Pass pageSize for amount and page for the section of notes to be returned. id refers to claim_id.
Parameters
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Sample request
curl --location --request POST '/api/v2/notes/retrieveNotes' \
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Sample response
{
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Step 13: Add a note to the claim
The storeNote endpoint takes a json_dict with the bc.models.Note() information and stores the record. It will return a success or an error message. Send the following parameters:
Parameters
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Sample request
curl --location --request POST '/api/v2/notes/storeNote' \
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Sample response
{
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You have successfully filed and updated a new claim with its related information.