POST api/SubmitClaim/SubmitClaim

Submit given health or travel claim input data

Request Information

URI Parameters

None.

Body Parameters

Submit Claim input model

SubmitClaimInputModel
NameDescriptionTypeAdditional information
ClaimType

ClaimType

None.

ClaimReferenceNumber

string

None.

IsSubmit

boolean

None.

TravelClaimDetails

TravelClaim

None.

HealthClaimDetails

HealthClaim

None.

PaymentDetails

Payment

None.

TreatmentDetails

Treatment

None.

AdditionalNotes

AdditionalNotes

None.

Attachments

Collection of Attachments

None.

MemberInformationDetails

MemberInformationDetails

None.

PaymentModeInformation

PaymentOptionViewModel

None.

Declaration

Declaration

None.

Language

PortalLanguage

None.

ClaimDocumentPath

string

None.

Request Formats

application/json, text/json

Sample:
{
  "ClaimType": 1,
  "ClaimReferenceNumber": "sample string 1",
  "IsSubmit": true,
  "TravelClaimDetails": {
    "JourneyStartDate": "sample string 1",
    "JourneyEndDate": "sample string 2",
    "WasJourney": 0,
    "IsClaimResultOfAccident": true,
    "PointOfOrigin": "sample string 4",
    "PointOfDestination": "sample string 5",
    "ClaimMedicalExpensesAndHospitalBenefits": true,
    "NatureOfIllnessOrInjury": "sample string 7",
    "DateOfIllnessOrInjury": "sample string 8",
    "TimeOfIllnessOrInjury": "sample string 9",
    "PlaceOfIllnessOrInjury": "sample string 10",
    "DescriptionOfHowInjuryOccurred": "sample string 11",
    "NameAndAddressOfDoctorOrHospital": "sample string 12",
    "WasInsuredPersonPregnant": true,
    "HowManyWeek": 1,
    "IsInsuredPersonSufferedFromthisBefore": true,
    "SufferedIllnessDetails": "sample string 15",
    "DetailsOfPersonalPhysicianOrDoctor": "sample string 16",
    "MedicalExpensesAddress": "sample string 17",
    "MedicalExpensesPhoneNumber": "sample string 18",
    "MedicalExpensesFax": "sample string 19",
    "MedicalExpensesEmail": "sample string 20",
    "InPatientTreatmentDate": "sample string 21",
    "WasEACContacted": true,
    "EACContactedReason": "sample string 23",
    "DoesInsuredPersonHavePrivateHealthInsurance": true,
    "InsuranceCarrierDetails": "sample string 25",
    "WasAnEHC": true,
    "WasPresentedToHospitalOrDoctor": true,
    "CancellationOrCurtailment": true,
    "JourneyBooked": "sample string 29",
    "JourneyCancelledOrCurtailed": "sample string 30",
    "JourneyCancelledExplanation": "sample string 31",
    "PersonCausedInTripCancelledAndRelationship": "sample string 32",
    "WasEACContactedIfJourneyWasCurtailed": true,
    "ReimbursementPayable": "sample string 34",
    "WereAdditionalExpensesIncurred": true,
    "AdditionalExpensesDetails": "sample string 36",
    "TravelDelayMissedDeparture": true,
    "ReasonForDelayedOrMissedDeparture": "sample string 38",
    "ScheduledDateOfDeparture": "sample string 39",
    "ScheduledTimeOfDeparture": "sample string 40",
    "ScheduledFlightOrFerryOrTransportNumber": "sample string 41",
    "NumberOfHoursDelayed": 1,
    "ActualDateOfDeparture": "sample string 42",
    "ActualTimeOfDeparture": "sample string 43",
    "ActualFlightOrFerryOrTransportNumber": "sample string 44",
    "FlightOrFerryOrTransportName": "sample string 45",
    "PointOfDeparture": "sample string 46",
    "PointOfMissedConnection": "sample string 47",
    "TransportUsedForDeparturePoint": "sample string 48",
    "RecommencedTrip": "sample string 49",
    "AmountClaimed": 1.0,
    "BaggageMoneyDocuments": true,
    "DateOfLossOrDamage": "sample string 51",
    "Time": "sample string 52",
    "DetailedDescriptionOfLossOrDamage": "sample string 53",
    "IssuerNotifiedIfLossRelatedToTravellers": "sample string 54",
    "ReportedToAuthority": "sample string 55",
    "Item1Description": "sample string 56",
    "Item1PricePaid": 1.0,
    "Item1AmountClaimed": 1.0,
    "Item1PurchasedPalceAndDate": "sample string 57",
    "Item1CostNow": 1.0,
    "Item2Description": "sample string 58",
    "Item2PricePaid": 1.0,
    "Item2AmountClaimed": 1.0,
    "Item2PurchasedPalceAndDate": "sample string 59",
    "Item2CostNow": 1.0,
    "NameofInsurer": "sample string 60",
    "ProvideOtherInsuranceDetails": "sample string 61",
    "InsuredPolicyNumber": "sample string 62",
    "CorrespondenceAddress": "sample string 63",
    "PassportLoss": true,
    "PassportLostPlace": "sample string 65",
    "DetailsOfExpensesIncurredToReplacePassport": "sample string 66",
    "PersonalAccident": true,
    "WhenInjuryOrDeathOccur": "sample string 68",
    "DetailsOfLossOrDeathOccurred": "sample string 69",
    "WasInjuryOrDeathResultOfNatural": true,
    "NaturalCausesDetails": "sample string 71",
    "RequestId": "sample string 72",
    "AuthenticationId": "sample string 73",
    "Portal": "sample string 74",
    "Individual": "sample string 75",
    "Language": "sample string 76",
    "Oid": "sample string 77",
    "Email": "sample string 78",
    "PhoneNumber": "sample string 79",
    "IsUpdateEmailAndPhone": true,
    "ClaimName": "sample string 81"
  },
  "HealthClaimDetails": {
    "IsMaternityTreatment": true,
    "DeliveryDate": "sample string 2",
    "IllnessOccurredDate": "sample string 3",
    "ProblemDetails": "sample string 4",
    "DiagnosisDetails": "sample string 5",
    "PreviousDiagnosisDetails": "sample string 6",
    "InjuryAnyWayToPatientsOccupation": true,
    "InjuryAnyWayToAutomobileAccident": true,
    "InjuryAnyTypeOfAccident": true,
    "AccidentDetails": "sample string 10",
    "AutomobileDetails": "sample string 11",
    "CoveredByOtherGroupPlan": true,
    "CoveredByMedicareOrGovtAgency": true,
    "CoveredByAutomobileInsurance": true,
    "OtherSourceDetails": "sample string 15",
    "ProviderName": "sample string 16",
    "ProviderPhoneNumber": "sample string 17",
    "ProviderAddress": "sample string 18",
    "ProviderEmail": "sample string 19",
    "ProviderPostalCode": "sample string 20",
    "ProviderCountry": "sample string 21",
    "RequestId": "sample string 22",
    "AuthenticationId": "sample string 23",
    "Portal": "sample string 24",
    "Individual": "sample string 25",
    "Language": "sample string 26",
    "Oid": "sample string 27",
    "Email": "sample string 28",
    "PhoneNumber": "sample string 29",
    "IsUpdateEmailAndPhone": true,
    "ClaimName": "sample string 31"
  },
  "PaymentDetails": {
    "MakePaymentTo": 0,
    "ReimbursmentMethod": 0,
    "MailingAddressType": 0,
    "CheckMailingAddress": "sample string 1",
    "MailingCity": "sample string 2",
    "MailingCountry": "sample string 3",
    "MailingPostalCode": "sample string 4",
    "MailingState": "sample string 5",
    "BankName": "sample string 6",
    "BankAddress": "sample string 7",
    "BeneficiaryAccountNumber": "sample string 8",
    "BeneficiaryName": "sample string 9",
    "Routing": "sample string 10",
    "SwiftCode": "sample string 11",
    "IBANNumber": "sample string 12",
    "IntermediaryBank": "sample string 13",
    "BeneficiaryAddress": "sample string 14",
    "Currency": "sample string 15",
    "City": "sample string 16",
    "Country": "sample string 17",
    "PostalCode": "sample string 18",
    "State": "sample string 19",
    "BankId": "sample string 20",
    "BankType": 0,
    "IntermediaryBankName": "sample string 21",
    "IntermediaryBeneficiaryName": "sample string 22",
    "IntermediaryIBANNumber": "sample string 23",
    "IntermediaryRoutingNumber": "sample string 24",
    "FurtherCreditBeneficiaryName": "sample string 25",
    "FurtherCreditAccountNumber": "sample string 26",
    "IsApplyNextInvoice": true
  },
  "TreatmentDetails": {
    "TreatmentItems": [
      {
        "CoverageType": 0,
        "Cost": 1.0,
        "DateOfService": "sample string 2",
        "Description": "sample string 3",
        "DateOfPurchase": "sample string 4",
        "DrugName": "sample string 5",
        "NoOfDrugsPurchased": 6,
        "NoOfDrugsInTakePerDay": 7,
        "Currency": "sample string 8"
      },
      {
        "CoverageType": 0,
        "Cost": 1.0,
        "DateOfService": "sample string 2",
        "Description": "sample string 3",
        "DateOfPurchase": "sample string 4",
        "DrugName": "sample string 5",
        "NoOfDrugsPurchased": 6,
        "NoOfDrugsInTakePerDay": 7,
        "Currency": "sample string 8"
      }
    ],
    "TotalPaidAmount": 1.0,
    "TotalUnpaidAmount": 2.0
  },
  "AdditionalNotes": {
    "AdditionalNote": "sample string 1"
  },
  "Attachments": [
    {
      "FileName": "sample string 1",
      "FilePath": "sample string 2",
      "FileType": "sample string 3",
      "FileSize": 4.0,
      "DocType": 1,
      "FormattedName": "sample string 5",
      "IsPMESupported": true
    },
    {
      "FileName": "sample string 1",
      "FilePath": "sample string 2",
      "FileType": "sample string 3",
      "FileSize": 4.0,
      "DocType": 1,
      "FormattedName": "sample string 5",
      "IsPMESupported": true
    }
  ],
  "MemberInformationDetails": {
    "PolicyPeriod": "sample string 1",
    "PolicyNumber": "sample string 2",
    "Product": "sample string 3",
    "FirstName": "sample string 4",
    "LastName": "sample string 5",
    "MiddleName": "sample string 6",
    "Dob": "sample string 7",
    "Address": "sample string 8",
    "PostalCode": "sample string 9",
    "PhoneNumber": "sample string 10",
    "Email": "sample string 11",
    "Fax": "sample string 12",
    "PolicyCurrency": "sample string 13",
    "PrimaryMemberGBGID": "sample string 14",
    "Employer": "sample string 15",
    "Country": "sample string 16",
    "GroupName": "sample string 17",
    "IsDifferentSecondary": true,
    "ClaimantFirstName": "sample string 19",
    "ClaimantLastName": "sample string 20",
    "ClaimantMiddleName": "sample string 21",
    "ClaimantDOB": "sample string 22",
    "ClaimantAddress": "sample string 23",
    "ClaimantPostalCode": "sample string 24",
    "ClaimantCountry": "sample string 25",
    "ClaimantPhoneNumber": "sample string 26",
    "ClaimantOccupation": "sample string 27",
    "Sex": "sample string 28",
    "Relastionship": "sample string 29",
    "IndividualNumber": "sample string 30",
    "MembershipNumber": "sample string 31"
  },
  "PaymentModeInformation": {
    "PaymentOptions": "sample string 1",
    "MakePaymentTo": "sample string 2",
    "BankingMethod": "sample string 3",
    "CheckMailingAddress": "sample string 4",
    "Currency": "sample string 5",
    "AccountNumber": "sample string 6",
    "BankName": "sample string 7",
    "BankingAccountType": "sample string 8",
    "BankAddress": "sample string 9",
    "Country": "sample string 10",
    "State": "sample string 11",
    "City": "sample string 12",
    "PostalCode": "sample string 13",
    "BeneficiaryAccountNumber": "sample string 14",
    "BeneficiaryRoutingNumber": "sample string 15",
    "BeneficiaryName": "sample string 16",
    "BeneficiaryAddress": "sample string 17",
    "BeneficiaryCountry": "sample string 18",
    "BeneficiaryState": "sample string 19",
    "BeneficiaryCity": "sample string 20",
    "BeneficiaryPostalCode": "sample string 21",
    "IBANNumber": "sample string 22",
    "SwiftCode": "sample string 23",
    "IntermediaryBank": "sample string 24",
    "IntermediaryBankName": "sample string 25",
    "IntermediaryBankAddress": "sample string 26",
    "IntermediaryBeneficiaryName": "sample string 27",
    "IntermediaryIBANNumber": "sample string 28",
    "IntermediaryRoutingNumber": "sample string 29",
    "ReimbursmentMethod": "sample string 30"
  },
  "Declaration": {
    "InsuredPersonName": "sample string 1",
    "InsuredDate": "2021-04-21T04:03:34.4196327-07:00",
    "PolicyHolderName": "sample string 3",
    "PolicyDate": "2021-04-21T04:03:34.4196327-07:00",
    "IsMember": true
  },
  "Language": 1,
  "ClaimDocumentPath": "sample string 3"
}

application/xml, text/xml

Sample:
<SubmitClaimInputModel xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://schemas.datacontract.org/2004/07/GBG.AS.AgentPortal.API.Areas.SubmitClaim.Models">
  <AdditionalNotes>
    <AdditionalNote>sample string 1</AdditionalNote>
  </AdditionalNotes>
  <Attachments>
    <Attachments>
      <DocType>Claim</DocType>
      <FileName>sample string 1</FileName>
      <FilePath>sample string 2</FilePath>
      <FileSize>4</FileSize>
      <FileType>sample string 3</FileType>
      <FormattedName>sample string 5</FormattedName>
      <IsPMESupported>true</IsPMESupported>
    </Attachments>
    <Attachments>
      <DocType>Claim</DocType>
      <FileName>sample string 1</FileName>
      <FilePath>sample string 2</FilePath>
      <FileSize>4</FileSize>
      <FileType>sample string 3</FileType>
      <FormattedName>sample string 5</FormattedName>
      <IsPMESupported>true</IsPMESupported>
    </Attachments>
  </Attachments>
  <ClaimDocumentPath>sample string 3</ClaimDocumentPath>
  <ClaimReferenceNumber>sample string 1</ClaimReferenceNumber>
  <ClaimType>Health</ClaimType>
  <Declaration>
    <InsuredDate>2021-04-21T04:03:34.4196327-07:00</InsuredDate>
    <InsuredPersonName>sample string 1</InsuredPersonName>
    <IsMember>true</IsMember>
    <PolicyDate>2021-04-21T04:03:34.4196327-07:00</PolicyDate>
    <PolicyHolderName>sample string 3</PolicyHolderName>
  </Declaration>
  <HealthClaimDetails>
    <AuthenticationId>sample string 23</AuthenticationId>
    <ClaimName>sample string 31</ClaimName>
    <Email>sample string 28</Email>
    <Individual>sample string 25</Individual>
    <IsUpdateEmailAndPhone>true</IsUpdateEmailAndPhone>
    <Language>sample string 26</Language>
    <Oid>sample string 27</Oid>
    <PhoneNumber>sample string 29</PhoneNumber>
    <Portal>sample string 24</Portal>
    <RequestId>sample string 22</RequestId>
    <AccidentDetails>sample string 10</AccidentDetails>
    <AutomobileDetails>sample string 11</AutomobileDetails>
    <CoveredByAutomobileInsurance>true</CoveredByAutomobileInsurance>
    <CoveredByMedicareOrGovtAgency>true</CoveredByMedicareOrGovtAgency>
    <CoveredByOtherGroupPlan>true</CoveredByOtherGroupPlan>
    <DeliveryDate>sample string 2</DeliveryDate>
    <DiagnosisDetails>sample string 5</DiagnosisDetails>
    <IllnessOccurredDate>sample string 3</IllnessOccurredDate>
    <InjuryAnyTypeOfAccident>true</InjuryAnyTypeOfAccident>
    <InjuryAnyWayToAutomobileAccident>true</InjuryAnyWayToAutomobileAccident>
    <InjuryAnyWayToPatientsOccupation>true</InjuryAnyWayToPatientsOccupation>
    <IsMaternityTreatment>true</IsMaternityTreatment>
    <OtherSourceDetails>sample string 15</OtherSourceDetails>
    <PreviousDiagnosisDetails>sample string 6</PreviousDiagnosisDetails>
    <ProblemDetails>sample string 4</ProblemDetails>
    <ProviderAddress>sample string 18</ProviderAddress>
    <ProviderCountry>sample string 21</ProviderCountry>
    <ProviderEmail>sample string 19</ProviderEmail>
    <ProviderName>sample string 16</ProviderName>
    <ProviderPhoneNumber>sample string 17</ProviderPhoneNumber>
    <ProviderPostalCode>sample string 20</ProviderPostalCode>
  </HealthClaimDetails>
  <IsSubmit>true</IsSubmit>
  <Language>English</Language>
  <MemberInformationDetails>
    <Address>sample string 8</Address>
    <ClaimantAddress>sample string 23</ClaimantAddress>
    <ClaimantCountry>sample string 25</ClaimantCountry>
    <ClaimantDOB>sample string 22</ClaimantDOB>
    <ClaimantFirstName>sample string 19</ClaimantFirstName>
    <ClaimantLastName>sample string 20</ClaimantLastName>
    <ClaimantMiddleName>sample string 21</ClaimantMiddleName>
    <ClaimantOccupation>sample string 27</ClaimantOccupation>
    <ClaimantPhoneNumber>sample string 26</ClaimantPhoneNumber>
    <ClaimantPostalCode>sample string 24</ClaimantPostalCode>
    <Country>sample string 16</Country>
    <Dob>sample string 7</Dob>
    <Email>sample string 11</Email>
    <Employer>sample string 15</Employer>
    <Fax>sample string 12</Fax>
    <FirstName>sample string 4</FirstName>
    <GroupName>sample string 17</GroupName>
    <IndividualNumber>sample string 30</IndividualNumber>
    <IsDifferentSecondary>true</IsDifferentSecondary>
    <LastName>sample string 5</LastName>
    <MembershipNumber>sample string 31</MembershipNumber>
    <MiddleName>sample string 6</MiddleName>
    <PhoneNumber>sample string 10</PhoneNumber>
    <PolicyCurrency>sample string 13</PolicyCurrency>
    <PolicyNumber>sample string 2</PolicyNumber>
    <PolicyPeriod>sample string 1</PolicyPeriod>
    <PostalCode>sample string 9</PostalCode>
    <PrimaryMemberGBGID>sample string 14</PrimaryMemberGBGID>
    <Product>sample string 3</Product>
    <Relastionship>sample string 29</Relastionship>
    <Sex>sample string 28</Sex>
  </MemberInformationDetails>
  <PaymentDetails>
    <BankAddress>sample string 7</BankAddress>
    <BankId>sample string 20</BankId>
    <BankName>sample string 6</BankName>
    <BankType>None</BankType>
    <BeneficiaryAccountNumber>sample string 8</BeneficiaryAccountNumber>
    <BeneficiaryAddress>sample string 14</BeneficiaryAddress>
    <BeneficiaryName>sample string 9</BeneficiaryName>
    <CheckMailingAddress>sample string 1</CheckMailingAddress>
    <City>sample string 16</City>
    <Country>sample string 17</Country>
    <Currency>sample string 15</Currency>
    <FurtherCreditAccountNumber>sample string 26</FurtherCreditAccountNumber>
    <FurtherCreditBeneficiaryName>sample string 25</FurtherCreditBeneficiaryName>
    <IBANNumber>sample string 12</IBANNumber>
    <IntermediaryBank>sample string 13</IntermediaryBank>
    <IntermediaryBankName>sample string 21</IntermediaryBankName>
    <IntermediaryBeneficiaryName>sample string 22</IntermediaryBeneficiaryName>
    <IntermediaryIBANNumber>sample string 23</IntermediaryIBANNumber>
    <IntermediaryRoutingNumber>sample string 24</IntermediaryRoutingNumber>
    <IsApplyNextInvoice>true</IsApplyNextInvoice>
    <MailingAddressType>None</MailingAddressType>
    <MailingCity>sample string 2</MailingCity>
    <MailingCountry>sample string 3</MailingCountry>
    <MailingPostalCode>sample string 4</MailingPostalCode>
    <MailingState>sample string 5</MailingState>
    <MakePaymentTo>MEMBER</MakePaymentTo>
    <PostalCode>sample string 18</PostalCode>
    <ReimbursmentMethod>Check</ReimbursmentMethod>
    <Routing>sample string 10</Routing>
    <State>sample string 19</State>
    <SwiftCode>sample string 11</SwiftCode>
  </PaymentDetails>
  <PaymentModeInformation>
    <AccountNumber>sample string 6</AccountNumber>
    <BankAddress>sample string 9</BankAddress>
    <BankName>sample string 7</BankName>
    <BankingAccountType>sample string 8</BankingAccountType>
    <BankingMethod>sample string 3</BankingMethod>
    <BeneficiaryAccountNumber>sample string 14</BeneficiaryAccountNumber>
    <BeneficiaryAddress>sample string 17</BeneficiaryAddress>
    <BeneficiaryCity>sample string 20</BeneficiaryCity>
    <BeneficiaryCountry>sample string 18</BeneficiaryCountry>
    <BeneficiaryName>sample string 16</BeneficiaryName>
    <BeneficiaryPostalCode>sample string 21</BeneficiaryPostalCode>
    <BeneficiaryRoutingNumber>sample string 15</BeneficiaryRoutingNumber>
    <BeneficiaryState>sample string 19</BeneficiaryState>
    <CheckMailingAddress>sample string 4</CheckMailingAddress>
    <City>sample string 12</City>
    <Country>sample string 10</Country>
    <Currency>sample string 5</Currency>
    <IBANNumber>sample string 22</IBANNumber>
    <IntermediaryBank>sample string 24</IntermediaryBank>
    <IntermediaryBankAddress>sample string 26</IntermediaryBankAddress>
    <IntermediaryBankName>sample string 25</IntermediaryBankName>
    <IntermediaryBeneficiaryName>sample string 27</IntermediaryBeneficiaryName>
    <IntermediaryIBANNumber>sample string 28</IntermediaryIBANNumber>
    <IntermediaryRoutingNumber>sample string 29</IntermediaryRoutingNumber>
    <MakePaymentTo>sample string 2</MakePaymentTo>
    <PaymentOptions>sample string 1</PaymentOptions>
    <PostalCode>sample string 13</PostalCode>
    <ReimbursmentMethod>sample string 30</ReimbursmentMethod>
    <State>sample string 11</State>
    <SwiftCode>sample string 23</SwiftCode>
  </PaymentModeInformation>
  <TravelClaimDetails>
    <AuthenticationId>sample string 73</AuthenticationId>
    <ClaimName>sample string 81</ClaimName>
    <Email>sample string 78</Email>
    <Individual>sample string 75</Individual>
    <IsUpdateEmailAndPhone>true</IsUpdateEmailAndPhone>
    <Language>sample string 76</Language>
    <Oid>sample string 77</Oid>
    <PhoneNumber>sample string 79</PhoneNumber>
    <Portal>sample string 74</Portal>
    <RequestId>sample string 72</RequestId>
    <ActualDateOfDeparture>sample string 42</ActualDateOfDeparture>
    <ActualFlightOrFerryOrTransportNumber>sample string 44</ActualFlightOrFerryOrTransportNumber>
    <ActualTimeOfDeparture>sample string 43</ActualTimeOfDeparture>
    <AdditionalExpensesDetails>sample string 36</AdditionalExpensesDetails>
    <AmountClaimed>1</AmountClaimed>
    <BaggageMoneyDocuments>true</BaggageMoneyDocuments>
    <CancellationOrCurtailment>true</CancellationOrCurtailment>
    <ClaimMedicalExpensesAndHospitalBenefits>true</ClaimMedicalExpensesAndHospitalBenefits>
    <CorrespondenceAddress>sample string 63</CorrespondenceAddress>
    <DateOfIllnessOrInjury>sample string 8</DateOfIllnessOrInjury>
    <DateOfLossOrDamage>sample string 51</DateOfLossOrDamage>
    <DescriptionOfHowInjuryOccurred>sample string 11</DescriptionOfHowInjuryOccurred>
    <DetailedDescriptionOfLossOrDamage>sample string 53</DetailedDescriptionOfLossOrDamage>
    <DetailsOfExpensesIncurredToReplacePassport>sample string 66</DetailsOfExpensesIncurredToReplacePassport>
    <DetailsOfLossOrDeathOccurred>sample string 69</DetailsOfLossOrDeathOccurred>
    <DetailsOfPersonalPhysicianOrDoctor>sample string 16</DetailsOfPersonalPhysicianOrDoctor>
    <DoesInsuredPersonHavePrivateHealthInsurance>true</DoesInsuredPersonHavePrivateHealthInsurance>
    <EACContactedReason>sample string 23</EACContactedReason>
    <FlightOrFerryOrTransportName>sample string 45</FlightOrFerryOrTransportName>
    <HowManyWeek>1</HowManyWeek>
    <InPatientTreatmentDate>sample string 21</InPatientTreatmentDate>
    <InsuranceCarrierDetails>sample string 25</InsuranceCarrierDetails>
    <InsuredPolicyNumber>sample string 62</InsuredPolicyNumber>
    <IsClaimResultOfAccident>true</IsClaimResultOfAccident>
    <IsInsuredPersonSufferedFromthisBefore>true</IsInsuredPersonSufferedFromthisBefore>
    <IssuerNotifiedIfLossRelatedToTravellers>sample string 54</IssuerNotifiedIfLossRelatedToTravellers>
    <Item1AmountClaimed>1</Item1AmountClaimed>
    <Item1CostNow>1</Item1CostNow>
    <Item1Description>sample string 56</Item1Description>
    <Item1PricePaid>1</Item1PricePaid>
    <Item1PurchasedPalceAndDate>sample string 57</Item1PurchasedPalceAndDate>
    <Item2AmountClaimed>1</Item2AmountClaimed>
    <Item2CostNow>1</Item2CostNow>
    <Item2Description>sample string 58</Item2Description>
    <Item2PricePaid>1</Item2PricePaid>
    <Item2PurchasedPalceAndDate>sample string 59</Item2PurchasedPalceAndDate>
    <JourneyBooked>sample string 29</JourneyBooked>
    <JourneyCancelledExplanation>sample string 31</JourneyCancelledExplanation>
    <JourneyCancelledOrCurtailed>sample string 30</JourneyCancelledOrCurtailed>
    <JourneyEndDate>sample string 2</JourneyEndDate>
    <JourneyStartDate>sample string 1</JourneyStartDate>
    <MedicalExpensesAddress>sample string 17</MedicalExpensesAddress>
    <MedicalExpensesEmail>sample string 20</MedicalExpensesEmail>
    <MedicalExpensesFax>sample string 19</MedicalExpensesFax>
    <MedicalExpensesPhoneNumber>sample string 18</MedicalExpensesPhoneNumber>
    <NameAndAddressOfDoctorOrHospital>sample string 12</NameAndAddressOfDoctorOrHospital>
    <NameofInsurer>sample string 60</NameofInsurer>
    <NaturalCausesDetails>sample string 71</NaturalCausesDetails>
    <NatureOfIllnessOrInjury>sample string 7</NatureOfIllnessOrInjury>
    <NumberOfHoursDelayed>1</NumberOfHoursDelayed>
    <PassportLoss>true</PassportLoss>
    <PassportLostPlace>sample string 65</PassportLostPlace>
    <PersonCausedInTripCancelledAndRelationship>sample string 32</PersonCausedInTripCancelledAndRelationship>
    <PersonalAccident>true</PersonalAccident>
    <PlaceOfIllnessOrInjury>sample string 10</PlaceOfIllnessOrInjury>
    <PointOfDeparture>sample string 46</PointOfDeparture>
    <PointOfDestination>sample string 5</PointOfDestination>
    <PointOfMissedConnection>sample string 47</PointOfMissedConnection>
    <PointOfOrigin>sample string 4</PointOfOrigin>
    <ProvideOtherInsuranceDetails>sample string 61</ProvideOtherInsuranceDetails>
    <ReasonForDelayedOrMissedDeparture>sample string 38</ReasonForDelayedOrMissedDeparture>
    <RecommencedTrip>sample string 49</RecommencedTrip>
    <ReimbursementPayable>sample string 34</ReimbursementPayable>
    <ReportedToAuthority>sample string 55</ReportedToAuthority>
    <ScheduledDateOfDeparture>sample string 39</ScheduledDateOfDeparture>
    <ScheduledFlightOrFerryOrTransportNumber>sample string 41</ScheduledFlightOrFerryOrTransportNumber>
    <ScheduledTimeOfDeparture>sample string 40</ScheduledTimeOfDeparture>
    <SufferedIllnessDetails>sample string 15</SufferedIllnessDetails>
    <Time>sample string 52</Time>
    <TimeOfIllnessOrInjury>sample string 9</TimeOfIllnessOrInjury>
    <TransportUsedForDeparturePoint>sample string 48</TransportUsedForDeparturePoint>
    <TravelDelayMissedDeparture>true</TravelDelayMissedDeparture>
    <WasAnEHC>true</WasAnEHC>
    <WasEACContacted>true</WasEACContacted>
    <WasEACContactedIfJourneyWasCurtailed>true</WasEACContactedIfJourneyWasCurtailed>
    <WasInjuryOrDeathResultOfNatural>true</WasInjuryOrDeathResultOfNatural>
    <WasInsuredPersonPregnant>true</WasInsuredPersonPregnant>
    <WasJourney>Holiday</WasJourney>
    <WasPresentedToHospitalOrDoctor>true</WasPresentedToHospitalOrDoctor>
    <WereAdditionalExpensesIncurred>true</WereAdditionalExpensesIncurred>
    <WhenInjuryOrDeathOccur>sample string 68</WhenInjuryOrDeathOccur>
  </TravelClaimDetails>
  <TreatmentDetails>
    <TotalPaidAmount>1</TotalPaidAmount>
    <TotalUnpaidAmount>2</TotalUnpaidAmount>
    <TreatmentItems>
      <TreatmentItems>
        <Cost>1</Cost>
        <CoverageType>Health</CoverageType>
        <Currency>sample string 8</Currency>
        <DateOfPurchase>sample string 4</DateOfPurchase>
        <DateOfService>sample string 2</DateOfService>
        <Description>sample string 3</Description>
        <DrugName>sample string 5</DrugName>
        <NoOfDrugsInTakePerDay>7</NoOfDrugsInTakePerDay>
        <NoOfDrugsPurchased>6</NoOfDrugsPurchased>
      </TreatmentItems>
      <TreatmentItems>
        <Cost>1</Cost>
        <CoverageType>Health</CoverageType>
        <Currency>sample string 8</Currency>
        <DateOfPurchase>sample string 4</DateOfPurchase>
        <DateOfService>sample string 2</DateOfService>
        <Description>sample string 3</Description>
        <DrugName>sample string 5</DrugName>
        <NoOfDrugsInTakePerDay>7</NoOfDrugsInTakePerDay>
        <NoOfDrugsPurchased>6</NoOfDrugsPurchased>
      </TreatmentItems>
    </TreatmentItems>
  </TreatmentDetails>
</SubmitClaimInputModel>

application/x-www-form-urlencoded

Sample:

Sample not available.

Response Information

Resource Description

Claim Reference Number

HttpResponseMessage
NameDescriptionTypeAdditional information
Version

Version

None.

Content

HttpContent

None.

StatusCode

HttpStatusCode

None.

ReasonPhrase

string

None.

Headers

Collection of Object

None.

RequestMessage

HttpRequestMessage

None.

IsSuccessStatusCode

boolean

None.