{ "$schema": "https://json-schema.org/draft/2020-12/schema", "$id": "https://raw.githubusercontent.com/api-evangelist/aflac/refs/heads/main/json-schema/enterprise-connect-claim-schema.json", "title": "Claim", "description": "A supplemental insurance claim record.", "type": "object", "properties": { "claim_id": { "type": "string", "description": "Unique claim identifier.", "example": "CLM-112233" }, "policy_id": { "type": "string", "description": "Policy associated with the claim.", "example": "POL-987654" }, "employee_id": { "type": "string", "description": "Claimant employee identifier.", "example": "EMP-789012" }, "claim_type": { "type": "string", "description": "Type of claim event.", "enum": [ "accident", "critical_illness", "cancer_diagnosis", "hospitalization", "disability" ], "example": "accident" }, "status": { "type": "string", "description": "Current claim processing status.", "enum": [ "submitted", "in_review", "approved", "denied", "paid" ], "example": "approved" }, "incident_date": { "type": "string", "format": "date", "description": "Date of the qualifying event.", "example": "2025-02-10" }, "submission_date": { "type": "string", "format": "date-time", "description": "Timestamp when the claim was submitted.", "example": "2025-02-15T09:30:00Z" }, "benefit_amount": { "type": "number", "description": "Approved benefit payment amount in USD.", "example": 1500.0 }, "denial_reason": { "type": "string", "description": "Reason for denial if the claim was denied.", "example": "Condition not covered under policy terms." } } }