RiskInformation
objectIndicator flag for weight loss
Allowed values:YesNoUnknown
lostWeightReason
Allowed values:DietIllnessExerciseOtherSurgeryUnknownPregnancy
Description value if lostWeightReason is selected as Other
Indicator flag for daily activity assistant required
Allowed values:YesNo
Duration stating use of tobacco
Example:5
Indicator flag for marijuana used
Allowed values:YesNoUnknown
Duration stating use of Marijuana
Example:5
Indicator flag for help needed or not
Allowed values:YesNoUnknown
Indicator flag for diagnostic tests
Allowed values:YesNoUnknown
Indicator flag for hospitalization history
Allowed values:YesNoUnknown
Indicator flag for outstanding treatment except AIDS and HIV
Allowed values:YesNoUnknown
Allowed values:Allergy TestingRoutine Blood workRoutine Urine testingRoutine Pap smearRoutine colonoscopyRoutine mammogramRoutine EKGImaging for bone or jointRoutine bone densityPregnancy or fertility relatedVision or HearingOther
Indicator flag
Allowed values:YesNoUnknown
Indicator flag for felony
Allowed values:YesNoUnknown
Indicator flag for covid 19 hospitalization
Allowed values:YesNoUnknown
Indicator flag for parents
Allowed values:YesNoUnknown
Show Child Parameters
Indicator flag for rejection of insurence application
Allowed values:YesNo
Show Child Parameters
Show Child Parameters
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MedicalHistory
objectMedical condition questions
Allowed values:NoneSubstance AbuseDrug AbuseAlcoholismSelf HelpArthritisAnkylosing SpondylitisMyositisRheumatoid ArthritisSclerodermaSLEGranulomatosisBenign TumorBrain TumorColon PolypsInsitu MelanomaInsitu BreastOvarian CystBlood DisorderAplastic AnemiaClotting DisorderEssential ThrombocytosisHemochromatosisLow PlateletsPolycythemia VeraCancerBreast CancerColon CancerLeukemiaLymphomasLung CancerMelanomaOvarian CancerPancreatic CancerProstate CancerSkin CancerTesticular CancerAlzheimer DiseaseALSCerebral PalsyEpilepsyMultiple SclerosisParaplegiaStrokeEndocrine DisorderAddisons DiseaseCushings DiseaseHyperparathyroidismHyperthyroidismPituitary DisorderThyroid NoduleHypothyroidismLiver DisorderAutoimmune HepatitisBarrett EsophagusChronic PancreatitisLiver CirrhosisCrohns DiseaseHepatitis BHepatitis CLiver EnzymesUlcerative ColitisHeart DisorderAbnormal HeartAneurysmBrain AneurysmThrombosisCoronary DiseaseHeart AttackHeart FailureCardiomyopathyHeart ValveHBPPacemakerKidney DisorderKidney InfectionGlomerulonephritisKidney failurePKDBlood UrineSelf CatheterizationRespiratory DisorderAsthmaCOPDSleep ApneaMens HealthPSAEnlarged ProstateMetabolic DisorderHigh CholesterolDiabetes Type1Diabetes Type2PrediabetesPsychiatric IllnessADHDAnxietyBipolar DisorderDepressionEating DisorderPTSDSchizophreniaUnspecifiedHIVAIDSARCHIVWomens HealthAbnormal MammogramAbnormal PapBrain DisorderCystic FibrosisPulmonary FibrosisChronic Kidney DiseaseOCDPsychosisDrugAlcoholPulmonary HypertensionDeep Vein ThrombosisHeart Disorder None ApplyMetabolic Disorder None ApplyEndocrine Disorder None ApplyRespiratory Disorder None ApplyKidney Disorder None ApplyPsychiatric Illness None ApplyWomens Health None ApplyLiver Disorder None ApplyBrain Disorder None ApplyArthritis None ApplyBlood Disorder None Apply
Indicator flag for medical history questions
Allowed values:YesNo
Indicator flag for treatment indicator
Allowed values:YesNoUnknown
Indicator flag for recovered status
Allowed values:YesNoUnknown
Condition Stage
Example:Stage 1
Indicator flag for organ cancer spread
Allowed values:YesNoUnknown
Indicator flag for basal or squamous cell skin cancer
Allowed values:YesNo
Indicator flag for test result value
Allowed values:YesNoUnknown
Indicator flag for bipolar Suicide
Allowed values:YesNo
Indicator flag for motar accident
Allowed values:YesNo
Results reading
Example:70
Last result reading date
Treatment Date
BP reading upper
Example:140
BP reading lower
Example:70
Year of first seizure in case of epilepsy
Example:2001
Last Seizure date if applicable
number of seizure in past year. Maximum value applicable is 10.
Example:6
Indicator flag for Rheumatoid arthritis limitation
Allowed values:YesNoUnknown
Indicator flag for Rheumatoid arthritis life impact
Allowed values:YesNoUnknown
Show Child Parameters
Show Child Parameters
TreatmentDetail
objectTreatment Type
Allowed values:MedicationHospitalizationCPAPSurgeryChemotherapyRadiationOtherTestMedication AddedMedication IncreasedQuit MedicationNone
Indicator flag for recovered status
Allowed values:YesNoUnknown
treatment description
Example:other type of treatment
Indicator flag for treatment completion
Allowed values:YesNoUnknown
Indicator flag for other test recommendation
Allowed values:YesNoUnknown
Indicator flag for treatment complication
Allowed values:YesNoUnknown
Last seen date for treatment observation
treatment description
Example:prescribed pain meds
treatmentStartDate in ‘YYYY-MM-DD’ format.
LifeStyleActivities
objectIndicator flag for bankruptcy
Allowed values:YesNo
Discharge date of bankruptcy in YYYY-MM-DD format.
Indicator flag for flying history
Allowed values:YesNoUnknown
Show Child Parameters
Indicator flag for flying experience
Allowed values:YesNoUnknown
Indicator flag for future flying plans
Allowed values:YesNoUnknown
Indicator flag for air racing
Allowed values:YesNoUnknown
Indicator flag for diagnostic tests
Allowed values:YesNoUnknown
Indicator flag for sky diving
Allowed values:YesNoUnknown
Indicator flag for scuba diving
Allowed values:YesNoUnknown
Indicator flag
Allowed values:YesNoUnknown
Indicator flag for jump skiing
Allowed values:YesNoUnknown
Indicator flag
Allowed values:YesNoUnknown
Indicator flag
Allowed values:YesNoUnknown
Indicator flag for no activity
Allowed values:YesNoUnknown
Indicator flag for motor racing
Allowed values:YesNoUnknown
Indicator flag for diving
Allowed values:YesNoUnknown
Indicator flag for climbing
Allowed values:YesNoUnknown
Indicator flag for high risk activity
Allowed values:YesNo
PartyOthers
objectFirst Name of the party
Example:Thomas
Last Name of the the party
Example:Lawrence
Middle name of the party
Full name of the party.
Example:Thomas Lawrence
Suffix for given party if Applicable
Example:Sr
Prefix for given party if Applicable
Example:Dr
Gender of party
Allowed values:MaleFemale
Example:Male
Date of birth of party
Age of the party
Example:26
Party SSN
>= 9 characters<= 9 characters
Example:121328426
Driver license number
Example:T61217265934
State Code
Allowed values:ALAKAZARCACOCTDCDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
Example:AL
Flag for Driver License
Allowed values:YesNoUnknown
Example:No
Addres line 1
Example:Wt Road
Addres line 2
Example:St Street
City name
Example:Test City
State Code
Allowed values:ALAKAZARCACOCTDCDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
Example:AL
Zip Code. Max char allowed is 9.
<= 9 characters
Example:123456
Birth Country
Allowed values:AFAXALDZASADAOAIAQAGARAMANAWAUATAZBSBHBDBBBYBEBZBJBMBTBOBQBABWBVBRIOBNBGBFBICVKHCMCAKYCFTDCLCNCXCCCOKMCDCGCKCRCIHRCUCWCYCZDKDJDMDOECEGSVGQEREESZETFKFOFJFIFRGFPFTFGAGMGEDEGHGIGRGLGDGPGUGTGGGNGWGYHTHMVAHNHKHUISINIDIRIQIEIMILITJMJPJEJOKZKEKIKPKRKWKGLALVLBLSLRLYLILTLUMOMKMGMWMYMVMLMTMHMQMRMUYTMXFMMDMCMNMEMSMAMZMMNANRNPNLNCNZNINENGNUNFMPNOOMPKPWPSPAPGPYPEPHPNPLPTPRQARERORURWBLSHKNLCMFPMVCWSSMSTSASNRSSCSLSGSXSKSISBSOZAGSSSESLKSDSRSJSECHSYTWTJTZTHTLTGTKTOTTTNTRTMTCTVUGUAAEGBUMUSUYUZVUVEVNVGVIWFEHXKYEZMZWOther
Example:US
Phone number
Example:111-111-2222
Email Id of the party
Example:test@abc.com
Type of email
Allowed values:PersonalBusiness
Example:Business
Communication preferences
Allowed values:MailEmailPhone
Example:Email
Party classification
Allowed values:IndividualBusinessTrustCorporationPartnershipOtherGroup of IndividualsEstateChild
Example:Individual
Relationship with insured
Allowed values:AuntBrotherBusinessBusiness AssociateCharityChildCo-MortgagerCousinDaughterDependantDomestic PartnerEstateExecutorsFatherFianceFianceeFormer SpouseFriendGod ChildGod ParentGrandchildGrandparentGreat GrandchildGreat GrandparentLegal GuardianLife PartnerMotherNephewNieceParentParents In LawSiblingSisterSonSpouseStepfatherStepmotherTrustUncleSelfOther
Example:Father
Requested percentage value
Example:100
Date of trust
Show Child Parameters
State Code
Allowed values:ALAKAZARCACOCTDCDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY
Example:AL