A Traceable Online Insurance Claims System Based on Blockchain and Smart Contract Technology

Chin-Ling Chen, Yong-Yuan Deng, Woei-Jiunn Tsaur, Chun-Ta Li, Cheng-Chi Lee and Chih-Ming Wu
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Chin-Ling Chen: School of Computer and Information Engineering, Xiamen University of Technology, Xiamen 361005, China
Yong-Yuan Deng: Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung 41349, Taiwan
Woei-Jiunn Tsaur: Computer Center, National Taipei University, New Taipei City 237303, Taiwan
Chun-Ta Li: Department of Information Management, Tainan University of Technology, Tainan City 71002, Taiwan
Cheng-Chi Lee: Department of Library and Information Science, Research and Development Center for Physical Education, Health, and Information Technology, Fu Jen Catholic University, New Taipei City 242062, Taiwan
Chih-Ming Wu: School of Civil Engineering and Architecture, Xiamen University of Technology, Xiamen 361024, China

Sustainability, 2021, vol. 13, issue 16, 1-39

Abstract: In the current medical insurance claims process, there are problems of low efficiency and complex services. When a patient applies for medical insurance claims, he/she must go to the hospital to apply for a diagnosis certificate and receipt and then send the relevant application documents to the insurance company. The patient will not receive compensation until the company completes the verification with the patient’s hospital. However, we can improve the current dilemma through blockchain technology. Blockchain technology can effectively open up the information channels of the insurance industry and medical institutions, promote industry integration, and enhance the ability of insurance companies to obtain information. In this research, we used blockchain and smart contract technology to make the following contributions to the development of Internet insurance. First, blockchain and smart contract technology can effectively solve the problem of online underwriting. Second, it is conducive to improving supervision. Third, it is conducive to solving risk control problems. Fourth, it is conducive to effective anti-money laundering. The proposed scheme fulfills the following security requirements: mutual authentication of identities, non-repudiation between each of two roles, and other major blockchain-based security requirements. In the event of a dispute, we also proposed an arbitration mechanism to divide responsibilities.

Keywords: blockchain; electronic medical record (EMR); insurance claim; mutual authentication; non-repudiation; smart contract (search for similar items in EconPapers)
JEL-codes: O13 Q Q0 Q2 Q3 Q5 Q56 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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