Blockchain-Based Fintech Architecture for Enhanced Interoperability in Health Insurance

Abstract

Health Insurances play vital role in one’s life to bear costly medical services and delays in payments from insurer to service providers causes chaotic to insureds seeking immediate treatment for their diseases. Almost every stakeholder in this ecosystem is equipped with his own significantly efficient independent information systems usually known as Management Information Systems (MIS) which most of the times remain sufficient for their internal business needs but apart from so much technical advancements, the inter-communication of these stakeholders for up-to-date status of insurer, insured, and health service provider is still missing in various scenarios which causes distress to all stakeholders and patients.  In this paper, we have proposed a Blockchain based data sharing solution among all the stakeholders to fast up the processes and smoothness of network along with a concept of Insurance e-Wallet for insured entities where they can have summary of all their purchased Insurance plans, their processed or pending claims, remaining limits, and upcoming changes in their policies from insurance vendors. Apart from interoperability, the second most important aspect this architecture addresses the avoiding of redundant paper work that every stakeholder manages to maintain their day-to-day activity records, these are almost the same set of documents regarding an insurance claim that a service provider, insurer, and a patient maintains. To avoid this redundancy, we made use of IPFS as the decentralized repository for such documents which makes Blockchain solution cost effective and light weight as just the reference or the hash ID is put in Blockchain instead of whole document in binary format. A prototype is developed based on suggested architecture and two experiments are performed on implemented prototype, first one for measuring expected growth rate of Blockchain based on routine appendment of data and second for measuring document access time required to access files from IPFS server. Lastly the paper concludes with some prominent implementation challenges that stakeholders may face during Blockchain ’s implementation to achieve transformation in this industry.