Blockchain Based Health Insurance System

The existing healthcare claims process suffers from many ills, like fraud, huge paperwork, and delays in claims verification, affecting both patients and insurers badly. This paper represents a blockchain-based health insurance system based on Ethereum smart contracts and IPFS to enhance the security and transparency and ensure automation in claims processing. The proposed system consists of the blockchain layer for automating the policy management, claims processing, and fraud detection via Policy, Claim, and Audit smart contracts; a decentralized storage layer (IPFS) that ensures secure and tamper-proof storage of claim-related documents; and a payment layer that formally settles transactions via smart contracts, thus lessening the company's reliance on intermediaries. Integrating middleware APIs ensures good interoperability among insurers, hospitals, patients, and administrators-real-time tracking of claims and compliance with regulatory demands. This will be a global, scalable, fraud-resistant model that optimizes claims settlement and minimizes administrative overhead and maximizes user satisfaction. This paper underscores how health insurance can benefit from blockchain technology.

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Publication Details

Published
2025-03-07
DOI
https://doi.org/10.1109/icdt63985.2025.10986743
Citations
1
Primary Topic
Blockchain Technology Applications and Security
Type
article
Field-Weighted Citation Impact
3.25
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article

Blockchain Based Health Insurance System

Bipin Kumar Rai, Pooja Malhotra, P Pallavi, T S Namitha et al.
1 citations
Blockchain Technology Applications and Security
3.25
article

Blockchain Based Health Insurance System

Bipin Kumar Rai, Pooja Malhotra, P Pallavi, T S Namitha, R Pavana
article en
1 citations

Abstract

The existing healthcare claims process suffers from many ills, like fraud, huge paperwork, and delays in claims verification, affecting both patients and insurers badly. This paper represents a blockchain-based health insurance system based on Ethereum smart contracts and IPFS to enhance the security and transparency and ensure automation in claims processing. The proposed system consists of the blockchain layer for automating the policy management, claims processing, and fraud detection via Policy, Claim, and Audit smart contracts; a decentralized storage layer (IPFS) that ensures secure and tamper-proof storage of claim-related documents; and a payment layer that formally settles transactions via smart contracts, thus lessening the company's reliance on intermediaries. Integrating middleware APIs ensures good interoperability among insurers, hospitals, patients, and administrators-real-time tracking of claims and compliance with regulatory demands. This will be a global, scalable, fraud-resistant model that optimizes claims settlement and minimizes administrative overhead and maximizes user satisfaction. This paper underscores how health insurance can benefit from blockchain technology.

Dayananda Sagar University (IN), Dr. Hari Singh Gour University (IN)
Decent work and economic growth
Openalex Percentile: Top 9%
Blockchain Technology Applications and Security
3.25
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Blockchain Based Health Insurance System — Bipin Kumar Rai, Pooja Malhotra, et al. · (2025) | TGRS Research Map | TGRS