TWI656497B - Blockchain-based insurance service method and system - Google Patents

Abstract

The invention provides a blockchain-based insurance service method, which is used for an insurance service related to a policy of a policy holder, and is implemented by an insurance system, and the insurance system and a hospital system are connected to the zone. a blockchain, and the hospital end system stores a medical data related to the policy holder, the method comprising the steps of: the insurance system receiving the blockchain written by the hospital end system from the blockchain The medical information; the insurance industry system generates a pair of claims data corresponding to the medical data according to the medical data; and the insurance industry system writes the claim data into the blockchain. The invention can improve the claim efficiency of the insurance company, and shorten the time required for the insurance company to make the claim and the time when the policyholder waits for the claim payment.

Description

Blockchain-based insurance service method and system

The invention relates to an insurance service method and system, in particular to a blockchain based insurance service method and system.

The current insurance company's procedures for claim settlements are as follows: (1) Application: The policyholder or the entrusted person carries the claim application documents to the insurance company's service window to file a claim; (2) Acceptance: Service Center personnel The claimant's claim application documents are entered into the system to generate claims; (3) Compensating: The case is dispatched to the relevant administrative unit of the insurance company according to the distribution rules, and the claimant makes the claim for compensation; and (4) Payment: The insurance company pays through the accounting system for claims that need to be paid.

However, the above-mentioned current claims method has the following disadvantages: (i) If the application for claim settlement is related to medical treatment, the policyholder must first prepare documents such as a diagnosis book, a receipt paper, etc., and the insured person or the entrusted person will The documents are submitted to the insurance company; (ii) if the insurance company needs to access the medical records of the policyholders in the process of the compensation, it will take extra time to wait for the file to travel. Therefore, the efficiency of the current insurance claims method needs to be improved.

Accordingly, it is an object of the present invention to provide a blockchain based insurance service method with high efficiency.

Therefore, the blockchain-based insurance service method of the present invention is applied to an insurance service related to a policy of a policyholder, and is implemented by an insurance system, and the insurance system and a hospital system are connected to the zone. a blockchain, and the hospital end system stores a medical data related to the policy holder, and the blockchain based insurance service method comprises a step (a), a step (b) and a step (c).

The step (a) is that the insurance system receives the medical data written by the hospital end system from the blockchain from the blockchain.

The step (b) is that the insurance system generates claim information for a pair of medical materials according to the medical data.

The step (c) is that the insurance system writes the claim data to the blockchain.

Further, another object of the present invention is to provide a blockchain-based insurance service system with high efficiency.

The insurance service system includes a hospital-side system and an insurance system.

The hospital end system stores a medical data related to the policy holder, parallelizes a blockchain, and writes the medical data into the blockchain.

The insurance industry system couples the blockchain and receives the medical data from the blockchain, and generates a pair of claims data corresponding to the medical data according to the medical data, and writes the claim data into the blockchain.

The effect of the invention is that it can improve the claim efficiency of the insurance company, and shorten the time required for the insurance company to make a claim and the time when the policyholder waits for the claim payment.

Referring to FIG. 1, the blockchain-based insurance service method of the present invention is applied to an insurance service related to a policy of a policy holder, and is connected to an insurance system 1 of a blockchain (not shown). A hospital end system 2 and a bank end system 3 are implemented. The blockchain stores a smart contract corresponding to the insurance service method of the present invention. The insurance system 1 is managed by an insurance company to which the policy belongs, the hospital system 2 is managed by a medical institution, and the bank system 3 is managed by a banker.

An embodiment of the blockchain-based insurance service method of the present invention comprises a pre-hospital phase, an inpatient phase, a discharge phase, and a nuclear payout phase, each phase corresponding to at least one step process, as described in detail below.

Referring to FIG. 2, in the pre-hospital stage, the employee of the insurance company obtains a medical fee deduction agreement signed by the policy holder, and then the insurance system 1 generates a pair of operations through the operation of the personnel of the insurance company. The medical fee is offset against the agreed fee deduction of the consent form (S11); then, the insurance system 1 writes the agreed fee offset information into the blockchain (S12), so that the blockchain stores the agreed fee Discounted information (S13). In particular, through the foregoing steps S11 to S13, the relevant information that the policyholder agrees to use the policy's claim payment to offset the medical expenses has been stored in the blockchain.

Referring to FIG. 3, after the insured person performs the hospitalization procedure, the hospital end system 2 queries the blockchain through the operation of the personnel of the medical institution (S21), so that the blockchain returns the consent. The fee is offset to the hospital end system 2 (S22). Then, the person in the medical institution obtains an electronic medical information transmission consent form signed by the policy holder, and then the hospital end system 2 inflicts a hospitalization of the policy holder related to the policy holder by the operation of the personnel of the medical institution The data is written into the blockchain (S23), so that the blockchain stores the insured hospitalization data (S24), and according to the smart contract, a hospitalization notification message related to the policyholder is transmitted to the insurance system 1 ( S25), so that the insurance company can immediately know the information that the policyholder has been hospitalized, and assign relevant service personnel to carry out policyholder care.

Referring to FIG. 4, on the day before the discharge of the discharge stage, the hospital end system 2 writes a medical data related to the policy holder to the blockchain (S31) via the operation of the personnel of the medical institution. The blockchain stores the medical data (S32), and transmits a discharge notification message related to the policy holder to the insurance system 1 (S33) according to the smart contract, wherein the medical data includes a medical certificate and a medical expense Details and so on. Next, the insurance system 1 queries the blockchain and receives the medical data from the blockchain and generates a corresponding claim piece according to the medical data (S34), and calculates a medical deductible amount. (S35), and writing the medical deductible amount and a pair of claims progressing claims data into the blockchain (S36), so that the blockchain stores the medical deductible amount and the claim progress data ( S37). Here, the medical deductible amount is not more than the policy's claim, and the amount agreed by the insurance company to offset the medical expenses by the policy's claim.

Referring to FIG. 5, on the day of discharge at the discharge stage, the insured households go through the discharge formalities, and the hospital end system 2 queries the blockchain (S41) via the operation of the personnel of the medical institution, so that the blockchain The medically deductible amount is returned to the hospital end system 2 (S42). Next, the hospital end system 2 calculates an actual discount amount according to the total medical expenses of the policy holder and the medical deductible amount, wherein if the total medical expenses is higher than the medical deductible amount, the actual discount The amount is the medical deductible amount, otherwise the actual deduction amount is the total medical expenses (S43). Next, the hospital end system 2 writes the total medical expenses and the actual deduction amount into the blockchain (S44), so that the blockchain stores the total medical expenses and the actual deduction amount (S45), and according to The smart contract transmits the actual discount amount to the insurance system 1 (S46). Next, the insurance system 1 transmits a grant notification message recording the actual deduction amount and the bank account number of the medical institution to the bank end system 3 (S47), so that the bank end system 3 will limit the actual amount to the actual The amount of the deducted amount is transferred to the bank account of the medical institution (S48). In addition, it is worth mentioning that when the total medical expenses are higher than the medical deductible amount, the insured households must pay the difference between the total medical expenses and the medical deductible amount.

Referring to FIG. 6, in the paying and paying phase, the employee of the insurance company obtains an electronic medical record consent signed by the policy holder, and the insurance system 1 generates a pair of operations through the operation of the personnel of the insurance company. The electronic medical record data is read by the consent of the electronic medical record consent form, and the electronic medical record data is written into the blockchain (S51), so that the blockchain stores the consent to access the electronic medical record data (S52). Then, the blockchain transmits a notification message corresponding to the electronic medical record data to the hospital end system 2 according to the smart contract (S53), so that the hospital end system 2 writes the electronic medical record of the policy holder to the area. Block chain (S54). Then, the blockchain transmits the electronic medical record to the insurance system 1 according to the smart contract (S55); thus, the insurance company's claimant can obtain the policyholder through the blockchain during the claim process. The electronic medical record of the medical institution exempts the manual processing and waiting time for file round-trip from the hospital to access the electronic medical record. Next, the insurance terminal system 1 queries the blockchain via the operation of the person of the insurance company (S56), so that the blockchain returns the actual discount amount to the insurance system 1 (S57). Next, the insurance system 1 determines whether the policy's claim is higher than the actual amount (S58), and when it is determined that the policy's claim is higher than the actual amount, the insurance system 1 transmits A notification message with a payment amount and a bank account number of the policy holder is recorded to the bank end system 3 (S59), wherein the claim amount is the sum of the payment amount and the actual deduction amount. Next, the bank end system 3 transfers the account with the amount of the payment amount to the bank account number of the policy holder (S510), and writes a corresponding remittance record to the blockchain (S511), so that the block The chain stores the remittance record.

In addition, it is worth mentioning that the policy holder can then operate a computer device network to connect to the insurance system 1 and further query the policy holder recorded in the blockchain through the insurance system 1 Related information, such as electronic medical records, remittance records, and so on.

In addition, it is worth mentioning that, in addition to automatically generating the claim through the step flow of the day before the discharge at the discharge stage shown in FIG. 4, in another embodiment, the policy holder may also be discharged. After that, the insurance industry system 1 independently applies for claims. In detail, the employee of the insurance company obtains a medical information transmission consent form signed by the policy holder, and then the insurance industry system 1 generates a consent for the medical information transmission consent form through the operation of the insurance company personnel. The medical information system is accessed; then, the insurance system 1 writes the consent medical information to the blockchain, so that the blockchain stores the consent to access the medical information. Then, the blockchain transmits a notification message corresponding to the medical information to the hospital end system 2 according to the smart contract, so that the hospital end system 2 writes the medical data of the policy holder into the blockchain. The medical data includes the electronic medical record, the medical certificate, the details of the medical expenses, and the like of the policy holder. Then, the blockchain transmits the medical data to the insurance system 1 according to the smart contract, so that the insurance system 1 generates a corresponding claim with the policy according to the medical data.

In addition, it is worth mentioning that if there is a need for insurance supervision, the blockchain can also be connected by a computer system corresponding to an insurance supervision agency, and the personnel of the insurance supervision agency can query the aforementioned blockchain through the computer system. The stored information, such as the medical fee discount agreement, the electronic medical record consent, and the like.

In summary, the present invention is based on a blockchain insurance service method, in which the hospital end system writes the medical diagnosis and expense data of the policy holder into the blockchain, and the insurance industry system from the blockchain Receiving the aforementioned medical diagnosis and expense data, and generating the corresponding claims and making the compensation payment, can improve the claim efficiency of the insurance company, and shorten the time required for the insurance company to make the claim and the policyholder to wait for the claim payment. Time, it is indeed possible to achieve the object of the present invention.

However, the above is only the embodiment of the present invention, and the scope of the invention is not limited thereto, and all the equivalent equivalent changes and modifications according to the scope of the patent application and the patent specification of the present invention are still The scope of the invention is covered.

<TABLE border="1" borderColor="#000000" width="85%"><TBODY><tr><td> 1········ Insurance industry system 2······· · Hospital-side system 3························ TABLE>

Other features and advantages of the present invention will be apparent from the embodiments of the present invention, wherein: Figure 1 is a block diagram illustrating a system for implementing the blockchain based insurance service method of the present invention; A flow chart illustrating a pre-hospital phase of the insurance service method; FIG. 3 is a flow chart illustrating an inpatient phase of the insurance service method; FIG. 4 is a flow chart illustrating the discharge of the insurance service method prior to discharge from the hospital One day; FIG. 5 is a flow chart illustrating the day of discharge of the discharge phase of the insurance service method; and FIG. 6 is a flow chart illustrating a core payout phase of the insurance service method.

Claims (7)

A blockchain-based insurance service method for an insurance service related to a policy of a policyholder, and implemented by an insurance system, the insurance system and a hospital system are connected to the blockchain, And the hospital end system stores a medical data related to the policy holder, the policy corresponds to a claim payment, and the blockchain based insurance service method comprises the following steps: (a) the insurance industry system from the blockchain Receiving the medical data written by the hospital end system in the blockchain; (b) the insurance industry system generates a pair of claims data corresponding to the medical data according to the medical data, and the insurance industry system is based on the medical data Calculating a medical deductible amount with the policy; (c) the insurance industry system writes the claim data and the medical deductible amount into the blockchain, wherein the medical deductible amount is not greater than the policy corresponding And (d) the hospital end system receives the medical deductible amount from the blockchain, and calculates an actual discount amount based on the total medical expenses of the policy holder and the medical deductible amount, and Actually fold The amount of the write block chain, which is higher than if the total medical costs may be set off against the amount of the medical, set off against the actual amount may be set off against the amount for health care, or set off against the actual amount of the total medical expenses. The blockchain-based insurance service method according to claim 1, wherein the insurance terminal system is connected to a bank end system via a network, and the hospital end system corresponds to a The bank account number, the blockchain-based insurance service method further comprises a step (e): the insurance system receives the actual discount amount from the blockchain, and transmits a pair of grant notification message that should be the actual amount of the discount To the bank end system, the bank end system transfers the account amount of the actual deduction amount to the bank account corresponding to the hospital end system. The blockchain-based insurance service method according to claim 1, wherein the policy holder corresponds to a bank account, and the insurance system is connected to a bank system via a network, and the blockchain-based insurance service method further includes Step (f): the insurance industry end system receives the actual discount amount from the blockchain, and determines whether the policy corresponding to the policy is higher than the actual discount amount, and when it is determined that the claim is higher than the actual discount When the amount is offset, the insurance system transmits a notification message recording the bank account number corresponding to the policy holder to the bank end system, so that the bank end system transfers the account amount of the payment amount to the insurance The bank account corresponding to the household, wherein the claim is the sum of the payment amount and the actual discount amount. The blockchain-based insurance service method according to claim 3, wherein the bank end system is also coupled to the blockchain, and the blockchain-based insurance service method further comprises a step (g): the bank end system A pair of remittance records of the bank account number corresponding to the policyholder should be written into the blockchain. The blockchain-based insurance service method according to claim 1, further comprising a step (h) performed before the step (a): the insurance system system is related to the medical data of the policy holder The consent form information is written into the blockchain to The hospital end system writes the medical data into the blockchain after determining that the consent form data has been stored in the blockchain. The blockchain-based insurance service method according to claim 1, further comprising a step (i): the insurance system receives from the blockchain a correlation written by the hospital end system to the blockchain Inpatient information on the policyholder. A blockchain-based insurance service system for insurance policy related to a policy of a policyholder, the policy corresponding to a claim, the insurance service system comprising: a hospital-side system, storing relevant policies of the policyholder a medical data, a blockchain is connected in parallel, and the medical data is written into the blockchain; and an insurance system, the blockchain is coupled, and the medical data is received from the blockchain, and according to the The medical data generates a pair of claim information for the medical data, and calculates a medical deductible amount based on the medical data and the policy, and writes the claim data and the medical deductible amount into the blockchain, the medical treatment The deductible amount is not more than the claim amount corresponding to the policy, wherein the hospital end system receives the medical deductible amount from the blockchain, and calculates the medical expenses according to the total medical expenses of the policy holder and the medical deductible amount An actual deductible amount, and the actual deduction amount is written into the blockchain. If the total medical expenses is higher than the medical deductible amount, the actual deduction amount is the medical deductible amount, otherwise Inter set off against the amount of the total medical expenses.