A Secure And Transparent Blockchain Framework For Automated Insurance Claim Processing And Risk Assessment

Abstract

The insurance companies currently encountered problems like delay in claims processing, lack of transparency and false claims. Conventional claim management systems rely on manual validation of the datasets which increase processing time and operational overhead. This paper proposes a blockchain enabled smart contract system for automated insurance claim validation and risk evaluation. The proposed solution includes the use of  blockchain technology to ensure secure and tamper-proof storage of insurance records and smart contracts to automate the claim submission validation approval and settlement process without human intervention. And, a data driven risk evaluation module has been incorporated to identify fraudulent and high risk claims based on insurance related datasets. For a first implementation, the proposed structure has been tested against sample insurance claim workflows and synthetic data set. Preliminary experimental results indicate that the system can helps claims verification time and transparency versus conventional claims processes. The architecture also provided reliable record management and automated claim processing over smart contracts. The objective is to create an architecture that enhances the transparency security Efficiency and trust for policyholders and insurance companies. The proposed system is compared with the traditional insurance system about parameters like processing time, scalability and security. The initial findings showed that the proposed structure would lessen the processing time involved in the claims procedure and make insurance work more reliable.