BUSINESS CASE

Smart blockchain for the insurance industry

Automate claims processing, reduce human error and mitigate the risk of fraud with a smart blockchain.

Despite past IT investments, complex and costly manual processes with multiple interactions, duplication of data entry, and risk of fraud continue to plague the insurance industry.

Using EDB, the Sky Republic Platform has the potential for modernizing, streamlining and simplifying the siloed design of the typical insurer with a shared claim smart contract.

This would enable all parties to the transaction to have their own exact copy of the same data that is stored in the same data structure, with no need to reconcile data or integrate different systems.

CASE SNAPSHOT

Potential use cases and benefits for the insurance industry

EFFICIENT CLAIMS MANAGEMENT

Automate claims submission

Reduce errors & delays via automation

Empower the client – e.g., directly manage supplier relationships

USE SHARED LEDGER TO MANAGE PROCESS

Enhance efficiency

Reduce costs with shared distributed process & data management

Accelerate claims settlement

Increase resilience through no single point of failure

FACILITATE ABILITY TO DETECT FRAUD

Enhance transparency

Reduce opportunity for fraud

Decentralize client databases & identity infrastructure

Integrate counter fraud platforms & 3rd party
investigation services

AUTOMATE POLICIES IN WHOLESALE MARKETS

Reduce duplication of data entry

Information is current, accurate, & available

Indelible audit history

Complete record of agreement & acceptance

Smarter blockchain for insurance

Insurance industry blockchain

The claims submission process can also be greatly simplified and fully automated. Once the Insurer smart app completes its pre-claim verification and affirmation of the case, the claim can immediately move to the case management process, with some claims programmed to execute automatically via the smart contract. The Platform automatically utilizes secondary data sources to access the claim and calculate the loss amount. If payment is approved, payment to the insured is initiated via the smart contract.

In the example of when loss information is submitted by a smart asset (via sensors or external data sources if the asset is technologically capable), this will trigger an automated claim application. Claim due diligence is automated via codified business rules within the Sky contract, using information submitted by the insured or smart asset. This could conceivably allow accidents or problems detected by sensors in the home to trigger a set of instructions that automatically transfer cash for the repairs to the insured.

In situations where insurers are looking to automate policy placement in wholesale markets, insurers can receive feedback regarding initial coverage in real-time for insurance policies issued via the Sky Platform. This greatly reduces duplicated data entry and improves accuracy, while also providing an indelible audit history and record of agreement and acceptance.

For added privacy and security, the Sky Platform can encrypt and store data, locked with a privatized key that only the user has access to. Public keys are then shared with other parties on the network to interact and process transactions. Many insurers are also exploring advanced technologies like EDB as a means to increase speed and resiliency of their IT infrastructure for greater business continuity, something the Sky Platform has been engineered to deliver.

Improving trust and fraud detection through greater transparency

Insurance claims is a highly distributed process that involves many parties – insured, insurer, third parties, regulators, etc. – often with insufficient transparency to the participants. The Sky Platform could help reduce fraud related to the integrity of a policy or claim or vehicle (virtually any asset). By maintaining the integrity of the asset through various owners, it can minimize counterfeiting, double booking, document or contract alterations. The Platform can record transactions at each point in the transactional lifecycle, from seeking a quotation to binding a policy contract, the immutable life record of that policy or the policy holder can be traced.

In lines of insurance where losses require onsite examination, claims adjusters or an investigator may be sent to conduct an investigation. However, a growing number of companies now specialize in offering claims investigation services for insurance companies. Such decentralization of the insurance production cycle is becoming increasingly common, requiring a breaking of existing monolithic structures, as well as integration and information sharing with these third-party services – again, something the Sky Platform has been designed to address.

This decentralization creates the obvious question of mutual trust between parties. The insurers and their network must be able to collaborate within the ecosystem in a transparent way to prevent fraud. The Sky Platform can help because the transactions are transparent and there can be fewer forgeries or manipulation of policies and contract. Additionally, it would allow for the auto-execution of coded logic embedded into smart contracts that can be used to oversee the claims process end-to-end.

Create a permanent audit trail

All transactions managed by the Sky Platform are visible to insurers, brokers, third-party administrators, service providers and shared cross multiple locations and impossible to alter or delete. As the basis for establishing consensus and enabling a contract between multiple insurers with an intermediary will be very useful as it creates a permanent audit trail. Mutual consensus verification protocols allow a network to agree on updates to the database collectively, with a certainty that the overall data set remains correct at all times.

Insurers can create receipts at different points in the claims process, resulting in an immutable, auditable record of all claims activities, which can be revisited by all parties including the regulators. This could lead to lower transactional cost, lower transaction risk and trustless computation.

The Sky Platform makes it possible for a group of independent parties to work with universal data sources, automatically reconciling between all participants — customer, broker, insurer, co-insurer and reinsurer. All parties could have a distributed, single view of the entire exposure data chain with real-time visibility. In principle, any stored data record could be represented by the Platform, from ownership of assets to contractual obligations, credit exposures or static data.

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