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Title: 以智能合約實現快速醫療保險理賠
Streamlining Medical Insurance Claims Processing With Smart Contracts
Authors: 林展民
Lin, Chan Min
Contributors: 陳恭
Chen, Kung
Lin, Chan Min
Keywords: 區塊鏈
smart contract
medical insurance
Date: 2016
Issue Date: 2016-08-22 13:41:04 (UTC+8)
Abstract: 現行醫療保險理賠申請流程相當繁複,被保險人需要向醫療機構申請診斷證明,填具理賠申請書向保險公司提出理賠申請,再由保險公司進行審核。若遇到無法從診斷書直接審核之個案,保險公司需先取得被保險人簽署之調閱病歷同意書後,方能至醫療機構調閱病歷,以利後續理賠審核。這樣的流程,對保險公司來說,需耗費大量人工成本;對被保險人來說,則也有資訊不夠透明的疑慮。
Current medical insurance claims application process is complex. It requires the insured to apply for medical diagnosis, and to fill out an application form to the insurance company. The insurance company then reviews the case. If they are unable to approve the claims, they must first obtain the consent form from the insured in order to access to his or her medical records to facilitate subsequent claims review. Throughout the process, the insurance company needs to pay a lot of labor costs; while the insured will have many concerns of information transparency.
Blockchain operates in an open and transparent manner and maintains its data in a tamper-free way. Smart contracts are programs executed on a blockchain platform to enforce an agreement such that the program will not be tampered with, and all records of execution will be kept from modification. These characteristics of a smart contract make it very good as a tool for streamlining the medical insurance claims process, as it will greatly reduce the human efforts involved on the insurance company side while increase the information transparency from the perspective of the insured.
This thesis presents a smart contract based solution for streamlining the medical insurance claims process. We design and implement the con-tract on the Ethereum platform. In addition to improving the existing problems, our solution builds an open and transparent claims system that takes into account the patient privacy and the practical requirement of re-using the existing claims processing system of the insurance company, thus achieving a proper balance between the ideal and reality.
Reference: [1] Nakamoto, Satoshi (2009). "Bitcoin: A Peer-to-Peer Electronic Cash System"
[2] Genesis Block (Block #0), from:
[3] Lamport, L.; Shostak, R.; Pease, M.(1982). "The Byzantine Generals Problem"
[4] David Lee Chaum. "Computer Systems Established, Maintained and Trusted by Mutually Suspicious Groups." University of California, Berkeley, 1982.
[5] V. Miller, "Use of elliptic curves in cryptography", CRYPTO 85, 1985.
[6] Neal Koblitz, "Elliptic curve cryptosystems", Mathematics of Computation 48, 1987.
[7] Rivest, R.; Shamir, A.; Adleman, L. (February 1978). "A Method for Obtaining Digital Signatures and Public-Key Cryptosystems"
[8] Ethereum White Paper, from:
[9] Solidity Docs, from:
Description: 碩士
Source URI:
Data Type: thesis
Appears in Collections:[資訊科學系碩士在職專班] 學位論文

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