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Review Article

A Literature Survey on Blockchain-based Healthcare Insurance Claims System

Prisha Kaushik1 Rachit Kala2 Ayush Ranjan3 Rishabh Raj4
1 2 3 4 B.M.S. College of Engineering, Bengaluru, Karnataka, India.

Published Online: September-December 2025

Pages: 212-221

Abstract

Health care insurance claims processing is usually plagued by fraud, delay, and inefficiency because it depends on centralized systems and paper-based processes. Our project presents a blockchain-based system that employs Self-sovereign Identity principles based on Decentralized Identifiers (DIDs) and Verifiable Credentials (VCs) to safely handle identities and entitlements. Patients, health care providers, and insurers each create DIDs to create cryptographic identities without depending on centralized authorities. Insurance coverage and professional qualifications are certified as VCs and verified without third parties. Smart Contracts running on a Layer-2 blockchain network log submissions of claims and retain tamper-proof hashes of encrypted off-chain medical records, maintaining privacy while providing unobstructed audit trails. HL7 FHIR standards are utilized by the system to integrate structured healthcare information and enhance interoperability. By automating claims validation and infusing trust into the claims lifecycle, this method minimizes the threat of insurance fraud, increases data security, and simplifies communication among patients, providers, and insurers

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