During the experimentation stage, we formulate a value proposition, run small-scale experiments to test our assumptions, and iterate until we’re confident with building a pilot. The result is real-world validation that can be used to build commercial products – without the risk and uncertainty that typically accompanies new ventures.
Using blockchain to serve the underserved
When we set out to build the world’s first blockchain-powered health insurance application, we needed to make sure it offered real benefits. Do the benefits of blockchain line up with real customer needs? Is the technology ready for actual insurance customers? Can we align the right group of partners to build a system on blockchain? These are just some of the questions we had when we started, and we would methodically answer every one of them as we moved forward.
Our first challenge was to find a proper product scope. We needed to cover a risk that was relatively low in cost but still represented a latent coverage gap for customers. It needed to be a niche market so we could keep it small enough to experiment. And we needed a short claim period, with a high enough incidence rate to ensure we could learn enough about the end-to-end customer experience in a short time span. After much deliberation, a team member’s pregnant wife suggested a solution: gestational diabetes mellitus, or simply GDM.
GDM is a form of diabetes that develops during pregnancy, occurring either when an expectant mother can’t produce enough insulin, or the insulin is not working well enough to act on the sugars in her body. This leads to excess glucose in the bloodstream, which can be passed on to the baby. Associated complications during pregnancy and labor include excess birth weight, premature birth and, in some serious cases, stillbirth.
GDM affects one in five pregnant women in Singapore and, crucially, is typically not fully covered by general health insurance. In other words, we’d found a real, address- able need that cut across the population.
Hence, Vitana was born. But we couldn’t do it alone.
Assembling the right partners
A key benefit of blockchain is that it eliminates many of the processes that add to the cost of insurance for customers – including under- writing, onboarding and claims processing. Our vision for Vitana was to shortcut the process to provide a frictionless experience for customers. We wanted customers to sign up in just a few minutes and our policies to be issued completely hassle-free. To top it off, we wanted to completely eliminate the claims process for customers afflicted with GDM. This meant payouts would automatically appear in patients’ bank accounts upon diagnosis – zero paperwork.
To realize this vision, we had to connect disparate data from many different systems. We needed clinics to help us distribute Vitana, electronic medical records (EMR) providers to record customer data, and a technology provider with deep expertise with DLT to help us implement our ambitious plans.
Because MetLife doesn’t have a traditional insurance business in Singapore, we also partnered with Swiss Re to reinsure the risk and offer valuable insight on product design and delivery in the Singapore market. Additionally, the Monetary Authority of Singapore (MAS) provided the regulatory sandbox that made the whole experiment possible.
Our team of collaborators also consisted of Singapore’s largest clinic group, Singapore Medical Group (SMG), EMR start-up Vault Dragon, and business services provider Cognizant. Together – over the course of six months – we developed a customer journey, reengineered clinical processes and built the technology that turned Vitana into reality.
Vitana in practice
Vitana has two elements: a mobile app for customers and a blockchain back-end to act as the source of truth for all involved parties. But for all the technology involved in Vitana, our focus was on the customer journey.
Early in her pregnancy, after being informed about the risks of GDM and being told about the innovative new coverage, the expectant mother is encouraged to sign up by simply downloading the app and entering her government-issued ID number. The app automatically connects to the customer’s electronic medical records and populates personal information. All that remains is for the customer to answer three simple underwriting questions and enter payment information. This takes about two minutes – and she is instantly covered.
A smart contract is automatically created, encrypted and deployed to an Ethereum blockchain. This creates a policy document, which is emailed to the customer virtually simultaneously. All parties – clinics, insurers, reinsurers and regulators – now have visibility of new policies in real time. It doesn’t just strengthen communications; it eliminates much of the transaction costs for the parties interacting with one another.
The truly transformational moment happens at the “claim” stage. From a customer’s perspective, it’s all invisible and completely frictionless. Around Week 25, the expectant mother is tested for GDM by her clinic, which updates her EMR with the results. Should the customer test positive for GDM, the EMR automatically writes the result onto the blockchain. The smart contract then executes, and a payout is automatically triggered to the customer’s bank account.
Again, all parties are instantly notified, and the insurers – in this case, us – can process the “claim” and make the payment, without the customer ever contacting MetLife.
Triggering the smart contract
When downloaded, the Vitana app automatically connects to the patient’s electronic medical record and deploys a smart contract to the blockchain. All parties now have visibility into new policies in real time. If the patient tests positive for GDM, the EMR automatically writes the result onto the blockchain, which executes the smart contract and triggers the payout to her bank account.
