Stand up a health insurance network where standard claims auto-adjudicate against policy terms in hours instead of the 15 to 45 days a TPA takes. Escrow and Conditional Settlement, a Logic and Actions Editor, and KYC and Identity Verification collapse the opaque handoffs that let duplicate billing and fraud thrive.
Turn a 45-day paper adjudication into a real-time, tamper-evident settlement between hospital, insurer, and policyholder.
01.
Encode the policy schedule once in the Logic and Actions Editor. Standard claims that satisfy the coverage rules settle without a human touch, cutting the 15 to 45 day window to hours.
02.
The Escrow and Conditional Settlement module holds insurer funds and releases them to the hospital only when the discharge summary and coding checks pass, so payment and proof move together.
03.
Every claim line is anchored by a content hash. A second hospital submitting the same procedure for the same admission is rejected on-chain, closing the duplicate-billing loophole.
04.
KYC and Identity Verification binds each claim to a verified policyholder and provider, removing the ghost-patient and phantom-provider fraud that opaque TPA routing hides.
05.
The policyholder reads their own claim state from the ledger in real time, from submission to adjudication to payout, instead of calling a TPA with no visibility.
06.
Six further Cerulea Studio modules replace the manual TPA middle layer, so the insurer pays for verified compute rather than a per-claim handling fee.
Follow a single hospital admission from discharge to a settled payout, all on the same afternoon.
14:02:11
[SYS] Initializing Claim Manifest for admission ADM_55120...
14:02:12
[CMD] submitClaim { policy: "PH_88421", provider: "HOSP_0x19", amount: 84200 }
14:02:12
[AUTH] Verifying policyholder KYC credential and coverage window...
14:02:13
[OK] Claim CLM_44219 anchored at block 5120441.
Cerulea decomposes health claims settlement into modular contracts. Each layer verifies identity, adjudicates coverage, guards against duplicates, and releases escrow without a TPA controlling the record.
Smart contract claims settlement is a horizontal capability. Here is how different actors in the health insurance chain put the shared ledger to work.
Submit itemized bills against verified policies and receive escrow payouts the same day, replacing months of TPA follow-up and reducing working-capital strain on the provider.
Key Asset Types
Auto-adjudicate standard claims against encoded policy rules, cut TPA handling fees, and block duplicate and phantom claims at the protocol level rather than in post-payment audit.
Key Asset Types
Track a claim from discharge to payout in real time from a single ledger view, ending the opacity of calling a TPA for a status no one can confirm.
Key Asset Types
Whether you are bridging a legacy claims platform at a large insurer or capturing discharge data from a hospital HMIS, Cerulea routes both into one shared adjudication ledger.
For insurers on legacy claims and policy admin systems. Existing claim events are translated into signed on-chain adjudication requests through the API gateway automatically.
Legacy Claims Platform
Insurer Core System
Cerulea API Gateway
Claim Hashing & Signing
Cerulea Private Chain
Consortium Adjudication Ledger
For hospitals submitting from their information system. A gateway app signs each discharge claim from a provider wallet and routes it directly to the adjudication ledger.
Hospital HMIS / App
Provider Devices
Consortium Validators
Adjudication Consensus
Cerulea Ledger
Shared Claims Record
Building a claims network with custom adjudication logic, duplicate-fraud guards, and conditional escrow from scratch requires specialised insurance engineers and long TPA integration cycles. Calculate your exact deployment speed using Cerulea.
Traditional Deployment
Solidity Coding & Audits
~ 13 Months
Visual Compilation
WASM Logical Artifacts
~ 4 Weeks
The legacy timeline reflects health-insurance core-system integration benchmarks. Wiring a claims platform to hospital systems, coding a custom adjudication and duplicate-detection engine, and shipping conditional escrow for an average network takes a baseline of 8 months. Building the same architecture on Cerulea takes a baseline of 2 weeks, because Cerulea Studio visually translates your policy and settlement rules into pre-audited WebAssembly binaries and provisions the shared adjudication ledger and escrow layer instantly.