Abstract:

The rising costs of healthcare pose a significant burden for individuals and societies worldwide. Traditional health insurance models struggle to adapt, leaving many vulnerable to financial hardship in the face of medical emergencies. Befyn presents a novel solution, leveraging blockchain technology and the power of collective support to create a more accessible and affordable healthcare financing system.

Problems:

Lack of transparency in health insurance companies' earnings and payouts

Earnings and Payouts:

Many insurance companies don't clearly disclose how they spend their money. This includes:

• Revenue: The total amount collected from premiums.
• Payouts: The actual amount paid out for medical claims.
• Administrative Costs: The money spent on running the company (salaries, marketing, overhead).
• Impact: Consumers struggle to compare plans effectively and might be overpaying for coverage.
• Recommendations: Request information directly from your insurer about their claims payout ratio (percentage of premiums paid for claims). Look for independent ratings and advocate for greater transparency in the industry.

Minimal payouts to users in times of crisis

• The Issue: Some insurance companies may deny or minimize payouts for legitimate claims, leaving policyholders struggling with medical bills.
• Possible Reasons: Utilization review processes might be overly stringent, or companies might prioritize profits over customer well-being.
• Impact: This creates financial hardship during times of medical need, potentially delaying or preventing necessary treatment.
• Recommendations: Understand your policy details and appeal denied claims if necessary. Consider filing complaints with regulatory bodies if you experience unfair treatment.

Fraudulent claims and incentivization for users to fake accidents

• The Problem: Staged accidents, fake patients, and inflated bills cost the system billions. Some might be tempted to commit fraud due to high deductibles or limited coverage.
• Incentivized Abuse: In rare cases, insurance companies might have structures that unintentionally incentivize unnecessary treatments to raise profits.
• Impact: Fraudulent claims drive up premiums for everyone, making health insurance less affordable.