Hyper Claims Exchange Protocol
Open-source, community driven protocol for decentralised Claims data Exchange
Our Vision
Our Vision
To create a community driven, trusted and open protocol that revolutionizes the insurance sector by enabling seamless data exchange among policyholders, insurers, service providers, third-party administrators, regulators, oberservers and other satkehodlers of the system. By fostering transparency, efficiency, and collaboration, we strive to transform the insurance experience, streamline claims processing, facilitate innovation, enhance risk assessment and pricing, improve insurance coverage and ultimately deliver greater value to policyholders. Together, we aim to build a future where data exchange becomes the foundation for a customer-centric, digitally-driven insurance ecosystem.
Overview
The insurance industry plays a crucial role in safeguarding individuals and businesses against risks. However, due to current non-digital and non-standardised processes it faces several challenges that hinder efficient operations, transparent processes, and seamless communication among stakeholders:
Policyholders
Policyholders face challenges such as complex policy administration, limited access to real-time information, and cumbersome claims processes. These hurdles often result in frustration, delays, and a lack of transparency.
Regulators
Regulators face the challenge of balancing consumer protection, fair market practices, and industry growth. They need to ensure compliance, monitor industry performance, and foster a competitive yet stable insurance market. Delayed, incomplete and non standardised dataexacerbates their challenges.
Insurers
Insurers and TPAs grapple with rising incurred claims ratios, increasing claims volumes, challenges in coordinating with service providers, and the need for effective risk assessment and pricing. Lack of standardisation results in manual adjudication and limited fraud analytics impacting their financial performance, operational efficiency, and overall customer satisfaction.
Service Providers
Service providers, including healthcare providers and third-party administrators, encounter difficulties in managing claims, ensuring timely payments, and maintaining smooth interactions with insurers. Lack of standardized processes and limited interoperability hinder efficient service delivery.
Hyper Claims Exchange (HCX) Protocol
To address these challenges and unlock the full potential of the insurance sector, the Hyper Claims Data Exchange (HCX) Protocol offers a transformative solution. This protocol revolutionizes the way data and information are exchanged, bringing together policyholders, insurers, service providers, and regulators on a unified network.
The HCX Protocol is a set of specifications consisting of APIs, data models, reference architecture, and domain specific standards that enable the creation of decentralised networks. Because of its layered design, insurance use cases can evolve independently and be included in the network. By leveraging digital technologies and an open protocol-based network, the protocol enables seamless data exchange between all ecosystem actors.
The HCX Protocol is an open and collaborative initiative. We encourage diverse stakeholders including insurers, policyholders, service providers, and regulators to join our growing community. Together, we can shape the future of insurance claims processing, foster innovation, and deliver greater value to policyholders.
Join our vibrant community to stay informed, work together, and help shape the future of the Claims Exchange Protocol.
Benefits of HCX Protocol
Improved Policyholder Experience
Enhanced Transperancy
Accurate Risk Assesment and Pricing
Efficient Claims Processing
Potential for Innovative Products
Improved Regulatory Compliance
Background
The journey of the HCX protocol began with a passionate community of 50+ volunteers comprising stakeholders from across the healthcare ecosystem. This diverse group included insurers, hospitals, third-party administrators (TPAs), insurance technology players, and think tanks. The inspiration behind HCX came from the recommendations of the IRDAI-NHA (Insurance Regulatory and Development Authority of India-National Health Authority) Joint Working Group, which emphasized the creation and adoption of a Health Claims Exchange. With the goal of establishing a transparent, collaborative, and open effort, HCX was initiated as a dedicated platform for health claims use cases, spearheaded by Swasth.
Since its inception, the HCX community has grown rapidly and now boasts a strength of over 125 dedicated individuals. This dynamic and diverse community is continuously working towards enhancing domain knowledge and refining policy specifications for the health sector. Through active collaboration and knowledge sharing, the community strives to develop best practices, establish robust standards, and promote innovation in health claims processing.
Expanding Horizons - Driving Innovation Across Insurance Domains
Empowered by the success of the health claims use case, the HCX community is actively expanding its achievements into other areas of insurance (Accident and Motor, Travel, etc.). Building upon the expertise and experience gained from the health sector, the community is extending the benefits of the HCX protocol to various insurance domains. Through collaboration and open participation, we are creating a standardized and efficient exchange platform that transcends boundaries and enhances the overall insurance ecosystem.
As the HCX community continues to thrive and progress, we wholeheartedly invite participation from the insurance industry, regulators, technology enthusiasts, and domain experts to join this transformative initiative. Together, we can shape the present and future of insurance claims exchange, drive innovation, and foster a more inclusive and efficient insurance landscape.