Automated Duplicate Case Detection for Adverse Events

Duplicate payments cost businesses billions annually. A shared, immutable ledger ensures each transaction is recorded once and only once, preventing:

• Double-dipping from vendors or claimants submitting the same invoice or claim.
• Internal errors from manual data entry across siloed systems.
• Real Example: A global insurer reduced fraudulent claims by 25% in the first year by using blockchain to track claim submissions across all regional offices.

Manual reconciliation of payments, claims, or cases across departments is a major cost center. Blockchain automates this by providing a single source of truth.

• Eliminate manual matching of invoices to payments or claims to policies.
• Free up finance & ops teams from low-value, error-prone tasks.
• ROI Driver: A financial services firm automated inter-branch settlement, reducing reconciliation staff requirements by 3 FTEs, saving over $300k annually.

Regulators demand transparent, tamper-proof records. Blockchain's immutable ledger creates an unbreakable audit trail for every transaction and case update.

• Prove compliance instantly with a verifiable history of all actions.
• Reduce audit preparation time from weeks to minutes.
• Industry Application: Pharmaceutical supply chains use this for serialized tracking, providing regulators with instant proof of provenance and handling.

In insurance or legal disputes, identifying duplicate or related cases quickly is critical. Blockchain enables real-time visibility across the entire organization.

• Instantly flag potential duplicates when a new case is logged, based on immutable historical data.
• Speed up legitimate payouts by eliminating unnecessary fraud checks for unique cases.
• Business Impact: Faster resolution improves customer satisfaction and reduces the capital held in pending claim reserves.

Complex cases often involve multiple entities (e.g., insurer, reinsurer, third-party adjuster). Traditional data sharing is slow and risky.

• Permissioned blockchain allows secure, real-time data sharing without exposing entire databases.
• Smart contracts automate multi-party approvals and fund flows upon consensus.
• Use Case: In trade finance, letters of credit are processed in days instead of weeks by all parties working from the same authenticated documents.

Justifying the investment requires a clear cost-benefit analysis. Focus on tangible savings and a phased rollout.

• Primary ROI Levers: Reduced fraud losses, lower administrative costs (FTEs), decreased audit fees, and freed capital.
• Implementation Tip: Start with a high-volume, low-complexity process (e.g., vendor invoice tracking) to prove value before expanding.
• Typical Payback Period: 12-18 months for targeted use cases in financial services and insurance.

The pain point is 'double-dipping' where a single incident generates multiple claims across providers, costing the industry billions. The blockchain fix creates a shared, permissioned ledger of incident hashes. When a new claim is submitted, smart contracts instantly check for duplicates against the immutable history.

• Real Example: A consortium of auto insurers can reduce fraudulent duplicate claims by verifying if a specific VIN and incident timestamp has already been logged.
• ROI Driver: Direct reduction in claim payouts, lower investigation costs, and improved loss ratios.

The pain point is duplicate billing for the same medical service, whether due to error or fraud, creating administrative waste and compliance risks. The blockchain fix uses a hashed record of billed procedures (patient ID, provider, service code, date) on a private network. Automated audits flag duplicates before payment is released.

• Real Example: A hospital network and its payers can reconcile claims in near real-time, preventing duplicate payments for the same CPT code.
• ROI Driver: Recaptured revenue, reduced accounts receivable disputes, and strengthened HIPAA compliance through audit-ready provenance.

The pain point is suppliers submitting the same invoice to multiple financing platforms or buyers, leading to over-financing and credit risk. The blockchain fix establishes a single source of truth for invoice origination. Once an invoice is financed on the ledger, its status is locked, preventing it from being used as collateral elsewhere.

• Real Example: A global manufacturer can integrate its ERP with a blockchain network shared with banks and suppliers to ensure invoice uniqueness.
• ROI Driver: Elimination of collateral fraud, reduced risk for lenders, and faster, more secure access to working capital for suppliers.

The pain point is individuals or entities applying for and receiving the same grant or subsidy from multiple agencies, draining public funds. The blockchain fix creates a cross-agency, tamper-proof registry of beneficiary identities and award amounts. Smart contracts enforce rules to prevent duplicate disbursements against the same eligibility criteria.

• Real Example: Agricultural subsidy programs can ensure a single farmer does not receive payments for the same plot of land from both state and federal programs.
• ROI Driver: Direct protection of public funds, enhanced transparency for auditors, and streamlined inter-agency coordination.

Weeks 1-4: Scope & Design

• Identify one high-value, high-friction process (e.g., vendor invoice approval).
• Map the "as-is" workflow and pain points.
• Design the "to-be" process integrating a blockchain ledger for event anchoring.

Weeks 5-10: Build & Integrate

• Deploy a private, permissioned blockchain node (e.g., Hyperledger Fabric).
• Develop smart contracts for core business logic (e.g., verifyUniqueInvoice).
• Build a simple front-end for your team to interact with the system.

Weeks 11-13: Test & Measure

• Run a controlled pilot with a subset of live transactions.
• Measure KPIs: Duplicates caught, time saved, manual labor reduced.
• Calculate the projected annual ROI for a full-scale rollout.

Justify the pilot investment with hard and soft returns.

Direct Cost Savings:

• Recovered Revenue: Value of prevented duplicate payments.
• Operational Efficiency: Reduction in FTEs dedicated to manual audit and reconciliation.
• Compliance & Audit Cost: Drastically lower cost of external audits due to provable records.

Strategic Value & Risk Mitigation:

• Reputation Protection: Avoid headlines related to fraud or wasteful spending.
• Regulatory Advantage: Demonstrate proactive compliance with immutable audit trails.
• Partner Trust: Become a preferred partner in your ecosystem due to transparency.

Pilot Justification: Focus the pilot on a process where the cost of a single duplicate incident exceeds the total pilot budget.