Customer Identity Management in Health Insurance with Blockchain
Technology: A Literature Review
Matthias Pohl
, Hannah Giegold, Christian Haertel
, Daniel Staegemann
and Klaus Turowski
MRCC VLBA, Faculty of Computer Science, Otto von Guericke University, Magdeburg, Germany
Customer Identity Management, Blockchain, Health Insurance, Access Management.
Customer identity management systems are an important part of the IT infrastructure of health insurance
companies. However, the current systems face challenges due to the centralized system architecture, display
disadvantages in identity verification, and pose security risks for customer data. Since blockchain systems are
often mentioned as a solution, the goal of this paper is to examine how blockchain-based identity manage-
ment can improve this particular process of identity management in the health insurance industry. Therefore,
a systematic literature review was conducted, covering the challenges of centralized systems, a solution to the
problem through decentralized systems, and possible designs and approaches of blockchain identity manage-
ment systems. This revealed that current systems face problems in identity verification, authentication, user
experience, data storage, data security, and data control. In addition to that, it was found that decentralized
systems can solve many of those challenges. They facilitate the know-your-customer process for customers
and companies, increase data security, create a trusting relationship between the customer and the company,
and give customers control over their data. Thus, the use of a decentralized identity management system for
the insurance industry is associated with advantages and has great potential to improve the current identity
management process.
As digitization progresses, our technology continues
to evolve and ensures that our everyday lives are in-
creasingly being shaped by the use of digital services
and processes, as shown by the Global Digital Sen-
timent Survey 2022 by McKinsey & Company, in
which 70% of respondents used these services (McK-
insey & Company, 2022). Due to fierce competition,
companies are under pressure to offer their customers
an excellent user experience (UX) to retain them in
the long term and attract new customers. In addi-
tion to the ease of use of the systems, providers must
ensure that the stored customer data is securely pro-
tected and offer suitable customer identification and
authentication. The latter is of central importance,
since according to the Global Identity & Fraud Re-
port, identity theft is one of the greatest risks within
the virtual world (Experian Information Solutions,
2022). According to the Modern Bank Heist 3.0,
the Banking, Financial Services and Insurance (BFSI)
sector is one of the most popular targets for cyber-
criminals and in 2020 80% of respondents reported an
increase in attacks compared to previous year (Keller-
mann and Murphy, 2020). The reason for this is the
large amount of valuable data, which includes the per-
sonal and financial information of customers (Euro-
pean Insurance and Occupational Pensions Author-
ity, 2021). As a result, companies in the insurance
environment need to ensure proper customer identity
and access management (CIAM) to meet the grow-
ing challenges. However, currently deployed sys-
tems face problems such as vulnerabilities in authen-
tication and verification methods, obstacles due to
centralized system architectures, high risk of cyber-
attacks, and drawbacks for UX (Mulaji et al., 2021).
Due to these challenges, it is significant to investigate
new alternatives. In this regard, blockchain technol-
ogy has the potential to transform identity manage-
ment processes in the insurance industry. The use of
this technology is not yet widespread in the sector, but
its use offers the opportunity to reduce costs, increase
process efficiency, facilitate new customer verifica-
Pohl, M., Giegold, H., Haertel, C., Staegemann, D. and Turowski, K.
Customer Identity Management in Health Insurance with Blockchain Technology: A Literature Review.
DOI: 10.5220/0012575200003657
Paper published under CC license (CC BY-NC-ND 4.0)
In Proceedings of the 17th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2024) - Volume 2, pages 803-811
ISBN: 978-989-758-688-0; ISSN: 2184-4305
Proceedings Copyright © 2024 by SCITEPRESS Science and Technology Publications, Lda.
tion, and increase trust and transparency among the
parties involved. In addition, the use of blockchain
facilitate the detection and prevention insurance fraud
(European Insurance and Occupational Pensions Au-
thority., 2021).
Several studies have examined the role of
blockchain in identity management and insurance.
One study highlights how blockchain and other digital
technologies can revolutionize the insurance industry,
emphasizing their potential for customer-centric ser-
vices and cost reduction, but also noting challenges
in replacing legacy systems (Eckert and Osterrieder,
2020). Another study uses a SWOT analysis to assess
benefits and drawbacks of blockchain in insurance,
suggesting its potential to streamline processes yet ac-
knowledging the need for further development (Gat-
teschi et al., 2018). Research in the BFSI sector fo-
cuses on the significance and transformative impact of
blockchain in identity management, particularly high-
lighting the promise of the Zero-Knowledge-Proof
technology (ZKP) (Akram and Sen, 2022). A com-
prehensive literature review and various investiga-
tions into blockchain-based identity management sys-
tems reveal their potential to overcome traditional
system limitations but indicate that blockchain tech-
nology still lags in implementation and efficacy com-
pared to existing solutions (Ahmed et al., 2022, Ku-
perberg, 2020). Lastly, a study on the practicality
of blockchain for organizational identity management
suggests it holds promise but is still in a developmen-
tal phase, with proper planning needed for effective
implementation (Mulaji et al., 2021). Compared to
existing studies, the paper at hand focuses on iden-
tity management and verification in the insurance en-
vironment. In order to clarify the objectives of future
research, the following research question (RQ) will be
RQ: How does the current research landscape of
academic and commercial Blockchain solutions for
identity management look like?
To answer the research question, this introduction
to the research topic is followed by a detailed expla-
nation of the research methodology, focusing on the
structured literature review process. The results sec-
tion (Sec. 3) presents a comprehensive overview of
academic and commercial solutions identified in the
literature review. Finally, the paper offers a compar-
ative analysis of these solutions from technical and
process perspectives, culminating in a conclusion that
summarizes key findings and suggests directions for
future research.
This section describes the procedure of the systematic
literature search. It includes the selected databases,
search terms, the inclusion and exclusion criteria, as
well as a presentation of the search results and the
search process. In general, we follow the approach of
vom Brocke et al. Brocke et al. (2009). After defin-
ing the review scope (I) in section 1, we conceptu-
alize the topic (II) of the literature review in subsec-
tion 2.1.Subsequently, the search process (III) can be
started, which is described in subsection 2.3. The re-
sults are compiled and analyzed in sections 3 and 4
(IV). Finally, the summary of results provides an out-
look on the research agenda (V).
The search process is conducted on the scientific
literature databases of ACM, IEEE, Scopus, Springer
Link, and Web of Science. These databases were cho-
sen for searching as they cover an extensive collection
of literature in the necessary subject areas.
2.1 Search Terms
For the systematic literature review, search terms
were formed, which were composed of different
topic-related terms. The terms were derived based on
the title, objective, and research question and divided
into the four components ”blockchain”, ”customers”,
”identity management”, and ”insurance”. The forma-
tion was done with the help of the Boolean operators
”AND” between the components to limit the search
results and ”OR” between the basic terms to consider
synonyms during a search. Furthermore, parts of the
expressions of the identity check were combined with
terms from the component ”customers” to reduce the
results of the search and to specify the generic terms.
In addition, the wildcard operator (*) was used to in-
clude variations of the individual terms in the search.
The search terms are constructed with the following
Blockchain: blockchain, blockchain-technology,
blockchain-based, distributed ledger, DLT
Customers: customer, user
Identity Management: identity, identification,
identity verification, identity authentication, iden-
tity management, access management, CIAM,
self-sovereign identity, SSI, decentralized iden-
tity, KYC
Insurance: insurance, BFSI
HEALTHINF 2024 - 17th International Conference on Health Informatics
2.2 Inclusion and Exclusion Criteria
For the systematic literature search, inclusion and ex-
clusion criteria were determined to assess the litera-
ture found in terms of its suitability and relevance.
The search was limited to publications in English and
German. In addition, only conference papers and
journal articles were considered due to being peer-
reviewed. In addition, exclusion will occur if the pro-
posed IDM solution is not a blockchain-based system.
Further, papers will be excluded that do not focus on
or consider IDM systems and papers that especially
focus on the legal topic of the systems. Additionally,
entries will not be considered if their environment and
the IDM are not in the enterprise, BFSI, general sys-
tems, cloud, Internet of Things, customer, or public
2.3 Literature Search Results
During the systematic literature search, a total of
2,090 hits were obtained using the databases by ap-
plying the search restrictions (Sec. 2.1). After dupli-
cates were removed, 1,545 entries remained. Subse-
quently, the title and abstract were evaluated for rel-
evance with the addition of the inclusion and exclu-
sion criteria of the topic and setting. Thus, the total
number was reduced to 370 entries. In addition to
this, a further 15 entries were removed because of un-
availability of the full text. After the pre-selection,
the remaining entries were subjected to a full-text re-
view. The elimination was based on the criteria of
language, availability, environment, and subject mat-
ter. Four papers were eliminated because the full text
was only available in Chinese. 20 other papers were
sorted out because they had a supply chain (4), en-
ergy sector (5), smart city (4), or other (7) environ-
ment. Thematically, a total of 248 entries were re-
moved. 147 articles were sorted out because they had
an inappropriate subject focus. Instead of an IDM
system, the focus was on specific advances (e.g., data
storage, data sharing, contact tracking), technologies
(e.g., blockchain, Inter Planetary File System, ZKP),
or financial applications and payment systems. 91 pa-
pers were eliminated because the proprietary solution
presented was not a blockchain-based IDM system,
and seven publications were excluded because they
had a strong focus on blockchain or the legal frame-
work of the systems. After the review, 83 submissions
remained. These were divided into the groups ”own
blockchain IDM solution” (50 entries) and ”other lit-
erature” (33 entries). Group one was used for the
selection of blockchain-based systems in Section 3.
For the second group, an additional look was taken
to see, which papers dealt with a tabular comparison
of blockchain-based IDM solutions. The comparison
criteria for Section 4 were derived from the remain-
ing 14 papers. Companies within this industry and
their IDM systems were investigated independently.
In addition, studies and articles from insurance trade
magazines were included. To provide a comprehen-
sive analysis of blockchain IDM systems, commer-
cial solutions were examined to amend the scientific
literature research. This analysis was based on pub-
lished white papers, documentations, and entries on
company websites.
Search Results
(n = 2096)
After Removing Duplicates
(n = 1545)
After Analysis of Titles and Abstracts
(n = 355)
Included Studies
(n = 83)
Studies on blockchain-based
solutions (n = 50)
Studies for framework analysis
(n = 33)
Figure 1: Overview of literature selection process.
In the following, various blockchain identity manage-
ment solutions are examined. The first subsection
gives an insight into proposed approaches from the
scientific literature and the second section delves into
commercial solutions.
3.1 Academic Solutions
From the literature review, 50 proposals emerged,
which were reviewed using an additional selection
process, thus reduced to eight solutions. This process
centered on determining if the proposal addresses a
general identity management system or specific in-
dividual processes. Emphasis is placed on identify-
ing publications that propose self-sovereign identity
(SSI) systems, with a focus on papers that adhere to
SSI principles and describe identity management or
Know Your Customer (KYC) processes. To ensure
relevance, papers lacking citations or use cases in gen-
eral identity management, BFSI, or cloud computing
are excluded from further analysis (see Table 1).
Customer Identity Management in Health Insurance with Blockchain Technology: A Literature Review
Table 1: Overview on solutions from academic literature.
Soltani et al. (2021) Hyperledger Indy public, permissioned Plenum n off
Chen et al. (2021) Hyperledger Fabric consortium Kafka-Consensus y off
Liao et al. (2022) Ethereum consortium Proof-of-Authority y off
Bandara et al. (2022) Rahasak permissioned Kafka-Consensus y off
Otta and Panda (2022) Ethereum - Proof-of- Work y off
Schlatt et al. (2022) - - - n off
Abraham et al. (2021) - permissioned - y off
Hong and Kim (2020) Ethereum - - y on
3.2 Commercial Solutions
The following section contains the analysis of ex-
isting blockchain-based IDM solutions. Based on
the “KuppingerCole Market Compass Decentralized
Identity: Blockchain ID & SSI Solutions” (Bailey,
2020), the solutions mentioned therein were consid-
ered. In a further selection process, the solutions
were reduced to five products, as the solutions elim-
inated did not have sufficient documentation or were
in the development or test phase at the time of the
review. Exclusion due to a lack of documentation
relates to the KYC systems Authenteq and Know-
MeNow. The identity solution ShoCard was taken
over by Ping Identity and integrated into their prod-
uct PingOne Neo (Bailey, 2020), whiich is currently
in its test phase. The two uPort products Serto Iden-
tity and Veramo as well as the Cambridge Blockchain
are only in beta status or development and are elimi-
nated for closer examination. Thus, only five selected
solutions are considered for comparison (see Table 2).
The following section examines the extent to which
self-sovereign identity management systems can have
the potential for improving identity management.
4.1 General Perspective
Decentralized identity management systems provide
a secure and trusted method for identity verification
and management (Akram and Sen, 2022). They are
considered as problem solvers of centralized systems
(Panait et al., 2020). With their advantageous sys-
tem architecture, they ensure that personal customer
data is no longer stored centrally at an instance, but
decentrally at the users themselves. The elimination
of the central authority shifts the balance of power
in favor of the customer and balances the previously
asymmetrical trust relationship (Panait et al., 2020).
When using digital services, the user can decide in-
dependently, which data should be shared with the
service provider (Nuggets Ltd, 2017) and disclosure
of the customer’s personal data is only possible with
their consent. In addition, the independence from
central organizations ensures that the existence and
functionality of users’ digital identities are not depen-
dent on them (SelfKEy DAO, 2023). The user can
select partial information from their Verifiable Cre-
dentials (VC), which ensures that the organization
only receives the data it needs to verify the user. Us-
ing cryptographic techniques such as ZKP and data
minimization, the user data privacy can also be in-
creased and legal regulations such as the GDPR are
easier to comply with (SelfKEy DAO, 2023). In-
creased data security is also the result of having cen-
tralized data servers, which mitigates the risk from
data leaks (Mulaji et al., 2021). If fraudsters want
to steal an identity of a user, they must be in pos-
session of their cryptographic key pair to prove that
they are the owner of the stolen VC (Dock Labs AG,
2023). However, since the customer data and pri-
vate keys are usually stored in their own SSI wallets,
they must have malicious actors to penetrate each user
wallet. Consequently, the chance of identity theft is
reduced (Panait et al., 2020). Another advantage is
the increased resilience to a Single-Point-of-Failure
(SPOF) compared to the centralized systems due to
disintermediation and decentralization (Mulaji et al.,
2021). Common standards and protocols such as De-
centralized Identifiers (DID) provide interoperability
among SSI-systems and an improved UX. They al-
low data to be transferred efficiently and more eas-
ily between systems without compromising user se-
curity, control rights, and privacy (SelfKey Founda-
tion, 2017). Moreover, they allow the user to use
the same digital identity for different applications or
services. Thus, the management of digital identities
becomes easier (SelfKey Foundation, 2023). The in-
secure password login method of centralized systems
HEALTHINF 2024 - 17th International Conference on Health Informatics
Table 2: Overview on commercial solutions.
Name BP BT C Year Costs S OS
BlockID Ethereum private, permissioned Proof-of-Authority 2018 y on n
Civic Solana public Proof-of-Stake, Proof-of-History 2015 y off n
Evernym Sovrin public, permissioned Plenum 2013 y/n off y
Nuggets Ethereum public - 2017 y off n
SelfKey Ethereum public Proof-of-Authority 2017 n off y
is replaced by a passwordless method, the decentral
identifier, in the SSI-IDM. Moreover, cryptographic
verification mechanisms of DID increase the security
of user authentication compared to passwords (Self-
KEy DAO, 2023). Through digital signatures, users
can prove the integrity and authenticity of the trans-
mitted data and be verified as the unique owner of
the digital identity (Dock Labs AG, 2023). Further,
the use of the trusted certificates and SSI solution en-
sures that insurance fraud can be better detected or
even prevented (Eckert and Osterrieder, 2020). Be-
sides the above point, the use of cryptography and
VC supports fast and easy verification of new cus-
tomers and guarantees the validity and integrity. The
SSI system can speed up the process because the veri-
fier can check the data of customers in real-time with-
out contacting the issuer of the information. In fi-
nance, this can reduce the onboarding process for new
customers from an average of one to three months
to a few days or hours (SelfKEy DAO, 2023). The
use of digital signatures enhances security by allow-
ing precise verification of the issuer of the data and
the intended recipient, thereby making it more chal-
lenging to manipulate, steal, or create false identity
data (Dock Labs AG, 2023). In addition, the use of
blockchain as a trusted data registry ensures that the
stored data is difficult to change or manipulate (Mu-
laji et al., 2021) and the origin of incorrect data can
be determined (Nuggets Ltd, 2017). The SSI system
reduces the number of KYC processes for new cus-
tomers to one verification, as companies can share
customer data from the decentralized ledger across
corporate domains (Akram and Sen, 2022, Eckert and
Osterrieder, 2020, Nuggets Ltd, 2017). The user can
use the VC received with other companies that also
require a KYC check (Dock Labs AG, 2023). In addi-
tion to saving time, shared customer verification saves
companies financial budgets (Nuggets Ltd, 2017). A
further reduction in expenses results from the fact
that companies no longer need to store, protect, and
manage sensitive data of users and passwords (Mu-
laji et al., 2021). In addition, customer SSI self-
management ensures a reduction in customer service
expenses as data can be changed and updated syn-
chronously across all services (Dock Labs AG, 2023,
SelfKEy DAO, 2023). The use of a decentralized
management system can improve the relationship be-
tween a company and its customers and help build a
two-way trust through mutual authentication. By us-
ing SSI agents as intermediaries between the two par-
ties, both agents can share VCs with each other and
verify that they are valid. If one party’s VC proves
to be invalid, the agents can inform their owners and
terminate the connection to protect users from phish-
ing sites (SelfKEy DAO, 2023). In summary, the use
of an SSI system provides clients with more conve-
nience, security, and privacy than a centralized IDM
(SelfKEy DAO, 2023).
4.2 Potentials of Blockchain Identity
Management Solutions
The analysis of the 13 solutions shows that the use
of a blockchain-based identity management in the in-
surance environment can solve challenges of central-
ized systems and realize the majority, of the elabo-
rated advantages. The evaluation criteria include as-
pects like decentralized data storage, user-centric data
sovereignty, independence from central authorities,
the application of cryptographic security measures,
and the management of private keys by users them-
selves. In addition, we checked on an increased resis-
tance to a SPOF, a portable identity, a reusable KYC-
VC as well as a passwordless login, and whether the
first identity check is performed with VC (see Table
3). The results of the analysis show that all but one of
the systems allow decentralized storage of user iden-
tity data and ensure that no single entity or central sys-
tem has complete control over customer data. In all of
the solutions examined, the user bears responsibility
for their data, can access it via their wallet, and can
easily manage or change it. In addition, all solutions
confirm the advantage that data sharing is only possi-
ble with the explicit consent of the customer and can
be done selectively. The analysis also shows that the
use of SSI systems provides an increased resistance to
SPOF. This is ensured by the decentralized structure
of the blockchain used in all systems, which stores
information regarding identity distributed across mul-
tiple nodes and enables secure data exchange across
enterprise domains. The increased resilience is sup-
ported by the use of decentralized login procedures
Customer Identity Management in Health Insurance with Blockchain Technology: A Literature Review
Table 3: Comparison of SSI solutions with an analysis framework adapted from scientific literature.
KYC2 Y Y Y N Y Y Y Y - Y Y Y Y Y - N Y N
SSI-Chain Y Y Y N Y Y Y Y - Y Y Y Y Y Y Y - N
BIMAC N Y Y N Y Y - Y - - Y Y Y Y Y - Y P
Casper Y Y Y N Y Y - Y - Y Y Y Y Y N N Y N
Otta et al. Y Y Y Y Y Y Y Y - - Y Y Y Y Y Y - N
Schlatt et al. Y Y Y P Y Y Y Y Y Y Y Y Y Y Y P Y P
Abraham et al. Y Y Y N Y Y Y Y - Y Y Y Y Y Y Y - N
Vault-Point Y Y Y Y Y - - Y - - Y P Y Y Y N - N
BlockID Y Y Y N Y Y Y Y - - Y Y Y Y Y N Y N
Civic Y Y Y P Y Y Y Y - - Y P Y Y Y N Y N
Evernym Y Y Y N Y Y Y Y - Y Y Y Y Y Y P Y N
Nuggets Y Y Y P Y Y Y Y - Y Y Y Y Y Y N Y N
SelfKey Y Y Y N Y Y Y Y - Y Y Y Y Y Y N Y N
DS: decentralized data storage, SM: self-management, DT: data sharing through user consent, U: independence from central instance, SD: selective data
forwarding, DID: decentralized identifier, VC: verifiable credentials, SP: key pair, LS: link secret, ZKP: zero-knowledge proof, S: private key on customer
device, W: Resistance to SPOF, AS: use of general standards, PI: portable identity, PL: passwordless login, IP1: initial identity check with verifiable
credentials, KYC1: one-off KYC check, DU: storage of all sensitive customer data at the company (Y: Yes, N: No, P: Partly)
and general standards. Additionally, the interoper-
ability among solutions reduces the risk of being de-
pendent on a particular system. However, complete
exclusion of a SPOF does not occur as the VaultPoint
and Civic solutions demonstrate. Each system allows
the customer to have a portable identity and eleven of
the analysed systems use a passwordless login. The
decentralized login used by the majority, using DIDs
or the cell phone as an authentication device, confirms
the replacement of the traditional username/password
method. Protected by cryptographic measures, it
leads to more security, convenience, and an improved
UX. Some of the anaylzed solutions show that this can
be increased by simply updating all accounts via the
wallet and automatically filling out forms. In addi-
tion, individual systems offer users to monetize their
own data and deposit them with a real value. Another
benefit reinforced by the research are the time and
cost savings for identity verification processes that
are possible with the use of SSI systems. The ma-
jority of solutions allow the customer to go through
the full KYC verification process only once. They
can use the issued VC or token to identify themself
at other service providers. In addition to cost savings
in the KYC process, the analysis shows a reduction in
spending due to the elimination of securing sensitive
data on company servers. A deviation only occurs in
two of the examined solutions, where storage in case
of suspicion or central storage of customer data on
bank servers is mentioned. All solutions use crypto-
graphic measures. They reduce the dangers of identity
verification through VCs and DIDs and provide more
security and privacy to the user through the use of
ZKPs, link secrets, and cryptographic key pairs. Sce-
nario analyses of the solutions also show that the SSI
systems provide increased security against data theft
as this is more costly compared to central databases.
Private keys of customers are stored on private de-
vices in all system architectures. The blockchain as a
trustworthy data registry and reputation system acts as
a bilateral communication channels, with mutual au-
thentication, zero trust, VC as well as tokens, thus the
trust is increased between the different parties. How-
ever, a complete independence from central instances
and improvements for identity verification cannot be
fully realized. The first point is influenced in the sys-
tems by the architecture of the blockchain, the used
consensus mechanism, or the initial identity verifica-
tion. Seven solutions use permissions, consortium, or
private blockchain, which provide clients with greater
independence than centralized systems, but network
access and participant rights are still controlled by one
or more central entities and are thus not fully decen-
tralized. Moreover, consensus mechanisms such as
proof-of-authority ensure that users are dependent on
a central authority and must trust the validators (Mal-
hotra et al., 2022). Benefits from using VC for ini-
tial verification cannot be realized in seven cases. In
these solutions, the initial identity verification in the
SSI ecosystem takes place without VC and relies on
the procedures already used in the centralized solu-
tions. In the study, only three of the identity manage-
ment solutions examined use VC for initial verifica-
tion, while two others offer both VC and alternative
methods. However, the identity verification process
in seven of the systems is vulnerable to tampered ev-
idence as they depend on trusted entities for the veri-
fication and issuance of VC. Regarding the introduc-
tion of these systems, high security requirements for
digital wallets (Bach, 2021) and the need for special-
HEALTHINF 2024 - 17th International Conference on Health Informatics
ized terminals to store cryptographic keys are further
challenges. A lack of awareness and lack of or in-
correct knowledge of people about the new technol-
ogy can lead to difficulties in adopting it (SelfKey
Foundation, 2023). In addition, the UX may suffer
if system operations are too complex or new to users.
The user trades control for convenience (Preukschat
and Reed, 2021) and faces extra work as they are re-
sponsible for managing, backing up, and protecting
their own data (SelfKey Foundation, 2023). There
is also a risk of consent fatigue if the customer has
to manage too many requests (Soltani et al., 2021).
Insurance companies face the problem of integrating
the new systems into their existing IT infrastructure.
Although the majority of the analyzed market solu-
tions are white-labeled products that are easy to inte-
grate with the help of documentation, the IT depart-
ment of the insurer still needs the technical know-how
and skills to understand and develop the code (Eckert
and Osterrieder, 2020). In addition, the redesign of
the IT landscape might necessitate large investments
(SelfKey Foundation, 2023). Further, for the utiliza-
tion of blockchain-based systems, both customers and
companies must obtain the appropriate currency to fa-
cilitate payment for transactions and services (1Kos-
mos Inc., 2023). The adoption of blockchain technol-
ogy and decentralized storage in systems faces several
challenges. Scalability issues and limitations in stor-
age space are significant concerns (SelfKey Founda-
tion, 2023). The choice of consensus mechanism can
affect system performance, resource usage, and may
result in less decentralization. Data storage methods
also present difficulties as on-chain storage hampers
scalability and system speed, and raises issues regard-
ing the right to be forgotten, as personal data could
remain permanently on the ledger. Off-chain storage,
on the other hand, is susceptible to corruption and
tampering (Nuggets Ltd, 2017). Additionally, user
access to data is dependent on private keys. Losing
these keys poses a risk, although recovery solutions
like BIP39 exist, they are not foolproof, and losing
recovery phrases means losing access to private data
(Soltani et al., 2021). Furthermore, authentication
with Decentralized Identifiers (DIDs) has been found
to be more time-consuming than traditional password
methods. Finally, uncertainties and lack of guide-
lines in the legal and regulatory environment compli-
cate the diffusion of systems in the insurance sector
and the verification of documents (Eckert and Oster-
rieder, 2020). Despite these challenges, the use of SSI
systems offers many benefits to the insurance indus-
try and its customers and can overcome the majority
of the challenges of centralized IDM systems. How-
ever, two issues cannot yet be fully answered and, in
conjunction with SSI systems’ native challenges, con-
tinuous development of the technology is needed to
solve these problems.
This research explored how blockchain could enhance
customer identity management in the insurance indus-
try. It highlights that current systems are centralized,
posing risks like data breaches and limited user con-
trol. The study suggests that blockchain-based SSI
systems could offer improvements by decentralizing
data management and enhancing security and user au-
tonomy. However, SSI systems also have limitations,
such as partial decentralization and similar vulnera-
bilities in identity verification. Future work should
include an in-depth security evaluation of blockchain-
based self-sovereign identity systems. This would in-
volve assessing their resilience to cyber threats, data
integrity, and privacy safeguards. Analyzing how
these systems conform to established security princi-
ples would be crucial (Allen, 2016). Expanding the
research to include insurance companies on a global
scale, particularly in Europe and other regions, would
provide a more comprehensive understanding of iden-
tity management practices. This broader perspec-
tive could highlight regional differences and similar-
ities, offering a more nuanced view of the challenges
and opportunities in adopting blockchain technology
for identity management. Investigating a variety of
other SSI and Decentralized Trust Infrastructure sys-
tems could enrich the understanding of the landscape.
This exploration should aim to assess different mod-
els and architectures, comparing their effectiveness,
user-friendliness, and scalability. The study should
expand its criteria catalog to encompass emerging at-
tributes and technologies. This would involve ex-
ploring new blockchain features, advancements in en-
cryption, and evolving regulatory requirements. Such
an extension would ensure that the analysis remains
relevant and comprehensive in the rapidly evolving
field of digital identity management. A further criti-
cal area for future research is the practical implemen-
tation of SSI systems in the insurance industry. This
includes pilot studies or case studies demonstrating
real-world applications and challenges. Investigating
the gap between theoretical benefits and actual out-
comes in these implementations would provide valu-
able insights into the feasibility and effectiveness of
SSI systems in a real-world setting. Besides, the de-
velopment of a further fully comprehensive approach
to SSI-IDM using blockchain technology (Pohl et al.,
2020) and the modeling of integration into organiza-
Customer Identity Management in Health Insurance with Blockchain Technology: A Literature Review
tional processes (Pohl et al., 2023) can be pursued.
Finally, understanding the factors that influence user
acceptance and adoption of these systems is essential.
Future studies should explore the societal, behavioral,
and technological barriers to the widespread adoption
of blockchain-based identity management solutions.
1Kosmos Inc. (2023). 1Kosmos Authenticators.
Abraham, A., More, S., Rabensteiner, C., and H
F. (2021). Revocable and Offline-Verifiable Self-
Sovereign Identities. In 2020 IEEE 19th International
Conference on Trust, Security and Privacy in Com-
puting and Communications (TrustCom), pages 1020–
Ahmed, M. R., Islam, A. K. M. M., Shatabda, S., and Is-
lam, S. (2022). Blockchain-Based Identity Manage-
ment System and Self-Sovereign Identity Ecosystem:
A Comprehensive Survey. IEEE Access, 10:113436–
Akram, M. and Sen, A. (2022). A case study Evaluation of
Blockchain for digital identity verification and man-
agement in BFSI using Zero-Knowledge Proof. In
2022 International Conference on Decision Aid Sci-
ences and Applications (DASA), pages 1295–1299.
Allen, C. (2016). The Path to Self-Sovereign Identity.
Bach, N. (2021). Dezentrale Identifikatoren (DIDs):
Die n
achste PID-Evolution: selbstsouver
an, daten-
schutzfreundlich, dezentral. o-bib. Das offene Biblio-
theksjournal / Herausgeber VDB, 8(4):1–20 Seiten.
Bailey, A. (2020). Decentralized Identity: Blockchain ID &
Self-Sovereign Identity Solutions.
Bandara, E., Shetty, S., Mukkamala, R., Liang, X., Foytik,
P., Ranasinghe, N., and De Zoysa, K. (2022). Casper:
a blockchain-based system for efficient and secure
customer credential verification. Journal of Banking
and Financial Technology, 6(1):43–62.
Brocke, J. v., Simons, A., Niehaves, B., Niehaves, B.,
Reimer, K., Plattfaut, R., and Cleven, A. (2009). Re-
constructing the giant: On the importance of rigour
in documenting the literature search process. In ECIS
2009 Proceedings.
Chen, Y., Liu, C., Wang, Y., and Wang, Y. (2021). A Self-
Sovereign Decentralized Identity Platform Based on
Blockchain. In 2021 IEEE Symposium on Computers
and Communications (ISCC), pages 1–7.
Dock Labs AG (2023). Blockchain Identity Management:
Complete Guide 2023.
Eckert, C. and Osterrieder, K. (2020). How digitalization
affects insurance companies: overview and use cases
of digital technologies. Zeitschrift f
ur die gesamte Ver-
sicherungswissenschaft, 109(5):333–360.
European Insurance and Occupational Pensions Authority
(2021). Cyber-Risiken: Was sind die Auswirkungen
auf die Versicherungsbranche? (ARTIKEL15).
European Insurance and Occupational Pensions Authority.
(2021). Discussion paper on blockchain and smart
contracts in insurance. Publications Office, LU.
Experian Information Solutions, I. (2022). 2022 Global
Identity and Fraud Report. Technical report.
Gatteschi, V., Lamberti, F., Demartini, C., Pranteda, C., and
ıa, V. (2018). Blockchain and smart con-
tracts for insurance: Is the technology mature enough?
Future Internet, 10(2).
Hong, S. and Kim, H. (2020). VaultPoint: A Blockchain-
Based SSI Model that Complies with OAuth 2.0.
Kellermann, T. and Murphy, R. (2020). Modern Bank
Heists 3.0. Technical report, VMware.
Kuperberg, M. (2020). Blockchain-Based Identity Manage-
ment: A Survey From the Enterprise and Ecosystem
Perspective. IEEE Transactions on Engineering Man-
agement, 67(4):1008–1027.
Liao, C., Guan, X., Cheng, J., and Yuan, S. (2022).
Blockchain-based identity management and access
control framework for open banking ecosystem. Fu-
ture Generation Computer Systems - The Interna-
tional Journal of EScience, 135:450–466.
Malhotra, D., Saini, P., and Singh, A. (2022). How
Blockchain Can Automate KYC: Systematic Re-
McKinsey & Company (2022). Digital Sentiment
Survey 2022: Deutsche Verbraucher:innen werden
zunehmend digitaler.
Mulaji, S. S. M., Roodt, S. S., and Zhang, Y. (2021).
The Practicality of Adopting Blockchain-Based Dis-
tributed Identity Management in Organisations: A
Meta-Synthesis. Sec. and Commun. Netw., 2021.
Nuggets Ltd (2017). Nuggets White Paper V18.
Otta, S. P. and Panda, S. (2022). Decentralized Iden-
tity and Access Management of Cloud for Security
as a Service. In 2022 14th International Conference
on COMmunication Systems & NETworkS (COM-
SNETS), pages 299–303.
Panait, A.-E., Olimid, R., and Stefanescu, A. (2020). Iden-
tity management on blockchain Privacy and security
aspects. Proceedings of the Romanian Academy Se-
ries A - Mathematics Physics Technical Sciences In-
formation Science, 21(1):45–52.
Pohl, M., Degenkolbe, R., Staegemann, D., and Tur-
owski, K. (2020). Towards a blockchain technol-
ogy framework–literature review on components in
blockchain implementations. In ACIS 2020 Proceed-
ings. Association for Information Systems.
Pohl, M., Degenkolbe, R., Staegemann, D. G., and Tur-
owski, K. (2023). Decentralised autonomous man-
agement of an association through smart contracts ac-
cording to german legislation. In ICEIS (1) 2023.
Preukschat, A. and Reed, D. (2021). Self-sovereign iden-
tity: decentralized digital identity and verifiable cre-
dentials. Manning, Shelter Island.
Schlatt, V., Sedlmeir, J., Feulner, S., and Urbach, N. (2022).
Designing a Framework for Digital KYC Processes
HEALTHINF 2024 - 17th International Conference on Health Informatics
Built on Blockchain-Based Self-Sovereign Identity.
SelfKEy DAO (2023). SelfKey DAO Whitepaper EN.
SelfKey Foundation (2017). SelkKey.
SelfKey Foundation (2023). Login with SelfKey · Develop-
Soltani, R., Nguyen, U. T., An, A., and Galdi, C. (2021).
A Survey of Self-Sovereign Identity Ecosystem. Sec.
and Commun. Netw., 2021.
Customer Identity Management in Health Insurance with Blockchain Technology: A Literature Review