Designing Claim Systems in Health Insurance Companies with Microservices and Event-Driven Architecture Approach

Through digital transformation, insurance companies, especially in the health sector, are increasingly adopting modern technologies to enhance efficiency and service quality. Health insurance allows individuals or families to mitigate the financial risks associated with high and unexpected medical expenses. One crucial area is insurance claim, where a fast and accurate process is key to customer satisfaction. This study proposes the design and architecture of an insurance claim system using a microservices and event-driven approach. This approach enables insurance companies to break down applications into separate components, facilitating scalability, flexibility, and easier maintenance. Additionally, with an event-driven approach, the system can quickly respond to changes and events in the business environment. A comprehensive analysis shows that implementing microservices and event-driven architecture in the insurance claim system can enhance overall system performance, scalability, and resilience. For insurance companies, adopting microservices and event-driven architecture can lead to increased operational efficiency, reduced time to market for new products, and improved customer experiences through faster claim processing. Policyholders will benefit from quicker claim resolutions and a more transparent and responsive claim process. This study provides valuable insights for health insurance companies looking to upgrade their IT infrastructure to meet future challenges. The findings from this research will be documented to support the development of insurance business technology, specifically for health insurance claims in Indonesia.