CLIENT FEEDBACK
"I had dengue a few days ago, saw the doctor, did the tests, got the meds. But why did I have to file three separate claims for one illness??? The app made no sense, and uploading documents was such a pain. The whole thing left me completely drained."
Senior Management
Top Client
CUSTOMER JOURNEY
Takes too long
Low success rate
No error checks
Missing documents
Feels repetitive
No real guidance
Too many steps
Hard to understand
CLAIM TIMELINE
FEEDBACK ANALYSIS
What we heard and why it mattered
I interviewed 30+ users and internal stakeholders, including corporate customers, support agents, product managers, and data analysts. Their feedback uncovered major usability gaps, which we organised into patterns to guide our redesign.
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Issues with claim filling journey
Issues with uploading documents
Claim Deficiency
Business Problems
INSIGHTS
From Gaps to Solutions
Mapped the four core user pain points and directly linked each to a strategic design response, laying the foundation for a more seamless claims experience.
Hover over cards to see details
Redesign around event, not benefits
Link documents to health files
to avoid duplication
Digital guidance for proper uploads
Instant validation before submission
Check deficiencies (image quality, size, format)
Automate process
Instant feedback
Onboarding for new users
Digital assistance & info sections
Conceptualization
We reimagined the claim journey to prioritise clarity, speed, and success. Using whiteboard flows and user patterns, we redesigned around real bottlenecks, balancing user ease with backend feasibility, while keeping the system scalable and intuitive.
Concept 1 - Reimburse AI
Rejected - Most seamless UX, but required full backend transformation.
Users just had to upload all their documents once, the system handled the rest. It matched files, filled details, and prepared the claim automatically, making the process almost effortless. But needed major backend changes to support it.
Concept 2 - Flexiclaim
Feasible, but UX not optimal
Users could upload documents at their own pace during the illness, and submit the claim for approval once everything was ready.
It offered flexibility, but ended up making the process too long and scattered.
Concept 3 - Conversational AI
Rejected - Didn’t build trust for this use case
The entire claim process was designed as a guided conversation, helping users step-by-step, but users didn’t trust a chatbot interface.
Concept 4 - Guided claims flow
Chosen – Scalable, user-first, dev-light
Users were guided step-by-step based on their illness, helping them upload the right documents without confusion or rework.
This approach struck the right balance, easy for users, low on tech effort, and scalable across different claim types.
Other enhancements - Smart entry points
To ensure users never feel lost, we introduced smart entry points and support touchpoints across the journey, helping them discover the claim feature naturally and get guidance whenever needed.
The Final Journey – Scalable, Guided, and User-Centric
View PDF
This journey view shows the final validated concept that streamlined claim submission end-to-end — from intent to payout. It reflects real user pain points, product constraints, and thoughtful orchestration across multiple modules, while keeping the agent system untouched.
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The ideation process was the most challenging part to navigate. With complex flows like document management, OCR, and error handling, I went through multiple iterations, learned from failures, and kept refining until the experience felt right.
Had a 'FINALLLLLLLLLLLLLL' moment 🤪
User Testing
Over 60 participants tested the design using Maze. Tasks and limitations were shared via a detailed document. Testing included remote sessions via a shared link and supervised in-person sessions with diverse personas, ensuring comprehensive feedback.
Note: The task sheet was crucial for helping first-time users experience the claim journey realistically. Given platform constraints (like no real uploads or camera access), a guided flow made sure the test still felt real.
Choose who’s filing the claim
Let users choose a member and instantly view available coverage. This step tailors the claim process to the right policyholder from the start.
1/7
Enter your treatment
Show relevant treatments from past claims to reduce effort and errors. Users can also add a new one if it’s not listed.
2/7
Add your bill amount
Select which benefits you’re claiming and enter the invoice amount. The available balance is shown upfront to avoid surprises. The header shows a persistent summary, treatment name, patient name, and navigation help, keeping users oriented throughout the process.
Only relevant benefits are shown to reduce clutter and guide users toward valid selections.
3/7
Upload your documents
Users are shown exactly what documents are needed for each selected benefit. Mandatory files are clearly marked to avoid confusion. The system checks for common issues like missing amounts or blurry prescriptions and guides users to fix them before moving ahead.
Each document shows its current status, whether it's uploading, complete, or needs attention, so users always know what’s happening. The top summary keeps key details visible at all times, who the claim is for, illness, and total amount so users never lose context.
4/7
Guided error handling
If a user tries to continue without uploading all required documents, a clear and focused prompt stops them. The popup highlights exactly what’s missing, so users can act quickly without guessing. This reduces drop-offs and ensures smoother, more accurate submissions.
Understand and fix document issues
When users open a folder, they can see all uploaded files and instantly spot any problems whether it's upload failure or missing details. The system checks every document against key criteria. If something’s missing like a patient name or doctor's stamp it flags the issue.
Tapping on a flagged file opens a zoomed-in view with clear highlights and tips on how to fix the problem, reducing guesswork and delays. This helps users feel in control, even when things go wrong.
5/7
Verify extracted claim details
The system pulls key information like doctor’s name, date, and bill number from the uploaded documents.
Users can quickly verify or edit details directly with the help of side-by-side previews. This reduces manual entry while ensuring claims are complete and accurate.
6/7
Submit and stay informed
Users see a full claim summary before submitting, including document count, payment method, and total amount. Once submitted,
a confirmation screen reassures them their claim is in process and offers a clear next step.
7/7
DIFFERENCE MAKER
File multiple claims with ease
You can now submit multiple claims under a single event without the hassle of duplicate document uploads. For example, if you were treated for dengue and had multiple doctor visits, lab tests, and medications, all of these can be filed under the same event.
Plus, you can reuse previously uploaded documents if needed no need to upload the same prescription
or report again.
The impact of our redesign
40% fewer errors. 64% more completions. Minimal changes to the backend.
Deficiency rate
40% decrease in 3 months
60%
48%
20%
August '24
September '24
October '24
First time right rate
48% increase in 3 months
88%
Users attaching multiple claims to one treatment
58%
57
56
55
54
53
52
51
50
49
48
47
46
45
44
40
35
30
25
20
10
0
This indicates that over 50% of our users were filing multiple claims for a single illness, thereby validating our hypothesis.
Reduction in customer queries
Reduction in rejection
Rise in landing to success funnel
What We Changed |
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Why We Did It |
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Smart Checklist |
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Cut deficiency by 40% by guiding users up front |
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Pre-filled timeline for faster completion |
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Stopped bad submissions early → 88% first-time-right (FTR) success |
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Human-Readable Status |
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Dropped 22,000+ queries by replacing claim codes with simple status messages |
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Document Reuse |
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Solved repeat claims under same illness → reduced friction |
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Guided > AI Flow |
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Faster adoption, simpler onboarding, scalable without backend overhauls |
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This project taught me that even small, thoughtful shifts, when rooted in the right insights, can flip critical journeys without changing a single line of backend code.