Leading Regional Insurer
Leading Regional Insurer
Helping customers prioritise recovery post-hospitalisation by alleviating the administrative burden of claims
As part of the digitalisation efforts, there was a growing demand from customers to make services available via digital channels. Hospitalisation claims, characterised by their high volume and relatively straightforward submission process, presented a suitable opportunity. The team was tasked to develop a new submission feature on the mobile app, enhancing both customer experience and operational efficiency for staff.
As part of the digitalisation efforts, there was a growing demand from customers to make services available via digital channels. Hospitalisation claims, characterised by their high volume and relatively straightforward submission process, presented a suitable opportunity. The team was tasked to develop a new submission feature on the mobile app, enhancing both customer experience and operational efficiency for staff.
My Contributions
My Contributions
User Research, Service Design, UIUX Design, User Testing, Web Design
User Research, Service Design, UIUX Design, User Testing, Web Design
Team
Team
Cross-functional team involving various departments
Cross-functional team involving various departments
Timeline
Timeline
6 months
6 months
Project summary
Project summary
Problem
Problem
Customers seeking medical expense reimbursement are often unsure of how to go about making their claims with the insurer due to lack of clear information. This leads to frustration and anxiety during a time when they should be focusing on recovery.
Customers seeking medical expense reimbursement are often unsure of how to go about making their claims with the insurer due to lack of clear information. This leads to frustration and anxiety during a time when they should be focusing on recovery.
Solution
Solution
A hospitalisation claim submission feature was introduced on the mobile app, offering step-by-step guidance and clear claim status tracking with payout details upon approval. Other complementary initiatives included:
Updating the corresponding page on the corporate website to illustrate the various stages within the claims process and samples of good quality submission
Creating an infographic detailing tips on ensuring claims approval for agents to share with their clients
Reviewing SMS notifications to ensure alignment with mobile app
A hospitalisation claim submission feature was introduced on the mobile app, offering step-by-step guidance and clear claim status tracking with payout details upon approval. Other complementary initiatives included:
Updating the corresponding page on the corporate website to illustrate the various stages within the claims process and samples of good quality submission
Creating an infographic detailing tips on ensuring claims approval for agents to share with their clients
Reviewing SMS notifications to ensure alignment with mobile app
Impact
Impact
15.2%
15.2%
improvement in customer satisfaction (CSAT) score
improvement in customer satisfaction (CSAT) score
4.6 stars
4.6 stars
user rating
user rating
Featured in internal company newsletter as noteworthy project
Featured in internal company newsletter as noteworthy project
My contribution
My contribution
I was involved in various parts of the project including conducting interviews and distilling research insights through creating the customer journey map and identifying pain points. From there, I created the mockups which served as initial concepts for discussion and handed over to the design team responsible for implementation. I was also responsible for designing the accompanying webpage and infographic mentioned above.
I was involved in various parts of the project including conducting interviews and distilling research insights through creating the customer journey map and identifying pain points. From there, I created the mockups which served as initial concepts for discussion and handed over to the design team responsible for implementation. I was also responsible for designing the accompanying webpage and infographic mentioned above.
Background
Background
Administrative burden of claims create additional stress after hospitalisation
Administrative burden of claims create additional stress after hospitalisation
Upon discharge from the hospital, customers should be able to dedicate their energy to recovery. However, they often face the added burden of navigating complex insurance claims. This is compounded by frequent follow-up appointments, each generating additional documentation. As the number of appointments (and incurred cost) increases, so does the administrative work creating significant mental and financial strain. Given that medical claims comprise the majority of our volume and are a key driver of dissatisfaction based on customer surveys, we focused our efforts on streamlining this process.
Upon discharge from the hospital, customers should be able to dedicate their energy to recovery. However, they often face the added burden of navigating complex insurance claims. This is compounded by frequent follow-up appointments, each generating additional documentation. As the number of appointments (and incurred cost) increases, so does the administrative work creating significant mental and financial strain. Given that medical claims comprise the majority of our volume and are a key driver of dissatisfaction based on customer surveys, we focused our efforts on streamlining this process.
research
research
Administrative work for claims submission presents yet another obstacle to their recovery
Administrative work for claims submission presents yet another obstacle to their recovery
To identify pain points in the claim submission process, I interviewed 6 customers who recently made a claim either through their agent or independently via email. Our research revealed the following insights:
To identify pain points in the claim submission process, I interviewed 6 customers who recently made a claim either through their agent or independently via email. Our research revealed the following insights:
Multiple appointments, repeated claim submissions
Due to the length of insurance coverage (up to 1 year post-hospitalisation), it was common for most to have multiple follow-up appointments that were spread over an extended period of time. This meant having to submit a claim after each visit, filling up a new form each time and providing their details over and over again.
Due to the length of insurance coverage (up to 1 year post-hospitalisation), it was common for most to have multiple follow-up appointments that were spread over an extended period of time. This meant having to submit a claim after each visit, filling up a new form each time and providing their details over and over again.
Tedious manual tracking
Adding onto the complexity, tracking often had to be done manually which made it challenging to reconcile payment. Some even resorted to maintaining spreadsheets or paper records to keep track of which bills have been settled.
Even for those assisted by agents, they had to communicate through unofficial channels such as WhatsApp to ensure that their claims were submitted and received by the company.
Adding onto the complexity, tracking often had to be done manually which made it challenging to reconcile payment. Some even resorted to maintaining spreadsheets or paper records to keep track of which bills have been settled.
Even for those assisted by agents, they had to communicate through unofficial channels such as WhatsApp to ensure that their claims were submitted and received by the company.
Fragmented communications
When a claim is a settled, a letter containing the detailed breakdown of the outcome is sent via post which can take up to 7 days. At the same time, payment is processed and sent to the customer on the same day. This creates an information gap, leaving customers waiting for the letter to arrive to understand the payment they've received.
When a claim is a settled, a letter containing the detailed breakdown of the outcome is sent via post which can take up to 7 days. At the same time, payment is processed and sent to the customer on the same day. This creates an information gap, leaving customers waiting for the letter to arrive to understand the payment they've received.
Problem definition
Problem definition
How might we help customers easily submit, manage and track their hospitalisation claims?
How might we help customers easily submit, manage and track their hospitalisation claims?
DESIGN APPROACH
DESIGN APPROACH
Building on the current email submission flow
Building on the current email submission flow
Another key observation was that customers frequently bypassed the formal claim process, submitting claims via email with only their policy number and receipts. This prompted an analysis of the existing claim form which revealed numerous redundant fields. Based on these findings, the form was thoroughly reviewed and streamlined, eliminating unnecessary questions. The streamlined form, with essential questions only, then served as the foundation for the app's claim submission flow.
Another key observation was that customers frequently bypassed the formal claim process, submitting claims via email with only their policy number and receipts. This prompted an analysis of the existing claim form which revealed numerous redundant fields. Based on these findings, the form was thoroughly reviewed and streamlined, eliminating unnecessary questions. The streamlined form, with essential questions only, then served as the foundation for the app's claim submission flow.
Design considerations
Related pain points/needs
Only essential information should be requested and manual user input is minimised.
Only essential information should be requested and manual user input is minimised.
Customers only need to attach their receipts when submitting via email or their agent.
Customers only need to attach their receipts when submitting via email or their agent.
Offer clear, in-app guidance on required claim documentation and provide actionable instructions on how to obtain them.
Offer clear, in-app guidance on required claim documentation and provide actionable instructions on how to obtain them.
Customers often struggle to figure out what supporting documents are needed for their claims if any.
Customers often struggle to figure out what supporting documents are needed for their claims if any.
Implement automated data retrieval and pre-fill fields wherever possible.
Implement automated data retrieval and pre-fill fields wherever possible.
Customers find it troublesome to fill in details that the company should already know, e.g. personal particulars, policy number.
Customers find it troublesome to fill in details that the company should already know, e.g. personal particulars, policy number.
Support both image and PDF document uploads, with clear instructions for each file type.
Support both image and PDF document uploads, with clear instructions for each file type.
Customers may receive receipts in a variety of formats including hard copy and digital documents.
Customers may receive receipts in a variety of formats including hard copy and digital documents.
tradeoffs
tradeoffs
Navigating the delicate balance between meeting user needs without overburdening staff
Navigating the delicate balance between meeting user needs without overburdening staff
Based on the interview findings, an initial version of the user flow and screens were shared with the stakeholders to determine if it would work with their current processes.
Based on the interview findings, an initial version of the user flow and screens were shared with the stakeholders to determine if it would work with their current processes.
A few areas of concern arose from the discussions:
A few areas of concern arose from the discussions:
Balancing customer effort and operational efficiency
Our initial design prioritized minimal customer input, leveraging on uploaded images to extract the necessary information. However, we recognised that this would significantly increase backend processing effort. To achieve an optimal balance between user experience and operational efficiency, we carefully selected information fields that customers could readily provide, while still facilitating efficient claim processing.
Our initial design prioritized minimal customer input, leveraging on uploaded images to extract the necessary information. However, we recognised that this would significantly increase backend processing effort. To achieve an optimal balance between user experience and operational efficiency, we carefully selected information fields that customers could readily provide, while still facilitating efficient claim processing.
Proposed
Proposed
Final
Final
Existing system limitations prevent individual receipt tracking
To address the challenge of managing multiple receipts, we initially aimed to provide tracking at the individual receipt level. This means that if a customer submits 3 receipts, they should receive 3 separate notifications for each of them.
However, this was incompatible with the current workflow which involves batch processing where multiple receipts are processed together as a single claim. Splitting them up would result in a substantial increase in processing volume, potentially overwhelming the system. As significant system enhancement was required to enable this, we aimed to address this in a future update.
PROPOSED
PROPOSED
FINAL
FINAL
KEY FEATURES
KEY FEATURES
One-stop platform to submit, manage and track hospitalisation claims
One-stop platform to submit, manage and track hospitalisation claims
Guided step-by-step process
Through a new guided claims process, submissions are significantly simplified. Policy selection is automated by retrieving information from backend systems, thereby reducing the need for personal details, such as name, IC, and policy number, to be entered. Guidance on required supporting documents is provided, ensuring a smooth and efficient claims experience.
Through a new guided claims process, submissions are significantly simplified. Policy selection is automated by retrieving information from backend systems, thereby reducing the need for personal details, such as name, IC, and policy number, to be entered. Guidance on required supporting documents is provided, ensuring a smooth and efficient claims experience.
Dynamic status updates
Customers are given clear visibility into their claim progress through proactive notifications on any status updates. Through in-app notifications and SMSes, they are kept informed at every step, eliminating uncertainty and providing reassurance.
Customers are given clear visibility into their claim progress through proactive notifications on any status updates. Through in-app notifications and SMSes, they are kept informed at every step, eliminating uncertainty and providing reassurance.
Easy reconciliation upon payout
To enable prompt and efficient reconciliation, a letter containing a detailed breakdown is generated and made available for immediate download upon claim approval. This eliminates the 7-day delay due to postal delivery, allowing customers to know their claim details promptly.
To enable prompt and efficient reconciliation, a letter containing a detailed breakdown is generated and made available for immediate download upon claim approval. This eliminates the 7-day delay due to postal delivery, allowing customers to know their claim details promptly.
SUPPORTING MATERIALS
SUPPORTING MATERIALS
Multifaceted communication strategy to encourage user adoption
Multifaceted communication strategy to encourage user adoption
To support the new feature rollout, we considered the overall communication strategy to ensure customers have access to comprehensive information via various channels. I designed the content webpage and an infographic for agents to share with clients easily over WhatsApp.
To support the new feature rollout, we considered the overall communication strategy to ensure customers have access to comprehensive information via various channels. I designed the content webpage and an infographic for agents to share with clients easily over WhatsApp.
Infographic containing quick tips on how to prepare their documents for submission
Webpage containing information about the claims process and photo guide with good and bad examples
FINAL DESIGN
FINAL DESIGN
IMPACT
Post-launch surveys showed measurable improvements in key metrics
To measure the effectiveness of the new claim submission feature, we collected feedback over a three-month period via surveys conducted at 2 time points. First, an in-app survey was presented immediately following successful claim submission, allowing us to gauge initial reactions and perceptions of the process. Second, an email survey was distributed to eligible customers after their claims had been fully processed, providing insights into the overall experience and satisfaction levels.
To measure the effectiveness of the new claim submission feature, we collected feedback over a three-month period via surveys conducted at 2 time points. First, an in-app survey was presented immediately following successful claim submission, allowing us to gauge initial reactions and perceptions of the process. Second, an email survey was distributed to eligible customers after their claims had been fully processed, providing insights into the overall experience and satisfaction levels.
“...the team delivered a great solution that improves employee and customer experience. I'm very proud of you all for your amazing work and teamwork.”
“...the team delivered a great solution that improves employee and customer experience. I'm very proud of you all for your amazing work and teamwork.”
- Managing Director, Operations
“The entire process is hassle free. I am able to go for my surgery with peace of mind and focus on recovery.”
“The entire process is hassle free. I am able to go for my surgery with peace of mind and focus on recovery.”
- Customer
TAKEAWAYS
TAKEAWAYS
Working towards a unified goal requires being adaptable
Working towards a unified goal requires being adaptable
Importance of early stakeholder engagement
Initially, the claim submission flow was perceived as a relatively simple process. However, through early and comprehensive stakeholder engagement, we uncovered critical technical limitations within the backend systems that had not been previously considered. This proactive approach allowed us to identify potential roadblocks and address them before development progressed too far.
Initially, the claim submission flow was perceived as a relatively simple process. However, through early and comprehensive stakeholder engagement, we uncovered critical technical limitations within the backend systems that had not been previously considered. This proactive approach allowed us to identify potential roadblocks and address them before development progressed too far.
Tapping on internal resources for gathering feedback
Due to the project's tight timeline, conducting thorough user testing with external customers was not a viable option. Recognizing the importance of user feedback, we set our sights inwards and identified colleagues who had recently submitted claims as potential proxy testers. These individuals, with their firsthand experience, provided valuable insights into the usability and effectiveness of the new flow.
Simultaneously, we continued to monitor feedback through regular surveys. This continuous feedback loop allowed us to respond to user needs and make necessary adjustments even after launch.
Due to the project's tight timeline, conducting thorough user testing with external customers was not a viable option. Recognizing the importance of user feedback, we set our sights inwards and identified colleagues who had recently submitted claims as potential proxy testers. These individuals, with their firsthand experience, provided valuable insights into the usability and effectiveness of the new flow.
Simultaneously, we continued to monitor feedback through regular surveys. This continuous feedback loop allowed us to respond to user needs and make necessary adjustments even after launch.
See more of my work:
Connecting passionate volunteers with Singapore's tech-for-good initiatives through a redesigned Better.sg website
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Digitalising hospitalisation claims to help customers submit, manage and track their claims easily on a single platform
See more of my work:
Connecting passionate volunteers with Singapore's tech-for-good initiatives through a redesigned Better.sg website
Better.sg
EBI
Empowering therapy seekers to better explore and express their thoughts through guided and interactive journaling
Great Eastern
Digitalising hospitalisation claims to help customers submit, manage and track their claims easily on a single platform