Claims Redesign

Enabling easier claim submissions and collecting information to automatically adjudicate pet insurance claims

Strategy
UX
UI

Timeline

Dec 2023 - Feb 2024

Company

Pumpkin

Platform

Web

Prototype

00
Context

The problem

Business context

  • Manual claim review processes were costly and slowed down reimbursements.
  • Automation of claims presented an opportunity to speed up straightforward cases, freeing our team to focus on more complex claims.

Human problem

  • Pet parents who are facing an emotionally charged situation, caring for a sick pet, need trust and predictability – not confusion or uncertainty.
  • Qual signals: Previous customer research, interviews with claims and CX
  • Quant signals: High volume of calls to CX with claim form related questions (~22% of volume), post-claim feedback ratings lower than member center average (2.4 vs. 3.8)

Design problem

  • How might we design clarity, ease, and predictability into our claims experience, creating trust while capturing structured, automation-ready information?

Before our redesign, users encountered several challenges with our current claim form: an unintuitive and outdated UI, lots of text, difficulty distinguishing between types of claims, and more.

01
Designing & Testing

Reducing risk through validation & iteration

One dimension I explored in my designs was the structure of the submission experience. In the early version shown above,  split the form across multiple screens, but this led to a disjointed experience, with users losing their place in the form and perceiving it to be longer than it actually was.

As I moved up in fidelity, I attempted to strike the right balance of helping users see their place in the task of filing a claim, while also helping them focus on the current step in the process.

User Research

Due to firm deadlines to start automating claims, I had to be smart about the time I allocated to discovery. I leveraged insights from observing user sessions in Full Story and incorporated customer feedback from previous research to rationalize design decisions.

Stakeholder Interviews

I also used my team's shared knowledge, getting feedback from stakeholders on the current claim form.

02
Framing

Defining the problem

How can we simplify our claims experience for customers while ensuring they feel confident in the information they've provided?

Design Goals

Align form with a user’s mental model of claims while fulfilling requirements for automation

Provide education in context, and give personalized next steps, to inspire confidence

Modernize the UI, creating new components to be used across our design system

Fix known issues with our current claim form

03
Design

Layering fidelity to build alignment at every step

By progressively layering fidelity—from maps to wireframes to final UI—I continuously engaged my team and stakeholders. This approach kept us aligned on the design vision while addressing evolving technical requirements for automation.

Mapping

Wireframes

Before beginning high-fidelity designs, I created wireframes with content blocks to align my team & stakeholders behind my vision for the claim form, and ensure my PM and tech lead could provide me with feedback on automation requirements and feasibility. I held a session with my PM to discuss which features were must-have, should-have, and nice-to-have.

Final UI

New Component Specs: Uploader

New Component Specs: Typeahead Search

Some examples of the detailed specs I created for engineers to understand the new components that were added to the design system. New components were built with future use cases in mind.

04
Impact

Automation is here, and claim processing is faster than ever

Customer experience with the claims process has already improved due to increased efficiency enabled by automation. Even with the addition of new fields to the claim form, there was no adverse effect on NPS, indicating the enhancements were well-received.

Revisiting the experience for customers viewing and tracking claims was outside the scope of this project, but is an important consideration that I hope to tackle in the near future.

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