UX Research, UX/UI Design, UX Writing
VHI Healthcare: Adding Claims Statements to the App
Winner of the 'Best Prototype Award' at the UX Tree Mentorship Program for reducing user friction in the health insurance claim process by streamlining the integration of Claims Statements within the Vhi mobile app through
User-Centered Design.
1. Project Overview
Vhi Healthcare is Ireland’s largest health insurer. As part of the UX Tree Mentorship Program, I was challenged at to optimize the mobile app experience, specifically targeting the addition and management of Claims Statements. The goal was to transform a complex, high-friction task into an effortless digital journey that builds user trust.
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Project Type: UX Tree Case Study.
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Role: UX Designer & Researcher.
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Outcome: High-fidelity, award-winning prototype validated with real users and reviewed by the Vhi Design and Research team for industry-standard feasibility.
2. The Challenge
The health insurance claims process is traditionally viewed as bureaucratic and fragmented.
Currently, users are unable to directly view responses to their claims within the Vhi app; instead, they are redirected to an external website that requires an additional verification step. This disjointed experience disrupts the user journey, increasing cognitive load and causing significant frustration.
My challenge was to identify the root causes of friction and redesign the experience to ensure users can access Claims Statements securely and effortlessly without leaving the application. The goal was to develop an intuitive, user-centric interface that simplifies the overall document retrieval process while maintaining the integrity of the existing app ecosystem.
3. Objetives and Goals
The primary objective was to eliminate cross-platform friction by localizing the Claims Statement functionality within the native app environment.
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Native Integration: Enable users to view and manage Claims Statements within the app, removing the need for external web redirects.
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Reduced Interaction Cost: Minimize steps and verification hurdles to directly lower the cognitive load.
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Process Optimization: Simplify the document access process to reduce user reliance on customer support for simple inquiries.
4. Design Process (Double Diamond)
Adopted to align with the Mentorship Program's structured phases:
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Discover: Conducted competitive benchmarking, surveys, social listening and usability testing on the existing flow to identify baseline friction.
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Define: Used Root Cause Analysis (RCA) to pinpoint friction.
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Develop: Iterated from sketches to mid-fidelity wireframes.
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Deliver: Produced an award-winning high-fidelity prototype after rounds of validation with Mentors, designers and users.
5. AI in this project
Due to the two-week deadline for conducting and delivering the research results, I used AI as a co-pilot in this project. This collaboration allowed me to build more robust and direct research structures, while maintaining a focus on user empathy and data privacy.
How I used AI in this project:
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Interview and questionnaire: I used AI to generate and refine my user interview and questionnaire scripts. This ensured that the questions were unbiased, clear, and specifically structured to reveal deep psychological pain points related to healthcare management.
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Categorization of data: Healthcare research often generates a large volume of qualitative feedback. I used AI to assist in the initial thematic mapping of raw data, allowing me to identify critical trends in user anxiety and accessibility needs more quickly than traditional manual tagging.
Critical Reflection on AI:
In the context of healthcare, empathy is fundamental. While AI helped structure the "skeleton" of my research, every final decision, interview tone, and ethical consideration was managed manually. This hybrid approach ensured the project was both data-driven and deeply human.
6. Research & Discovery
To build a solid foundation for the redesign, I conducted a deep dive into user sentiment and market standards within a compressed two-week sprint.
Social Listening:
I analyzed hundreds of user reviews on the Apple App Store and Google Play Store. By identifying recurring patterns, I translated raw feedback into a prioritized list of functional pain points.
Quantitative Insights (Survey)
I launched a targeted survey to understand app usage motivations.
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Sample Size: 18 respondents (Exceeding the mentorship requirement of 10).
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Constraints: While I recognize the sample size is limited for broad statistical significance, it provided crucial qualitative directions within the project's tight timeframe.
Competitor Benchmarking
Benchmarking in the healthcare sector is challenging due to the need for active insurance plans.
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Solution: I demonstrated resourcefulness by gaining access to the direct competitor's application through a primary user, allowing for a firsthand audit of the end-to-end claims flow—an essential step that many designers skip due to access barriers.
User Interviews & Key Questions
What is the primary function you use within the Vhi app, and how often do you access it?
Can you describe a specific time you encountered difficulty or frustration while using the application?
Have you ever needed to verify a claim status or search for doctor’s notes/statements? Can you walk me through that experience?
On a scale of 1-10, how confident do you feel that your claim was processed correctly after you finish the journey?
6.1 Key Research Insights
Translating user pain points into strategic design opportunities.
"I can't view that claim response on the app,
I need to view that in the browser"
"If I want to check if my claim has been accepted or not... but instead have to login to my vhi, and the process is very cumbersome"
"Interface is a little messy and you don't receive proper updates on progress"
1. "Native Continuity" Gap
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Insight: While submitting claims is easy, the journey breaks immediately after. Users are forced to check emails or external websites and repeating 2FA (Two-Factor Authentication) to find claim responses and medical notes.
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User Evidence: "I expect to receive a response in the app... it’s frustrating to be pushed to the website and remember my password every time."
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Design Opportunity: Eliminate external redirects by integrating a native Claims Statements Center within the app.
2. Discoverability & Information Hierarchy
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Insight: Critical information like VHI numbers and coverage details are hidden in the app. Users are unaware of the coverage of their insurance because the UI doesn't prioritize discoverability.
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User Evidence: "I only recently learned I had access to physio... it isn’t clear how to navigate to find the list of policy benefits" ; "I do think some of the benefits of having the insurance policy could be better outlined.
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Design Opportunity: Streamline the Information Architecture by creating a dedicated, high-visibility "Policy Dashboard".
3. Cognitive Load & Onboarding
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Insight: The journey for new users is heavy on text and slow, leading to confusion and a "cumbersome" experience.
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User Evidence: "Tricky, I would say... It's not that complicated, I could find what I needed fast, but I had to read everything, it's not really straightforward to find what you want."
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Design Opportunity: Simplify the User Flow by reducing text density and implementing visual progress indicators to guide the user.
7. "How Might We" Questions ( HMW)
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How might we streamline the claim response viewing process in the app to prevent redirection to the website?
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How might we integrate the additional verification step seamlessly within the app to enhance user experience?
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How might we make the verification process more user-friendly and less time-consuming to reduce user frustration?
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How might we ensure that users can easily access and understand the responses to their claims within the app?
8. Root Cause Analysis (RCA)
To move beyond surface-level issues, I mapped each user pain point against its underlying systemic causes. This "Deep Dive" allowed me to distinguish between UI glitches and structural experience gaps, resulting in a more precise and actionable problem statement.
9. Personas
To ensure a truly inclusive solution, I developed personas representing two distinct ends of the digital spectrum: the Tech-Savvy user, who demands efficiency and speed, and the Non-Tech-Savvy user, who prioritizes clarity and guided navigation.
10. Sketches
From paper to logic I began the ideation phase with hand-drawn sketches to refine design concepts and define a clear hierarchy for the insurance features. This iterative approach served as a blueprint for the low-fidelity prototype, ensuring the logic was solid. Initial testing with my mentor confirmed that the proposed journey was intuitive, providing a green light for digital development.
11. Interation & Refinement
Using Figma, I designed a mid-fidelity prototype, the goal was on establishing the Information Architecture while strictly adhering to the existing Vhi brand guidelines. I presented the prototype my mentors at UX Tree to refine the navigation and interactions, allowing me to validate the core user flows and usability before moving into high-fidelity UI.
Claims Categorization
Feedback: Mentors indicated that mixing pending requests with requests that have already been made could cause confusion.
Solution: Separated claims into three clear sections: Pending, Unviewed, and History.
UX Principle: Mental Models & Information Architecture.
Information Density
Feedback: The history page was too long, making it hard to find specific statements.
Solution: Applied Progressive Disclosure. Users now see a summary and click to expand details.
UX Principle: Reducing Cognitive Load.
12. Validation & Usability Testing
To validate the refinements, I conducted usability tests with 4 participants, benchmarking two different user flows. The goal was to measure efficiency and identify potential friction points in the claim-to-statement journey.
1. Performance Metrics:
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Success Rate: 100% of participants reached the Statement on their first attempt.
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Time on Task: Users completed the flow in an average of 15 seconds across all scenarios.
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Qualitative Feedback: Participants described the new flow as "direct, intuitive, and highly organized."
2. Critical User Insight & Iteration:
While the speed was optimal, a key concern emerged regarding the Claim Details:
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The Problem: Users felt that losing access to claim details (like reasons for a query or decline) when opening the document page could be frustrating.
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The Pivot: Based on this, I ensured that the Statement page maintains a persistent link or summary of the Claim Details, allowing users to verify information without backtracking.
Final Reflections & Strategic Learnings
This project was a deep dive into the importance of evidence-based design. Beyond the UI, these were the core takeaways from the iteration process:
1. The "Directness" Paradox
While 100% of users completed the task in record time (15s), the testing phase revealed that excessive directness can overlook critical context. I learned that efficiency should never come at the cost of losing essential information, leading to the re-inclusion of persistent claim details.
2. Active Listening vs. Designer Assumption
Mid-project insights from design mentors often conflicted with actual user preferences. This highlighted the necessity of active listening and the courage to pivot when findings contradict the initial proposal.
3. Feasibility & Development
In a real-world product cycle, my next step would be a technical hand-off with developers to assess the performance impact of home screen loading states, ensuring that UX improvements don't compromise app latency.
4. Process Optimization
Reflecting on the discovery phase, I identified opportunities to refine my survey methodology. For future iterations, I would expand the recruitment reach via professional networks (like LinkedIn groups) to secure a more diverse data set