Work  /  Claims handling system

Upgraded claims handling system — Research & Discovery

UX Research
Overview

In my previous design job at Sapiens, I worked on a role-based system within a SaaS product for Claims departments of insurance providers. This new solution would support claims handlers in completing their workflows more efficiently and accurately compared to using older legacy systems.

Below is an overview of the early-stage research as one of the first stages in the design process. It includes reviewing and understanding the existing company products, a facilitated stakeholder workshop and Customer journey mapping.

Methods & tools
Sticky notes, markers and highlighters used during the stakeholder workshop
01

Stakeholder workshop

Purpose

The purpose of this workshop was to gain a deeper understanding of the Claims Handler role within insurance, including the tasks they typically face during a workday or week. We set out to:

Participants

Colleagues working in Professional Services, Product manager, UX Lead and UX Designer (me).

Personas

Two personas were created representing 2 different roles within Claims department who could assumably be among users of the system. These personas helped us list different claims handler daily tasks, their needs and possible struggles.

Claims Handler persona
Claims Manager persona
Main pain-points and needs
  • Quick access to all the necessary customer information and their policies (object details, coverage) is a must
  • Performance and efficiency should be increased
  • Some process automation is missing
  • Case status and alerts must be more prominent
  • Navigation should be fast and easy (avoid unnecessary clicks and steps)
Personas whiteboard from the workshop

Grouping needs and pain-points around each persona on the workshop whiteboard

User stories

A set of high-level user stories was created to build empathy with users and better understand what they aim to do and achieve when using a claims handling system.

User stories sticky notes board
As a user, I want to
So that I can
Quickly access customer or case details
Help them on the phone faster
See case status
Update the customer regarding their claim
Get policies and covers information
Inform the customer around their insurance rights
See claim case activity log and history
Provide better and detailed case information to the customer
Get alerts if customer consent is missing
Ask for that consent and have all the necessary data in place
Fill out primary claim information
Quickly complete filling out the required FNOL details
Perform one quick settlement
Close customer claim case as fast as possible
Journey map

As a result of the workshop activities, stakeholder input, and early research findings a user journey map was created. Mapping the end-to-end journey helped visualize the claims handler's experience, highlight key tasks, pain-points, and hypothetical emotions, and identify gaps in our understanding.

Claims handler customer journey map
02

Current product user flow

Flowchart of the existing claims handling product

To better understand how claims were processed in the existing system, I mapped the end-to-end workflow used by claims handlers. This flow shows key tasks, decision points, and interactions across different stages of the claims journey. By analyzing the current process, I was able to identify areas where users experienced unnecessary complexity, manual work and navigation challenges — insights that revealed opportunities to simplify workflows, reduce friction and improve efficiency in the future product redesign.

03

Next steps

After thorough internal research and a very productive workshop, the next steps to take further in the design process of the future product:

  1. Interviewing real customers who work with handling claims
  2. Merging the internal research, workshop and external interview findings
  3. Defining requirements and MVP
  4. Ideation phase followed by sketching, wireframing and first high-fidelity designs
  5. Testing the designs with the users and gathering their feedback

Want to work together?

If you like what you see and want to work together, get in touch.