Opportunity
Being a healthcare insurer, policy is the bread and butter of the company, because of this, we wanted to make sure that the policy journey is seamless, provides a strong customer experience that supports changing consumer needs.
The core challenge lay in balancing complex plan structures (policy > plan > member) with new features such as Facility Finder, Glossary, Key Benefits, and Cover Check — all while maintaining clarity, reducing cognitive load, and adhering to regulatory content requirements.
We needed to create a scalable structure that gave users immediate access to critical information, without overwhelming them, and made it easier to take action particularly when checking if a treatment or hospital was covered.
What we are solving
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Disjointed Policy Access: Users had to piece together coverage information through a basic summary page and dense PDF documents. This created friction for those seeking clarity on their entitlements and terms.
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Unclear Coverage Details: Key policy information like what’s covered, where it applies, and under what conditions was hard to locate or understand, often requiring a call to customer support.
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Ineffective Support Tools: The in-app 'Am I Covered' chatbot was one of the most accessed features, yet had the lowest completion rate. Rather than resolving queries, it often redirected users to PDFs or call centres, limiting its usefulness.
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Heavy Customer Service Load: Analytics revealed that 66% of service queries were policy-related. Top queries included benefit guidance, policy clarification, and amendment requests highlighting a strong demand for better self-serve tools.
Increase of 26% from 2020 to 392,203 calls related to benefits advice.
59.5% of 658,770 total calls.
First quarter of 2021, 82,737 queries on policy advice and amendment
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Objectives
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Empower users with self-serve: Replace static PDFs with intuitive, in-app experiences that allow users to quickly understand what they’re covered for, where, and under what conditions, ultimately reducing their reliance on customer support.
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Increase Feature Satisfaction: Redesign the 'Am I Covered' experience to provide tailored, in-context responses. Improve completion rates and user satisfaction by delivering answers directly in the flow.
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Improve Operational Efficiency: Help users resolve common queries like policy changes or benefit clarifications within the app, reducing pressure on customer service teams.
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Build Trust and Confidence: Make policy details more accessible and transparent, strengthening trust in VHI’s services and empowering users to make informed healthcare decisions.
Process
Research
We conducted semi-structured interviews with 13 participants to understand current app and feature usage and how users performed on scenario-based tasks to see how confident they were to make a claim based on the information they could find. We wanted to understand the following:
How users understand their Vhi policies
Which policy information is crucial to users and why
When and why users buy and switch policies
What users' needs and pain points are around accessing policy information in-app
Process
Findings
Participants found the overall reading experience difficult and wanted a clearer, more structured presentation to help them locate information more easily.
Poor Readability and Information Access
Users disliked being directed to a PDF to access policy details. They felt overwhelmed by the lengthy format and found it challenging to identify relevant information quickly.
Frustration with PDFs
Participants wanted to clearly see which hospitals were included in their specific policy, without needing to interpret complex documents.
Unclear Hospital Coverage
Many struggled to understand the policy language, noting that excessive use of jargon made the content hard to interpret.
Confusing Jargon
Process
Improved Journey
We revisited the customer journey to see where we could improve the user experience, we also compared the app’s policy layout to that of the website (PDF) so that we could create consistency in navigation, IA and categorisation of topics as well as incorporate cross-project research to make sure we are using the same language.
Participants are goal-oriented when checking their policy and cover details, they want to be directed immediately to the correct section.
Process
Design Exploration
To identify the optimal structure, we explored three navigational concepts and validated them through internal review and user testing. Each direction aimed to address a different facet of the user’s mental model and content findability.
Carousel-based Navigation:
Taking inspiration from banking apps, this version allowed users to swipe through plans in a carousel format.
Each plan was displayed as a card, highlighting payment details and covered dependants.
The goal here was to keep all plan-related information visible at a glance, leveraging a familiar mobile pattern.
Icon Navigation Bar:
This concept reintroduced familiar UI components from the dashboard, which aligned with our goal to minimise cognitive load while introducing new features.
Using iconography helped reinforce scannability and supported a more intuitive grouping of services.
It also gave us insight into how users interpret visual cues versus text-based navigation, a valuable learning that informed the final IA structure and labelling decisions.
Hamburger Menu:
This concept reintroduced familiar UI components from the dashboard, which aligned with our goal to minimise cognitive load while introducing new features.
Using iconography helped reinforce scannability and supported a more intuitive grouping of services.
It also gave us insight into how users interpret visual cues versus text-based navigation, a valuable learning that informed the final IA structure and labelling decisions.
Process
User & Stakeholder Insights
Each concept was reviewed with stakeholders and tested with Vhi customers to assess usability, content clarity, and behaviour alignment.
User Findings
Users preferred information broken into clear sections to avoid overwhelm
Most users were task-driven — they wanted to get to Cover Check quickly
Browsing behaviour was minimal; users sought direct answers
Content needed to be shown in manageable chunks to match user mental models
Stakeholder Considerations
Cover Check was only available for hospital-related plans due to API limitations
Member-level coverage conditions varied but weren’t currently displayed
Policy information had to remain compliant with official insurance documentation
Solution
Design Solution
Guided by both user insights and backend constraints, I made the decision to move forward with a fourth approach, combining the strongest elements of our previous explorations while simplifying the user journey.
We separated the journeys for plan browsing and cover checking, allowing users to focus on one action at a time. This also respected the hierarchy of the data structure:
Policy > Plan > Member
The separation reduced friction for task-driven users while still supporting secondary behaviours like browsing.
We leaned on existing app design patterns such as top bar RHS links, cards, and tab navigation to provide familiarity and ensure visual consistency. These patterns enabled quick access to content while supporting content modularity and future scalability.
We also restructured the feature’s information architecture, applying content design best practices to:
Improve scan-ability through tabs and columns
Reinforce logical reading flow
Increase awareness of secondary features like Facility Finder
Provide better surfacing of covered hospitals and treatments
This reduced user confusion, simplified interactions, and supported the goal of reducing pressure on the call centre by empowering users to self-serve.
Solution
Outcome
The redesigned flow delivers a clearer, more structured experience. By separating core actions, using familiar patterns, and guiding users through manageable steps, the new design supports quicker task completion, better comprehension, and increased awareness of value-added services.
Quicker task completion
Better comprehension
Increased awareness of value-added services
It’s a scalable foundation that accommodates future enhancements while addressing the core needs of both users and the business.
