HEALTH CARE INSURANCE APPLICATION DESIGN

Project submitted to the

SRM University – AP, Andhra Pradesh

for the partial fulfillment of the requirements to award the degree of

Master of Technology
In
Computer Science and Engineering
School of Engineering and Sciences

Submitted by
BOMMALI DHARMARAMAKRISHNA (AP25122040026)
PUJARI SATYA NAGA VARA PRASAD (AP25122040038)

Under the Guidance of

Prof. Niraj Upadhayaya
Professor
SRM University–AP
Neerukonda, Mangalagiri, Guntur
Andhra Pradesh – 522 240
Nov, 2025
 CERTIFICATE

Date: 9-Dec-25

This is to certify that the work present in this Project entitled “health care insurance
application design” has been carried out by Bommali Dharmaramakrishna
(AP25122040026), Pujari satya naga vara prasad (AP25122040038) under my/our
supervision. The work is genuine, original, and suitable for submission to the SRM
University – AP for the award of Master of Technology in School of Engineering and
Sciences.

Supervisor

(Signature)
Prof. Niraj Upadhayaya
Professor

Co-supervisor

(Signature)

Department of Computer Science & Engineering

1
 Acknowledgements

The satisfaction that accompanies the successful completion of any task would be
incomplete without introducing the people who made it possible and whose constant
guidance and encouragement crown all efforts with success.

I am extremely grateful and express my profound gratitude and indebtedness to my

Prof. Niraj Upadhayaya , Department of Computer Science & Engineering, SRM
University, Andhra Pradesh, for her kind help and for giving me the necessary
guidance and valuable suggestions in completing this project work.

BOMMALI DHARMARAMAKRISHNA
(AP25122040026)

2
 Acknowledgements

The satisfaction that accompanies the successful completion of any task would be
incomplete without introducing the people who made it possible and whose constant
guidance and encouragement crown all efforts with success.

I am extremely grateful and express my profound gratitude and indebtedness to my

Prof. Niraj Upadhayaya, Department of Computer Science & Engineering, SRM
University, Andhra Pradesh, for her kind help and for giving me the necessary
guidance and valuable suggestions in completing this project work.

PUJARI SATYA NAGA VARA PRASAD

(AP25122040038)

3
Contents
CERTIFICATE ......................................................................................................................... 1
Acknowledgements ................................................................................................................ 2
Acknowledgements ................................................................................................................ 3
ABSTRACT .............................................................................................................................. 5
Abbreviations .......................................................................................................................... 6
List of Tables ........................................................................ Error! Bookmark not defined.
List of Figures .......................................................................................................................... 7
List of Equations.................................................................. Error! Bookmark not defined.
1. INTRODUCTION ........................................................................................................... 8
Figure 1.2: Mobile Healthcare Architecture .................... Error! Bookmark not defined.
2. METHODOLOGY ......................................................................................................... 11
2.1. Empathy Stage .................................................................................................................. 12
2.2. Define Stage ....................................................................................................................... 13
2.3. Ideation Stage .................................................................................................................... 13
2.4. Prototype Stage ................................................................................................................. 15
2.5. Testing & Feedback Stage ................................................................................................ 17
3. RESULTS AND DISCUSSIONS .................................................................................. 18
4. CONCLUSION AND FURTURE WORK .................................................................. 20
4.1. Future Work ...................................................................................................................... 20
References .............................................................................................................................. 21

4
 ABSTRACT

Health insurance is essential for providing financial protection during medical

emergencies, yet many users struggle to understand policy details, file claims, and
locate network hospitals. This project aims to design a user-friendly Health Care
Insurance Application using the Design Thinking approach to simplify these
challenges. The proposed solution, SmartCare, focuses on delivering a transparent
and intuitive platform where users can easily browse insurance plans, compare
coverage, apply for policies, and manage their documents digitally. The application
includes features such as guided claim assistance, real-time claim tracking, a hospital
finder with cashless indicators, and chatbot-based support for quick help. By
prioritizing user needs and addressing common pain points, the SmartCare
application enhances clarity, improves decision-making, and provides a smoother
insurance experience. Overall, the project demonstrates how thoughtful design can
make health insurance more accessible, efficient, and user-centered.

5
 Abbreviations

Term Full Form

UI User Interface

UX User Experience

OTP One-Time Password

API Application Programming Interface

AI Artificial Intelligence

OCR Optical Character Recognition

PDF Portable Document Format

DB Database

DOB Date of Birth

EMI Equated Monthly Installment

UPI Unified Payments Interface

FAQ Frequently Asked Questions

ID Identification

GPS Global Positioning System

SMS Short Message Service

OTP One-Time Password

CRUD Create, Read, Update, Delete

JSON JavaScript Object Notation

ABI Annual Benefit Increase

TPA Third Party Administrator

IRDAI Insurance Regulatory and Development Authority of India

KYC Know Your Customer

6
 List of Figures

Figure Page
Figure Name / Description
No. No.

The Primary Benefits and Objectives of Health Insurance

Figure 1 8
Coverage

Figure 2 Mobile Healthcare Architecture 10

Figure 3 Illustration of User Challenges Identified in the Empathy Stage 12

Figure 4 Wireframe Design of the Health Insurance App 16

Figure 5 User Interface Screen Flow for Health Insurance App 18

7
 1. INTRODUCTION
Health insurance plays an essential role in safeguarding individuals and families
against unexpected medical expenses. With rising healthcare costs, access to reliable
insurance has become a necessity rather than a choice. However, despite its
importance, the health insurance system remains complicated for the average user.
Policy documents often contain technical terms, lengthy conditions, and unclear
procedures that users find difficult to understand. Many individuals struggle to
identify what is covered, how to submit a claim, or which hospitals offer cashless
treatment. As a result, users feel confused, anxious, and unprepared during urgent
medical situations. This project aims to address these challenges by designing a
simple, intuitive, and user-friendly Health Care Insurance Application that makes
insurance management easier and more accessible for everyone.

Figure 1: The Primary Benefits and Objectives of Health Insurance Coverage

The need for digital health insurance platforms has increased significantly, especially
after the COVID-19 pandemic. People prefer online methods to buy policies, store
documents, and access medical support. However, most existing applications either
lack clear design, have complex navigation, or fail to provide sufficient guidance. A
user-centered application must address the gaps between users' needs and the
insurance system’s complexities. This is where Design Thinking becomes a powerful
approach. Design Thinking emphasizes empathy, understanding user pain points,
defining real problems, brainstorming meaningful solutions, and creating prototypes
that solve those problems effectively. By applying this methodology, the proposed
SmartCare application focuses on improving the user experience throughout the
insurance journey.

8
In the initial stages of research, it became clear that users face multiple obstacles while
interacting with health insurance systems. Many users do not understand policy
terminology, exclusions, or limits; others face difficulty while submitting claims due
to lack of guidance or missing documents. Furthermore, locating nearby hospitals that
support cashless treatment is a challenge, especially in emergencies. Users often rely
on agents or customer care, leading to long waiting times and frustration. A digital
tool that simplifies these processes and provides quick, accurate information can
significantly improve user satisfaction and reduce stress.

The SmartCare application is designed to serve this purpose by offering easy

navigation, clear policy explanations, visual summaries, and step-by-step assistance.
One of the main goals of the application is to make insurance information more
transparent. Instead of reading long PDF documents, users can view coverage details
in neatly organized sections, supported by icons and simple language. The app also
includes a Claim Assistance feature that guides users through each step of the claim
process—reason for claim, required documents, submission method, and expected
timelines. This eliminates confusion and reduces the chances of claim rejection due to
incorrect or incomplete information.

Another major challenge users face is identifying network hospitals for cashless
treatment. The SmartCare application introduces a Hospital Finder that displays
nearby hospitals based on location, specialty, and network availability. With features
like “Cashless Available” tags, map integration, and direct call options, users can
easily contact hospitals during emergencies. The application also stores digital
versions of important documents, such as the insurance card, ID proofs, medical bills,
and prescriptions, making it convenient to access them anytime.

9
 Figure 2: Mobile Healthcare Architecture

In addition to solving current issues, the application is built with scalability in mind.
Future enhancements such as AI-based recommendations, voice assistance, wearable
integrations, and multilingual support can further improve accessibility for senior
citizens and users with limited digital literacy. The goal is not just to create an app but
to establish a complete digital ecosystem for insurance management.

The Design Thinking framework—Empathy, Define, Ideate, Prototype, and Test—

forms the backbone of this project. Empathy helped identify real user struggles; the
Define stage clarified the core problem; Ideation generated useful and creative
solutions; the Prototype provided a visual structure; and user feedback helped refine
the design. This iterative approach ensures that the final product focuses on real user
needs rather than assumptions.

In conclusion, the SmartCare Health Insurance Application represents an innovative,

user-driven solution to the common challenges faced in the health insurance industry.
By combining modern design practices with essential insurance features, this project
aims to deliver an accessible, transparent, and efficient digital platform. The
application not only enhances user experience but also supports faster decision-
making, better policy understanding, and improved emergency readiness. Through
this project, the goal is to bring clarity and simplicity to an area often considered
complicated, ensuring that health insurance becomes easy to access, easy to
understand, and easy to use for everyone.

10
 METHODOLOGY

The Design Thinking approach was chosen because it offers a structured yet
flexible methodology that places the user at the center of the design process. Unlike
traditional system development models that focus primarily on technical
implementation, Design Thinking prioritizes human needs, user behavior, real-life
challenges, and emotional responses. This makes it highly suitable for applications
like health insurance, where users often face confusion, anxiety, and lack of clarity
during critical moments such as emergencies or claim processing.

By following this methodology, the SmartCare application is developed through

continuous research, iteration, and user feedback. Each stage contributes uniquely
to the final outcome. The Empathy stage allows developers to deeply understand
the user’s struggles and expectations. The Define stage synthesizes this
information into a clear problem statement, ensuring the project remains focused
on solving actual issues rather than adding unnecessary features. During the
Ideation stage, multiple creative solutions are generated, encouraging innovation
and exploring different approaches before finalizing the best ones.

The Prototype stage helps transform ideas into visual designs that represent how
the application will function. These prototypes include screen layouts, navigation
flows, and sample interactions, which help stakeholders visualize the user
experience before development. Finally, the Testing stage gathers user feedback to
validate whether the design truly meets their needs. It helps identify mistakes,
improve usability, and refine the overall experience.

Design Thinking ensures that development is not a one-time process but an

iterative cycle. If users still face challenges or identify new needs, the process loops
back to Empathy and continues until the solution achieves the desired

11
effectiveness. This makes the methodology extremely powerful for creating
applications where clarity, simplicity, and user guidance are essential.

In the context of health insurance, where multiple processes like policy selection,
claim submission, and hospital search can be overwhelming, this methodology
brings structure and simplicity. By understanding how users think, feel, and
behave, SmartCare delivers a well-designed interface that reduces complexity and
enhances confidence. Overall, the Design Thinking methodology ensures that the
final application is accessible, reliable, user-friendly, and capable of addressing
real-world insurance challenges.
1.1. Empathy Stage
The Empathy stage focuses on understanding the experiences, challenges, and
expectations of users dealing with health insurance. To gather insights, informal
interviews, observations, and surveys were conducted with potential users,
including students, working professionals, elderly individuals, and families. The
aim was to uncover problems from the user's perspective

Figure 4: Illustration of User Challenges Identified in the Empathy Stage

1. Key Findings:
• Users struggle to understand policy terminology, exclusions, and claim
rules.
• Many do not know how to file a claim or what documents are required.
• Users face confusion during emergencies and rely on agents for support.
• Finding nearby network hospitals is difficult without proper tools.

12
 • Existing insurance apps feel complicated and are not user-friendly.
The Empathy stage laid the foundation for identifying real user problems rather
than assumed ones.
1.2. Define Stage

In the Define stage, all observations, user interviews, and pain points gathered during the
Empathy phase are carefully analyzed and organized. This stage transforms raw data into
meaningful insights by identifying patterns, common challenges, and the exact frustrations
users face while interacting with health insurance systems. By synthesizing user emotions,
behaviors, and expectations, the Define stage helps narrow down the broad problem into a
clear, actionable statement.

The main objective of this stage is to ensure that the design process is aligned with real user
needs rather than assumptions. The insights revealed that users consistently struggle to
understand coverage details, find accurate information, and complete claim processes
without confusion. Many users depend heavily on agents due to unclear documentation and
complicated insurance terms. These findings highlighted the need for a more transparent
and supportive digital platform.

1. Problem Statement:

Users need a simple, transparent, and guided digital platform that helps them
understand their insurance policies, apply for new policies, submit claims easily, and
find network hospitals without confusion.

This problem statement became the foundation of the SmartCare application. It guided
every design decision, ensuring that the solution focused on improving clarity, reducing
complexity, and increasing trust. By framing the problem clearly, the Define stage
prevented the addition of unnecessary features and kept the project centered on solving the
most critical issues.

The Define stage also helped prioritize user needs:

• Simplifying policy information

• Streamlining claim submission
• Providing guidance and support
• Making hospital search quick and accurate
• Ensuring easy navigation for all age groups

These refined insights provided clarity for the next stages, ensuring smooth transition into
Ideation and Prototype development. Ultimately, the Define stage ensured that the
SmartCare application aims to be accessible, reliable, user-friendly, and built around
real-world challenges faced by insurance users.

1.3. Ideation Stage

Once the problem was clearly defined, the Ideation stage played a crucial role in generating
a wide range of creative and meaningful solutions. The objective of this stage is to explore
as many possibilities as possible without limiting creativity or focusing on constraints.

13
Ideation encourages open thinking, collaboration, and innovation, which are essential for
designing a user-centered application like SmartCare.

During this phase, brainstorming sessions, mind mapping, and sketching techniques were
used to develop potential solutions that address the primary challenges identified in the
Empathy and Define stages. The goal was to think from the user’s perspective and propose
features that would simplify the health insurance journey, improve clarity, and enhance
overall usability.

a. Key Ideas Generated:

1. A simple and intuitive dashboard that provides an overview of policy coverage,

renewal dates, claims, and quick shortcuts.
2. Clear policy details displayed using icons, categories, and simplified language
to avoid confusion caused by technical terms.
3. A step-by-step guided claim assistance flow to help users submit claims easily
without missing required documents.
4. Document upload functionality using the phone camera or PDF files for faster
and safer claim submission.
5. A hospital finder tool that allows users to search for nearby network hospitals
with filters for cashless availability and specialties.
6. Real-time claim status tracking so users can stay updated on each stage of the
claim review process.
7. A secure profile management system to store personal details, policy records,
and important documents digitally.
8. An integrated chatbot and FAQ system to provide immediate answers to
common doubts about coverage, claims, and hospitals.
9. A user-friendly Apply Policy feature, enabling new users to browse plans,
compare benefits, and apply instantly.
10. Notifications and alerts to remind users about premium due dates, claim
updates, and important announcements.

These ideas were evaluated based on three key criteria:

• User Benefit: How effectively does the idea solve real user problems?

14
• Feasibility: Can the idea be implemented using available tools and technology?
• Usability: Will the feature be easy for users of all ages to understand and use?

After analyzing all proposed ideas, the most impactful and feasible solutions were
shortlisted for the prototype phase. The selected ideas focused on clarity, simplicity, and
guidance—ensuring the app becomes a supportive tool rather than a technical barrier.

❖ Outcome of the Ideation Stage

The Ideation stage provided a strong foundation for building the SmartCare application.
It ensured that every feature included in the prototype:

• Directly addresses a real user need

• Enhances overall user experience
• Reduces insurance-related confusion
• Supports faster decision-making
• Improves accessibility for all users

By exploring multiple solutions and refining them thoughtfully, this stage ensured the
creation of a meaningful and user-centered application design.

1.4. Prototype Stage

The Prototype stage is a crucial part of the Design Thinking process, as it transforms ideas
and conceptual solutions into visual and interactive models. In this stage, both low-fidelity
and high-fidelity prototypes were developed to represent how the SmartCare Health
Insurance Application would function in real use. Prototyping allowed early visualization
of screens, navigation flow, and user interactions before moving into actual development.

Low-fidelity prototypes were used to sketch rough ideas and outline the basic layout of
each screen. These sketches helped in quickly exploring multiple design possibilities
without spending too much time on detailed visuals. They also enabled faster iteration and
refinement based on initial feedback. High-fidelity prototypes were later created using
digital tools to represent the actual look and feel of the application. These screens included
colors, icons, typography, spacing, and functional components, giving a realistic view of
the final product.

The primary purpose of the prototype was to simulate the complete user journey within the
application, including how users navigate through different features and how individual
screens interact with each other. This helped identify usability issues early and ensured that
the app provided a smooth and intuitive experience.

2. Key Prototype Screens Developed:

1. Splash Screen – Introduces the SmartCare brand and app identity.

2. Login and Signup Screens – Allow users to create an account or sign in
seamlessly.
3. OTP Verification Screen – Ensures secure authentication using a one-time
password.

15
 4. Home Dashboard – The main hub displaying policy coverage, renewal dates,
and quick-action buttons.
5. Policy Details Page – Shows coverage, exclusions, and PDF download options
in a clear format.
6. Apply Policy Form Pages – Step-by-step forms for new users to apply for
insurance.
7. Claim Assistance Screens – Including Step 1 (Reason Selection), Step 2
(Document Upload), and Step 3 (Review & Submit).
8. Claim Status Screen – Displays progress bar, claim ID, and expected processing
time.
9. Hospital Finder and Hospital Details – Allows users to search for network
hospitals and view details.
10. Profile Page – Contains personal details, saved policies, and preferences.
11. Support and Chatbot Screens – Provide instant help, FAQs, and answers to
common queries.

Each of these screens was carefully designed to ensure clarity and ease of use. Navigation
arrows, icons, and buttons were placed strategically to reduce confusion and help users
move smoothly through the app. The prototype also demonstrated how data flows between
screens, such as how claim details entered in one step appear in the review section.

Figure 4: Wireframe Design of the Health Insurance App

A major benefit of the prototype was its ability to simulate real interactions. Users could
click through screens, test transitions, and perform basic tasks much like they would in the
final application. This offered valuable insights into user behavior and highlighted areas
that needed improvement. For example, some buttons were resized for better visibility, and
instructions on the claim pages were rewritten for clarity.

The prototype served as a visual blueprint for developers and designers, ensuring that
everyone shared the same understanding of the application’s structure. It also helped

16
stakeholders visualize the final product, gather feedback early, and validate that the design
met user needs.

Overall, the Prototype stage played a vital role in shaping the SmartCare application into a
user-centered, easy-to-navigate, and efficient digital platform for managing health
insurance

1.5. Testing & Feedback Stage

Prototype screens were shared with users to observe how they interacted with
the application. Users were asked to perform specific tasks such as:

• Viewing policy coverage

• Navigating the dashboard

• Finding a network hospital

• Filing a claim

• Applying for a new policy

❖ Feedback Received:
• Some buttons needed to be larger for better accessibility.

• Instructions had to be clearer, especially in the claim process.

• Users liked the layout but suggested adding icons for easier
understanding.

• Hospital Finder needed more filters.

Based on user feedback, adjustments were made to improve clarity, navigation

flow, and visual layout. This iterative process helped refine the final design.

17
 RESULTS AND DISCUSSIONS

The SmartCare Health Insurance Application was developed using the Design
Thinking methodology, and the final prototype successfully demonstrated how user-
centered design can simplify the complex processes associated with health insurance.
By focusing on real user challenges, the prototype highlighted how intuitive
navigation, clear information layouts, and guided workflows can significantly
improve the overall user experience. This section presents the results obtained from
the prototype development, user testing, and interface evaluations, followed by a
detailed discussion of the findings.

Through multiple iterations of prototyping and feedback, the SmartCare application

evolved into a refined digital platform that addresses key issues faced by insurance
users, including difficulty understanding policy details, confusion during claim
submission, and trouble locating network hospitals during emergencies. The user
testing process provided valuable insights into how well the interface supported users
in performing essential tasks such as applying for policies, reviewing coverage,
uploading documents, and tracking claims. Test participants from different age
groups and backgrounds interacted with the application to evaluate ease of use, clarity
of information, accessibility, and overall satisfaction.

Figure 5: User Interface Screen Flow for Health Insurance App

18
The results indicated that the application’s structured flow—beginning from the
dashboard and extending to policy details, claim steps, and hospital finder—greatly
reduced cognitive load for users. The app’s visual components, including icons, color
coding, and categorized information sections, made complex insurance concepts
easier to understand. Users reported feeling more confident navigating the system
compared to traditional insurance websites or offline documents. Additionally, the
guided claim assistance flow ensured that users did not miss important steps,
significantly reducing the likelihood of claim rejection due to incomplete information.

Overall, the prototype findings validated that a well-designed, user-focused

application can transform the way individuals interact with insurance systems. By
simplifying processes, increasing transparency, and providing real-time support, the
SmartCare prototype demonstrated strong potential to improve user trust, efficiency,
and satisfaction in the health insurance ecosystem.

19
 CONCLUSION AND FURTURE WORK

The SmartCare Health Insurance Application successfully simplifies complex

insurance processes through a user-centered design approach. By applying the Design
Thinking methodology, the application effectively addresses real user challenges such
as claim confusion, unclear policy details, and difficulty finding network hospitals.
The prototype demonstrates an intuitive interface that enhances user understanding,
improves navigation, and provides a seamless overall experience. Key features such
as guided claim assistance, a hospital finder, and digital policy management make
insurance more accessible, transparent, and easier to use. User testing further
confirmed that the application reduces dependency on agents and increases
confidence in using digital insurance services. Overall, SmartCare offers a practical,
efficient, and user-friendly solution that transforms the way individuals interact with
health insurance systems.

1.6. Future Work

• Integration of AI-based document verification and claim eligibility prediction

• Multi-language support for users across different regions

• Real-time integration with insurance company databases for live claim updates

• Voice assistance to support elderly and digitally inexperienced users

• Emergency SOS feature with GPS-based hospital detection

• Biometric authentication and advanced security protections

• Wearable device integration for health monitoring and wellness rewards

20
 References

1. Brown, T. (2008). Design Thinking. Harvard Business Review, 86(6), 84–92.

2. Plattner, H., Meinel, C., & Leifer, L. (2011). Design Thinking: Understand –
Improve – Apply. Springer.
3. Krug, S. (2014). Don’t Make Me Think, Revisited: A Common Sense Approach to Web
Usability. New Riders Publishing.
4. Chatterjee, S., & Armentano, R. (2020). Technology-enabled patient-centric digital
health ecosystem. Health Policy and Technology, 9(3), 100–115.
5. Adler-Milstein, J., & Huckman, R. S. (2019). Health Information Technology and
the Patient Experience. New England Journal of Medicine, 380(24), 2377–2379.
6. Abdullah, N., & Fakhrorazi, A. (2021). A User-Centered Design Approach for
Developing a Health Insurance Mobile Application. International Journal of
Advanced Computer Science and Applications (IJACSA), 12(5), 250–257.

21