Challenge
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Guidewire Claim’s customers face numerous internal challenges. They are seeking new ways to increase efficiency, reduce claims expenses, and improve claims accuracy.

• 1 in 3 customers switch within a year due to bad claims experience

• 29 pt drop in CSAT when insurers send in an adjuster on a claim  

We polled customers and noticed:

• <10% have fully automated claims handling today

• >50% want some level of automation in claims handling in 3 years

How might we improve the Claim’s Intake development process to …

Long-term Goal

Lowering the barriers of creating and maintaining digital Claims Intake experiences for insurers.

KPI For Success

• Successful adoption of the product by customers

• Key driver for Cloud Adoption

Target Users

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Our users are Claims Analysts, who are claims experts with advanced industry experience. They typically collaborate with Claims VPs, IT specialists, and business professionals to configure claims automation, define intake flows, and analyze business metrics.

Key Needs & Frustrations:

• Wants an easy tool to modify claim intake and automation without IT assistance

• Needs visibility into claims metrics for better decision-making

• Frustrated by IT dependency, complex tools, and downtime when making changes

Success Means:

• Quick, seamless updates to claim processes with minimal IT reliance and no downtime

Kick off

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I started with creating as-is user flow to better understand the existing process of creating and developing the Claims Intake experience for insurers. This helped identify the personas involved in each phase and how they interact with one another.

The process consists of 3 stages at a high level:

• Initial setup: Focuses on defining business needs, primarily involving claims executives and business-oriented users.

• Implementation and post-implementation phases: These stages are where engineering and IT teams play a significant role.

I also create hypothetical to-be user flows based on previous user feedback. The highlighted areas in blue represent our primary focus—tasks that are currently performed by IT personas but could potentially be handled by business users with the right tools. Enabling business users to take on these tasks would significantly reduce processing time and improve efficiency.

Inspiration/Competitive Analysis

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I explored both insurance and non-insurance solutions for inspiration. Some of them were included: Metromile, Lemonade, BPMN workflow, SalesForce, and Survey Moneky.

Key Insights

1. Metromile & Lemonade provide automation-driven claims processing, but customization is limited.

2. BPMN Workflow & Salesforce offer visual workflow tools (conditional branching), but they are complex and require technical expertise.

3. SurveyMonkey introduces a question bank concept, inspiring structured data collection which could be used for claims intake.

Key MVP Use Cases

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 Together with PM, we identified the key use cases/ JTBD we want to support for MVP.

As a Business Analyst I want/need to :

1. Create a First Notice of Loss (FNOL) for a specific Line of Business (LOB) and claim type.

2. Utilize an Out-of-the-Box (OOTB) claims model based on the claim type (starting with Auto Physical Damage).

3. Visually design and organize intake questions in a logical order.

4. Modify and refine question text as needed.

5. Configure conditional branching to ensure insureds only see relevant questions.

6. Easily customize answer options for each question.

7. Define answer types (e.g., radio buttons vs. checkboxes).

8. Preview FNOL changes to see how they will appear in the digital UI for policyholders.

9. Simulate and test changes before deploying them to production (likely outside the Intake Designer).

Evolve Problem Statement Into a Solution

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I conducted a working session with the PM and Dev to map problems and solutions for some of the previously defined use case.

1. Ideated based on key insights from one our main customers, SCs, and competitive analysis.

2. Explored feasibility with Dev.

Key Insights

1. Dynamic Question Tree: Branching logic should be based on prior answers to ensure progressive questioning.

2. Rule Configuration: Business analysts require a no-code Rules Editor with quick modifications and simulation capabilities for testing.

3. Integration & Workflow: Must integrate with policy and claims management systems, while third-party services are out of scope for MVP. Real-time data exchange (e.g., ScalePoint) is essential.

4. User Experience: A drag-and-drop UI for intake configuration and a preview workflow will improve usability.

5. Claims Prioritization: MVP will focus on auto physical damage claims (1st party) while addressing complexity across different claim types.

Design Iterations

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I created the initial wireframes, followed by multiple rounds of design iterations based on feedback from PMs, developers, and our design team.

Key considerations

• Use of different node colors based on the question's answer type

• Start and end nodes must always be present and cannot be deleted

• Ability to add or remove nodes by right-clicking

• Zoom in/out functionality for better navigation

Introducing Claims Intake Designer
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Claims Intake Designer helps Business Users quickly design and modify claim intake questions, while the Claims Automation Service (or Autopilot) automates the claims process based on the gathered data, aiming for efficient and accurate claims handling. 

Design Details

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Question Library & Question Details Panels

Connector Details

The Connector Details panel defines the rule for branching logic based on specified conditions. It acts as a rule-based decision point that controls how the process moves from one step to another.

Intake Designer’s Toolbar

Claims Automation service (Autopilot)

The Claims Intake Designer and the Claims Automation Service are closely coupled, with the information gathered by the runtime UI creating a payload for the Claims Automation Service. 
Evaluates each claim as it comes into ClaimCenter and then begins automating tasks, aiming to move towards manual

Automate: It evaluates each claim as it enters ClaimCenter and begins automating tasks accordingly.
Knockout: Its goal is to reduce manual handling to exceptions, making it the rare case rather than the standard.

INtake designer runtime

The Intake Designer ultimately generates the runtime UI, which policyholders will access. To ensure a seamless user experience, I also explored end-user interaction design, visualizing how the final output of the Intake Designer would appear to insured users.

I conducted a usability research to improve the digital Claims Intake experience, including:

• Usability testing with 3 customers and 3 Guidewire service reps to gather firsthand insights

• Interviews with insurer business users to understand their core tasks and workflows

• Deep dive into existing processes to analyze how digital Claims Intake is currently defined and managed

Key Insights & Action Plan

1. User Challenges

• Non-UX Friction: Navigation, zooming, and terminology are confusing.

• Rule Configuration: Adding, modifying, and linking questions is non-intuitive.

2. Priorities & Execution

• High-Impact Fixes: Improve node behavior, field configurability, and UI labels.

• Quick Wins: Enhance clickability, navigation, and terminology.

• Future Work: Streamline question grouping and auto-hierarchy selection.

3. Design Focus

• Simplify interactions, increase configurability, and refine UI clarity.

• Ensure accessibility for seamless user experience.

Accessibility Validation

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I categorized accessibility issues into two groups: Jutro components and custom components to better streamline the resolution process.

To support the dev team, I compiled a detailed list of issues for further investigation.

Key findings

• Keyboard inaccessibility: The canvas was not navigable using a keyboard, limiting usability for keyboard-only users.

• Insufficient color contrast: The contrast between text and its background did not meet accessibility standards, making content difficult to read.

• Loss of functionality at high zoom levels: When the page was zoomed to 200%, certain functionalities were lost, affecting users with visual impairments.

Things we need to do as the next step

Impact

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Reflection

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1. Stakeholder Collaboration: Engaging with claims analysts, product managers, and engineers early ensured alignment on user needs and technical feasibility.

2. Early Research for Validation: User interviews revealed frustration with IT-dependent tools, guiding us toward a low-code, drag-and-drop experience that put control in the hands of claims teams.

3. Iterative & Inclusive Design: Continuous feedback helped refine workflow visibility, rule logic, and accessibility, ensuring a seamless experience for the users.