Claim Status Tracking

Context

Loop is a B2B health insurance provider that offers group insurance to employees and their families. Claims are a core part of Loop’s experience — emotionally and operationally.

40% of all customer support tickets are related to claims
73% of these are simply about claim status updates

This volume hinted at something deeper:

Users weren’t just asking “what’s the status” — they were asking “is my claim actually moving?”

The problem

Despite SLAs and support infra, users felt anxious, stuck, and unsupported through their claim journey. Their questions weren’t being answered by our existing tools or updates.

“Can someone tell me what is actually going on with my claim? I get the same response again and again”

~ Neha, a loop customer

Research approach

We dug into:

📄 60 support tickets
📞 20 user calls
Conversations with ops and support teams

We wanted to uncover why users were feeling lost — not just what they were asking.

Key user pain points

We dug deeper into these 60 tickets and listened to 20 user calls. Here's what we uncovered:

1. I don’t know what’s happening

Users kept getting the same vague update like “in progress,” with no indication of real movement.
It felt like Loop was just relaying updates from the TPA, without interpretation or ownership.

“Teen hafte se ‘claim in progress’ bol rahe ho, actually mein ho kya raha hai?”

2. I don’t know what to do

Especially when a claim went under query, users had no idea what was expected
Anxiety about pending documents or actions that might delay approval further

“Which documents do I need to submit to move forward?”

3. I don’t know when I’ll get my money

Payout timelines were either missing or repeatedly breached
There was no clarity on when the next movement would happen

“It’s been a month — when am I going to get my money back?”

4. I don’t know what to do when I’m stuck

When claims stalled, users didn’t know who to escalate to
Many ended up contacting their HRs out of helplessness

“This is unacceptable — I’m raising this with my HR.”

Design Principles for the Status Tracker (Ideation phase)

Design Principles for the Status Tracker

Our screens needed to directly address the above questions and anxieties. Every design decision was filtered through:

✅ What’s pending from the user (if anything)?

✅ What stage is the claim at, and what’s next?

✅ When can the user expect payout or next update?

✅ How do we show movement and ownership, even during delays?

Claim will be resolved on 11 July, 24

On Time

12:22

Raise a Claim

Get Help

Current Status :

Insurer’s medical team is reviewing the documents

24th July, 24 :

Insurer has received the documents

View Detailed Timeline

TIMELINE:

Claim Registration

Completed on 05 Jul’ 24

Document Submission

Completed on 06 Jul’ 24

Review by Loop

Completed on 08 Jul’ 24

Review by Insurer

Expected date : 12 Jul’ 24

Documents received by insurer

Documents reviewed by medical team

Payment Complete

Expected date : 13 Jul’ 24

12:22

Raise a Claim

Get Help

#64846

Claim Tracking ID

On Time

Current Status :

Loop is submitting the documents to your insurer

Estimated Claim Payment Date :

24th Feb, 2023

Status of your claim

Claim registered

Completed on 1st July, 24

Documents Submitted

Completed on 3rd July, 24

Loop is submitting the documents to your insurer

Takes 1-2 Days.

Claim submitted to insurer

Documents review by insurer

Takes 7-10 Days.

Claim approval

Claim payment

Takes 3-4 Days.

Claim Details

Patient Name

Anoop Agarwal

Claim Amount

₹50,000

Reason

Cataract

Hospital

Apollo Hospitals

Hospitalisation Days

12 Apr 2024 - 16 Apr 2024

Previously submitted documents

FAQs

Need Help?

Reach out instantly to Loop about any claim questions

Chat with your agent

Final solution

Here’s how the new status tracking experience solves for users’ key anxieties while bringing more clarity and control to the claims journey.

Final solution (key components)

1. Timeline with Clarity and Momentum

A structured claim timeline that not only shows each stage but also:

Clearly highlights where the claim is right now
Shows ETAs for each upcoming step, including estimated payout
Shows sub status of claims to create a sense of progress, especially important when claim stage remains the same for a few days

2. Visibility on Actionables

Users often feel anxious about whether something is pending from their side — especially when a claim goes under query. We addressed this by:

Highlighting actionables directly on the timeline step itself (e.g.when claim is under query - highlighting which documents are missing)
Providing clear instructions on what needs to be done, along with an upload/resolution flow
Automatically marking the step as complete once action is taken — reinforcing that progress has been made

Current Status

Submit your claim documents to Loop

Your claim would be paid 10-15 days after you submit the documents

Submit Documents

3. Loop’s Role Made Visible

Added a step called “Review by Loop” before claim submission to insurer for review

Reinforces Loop’s involvement in verifying documents, ensuring quality, and pushing things forward — not just relaying status
Helps counter the perception that Loop is a passive middleman

4. Dedicated Claims Agent

Every user is now mapped to a single claims agent who handles all communication and updates

No more bouncing between agents or repeating context
Users can reach out to someone who knows their case inside out, improving trust and resolution time

Edge Cases & Exceptions

MIS-Based Claims

Status not updated in real time due to lack of API from certain insurers
Marked with a notice so users understand potential delay isn't on Loop

ATTENTION

Due to delayed updates from Insurer, the status is updated every 7 days

Last Updated: 02 Aug 24

2. Hard Copy Submissions

Separate flow for claims submitted via physical documents
UI reflects different handling and turnaround time

Current Status

Courier your claim documents to Loop

Once you have submitted documents to Loop, let us know

View documents to submit

I’ve sent my documents

3. Under Query View

Dedicated screen with visibility on reason for query
Clear CTA for what user needs to do next

Action Required

Claim is on hold as the insurer requires additional documents

View and Submit Documents

4. Escalation Mechanism

If a claim stalls beyond a threshold (e.g., X days at the same step)
Automatically escalated to a senior claims agent
Prevents users from feeling helpless or needing to involve HR themselves

Business impact

Claims CSAT improved from 2.8 to 3.54/4.
Reduction in claim support tickets by 60%

Customer testimonials

Customers loved and apprecoated the

Process

Solution

Impact

Claim Status Tracking

Context

Loop is a B2B health insurance provider that offers group insurance to employees and their families. Claims are a core part of Loop’s experience — emotionally and operationally.

40% of all customer support tickets are related to claims
73% of these are simply about claim status updates

This volume hinted at something deeper:

Users weren’t just asking “what’s the status” — they were asking “is my claim actually moving?”

The problem

Despite SLAs and support infra, users felt anxious, stuck, and unsupported through their claim journey. Their questions weren’t being answered by our existing tools or updates.

“Can someone tell me what is actually going on with my claim? I get the same response again and again”

~ Neha, a loop customer

Research approach

We dug into:

📄 60 support tickets
📞 20 user calls
Conversations with ops and support teams

We wanted to uncover why users were feeling lost — not just what they were asking.

Key user pain points

We dug deeper into these 60 tickets and listened to 20 user calls. Here's what we uncovered:

1. I don’t know what’s happening

Users kept getting the same vague update like “in progress,” with no indication of real movement.
It felt like Loop was just relaying updates from the TPA, without interpretation or ownership.

“Teen hafte se ‘claim in progress’ bol rahe ho, actually mein ho kya raha hai?”

2. I don’t know what to do

Especially when a claim went under query, users had no idea what was expected
Anxiety about pending documents or actions that might delay approval further

“Which documents do I need to submit to move forward?”

3. I don’t know when I’ll get my money

Payout timelines were either missing or repeatedly breached
There was no clarity on when the next movement would happen

“It’s been a month — when am I going to get my money back?”

4. I don’t know what to do when I’m stuck

When claims stalled, users didn’t know who to escalate to
Many ended up contacting their HRs out of helplessness

“This is unacceptable — I’m raising this with my HR.”

Design Principles for the Status Tracker (Ideation phase)

Design Principles for the Status Tracker

Our screens needed to directly address the above questions and anxieties. Every design decision was filtered through:

✅ What’s pending from the user (if anything)?

✅ What stage is the claim at, and what’s next?

✅ When can the user expect payout or next update?

✅ How do we show movement and ownership, even during delays?

Claim will be resolved on 11 July, 24

On Time

12:22

Raise a Claim

Get Help

Current Status :

Insurer’s medical team is reviewing the documents

24th July, 24 :

Insurer has received the documents

View Detailed Timeline

TIMELINE:

Claim Registration

Completed on 05 Jul’ 24

Document Submission

Completed on 06 Jul’ 24

Review by Loop

Completed on 08 Jul’ 24

Review by Insurer

Expected date : 12 Jul’ 24

Documents received by insurer

Documents reviewed by medical team

Payment Complete

Expected date : 13 Jul’ 24

12:22

Raise a Claim

Get Help

#64846

Claim Tracking ID

On Time

Current Status :

Loop is submitting the documents to your insurer

Estimated Claim Payment Date :

24th Feb, 2023

Status of your claim

Claim registered

Completed on 1st July, 24

Documents Submitted

Completed on 3rd July, 24

Loop is submitting the documents to your insurer

Takes 1-2 Days.

Claim submitted to insurer

Documents review by insurer

Takes 7-10 Days.

Claim approval

Claim payment

Takes 3-4 Days.

Claim Details

Patient Name

Anoop Agarwal

Claim Amount

₹50,000

Reason

Cataract

Hospital

Apollo Hospitals

Hospitalisation Days

12 Apr 2024 - 16 Apr 2024

Previously submitted documents

FAQs

Need Help?

Reach out instantly to Loop about any claim questions

Chat with your agent

Estimated resolution date24th July, 24

On Time

Insurer’s medical team is reviewing the documents

TIMELINE:

Claim Registration

Completed on 05 Jul’ 24

Document Submission

Completed on 06 Jul’ 24

Review by Loop

Completed on 08 Jul’ 24

Review by Insurer

Expected date : 12 Jul’ 24

Documents received by insurer

Documents reviewed by medical team

Documents reviewed by specialist team

Show Less

Payment Complete

Expected date : 13 Jul’ 24

Care Health Insurance

Group Health Insurance

Claim Type

Reimbursement

Submitted on

24th March, 2023

Claim ID

ABCXYZ123

Claim amount

₹1,50,000

Disbursed amount

To be decided

Admitted on

12th March, 2023

Discharged on

23rd March, 2023

Treatment reason

Tuberculosis

12:22

Raise a Claim

Get Help

Final solution

Here’s how the new status tracking experience solves for users’ key anxieties while bringing more clarity and control to the claims journey.

Final solution (key components)

1. Timeline with Clarity and Momentum

A structured claim timeline that not only shows each stage but also:

Clearly highlights where the claim is right now
Shows ETAs for each upcoming step, including estimated payout
Shows sub status of claims to create a sense of progress, especially important when claim stage remains the same for a few days

2. Visibility on Actionables

Users often feel anxious about whether something is pending from their side — especially when a claim goes under query. We addressed this by:

Highlighting actionables directly on the timeline step itself (e.g.when claim is under query - highlighting which documents are missing)
Providing clear instructions on what needs to be done, along with an upload/resolution flow
Automatically marking the step as complete once action is taken — reinforcing that progress has been made

Current Status

Submit your claim documents to Loop

Your claim would be paid 10-15 days after you submit the documents

Submit Documents

3. Loop’s Role Made Visible

Added a step called “Review by Loop” before claim submission to insurer for review

Reinforces Loop’s involvement in verifying documents, ensuring quality, and pushing things forward — not just relaying status
Helps counter the perception that Loop is a passive middleman

4. Dedicated Claims Agent

Every user is now mapped to a single claims agent who handles all communication and updates

No more bouncing between agents or repeating context
Users can reach out to someone who knows their case inside out, improving trust and resolution time

Edge Cases & Exceptions

MIS-Based Claims

Status not updated in real time due to lack of API from certain insurers
Marked with a notice so users understand potential delay isn't on Loop

ATTENTION

Due to delayed updates from Insurer, the status is updated every 7 days

Last Updated: 02 Aug 24

2. Hard Copy Submissions

Separate flow for claims submitted via physical documents
UI reflects different handling and turnaround time

Current Status

Courier your claim documents to Loop

Once you have submitted documents to Loop, let us know

View documents to submit

I’ve sent my documents

3. Under Query View

Dedicated screen with visibility on reason for query
Clear CTA for what user needs to do next

Action Required

Claim is on hold as the insurer requires additional documents

View and Submit Documents

4. Escalation Mechanism

If a claim stalls beyond a threshold (e.g., X days at the same step)
Automatically escalated to a senior claims agent
Prevents users from feeling helpless or needing to involve HR themselves

Business impact

Claims CSAT improved from 2.8 to 3.54/4.
Reduction in claim support tickets by 60%

Customer testimonials

Customers loved and apprecoated the

Process

Solution

Impact

Claim Status Tracking

Context

Loop is a B2B health insurance provider that offers group insurance to employees and their families. Claims are a core part of Loop’s experience — emotionally and operationally.

40% of all customer support tickets are related to claims
73% of these are simply about claim status updates

This volume hinted at something deeper:

Users weren’t just asking “what’s the status” — they were asking “is my claim actually moving?”

The problem

Despite SLAs and support infra, users felt anxious, stuck, and unsupported through their claim journey. Their questions weren’t being answered by our existing tools or updates.

“Can someone tell me what is actually going on with my claim? I get the same response again and again”

~ Neha, a loop customer

Research approach

We dug into:

📄 60 support tickets
📞 20 user calls
Conversations with ops and support teams

We wanted to uncover why users were feeling lost — not just what they were asking.

Key user pain points

We dug deeper into these 60 tickets and listened to 20 user calls. Here's what we uncovered:

1. I don’t know what’s happening

Users kept getting the same vague update like “in progress,” with no indication of real movement.
It felt like Loop was just relaying updates from the TPA, without interpretation or ownership.

“Teen hafte se ‘claim in progress’ bol rahe ho, actually mein ho kya raha hai?”

2. I don’t know what to do

Especially when a claim went under query, users had no idea what was expected
Anxiety about pending documents or actions that might delay approval further

“Which documents do I need to submit to move forward?”

3. I don’t know when I’ll get my money

Payout timelines were either missing or repeatedly breached
There was no clarity on when the next movement would happen

“It’s been a month — when am I going to get my money back?”

4. I don’t know what to do when I’m stuck

When claims stalled, users didn’t know who to escalate to
Many ended up contacting their HRs out of helplessness

“This is unacceptable — I’m raising this with my HR.”

Design Principles for the Status Tracker (Ideation phase)

Our screens needed to directly address the above questions and anxieties. Every design decision was filtered through:

✅ What’s pending from the user (if anything)?

✅ What stage is the claim at, and what’s next?

✅ When can the user expect payout or next update?

✅ How do we show movement and ownership, even during delays?

Claim will be resolved on 11 July, 24

On Time

12:22

Raise a Claim

Get Help

Current Status :

Insurer’s medical team is reviewing the documents

24th July, 24 :

Insurer has received the documents

View Detailed Timeline

TIMELINE:

Claim Registration

Completed on 05 Jul’ 24

Document Submission

Completed on 06 Jul’ 24

Review by Loop

Completed on 08 Jul’ 24

Review by Insurer

Expected date : 12 Jul’ 24

Documents received by insurer

Documents reviewed by medical team

Payment Complete

Expected date : 13 Jul’ 24

12:22

Raise a Claim

Get Help

#64846

Claim Tracking ID

On Time

Current Status :

Loop is submitting the documents to your insurer

Estimated Claim Payment Date :

24th Feb, 2023

Status of your claim

Claim registered

Completed on 1st July, 24

Documents Submitted

Completed on 3rd July, 24

Loop is submitting the documents to your insurer

Takes 1-2 Days.

Claim submitted to insurer

Documents review by insurer

Takes 7-10 Days.

Claim approval

Claim payment

Takes 3-4 Days.

Claim Details

Patient Name

Anoop Agarwal

Claim Amount

₹50,000

Reason

Cataract

Hospital

Apollo Hospitals

Hospitalisation Days

12 Apr 2024 - 16 Apr 2024

Previously submitted documents

FAQs

Need Help?

Reach out instantly to Loop about any claim questions

Chat with your agent

Estimated resolution date24th July, 24

On Time

Insurer’s medical team is reviewing the documents

TIMELINE:

Claim Registration

Completed on 05 Jul’ 24

Document Submission

Completed on 06 Jul’ 24

Review by Loop

Completed on 08 Jul’ 24

Review by Insurer

Expected date : 12 Jul’ 24

Documents received by insurer

Documents reviewed by medical team

Documents reviewed by specialist team

Show Less

Payment Complete

Expected date : 13 Jul’ 24

Care Health Insurance

Group Health Insurance

Claim Type

Reimbursement

Submitted on

24th March, 2023

Claim ID

ABCXYZ123

Claim amount

₹1,50,000

Disbursed amount

To be decided

Admitted on

12th March, 2023

Discharged on

23rd March, 2023

Treatment reason

Tuberculosis

12:22

Raise a Claim

Get Help

Final solution

Here’s how the new status tracking experience solves for users’ key anxieties while bringing more clarity and control to the claims journey.

Final solution (key components)

1. Timeline with Clarity and Momentum

A structured claim timeline that not only shows each stage but also:

Clearly highlights where the claim is right now
Shows ETAs for each upcoming step, including estimated payout
Shows sub status of claims to create a sense of progress, especially important when claim stage remains the same for a few days

2. Visibility on Actionables

Users often feel anxious about whether something is pending from their side — especially when a claim goes under query. We addressed this by:

Highlighting actionables directly on the timeline step itself (e.g.when claim is under query - highlighting which documents are missing)
Providing clear instructions on what needs to be done, along with an upload/resolution flow
Automatically marking the step as complete once action is taken — reinforcing that progress has been made

Current Status

Submit your claim documents to Loop

Your claim would be paid 10-15 days after you submit the documents

Submit Documents

3. Loop’s Role Made Visible

Added a step called “Review by Loop” before claim submission to insurer for review

Reinforces Loop’s involvement in verifying documents, ensuring quality, and pushing things forward — not just relaying status
Helps counter the perception that Loop is a passive middleman

4. Dedicated Claims Agent

Every user is now mapped to a single claims agent who handles all communication and updates

No more bouncing between agents or repeating context
Users can reach out to someone who knows their case inside out, improving trust and resolution time

Edge Cases & Exceptions

MIS-Based Claims

Status not updated in real time due to lack of API from certain insurers
Marked with a notice so users understand potential delay isn't on Loop

ATTENTION

Due to delayed updates from Insurer, the status is updated every 7 days

Last Updated: 02 Aug 24

2. Hard Copy Submissions

Separate flow for claims submitted via physical documents
UI reflects different handling and turnaround time

Current Status

Courier your claim documents to Loop

Once you have submitted documents to Loop, let us know

View documents to submit

I’ve sent my documents

3. Under Query View

Dedicated screen with visibility on reason for query
Clear CTA for what user needs to do next

Action Required

Claim is on hold as the insurer requires additional documents

View and Submit Documents

4. Escalation Mechanism

If a claim stalls beyond a threshold (e.g., X days at the same step)
Automatically escalated to a senior claims agent
Prevents users from feeling helpless or needing to involve HR themselves

Business impact

Claims CSAT improved from 2.8 to 3.54/4.
Reduction in claim support tickets by 60%

Customer testimonials

Customers appreciated how easy and clear the new claims experience felt - below are a few examples

Process

Solution

Impact