Insurance, Policy & Claims App
Policy wallet, instant photo claim filing, cashless hospital locator, and renewal alerts.
Take the dread out of insurance. Provide policyholders with a digital policy wallet, cashless hospital/garage locators, 1-click photo claim submissions, and automated renewal reminders.
Who is the audience?
- Policyholders & Family Members: Individuals holding health, motor, or life insurance policies needing fast access during emergencies.
- Insurance Agents & Brokers: Agents managing client portfolios, tracking renewal commissions, and aiding claim filings.
- Claims Adjusters & TPA Officers: Third-party administrators reviewing hospital bills, accident photos, and approving payouts.
Screens involved
- Policy Wallet Dashboard: All family insurance covers in one place with coverage limits and renewal dates. (Elements: Active policy cards (Health, Car, Term Life, Travel), Total sum insured with live used vs remaining balance meter, Digital insurance card with member ID and TPA details, Add new policy or nominee button)
- Instant Photo Claim Filing: Step-by-step guided claim submission with hospital bill and damage photo upload. (Elements: Incident type picker (Cashless Hospital, Reimbursement, Car Accident), Camera capture for hospital discharge summary / vehicle damage, Claim amount entered with bank account picker for settlement, Submit claim and receive tracking claim number)
- Cashless Network Locator: Interactive map of verified network hospitals and authorized cashless garages. (Elements: Search by hospital name or current GPS radius, Cashless approval desk contact and opening hours, One-tap turn-by-turn navigation link, Specialties covered badge)
- Live Claim Tracker: Full transparency into claim evaluation from submission to bank settlement. (Elements: Visual progress timeline (Submitted, Document Verified, TPA Review, Approved, Settled), Real-time notes from claims adjuster, Download cashless pre-authorization approval letter, One-tap claim escalation contact)
User journey flow
flowchart TD
A["Policyholder Opens App in Emergency"] --> B["Locates Nearest Cashless Network Hospital"]
B --> C["Shows Digital Health Card at Hospital TPA Desk"]
C --> D["Or: Submits Reimbursement Claim via Photo Upload"]
D --> E["App Auto-Categorizes Medical Invoices via OCR"]
E --> F["TPA Adjuster Reviews Documents Online"]
F --> G["Claim Approved with SMS & Push Notification"]
G --> H["Cashless Pre-Auth Letter or Direct Bank Settlement"]System architecture
flowchart LR
App["Policyholder & Agent App"] --> Gateway["InsurTech Gateway"]
Gateway --> PolicyEngine["Core Policy & Underwriting Service"]
Gateway --> ClaimEngine["Claims & TPA Processing Workflow"]
ClaimEngine --> OcrSvc["Medical Invoice & Damage Photo OCR"]
Gateway --> GeoHospital["Network Hospital & Garage Spatial Locator"]
Gateway --> DB[("PostgreSQL InsurTech DB")]
Gateway --> SmsGateway["Priority Emergency SMS / WhatsApp"]Key features
- Digital insurance wallet accessible offline for emergency hospital admission
- Guided claim filing wizard with automated invoice amount OCR extraction
- Geospatial network hospital and cashless garage search with distance sorting
- Automated renewal push alerts 30, 15, and 3 days before policy lapse
- Family floater management allowing multiple members under single account
Admin capabilities
- Claims adjudication queue with document fraud and duplication detection
- Policy renewal retention rates and lapse prevention tracking
- Agent commission ledger and performance leaderboards
- Loss ratio and claim settlement turnaround time (TAT) analytics