inSure.AI: Agentic Health Insurance Navigator

🏆 Agentic AI App Hackathon Submission

📌 Project Overview

inSure.AI leverages agentic AI to revolutionize healthcare navigation by automating insurance analysis and decision-making during medical emergencies. Our solution helps patients find appropriate care facilities while understanding their financial responsibility.

🚀 The Problem & Solution

The Problem

When facing medical emergencies, people struggle with:

• Determining which hospitals accept their insurance
• Understanding potential out-of-pocket costs
• Making informed decisions under stress

Our Solution

inSure.AI delegates these complex tasks to an intelligent Gemini-powered agent that:

1. Analyzes insurance policies - Extracting coverage details, deductibles, and limitations
2. Evaluates medical needs - Identifying potential procedures for specific symptoms
3. Locates nearby facilities - Finding and ranking hospitals by relevance
4. Calculates expected costs - Determining insurance coverage vs. personal responsibility
5. Presents actionable options - Enabling immediate contact or navigation to facilities

💡 Agentic Architecture

Our application uses a google-agent system where specialized the agent does below:

• Policy Analyzer - Parses insurance documentation
• Medical Procedure Estimator - Maps symptoms to likely treatments
• Cost Calculator - Applies insurance rules to procedure costs
• Location Coordinator - Finds and ranks nearby facilities
• Orchestrator Agent - Coordinates the workflow and presents results

The Gemini LLM serves as both the reasoning engine and coordinator across these specialized functions.

🛠️ Technical Implementation

• Frontend: SwiftUI for iOS interface
• Backend: Firebase for authentication and data management
• AI Component: Gemini LLM API for intelligent analysis
• Data Processing: Local-first approach with minimal storage for privacy
• Integration: Real-time connection to insurance eligibility verification APIs

🌟 Key Differentiators

Unlike standard healthcare apps that simply display data, inSure.AI:

• Takes initiative - Proactively gathers relevant information
• Makes decisions - Evaluates options based on multiple factors
• Explains reasoning - Provides transparency into recommendations
• Presents actionable options - Enables immediate next steps

📊 Societal Impact

inSure.AI addresses critical healthcare accessibility issues:

• Reduces financial uncertainty in medical emergencies
• Democratizes access to insurance expertise
• Decreases the likelihood of surprise medical bills
• Empowers patients with knowledge typically reserved for insurance experts

🔒 Privacy & Ethics

Our agent architecture prioritizes:

• Minimal data storage with local-first processing
• Transparent explanations of recommendations
• Ethical presentation of medical options without bias
• HIPAA-compliant data handling

📱 User Interface

Onboarding Flow

Insurance Analysis

User Symptom Input

Hospital Recommendations

Cost Breakdown

Hospital Direction

🔮 Future Development

We plan to expand our agent's capabilities to:

• Negotiate bills on behalf of users
• Schedule appointments autonomously
• Track and submit claims
• Monitor insurance usage throughout the year
• Proactively suggest preventative care options

📋 Submission Checklist

• All code in src/ runs without errors
• ARCHITECTURE.md contains a clear diagram sketch and explanation
• EXPLANATION.md covers planning, tool use, memory, and limitations
• DEMO.md links to a 3–5 min video with timestamped highlights

🎬 Demo

See our DEMO.md for a video walkthrough with the following highlights:

• 0:45 - User onboarding and insurance verification
• 1:30 - Insurance policy analysis and summary
• 2:15 - Symptom search and hospital recommendations
• 3:00 - Cost breakdown and comparison
• 3:45 - One-tap facility contact and directions

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inSure.AI - Your personal healthcare navigator, powered by intelligent agency