Reliance Matrix's mission is to digitize and accelerate existing HR & Benefits business processes from paper-first to data-first, through cutting edge technology and world-class user experiences.
When I arrived at Reliance Matrix, the existing process for filing a claim was primarily paper-only. It took customers weeks to file a claim. One of the biggest initiatives on the roadmap, was to modernize and digitize the entire claims process.
The insurance claims process was inefficient and cumbersome, relying entirely on a paper-based system. This approach caused delays in claim processing, increased errors, and added frustration for users navigating a complex and opaque process. Claimants lacked visibility into their claim status, and struggled to manage and track claims effectively. There was a critical need to modernize the process by digitizing it, improving accessibility, and enhancing the overall user experience for claimants.
Digitize the insurance claims process by creating an intuitive online portal where claimants can effortlessly file claims, track their progress in real-time, and initiate appeals. The solution aims to streamline the experience, reduce complexity, and empower users with greater transparency, visibility, and control over their claims journey.
Year: 2023-2024
My Role: Lead Product Designer
What I did: Research Strategy, Design Vision, Interaction Design, Prototyping
Since the goal is to digitize a primarily paper-driven process, as part of my initial research, I also needed to study, and map-out the existing claims process, as a starting point.
For this case, I am going showcase the design through the Lens of Dylan, a Delivery Driver from one of our largest Enterprise clients.
Dylan is a Delivery Driver at one of our largest enterprise clients. He sustained a non-work-related injury. He fractured his spine while rock climbing with his wife. His severe spinal injury will impede his ability to perform his daily job functions, for at least the next 9-12 months. In order to ensure he has enough money coming in to support his family, he will need to file both short term and long term disability insurance claims.
• Knowing the claims process up-front.
• Easy to fill out forms.
• Being "in the know" about the state of his claim.
• Easy to use claims platform.
• Navigating the process while in a reduced physical & mental state.
• Filling out long forms with hard to understand terminology.
• Not knowing the claims process up-front.
• The uncertainty of not being able to track the state of his claim.
“I didn’t understand how to file my claim. Was there an online portal? Did I need to fill out paper documents for my claim? What steps should I expect?”
“The forms are long, really long. I had multiple claims to file, and it took hours. I was still recovering from my injury, so I had to put much of the burden on my wife to fill out the crazy forms for me.”
“Not only were the forms long, but all throughout the process, I didn’t understand much of the terms and what was being asked of me.”
“The worst problem of all is not being able to track my claim’s progress. The unknown is nerve-wracking. I didn’t know where I was in the process, how long it would take.
How might we ensure the users know the process up-front, in the clearest, most intuitive way possible?
How might we leverage technology and automation to cut down on the amount of time it takes users to fill out the forms?
How might we ensure the user can understand the complex, and often foreign terminology used in the claims process?
How might we establish trust and visibility with users at each stage of the claims process, enabling users to track progress from end-to-end?
Taking what I learned from research, I kicked off the design process with a cross-functional design thinking session. I invited Product Management, Engineering, Benefit/Claims Operations, and Business stakeholders. The goal of the session was to co-create together, a northstar vision for the claims portal, while ideating upon the previously defined opportunity statements.
I launched a study, with 5 participants, testing two separate prototype iterations. These two prototype tests shaped my initial concepts into a viable, engineering-ready design.
Second of two early prototypes I tested with initial participants
Based on feedback from the two prototype tests, users wanted a more comprehensive way to visualize both claim status and claim progress. Before I started designing the progress indicator, I needed to start by mapping out all of the different states and statuses.
The winner, based on testing, uses a chip design with tooltip. The chip design uses color for emphasis & categorization, to display the current state, and the tooltip provides a detailed view of error and warning states. The progress indicator breaks the claims progress into 4 stages: Submitted, Processing, Processed, and Closed. At this point, this was the best design, but further testing would still be needed for additional validation and refinement.
Another action item, from the second prototype, users needed to view their progress, as they worked their way through filling out the claims forms. The new form navigation needed to support progress visibility through the claims forms process, ensuring users can maintain their progress if they leave and come back. To set the stage for form navigation, I started by mapping out the user flow for each policy type.
The guiding principles are establishing a clear visual and information architecture, maintaining consistency in design patterns, and providing clear feedback on ongoing processes.
The winner, again, based on user testing, leverages the same progress indicator design pattern from claims tracking, making it vertical. In testing, users found this design intuitive, simple, and easy for to follow, especially when coming back to complete a saved claim.
Based on initial research and prototype feedback, users felt the forms were too long, they didn't understand why they needed to provide information Reliance Matrix already has, and didn't understand many of the terms on the form. By the time I was ready to design for the beta launch, Engineering and Data Science had the tech stack ready for form automation. To get started with the form designs, I mapped out the information architecture for each benefit and policy type.
The guiding principles are to deduplicate information, leverage automation to pre-fill forms, and lessen the complexity of understanding unfamiliar information and difficult terminology. Users have the ability to edit the pre-filled information, in the case any of it is incorrect. To support users understanding of fields and difficult terminology, I added tooltips to all of the input fields, so users always know what's being asked of them.
Notifications are an important part of how users are informed about the current state of their claim. After the second prototype test, users asked for a more robust way to be informed about delays in the claims process, and an intuitive way to resolve delay-related issues that prevent the claim from progressing.
The guiding principles are attend the user, prioritize critical notices, inform the user on context, and enable the user to easily act to resolve.
The winning strategy, at this stage, based on testing and user feedback, was to use a combination of toast notifications on the dashboard, and full notification cards, in the notification center. However, supported by user feedback, I still felt like further testing and validation would be needed to ensure the users had the best notification strategy. The upcoming Beta would give me the opportunity for this further testing and validation.
Deployed on the dashboard, the toast notification draws the user's immediate attention, informs about the issue context, gives the user the option to learn more, or immediately resolve the issue.
If the user dismisses the toast notification, they still have the ability to view and resolve the issue from the notification center, ensuring the user can always take action to keep the claims process proceeding forward.
Once the beta launched, I had real-time data collection, surveys, and a feedback form, from 50 beta users, which gave me new high value user insights. To dive deeper into these insights, I conducted an additional study, consisting of 10 users.
The primary takeaway from the beta feedback was the experience was really good, clear, and intuitive. But, there were a few additional things users needed: simplification of claims states, additional layers of visibility into claims progress, clearer steps to take action to resolve issues, visibility into claims payout status, quicker access to notifications, and more robust in-app help resources.
Based on testing and beta feedback, users preferred the notifications alone, as compared to the notifications + toast messages. I added a notification popover directly on the dashboard to replace the toast, and this gives the user the ability to view notifications directly on the dashboard without needing to navigate to the notification center (which remains as a secondary option).
To support the users request for more in-app resources, I worked with the business to create a comprehensive set of claim resources videos, and a robust FAQ section.
Insurance claims rely on heavy nuance across product types. I tested 2 insurance products during initial tests, and 4 products in beta. As a requirement for General Availability, all possible validations and edge cases, across all 7 insurance products had to be accounted for, in order for the product to be used in the real world. Only once all permutations were accounted for, and beta feedback in decline, did we roll out the new claims product to all 1M+ users.
From the claims dashboard, Dylan can file, manage, view, and track all of his claims in real-time. Everything he needs is all available in a single pane, with all of the most important and relevant information available at a glance.
In addition to the FAQ's and Claims Resources videos, Dylan also has access to a series of walkthroughs that help him understand how to use every part of the Reliance Matrix Claims Portal.
Dylan can easily appeal a denied claim in minutes, instead of days, with just a couple of clicks. He has the ability to view and track his appeals, just like his claims, from the single dashboard view.
Dylan has everything he needs to view both claims and appeals, and take needed actions, all from one single view on the My Claims page.
Dylan no longer has to provide a wet signature to file a claim, accept Reliance Matrix's HIPPA notice, or authorize his healthcare provider to release medical records to Reliance Matrix. This saves days to weeks on claim processing time.
Designing our own internal document signature tool also enabled us to sunset DocuSign as a third-party signing app, across the organization.
Dylan can use the document center to access documents he's previously uploaded, documents uploaded by Reliance Matrix, and documents uploaded by his health care provider. If he needs to file an additional claim, all of the documents he needs to provide can be easily accessed, without the need for him to track down and/or re-upload documents.
