Why Health Insurers Can’t Fix Claims And Benefits Self-Service Through Design Alone

Over the years, I have worked with dozens of health insurers on the usability of their member self-service sites. The sites have admittedly gotten better over the years — easier navigation, fewer confusing links, clearer presentation of information, and even better feedback in response to user actions. But most companies are still struggling to show the value of their self-service solutions. This breaks down into two fundamental problems. The first is measurement — a problem I’ll tackle in a future post. The second is a problem I can most succinctly describe as garbage in, garbage out.

Digital customer experience professionals and eBusiness professionals responsible for website design typically have no control over benefits and claims content. That means that while sites have arguably made users’ tasks of finding claims and benefits information more efficient, the information is just as useless as it is was a decade ago.

This content is rarely designed with the consumer in mind. It’s written by lawyers and for lawyers — and (sorry, Dad) lawyers don’t speak English. They usually speak CYA. But CYA doesn’t answer people’s questions — real average-reading-level human beings who just want to know what different procedures will cost before they blindly follow their doctors’ advice.

This is the fundamental problem with the majority of today’s health insurance member websites, at least as far as claims and benefits are concerned. Until insurers produce better, clearer information outlining what is covered, what is not, how much services will cost, and (for claims) who owes/paid how much and why, it is not possible to design a member site that drives self-service for these critical areas.


AWESOME blog!!

You really hit this nail on the head!!! A long time ago, early in my UX career, I took a legal writing course to de-mystify all the legal CYA content that seems to be everywhere. For starters, simply eliminating passive voice and bulletizing details can help. There is such a thing as "writing usable content," which is why real content writers (who understand the human factors of reading comprehension and text layout) are so valuable.

Boy, this post made me laugh right out loud!