submitting a claim the easy way.
A guided claims experience that puts the employee—not the paperwork—at the forefront.
Pacific Life has expanded its product offerings into the workforce benefits space with the goal of differentiating itself with a seamless digital experience.
We launched our MVP portal for brokers to sell policies in just 10 months. Within the next four months we digitized the inherently complicated implementation process for new companies, and built an employer-facing portal to manage benefits, a digital application for life and disability insurance, and finally, a portal for employees to manage their own benefits.
Our first feature enhancement to the base employee portal was the ability to file claims.
The visibility of this project gave us an opportunity to evangelize the what and why of UX to an organization that largely views design as simply “making things pretty.”
Timeline
· Initial Delivery: 3 weeks
· Final Delivery: 3 months
Role
Lead Product Designer
Partners
Claims Product Owner and Team
Legal & Compliance, and Marketing
Product Designer Teammate
Business Analyst
Front-end Developers
the background.
Pacific Life is a B2B financial company offering life insurance, and employee benefits. The company launched the start-up like Workforce Benefits Division in 2022, going to market in 2023 servicing small to mid-sized businesses. We sell benefits through Brokers to Employers, who offer them to their Employees.
the current problem.
Supplemental health claims are often confusing, repetitive, and paper-based—adding stress during an already difficult time. Employees must figure out which products apply, submit claims for each one separately, and often repeat the same information across poor digital tools or manual forms.
our solution.
Let’s put the employee at the center of the experience—NOT the paperwork—and build a process based on what happened, not what products you have!
Employees answer questions about what’s going on and we determine eligible claims on their behalf — no combing through policy documents or repeating information.
This process allows for straight-through processing on simple claims, meaning less work for the business and faster payments for employees.
project kickoff.
In our first stakeholder meeting, we reviewed an existing process map and we proposed improvements—but the backend had already been built without design input. This underscored the need to involve design earlier to avoid rework.
With only three weeks to deliver low-fidelity designs and any data point or flow that affected the back-end, our challenge was clear: how might we create a simple, intuitive intake flow that gives us confidence in both question order and data capture?
refining user flows.
Because of our hard deadline to refine the order of data elements, we continued to meet closely with our stakeholder team, refining their process map to have better organization of sections, and to include the entire employee experience: from Beatrix realizing she may need to file a claim through receiving claim results and payment.
High-level Flow — Entire Claims Experience
Focused User Flow - Claims Intake Process
low-fidelity exploration.
We prioritized mobile-first design because employees, unlike employer and broker personas, are more likely to use phones than desktops. With Pacific Life targeting small to medium-sized businesses, many employees may not have access to a computer, making phone accessibility essential—an often-overlooked priority in other lines of business where desktop use dominates.
time to test.
Methodology
Survey to find participants.
A/B testing with Counterbalancing:
Varied flows to reduce learning effects while exposing multiple journeys.
Evaluated alternative copy to identify the most user-friendly language.
Moderated, 60-minute, qualitative interviews using a clickable prototype.
Participants
Wide age range (25 to 65+).
Primary insurance holder or adult dependent, with and without dependents.
Had filed a claim before.
A Group
B Group
test results.
terminology.
Draft
vs.
Not Submitted
🎉 Human Language: 1, Claims Jargon: 0!
The Claims Team and Legal and Compliance were committed to Not Submitted, but Design won this battle with compelling data showing 100% of employees clearly understood Drafts, and in fact felt confused by Not Submitted.
Hospital Stay
vs.
Admitted to Hospital
While Hospital Stay felt more succinct to the design team, being clear about hospital admission turned out to be key to user comprehension.
Preventive Care
vs.
Wellness Claim
While users showed a slight preference for "Preventive Care," both terms were well understood. Given the business's strong preference for "Wellness" and the lack of significant usability impact, we aligned with the business terminology.
usability.
Users found the process simple, clear, and faster than expected. Areas where we feared tedium and potential abandonment were understood as necessary by users.
Testers helped pin point the areas where extra help text or explanation would be most helpful.
“I like the cleanness of everything you have, it’s all so easy to read and understand.”
“Is that how long it really is? That was short!”
iterating.
66% of users didn’t find it clear enough to have “Terminal” be an option under the Illness Type, and thought it would be clearer to have a specific question asking about it.
testing round 2.
We made these changes and a few more and wanted to make sure they were understood by users, so we did another quick round of low fidelity testing.
Methodology
30 minute wireframe share
Participants
3 employee users.
Wide age range (25 to 65+).
Primary insurance holder or adult dependent, with and without dependents.
Had filed a claim before.
round 2 test results.
100%
Found “Are you still working” question UNCLEAR
66%
Found the new Terminal question very jarring
iterating again.
Adding more context to help users understand why we’re asking certain questions.
1
2
initial delivery and next steps.
After two rounds of testing and lots of iteration we delivered the final flows of all paths and data points to be collected in low-fidelity wireframe format so that the backend team could build the structure of the processes and implement the logic necessary.
We then pivoted to high fidelity visuals, starting first with a template for the questions to again allow front-end teams to start building components while we designed all the screens.
hi-fi templates.
more testing.
Methodology
Moderated, 30-minute, qualitative interviews using a clickable prototype and gathered both usability and evaluative feedback. to find participants.
Participants
4 employee users.
Within target age range (35 to 60).
Primary insurance holder or adult dependent, with and without dependents.
Had filed a claim before.
high-fidelity test results.
Our previous updates to confusing sections were successful!
100%
Changing the phrasing of the question from “Are you still working?” to “When was your last day of work?” improved user understanding from 0% to 100%.
75%
Updates made to the Accelerated Benefit flow were clear to 75% of users, and 100% recognized it could only be used one time.
opportunities for improvement.
“If I can only do this once, I want the space to decide what the right answer is. This is a pretty serious decision. If I couldn’t skip, I would just close the whole app and call you because I would be so afraid that I would push the wrong button and make a withdrawal from my life insurance that I hadn’t thought through.”
Problem #1
50% of users felt the Accelerated Benefit Option would require a lot of thought and would have appreciated a specific option to return later to this portion of the flow.
Potential Design Enhancement
Breaking this out into a separate flow so user can submit claim and return to the ABO portion later could reduce attrition and stress.
Problem #2
It took 50% of users more time than expected to understand the Healthcare Visit Flow.
Potential Design Enhancement
Adjusting the copy could reduce cognitive load.
final delivery.
outcomes + learnings.
Event-based claims experience released to employees on time and currently allowing for straight-through processing and immediate payment on 80% of Wellness Claims.
Our efforts elevated design to a strategic role in feature prioritization, ensuring user-centric decisions across our products. As the lead designer championing this change, it also meant gaining a seat at the feature prioritization table—where design could actively shape both vision and execution.
Takeaways
Consistent Omni-Channel Experience
Success within Constraints
Enhanced Cross-Team Collaboration and UX awareness for the whole org
Next Steps
We shipped an MVP with known flaws, while it still surpasses industry standard, we have plants to implement some of the features and user feedback that was out of scope for our first release.
Upcoming new benefit offerings will also introduce new flows, requiring thoughtful integration into the existing claims experience.