by Stephanie Overby

How Aflac put claims processing in the fast lane

News Analysis
May 12, 20153 mins
Agile DevelopmentCMOCollaboration Software

The insurer can now receive, process and pay most individual claims in just one business day, thanks to streamlined IT systems.

When it comes down to it, insurance is little more than an assurance. “When you think about what we sell, you can’t touch it, you can’t see it, you can’t smell it. Our product is nothing more than a promise to be there when you need it,” says Michael Zuna, CMO of Aflac, an insurer with $120 billion in assets. “And that happens when you submit a claim.”

Aflac had previously reworked its claims processes to achieve the goal of processing and paying all customer claims within four days. In 2014, the company actually paid more than 6 million individual claims in an average of 2.8 business days. But early last year, company leaders began wondering what it would take to turn those claims around in just one day.

In today’s market, customers expect to get same-day service from their preferred brands, Zuna says. With that in mind, he started a discussion with CIO Julia Davis and Chief Administrative Officer Laree Daniel about “whether there was a way we could pay our customers even faster, given the trends of customer expectations.”

Once Davis picked her jaw up off the floor –“we were already the industry leader in claims processing, and now we wanted to do that even faster,” she says — her team began figuring out how Aflac’s claims technology could be optimized. They would have to modify 21 applications and create new rules for automated adjudication of claims. The initial plan to use the IT department’s standard waterfall methodology would take too long to implement, says Davis, “so we had to get creative.”

To speed up implementation, the group decided to use agile development methods; it was the largest project Aflac had ever handled that way, Davis says. They pulled together a multidepartmental team and put it on the project full time. After establishing the overall architecture, they broke the project into chunks, starting with complex issues like integrating with Aflac’s bank for quicker payments. Then they conducted a pilot with employee claims.

“The most challenging aspect was trying to move the organization to working in this new agile model with one team completely sequestered working on nothing else. There were things people wanted to work on that had to be put on hold,” says Davis.

In February, Aflac publicly introduced its One Day Pay initiative, which allows the company to receive, process, approve and disburse payment for eligible claims within one business day. As of early April, Aflac had processed more than 260,000 One Day Pay claims with a success rate of close to 100 percent for the 70 percent of individual claims that can be processed and paid that way. “It’s a tremendous competitive advantage for us” and is expected to increase sales, says Zuna.

One side benefit: “We were able to prove that we can do things in a focused, sequestered manner much faster than we can when we’re trying to accomplish 10 things simultaneously,” Davis says. As a result, the rest of the IT organization is now focusing on adoption of agile delivery methods.