Insurance Process Transformation with Low-Code

Zilveren Kruis is one of the largest health insurance enterprises in The Netherlands with five brands servicing more than 5 million people.

Owned by Dutch international financial services giant Achmea Group, Zilveren Kruis’s modestly-sized development team has used low-code for over a decade to extend their capacity for digital transformation.

Since adopting Mendix in 2009 Zilveren Kruis has used low-code to elevate their service-based business model, helping their customers get the financial and medical support they need.

Today, Zilveren Kruis has a flourishing low-code team with a new future-proof platform. They have delivered more than 25 Mendix apps that eliminate shadow IT, improve customer experience, and accelerate development — all without disrupting Achmea’s larger digital ecosystem.

Responding to Regulatory Changes

Zilveren Kruis works with the Dutch government to manage health insurance payments for their members. Millions of people turn to Zilveren Kruis for help in getting the right medical care and assistance in paying medical bills. The organization makes a modest amount of profit year-over-year after operational costs, instead focusing on delivering the best customer experience to the Dutch people it insures.

“We are a very cost-conscious business,” said Hans Voorthuijzen, head of information management at Zilveren Kruis. “Our main priority is to spend as efficiently as possible and invest into initiatives that will benefit our customers.”

Zilveren Kruis designed its first Mendix-built application in 2009 to connect policyholders who struggle to pay their insurance bills or premiums. The plan was to build a workflow and portal for users at risk of defaulting on their payments.

The project deadline was driven by a regulatory update, meaning that the team had to complete the application by a deadline that was out of their standard way of working. “We had a set timeline in which we needed to deliver this first application in order to remain compliant with governmental regulations,” said Voorthuijzen.

We knew we had to build a portal, but traditional IT and IT departments could not deliver what we needed, as these teams were already overbooked, so we decided to build it with Mendix.
— Hans Voorthuijzen / Head of Information Management

Self-Sufficiency in Development

After a successful first project, Zilveren Kruis continued to release Mendix applications that:

  • Address critical customer-facing experiences.
  • Respond to time-sensitive external requests or requirements.
  • Automate and digitize internal business processes.
One app replaced a huge amount of shadow IT in Excel, where we managed the administration of contracts with hospitals and medical companies.
— Hans Voorthuijzen / Head of Information Management

“We’re talking about astronomic amounts of money, and before building a new app with Mendix we tried to manage it all with an Excel spreadsheet city,” said Voorthuijzen.

With low-code, Zilveren Kruis has become more efficient in responding to shifting end-user requirements and able to fulfill software needs that fall outside of their core systems. In one example, the Zilveren Kruis dev team was able to separate tax-applicable services from non-tax-applicable health insurance charges within their system that would have required a complete system overhaul without Mendix.

Structuring Teams for Success

By 2017, the development team realized they needed more flexible solutions than traditional development could offer.

Setting up a new app platform — especially as part of a larger organization with inter-operational requirements — meant a good amount of requirements had to be filled in. This was of particular importance because some Mendix applications would have to integrate with Zilveren Kruis applications that reside in the Achmea ecosystem.

With the launch of the platform project, Zilveren Kruis also launched its own Mendix practice. In 2018 it started with the recruitment of a small four-person team with no Mendix experience, but having various backgrounds in business app development.

To bolster their team’s Mendix knowledge, Zilveren Kruis contracted an expert Mendix implementation partner to co-develop alongside their people. This partner would coach them on the job, guide them as they made future decisions, and run additional training sessions to accelerate their learning.

“We selected Mansystems — now CLEVR — as a partner. We had two basic rules. The first was to let the independent architecture discipline guide whether we build in Mendix or choose a different option, and the second rule was to use the Mendix platform as it is — no Java or .NET or anything,” said Voorthuijzen. “Basically, just stick to the platform.”

After a full year working with Clevr, the Zilveren Kruis team of four grew confident enough to start dialing back their partner’s involvement and building their own applications.

When we started on our own a few years ago, we had 5 apps built by Mendix and some partners. Now we are well beyond 25.
— Hans Voorthuijzen / Head of Information Management

In taking control of low-code application development, Zilveren Kruis learned a few lessons about velocity, low-code innovation, and team building that helped them further speed up their digital transformation and assume greater control over their technology stack.

Beginning with the development speed, Voorthuijzen and his team learned they had to reevaluate the software development lifecycle holistically to continue making meaningful gains.

“With Mendix, your development velocity can be 5 to 10 times higher, but that doesn’t necessarily mean you become 5 to 10 times faster,” said Voorthuijzen. “We found out that also the requirements phase and the acceptance phase had to be reinvented, forcing the internal customers to new ways of interaction with the development team.”

The health insurance enterprise also learned that adding more resources doesn’t always solve a problem faster. When development projects fell behind schedule and they added extra team members to help catch up, they often ended up with bigger backlogs.

“According to Brooks’s Law, when your project is not on track, and you want to speed up, you think you should add more people. You should actually reduce the number of people,” said Voorthuijzen.

In our ideal model, we have one Mendix developer, one product owner, and maybe one tester. Usually that’s all we need to build the application, besides a common attitude of hitting the finish early and get the things done.”

Systems of Differentiation

The modern technology landscape requires constant change, which even applies to insurance, a traditionally steadfast industry. While Voorthuijzen admits that there is limited feature innovation within the Zilveren Kruis health insurance model — people want to be paid on time, above all else — there are still plenty of opportunities to innovate.

Mendix applications are mainly used as systems of differentiation
— Hans Voorthuijzen / Head of Information Management

At Zilveren Kruis, this term applies to non-critical industry- or core business processes that evolve to reflect customer requirements and available technology.

“When you step into your helicopter and you fly over the landscape of Zilveren Kruis, you’ll see the Mendix applications popping up more in the periphery, not in the core,” he said.

A good example of this is the cost recovering process of Zilveren Kruis, in case the health care costs are due to – for example – a car accident. In that case, the core process is that the ambulance invoices are paid immediately. Afterwards, a secondary process is triggered to recover these costs from the car insurance company.

The cost recovering process is managed by a dedicated Mendix application as a system of differentiation, augmenting the primary process of paying health care costs in the primary system. The secondary process is maybe no more than one or two percent of the primary process, and therefore these systems work together but are not creating duplicate work.

Zilveren Kruis has even applied the Mendix platform to build more central systems within their technology stack. They rapidly modernized a legacy platform for customer base registration and found that they could easily integrate a solution to handle the registration needs of their robust user base.

“Clix is our customer base registration system — and that’s typically not a system of differentiation — but we built it with Mendix because we had a legacy platform that was at very high risk and we needed to overhaul,” said Voorthuijzen. “That application has millions of Dutch citizens registered and is today our biggest application with the largest volume of users.”

Growing a Low-Code Practice

What started as a small low-code team of four developers has grown to more than a dozen creators with complementary skills and a quickfire approach to innovation.

Zilveren Kruis’ team can ensure full compliance with insurance regulatory agencies, automate much of their testing, and even interface with the larger corporate systems of Achmea to support entire business processes.

When asked what has been key to Zilveren Kruis’ success with Mendix, Voorthuijzen shared:

  1. Start slow and create a healthy environment where it’s ok to make mistakes
  2. Find good partners — Mendix can help
  3. Don’t make too many rules in the beginning; use just-in-time governance
  4. Use the Mendix platform as it is designed and provided
  5. Obey guidance from an independent architecture function
  6. Manage stakeholders at all levels
  7. Set a maintenance schedule and stick to it
  8. Try to keep apps standalone when simplicity matters
  9. Be Agile from top to bottom
  10. Do your platform upgrades on time
  11. Support your team day and night
  12. Integrate low code everywhere where needed
  13.  Have fun!

“Building a Mendix practice ourselves was quite a challenge, but with the great support of Mendix and Clevr it has proven to become a big success,” Voorthuijzen concluded.

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