Customer Service Transformation for Tier One Life & Health Insurer

The Company

The client is a Fortune 500 company, providing financial protection to more than 50 million people worldwide through its Life and health insurance policies


To transform its contact center operations:

  • To drive 24x7 digital customer interactions
  • Decrease live person interactions by automating the CSR capabilities (chat, email, phone) using Pega
  • Automate routine queries by reducing the manual intervention involved in day to day activities, resulting in reduced cost and increased efficiency
  • Improve agent experience by providing 360° customer view
  • Improve the customer experience when calling the client

The Challenge

The challenges while transforming the contact centre operations were:

  • Large volume of inbound calls
  • Limited digital channel capability
  • Legacy infrastructure

The Solution

  • Virtual Assistance (with Customer Authentication) has been introduced into chat and email channels with Pega bots
  • First deployment of Natural Language Processing (NLP) to understand and categorize the customer’s reason (intent) for interacting with the client
  • Integration with Experian for two-factor authentication to support specific customer intents (e.g. password reset)
  • Sentiment Analysis to help prioritize work in the queues
  • Case management capabilities to efficiently route work for manual triage which are not handled by Virtual Assistant to specialist and to track SLAs
  • First deployment of the Customer 360 functionality to provide holistic view of Customer information, his/her policies and claims in a single view for CSR specialists
  • Operational reports and dashboards for insight into chat and email channel performance (both the bots and the CSR specialists)

Technology Stack

  • Pega Customer service framework
  • AI / ML / NLP based Chatbot, Automatic Email response system

The Impact – Amplifying Outcomes

  • 10% of call traffic diverted to virtual assistants
  • 67% containment of virtual assistant interactions
  • Average response time for emails reduced from 8 hours to less than 30 minutes
  • Estimated cost savings of $250K per quarter
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