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Enabling Intelligent Operations to Improve Business Operations


Customer service transformation has ranked among the top 5 initiatives for most insurers. Insurers are focused around two inter-related goals:

  • Customer experience improvement
  • Cost reduction and optimization

While providing customers ability to do self-service transactions on digital channels remains important, modernization and enhancing capabilities of contact center continues to be a critical part of customer service transformation. Our client wanted to transform its contact center operations to drive 24x7 digital customer interactions, decrease live person interactions, automate routine queries & improve agent experience by providing 360 degree customer view. Coforge did a detailed assessment of our client’s current state capability of contact center and developed a comprehensive multi-year roadmap for transforming the contact center capabilities.

About the Client

The client is a leading Life & Health insurer providing group benefits & supplemental insurance to more than 50 million people worldwide.

Business Challenge

Our client had outdated, legacy contact center infrastructure and applications. Some of the key challenges faced by our client were:

  • Large volume of inbound calls – a significant volume of calls were routine non-value adding calls such as ‘how do I file a claim?’
  • Limited digital channel capability. The only channels offered were voice calls, IVR and emails.
  • Legacy infrastructure – the call center had legacy application that did not provide a comprehensive, 360o customer view. Call center agents had to access multiple applications to respond to customer questions.
  • Manual operations – response to email requests were completely manual and time consuming.

Our Solution

Coforge did a detailed assessment of our client’s current state capability of contact center and captured the key client goals for the customer service transformation program. These were:

  • Comprehensive self-service across multiple channels with Omnichannel experience
  • Providing a consolidated, 360o view of the customer
  • Increasing automated services with ‘bot’s and artificial intelligence technologies
  • Delivering greater efficiencies with Clients’s operational and customer engagement processes
  • Inbound & outbound with proactive communication

We developed a blueprint of customer services framework and a comprehensive multi-year roadmap for transforming the contact center capabilities. Pega, a modern cloud-based solution platform was selected as a key technology platform by our client. We leveraged advanced Pega AI capabilities such as text analysis, sentiment analysis, and natural language processing to enable automated responses to emails and where human touch was required, routing cases to the right customer service representative (CSR).

A critical component of the solution was an API solution to integrate with policy and claims systems of record to deliver a customer 360 UI, which significantly enhanced the productivity of the CSRs. We used a 3-layer API approach with experience, process and system APIs.

Following is a summary of capabilities delivered:

  • Integration of IVR & CTI with Pega CSR platform
  • Chat capability
  • AI based Virtual Assistant capability
  • Proactive outbound communication and bidirectional text communication
  • Email bots for automated response to email service requests
  • Visual IVR capability
  • Co-browse capability

Delivering Value

  • 24x7 availability using intelligent virtual assistant and near real-time response to requests, expected to increase customer retention by 20%
  • Implementation of self-service capability enabling savings of 7% of cost of operations
  • Fast query resolution (~1 minute)
  • Average response time to email service requests reduced from 8+ hours to less than 30 minutes
  • 65%+ interactions contained within AI chat
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