Transforming Insurance Operations with an Advanced Support System
Business Overview
The client is the direct marketing division of a licensed insurance corporation in the Philippines. The company offers a broad portfolio of affordable and accessible insurance solutions, including health care, life, accident, motor, and travel insurance, to individuals and families across the nation.
Challenges
Fragmented Communication: The use of multiple, disconnected channels for communication resulted in misalignment and missed updates.
Manual Ticket Routing: The process for assigning tickets was time-consuming and inefficient, which slowed down response times.
Inconsistent Interaction Quality: Varying customer experiences negatively affected overall satisfaction.
Slow Internal Approvals: Bottlenecks in the approval process caused significant delays in claim resolution.
Limited Self-Service Options: Customers had to rely on agents for routine inquiries, leading to increased workloads and longer wait times.
Solution
Lifecycle Mapping
The entire claims and facility process was defined and optimized for clarity and efficiency.
Unified Communications
All customer and partner interactions were consolidated into a single platform for seamless tracking and management.
AI-Powered Tools
Automated tools were enabled to provide faster responses, smart self-service options, and automated quality reviews.
Structured Forms
Standardized forms for requests and claim submissions were created to reduce data entry errors and improve accuracy.
Intelligent Chatbots
AI-driven bots handled FAQs and L1 queries, reducing agent workload.
SLA Profiles
Service Level Agreements were applied to ensure timely processing and escalation of all issues.
Collaboration Tools
Enhanced tools were provided to improve interdepartmental coordination for a quicker approval and resolution process.
Return from Solutions
SLA Compliance: The new processes ensured that timely resolutions were delivered, leading to better service reliability.
Scalable Partner Support: Standardized processes benefited over 13,000 partners nationwide, demonstrating the solution's scalability.
Streamlined Processes: The combination of lifecycle mapping and structured forms simplified claims and facility workflows, improving overall efficiency.