Delivering Empathy and Excellence: Transforming Claims and Customer Experience for a Leading Insurance Provider

Challenges.

• High dependency on manual processes resulted in errors and inconsistent service.
• Insufficient KPIs and SLAs led to variability in turnaround and response times.
• Member dissatisfaction grew due to backlog issues and delayed resolutions.
• Complex and fragmented workflows strained internal teams and affected outcomes.

Solution.

We focused on improving the quality of service through an empathetic and systematic approach:

• Empathy as a Standard: Trained teams to deliver empathetic and thoughtful responses to agents and members.
• Quality Framework: Designed robust monitoring protocols to ensure accuracy and consistency in every interaction.
• Simplified Processes: Streamlined workflows to minimize errors and align with member-centric goals.
• Enhanced Transparency: Deployed industry-leading Work Force Manager – Prohance for real-time insights.
• Skilled Workforce: Recruited and trained experienced professionals to deliver superior outcomes.

Impact.

• Enhanced Service Accuracy: Achieved a 30% reduction in errors, ensuring consistent and reliable claims processing.
• Superior Member Experience: Resolved 90% of claims on the first attempt, significantly boosting member satisfaction.
• Faster, Reliable Turnaround: Reduced client’s claims processing time from over 10 days to under 4 days without compromising quality.
• Improved Transparency: Empowered teams with advanced reporting and visibility for proactive decision-making.
• Peak Period Excellence: Maintained high service standards during peak times with a dynamic and flexible model.