How a Health Insurance Company has Enhanced the Customer Experience using an IBM Watson Powered Smart Virtual Assistant

Old World

In the old world, our Client, a Health Insurance Provider used to handle its customer interactions via the below traditional channels:

Branch Offices – 540 Branch Offices
Call Center – 850 Personnel
A Matured Web Portal and a Mobile App

Customer Support & Marketing Costs are increasing due to the rising call center cost, hiring & training the tele-callers and a decreasing customer satisfaction index were among the major business challenges at the Health Insurance Provider.

The Health Insurance Company’s forward-looking management team chose to invest in IT and bring Artificial Intelligence (AI) to the game to outsmart the competition. In conjunction with IBM & Streebo, they employed a Smart chatbot for their Health Insurance Service.

The Journey to the new world

Prior to the launch, IBM & Streebo team trained the Virtual Assistant on various back-end systems at the Health Insurance Company, including ERP Systems & IBM’s AS/400 and showed it how to fetch information from various siloed systems in a secured and scalable manner. Powered by IBM Watson Assistant, the leading Natural Language Processing (NLP) engine (as per Gartner and Forrestor report of 2022), Streebo’s Smart Cognitive Assistant was Trained until 99% Accurate, meaning it would answer at least 99 out of 100 questions correctly.

The Streebo Smart Virtual Assistant for Health Insurance was added to the workforce after a few rounds of evaluation. The Virtual Assistant was pre-trained in various Health Insurance functions such as:

Apply for a Health Insurance
Premium Calculator
Pay the Premium

The Bot had in-build functionality to transfer to a Live Agent in case it was not able to answer any questions.

Bot Features

IBM Watson Powered Streebo bots are omni-channel, meaning they can answer queries from across channels including web app (Health Insurance Website), mobile app (Health Insurance App) and external-facing social media channels like Facebook Messenger, WhatsApp, Google Chat, Telegram and SMS among others. Streebo’s AI powered Virtual Assistants also support voice assistants such as Google Home, Amazon Alexa and Siri.

By deploying the Virtual Assistant, the Health Insurance Provider has expanded its outreach to new social media channels and at the same time put in a smart & highly intelligent employee in place for instant customer service. The Smart chatbot for Customer Assistance now manages the first line of interaction and provides instant responses. The blog below captures the customer’s journey in the new world after the Virtual Assistant was put in place.

Health Insurance Customer Experience in the New World

The blog below captures the journey of a new customer’s (Alice’s) once the AI Powered chatbot was put in place.

Browse Policy & Calculate Premium on Facebook Messenger

Alice (prospect) receives an advertising message in her Facebook inbox from a Health Insurance Company and it reminds her of the marketing email she received earlier from the same Health Insurance Company about lucrative health insurance rates. As she is searching for a health insurance policy, a click brings her to the company’s FB landing page. Here, an IBM Watson Powered Health Insurance Facebook Messenger chatbot is on stand-by to answer queries from the prospect.

A study by InstaTech shows that 43% of people prefer to chat rather than browse the site or page as they need specific information.

Alice posts her question in the Facebook Messenger. IBM Powered chatbot promptly greets her and starts sharing information.

Alice asks the chatbot about the eligibility criteria for buying a critical illness insurance policy and the chatbot provides the necessary information. Further, she requests for calculating premium by entering input “I wnat to calulate premuim”. (Notice she makes spelling mistakes, and the chatbot still understands it) All this happened because of a smart IBM Watson Assistant NLP engine under the covers.

She is impressed by the displayed rates but then gets interrupted by a meeting reminder and hence has to stop her research. However, she learns that the Health Insurance Provider also has a customer-facing website and bookmarks the link for the same to visit later.

Purchase a Health Insurance Policy through WebApp

Once she gets done with the meeting, Alice visits the Health Insurance Company’s website as she is looking to buy an Insurance Policy. In the meantime, she has a conversation with her family after which she is increasingly confident about going ahead with buying the policy.

She applies to buy a new policy with the intent “My name is Alice, my DOB is 12th July 1990. My annual income is 30000 dollars. I want an insurance policy” (Entity Recognition). The IBM Watson Powered Smart Virtual Assistant for Health Insurance understands the intent of applying for insurance and kicks off the application for insurance flow.

In the midway she wanted to know information about payments so asked an FAQ about the interval in which she can make payments (Digression). The virtual assistant replies to her question by showing the available options and continues with the use-case of buying a policy from where it is left.

Alice buys the insurance policy and receives an email (email integration) and WhatsApp Notification containing details such as Policy Number and others with an attached PDF of the Policy (Dynamic PDF Generation).

Query Resolution via Google Home

In the evening, at home when Alice is going through the policy documents, a question pops up in her mind so she decides to ask her query via the Google Home device at her home which is linked to her phone. Alice is based out of Dubai, after giving her policy number to the IBM Watson Powered Voice Bot for Health Insurance she explores in the Arabic language by asking – “هل يتع ن ي ع ي ل دفع ن ضائب عل المزايا الأسبوعية؟ ” (Do I have to pay taxes on weekly benefits?) and gets required information (Multi-lingual Feature with Voice Assistance). The AI Powered Smart Chat and Voice Bot is multilingual and provides support in the local language as well.

File a Claim through Mobile App

A few months later, Alice’s health is not stable and she needs to undergo surgery. For treatment purposes, she is looking to have a claim. She applies for a claim from her health insurance mobile application chatbot using the intent “Help me with the claim”.

The chatbot asks her to enter the Policy Number and walks her step by step and helps her file a claim. The Smart Virtual Assistant even assists with uploading relevant documents to file the claim (Document Upload).

After completing the procedure, she receives an email on the registered email id with the details of the Claim with an attached PDF.

Know the Claim Status with Single SMS

Alice wants to know how much time it will take to process the claim and as she is in a ‘No-internet zone’, she reaches out to the IBM Watson Powered Virtual Assistant for Health Insurance on SMS and searches for “How long does it take to process insurance claim?” and “What are the working hours of branches?”.

The Virtual Assistant on SMS understands the intents of FAQs, fetches the appropriate details, and reverts to Alice about the required information of the claim status and branch work timings.

Renew the Policy on WhatsApp

Now the renewal of the policy is due and Alice receives a WhatsApp notification on the AI Powered Smart Bot for Health Insurance. She replies to renew the policy by typing the input “Help me renew the policy”. The chatbot asks to enter the Policy Number & Payment Details and validates the same with an OTP (PII Masking, OTP integration).

The process gets completed and the chatbot replies with the payment confirmation message and shares the policy renewal details on Alice’s registered email ID and WhatsApp Number with an attached PDF of Renewal.

The chatbot also asks for her feedback in order to improve customer support. As Alice is already delighted with the instant support provided by the Virtual Assistant of the Health Insurance Company on all the social media & voice channels that she uses. She shares the Five Star ratings.

As you can see from the above experiences, the Health Insurance Company can now serve the client on any and all channels. This results in a great customer experience, yet it was all automated and hence no additional costs were incurred by the Health Insurance Provider.

Do you want to improve your customer experience? Are you looking to leverage Social Media to increase revenue? Look no further…

Thinking about a Bot for your Health Insurance Company?

Click here to learn more about IBM Watson Powered Health Insurance chatbots

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Pricing Options

MVP(Minimum Viable Product) bot includes:

3 transaction used cases.

1 backend integrations

50 FAQ’s

Channels – Web, Mobile App, 1 Social media channel such as WhatsApp/Facebook messenger.

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