Case Study: Large Health Insurer Reduces Call Center Costs with CognitiveScale's AI Cognitive Service Experience

Large Health Insurer Company - Customer Case Study

Large Health Insurer Company, a health insurer serving over 40 million customers, was handling more than 6 million claims-related calls each year in its contact center. Agents spent valuable time figuring out why customers were calling, locating the right claim, and explaining how it was processed, driving high call center costs. CognitiveScale helped address this challenge with its Cognitive Service Experience solution built on the Cortex platform.

CognitiveScale implemented an AI-based cognitive service experience system that predicts which claim a customer is likely calling about and generates simple explanations for agents to share with customers. The solution also learns from omnichannel signals and agent feedback, and extends insights into digital self-service channels. As a result, Large Health Insurer Company saw an estimated 13% reduction in average handling time, a 10% reduction in call volume, and an annual savings opportunity of $10M.