Insurance provider transforms customer service with AI agents

Overview

A national insurance provider serving policyholders and members across the United States sought to modernize its customer service operations. Handling more than 360,000 customer inquiries annually in a regulated environment, the organization needed a scalable way to deliver fast, accurate support without increasing contact center costs.

At the outset, the provider had no conversational AI or digital self-service infrastructure. All customer inquiries were handled by human agents through traditional service channels, creating operational strain and limiting scalability.

To establish a more resilient and future-ready service model, the organization partnered with Kore.ai to implement intelligent self-service across both digital and voice channels, creating a scalable foundation for more automated and agentic customer service.

The Challenge

Without modern self-service capabilities in place, the provider faced increasing pressure to manage routine policyholder inquiries efficiently while maintaining the accuracy and responsiveness required in a regulated insurance environment. A large share of common service requests continued to flow directly to human agents, limiting the organization’s ability to scale support and control operational costs. Key challenges included:

• High volumes of routine policyholder inquiries handled manually by human agents
• Limited self-service options for common requests such as policy details, billing questions, and account updates
• Growing operational pressure on contact center teams during peak inquiry periods
• Difficulty providing always-on service without increasing staffing costs
• Inconsistent resolution paths across digital and contact center channels

Together, these challenges highlighted the need for a modern self-service layer capable of automating high-frequency interactions while preserving seamless access to human agents for more complex policyholder needs.

The Solution

The organization implemented AI for Service from Kore.ai to modernize customer interactions across both digital and voice channels. Intelligent AI Agents were deployed to handle high-frequency insurance inquiries through natural, conversational interactions while maintaining seamless access to human agents when more complex support was required.

These AI Agents automate a wide range of routine policyholder requests, allowing customers to quickly resolve common needs through self-service while reducing pressure on contact center teams.

Key capabilities include:

• AI Agents supporting both voice and digital customer interactions through conversational self-service
• Automated handling of common insurance requests such as policy status, account access, and frequently asked questions
• Secure authentication and identity verification workflows aligned with insurance requirements
• Intelligent routing and seamless escalation to human agents with full interaction context when needed
• Continuous optimization of automation performance to improve containment and customer experience

Together, these AI Agents now serve as a scalable front door for customer service, resolving routine inquiries automatically while ensuring policyholders can quickly reach human support for more complex needs. The result is a modern, AI-driven service model that balances automation with human expertise across the customer journey.

Business Impact

With AI for Service in place, the organization established a scalable self-service layer capable of handling routine policyholder inquiries through automated digital and voice interactions. This shift reduced reliance on human agents for common requests while improving access to fast, always-on support for customers.

Key outcomes include:

• 50.9K customer sessions handled through AI-driven self-service, reducing reliance on human agents for routine requests
• Approximately 45 percent self-service resolution, shifting a meaningful portion of inquiries away from traditional contact center channels
• $221K in realized operational value, with $1.06M projected through December 2026 as automation adoption continues to expand

Beyond direct value creation, the organization achieved steady improvements in containment and automation performance over time, demonstrating operational maturity across thousands of real customer interactions.

Together, these results establish a scalable foundation for expanding AI-driven service across additional channels and customer journeys.

Kore.ai Advantage

Kore.ai enabled the provider to modernize customer service with a unified AI for Service platform capable of supporting both digital and voice automation within a regulated insurance environment.

With Kore.ai, the organization was able to:

• Rapidly launch conversational AI Agents despite having no prior automation infrastructure
• Continuously optimize automation performance to improve self-service resolution and containment
• Maintain governance, security, and compliance controls aligned with insurance industry requirements
• Extend automation from digital channels into voice without requiring a platform change

By leveraging a single AI platform across channels, the provider established a scalable and consistent service foundation as its automation strategy expanded. This approach also provides a model for other insurance organizations seeking to modernize customer service with AI-driven self-service while maintaining operational control and regulatory compliance.