Transforming Customer Experience with a GenAI-Powered Claims Chatbot
A global bank wanted to modernise the claims experience - easing call centre pressure, enabling 24/7 support, reducing operational inefficiencies, and improving customer satisfaction, all while maintaining strict compliance and data privacy standards.
Outcomes
2x
Faster Claims Triage + Response
60%
Less Manual Workload
24/7
Support Availability
3 weeks
PoC Cycle
Technology Vendors Suited to Evaluation
Business Problem
The bank’s claims process was heavily manual and resource-intensive, leading to slow response times, mounting call centre volumes, and rising loss adjustment expenses.
Legacy systems and strict compliance requirements made it difficult to adopt innovative, AI-driven solutions – resulting in missed opportunities to improve efficiency, reduce fraud, and enhance the overall customer experience.
Challenges
- Manual, slow claims processing and high call center volumes.
- Rising Loss Adjustment Expenses (LAE).
- Pressure to modernise due to fraud and poor customer experience.
- Innovation blocked by compliance hurdles.
From Idea to Evidence with NayaOne
The bank used NayaOne’s secure sandbox to validate multiple GenAI-powered claims chatbot solutions in a controlled, compliant environment.
- Rapid Scoping: Business and technical requirements were captured within the first week to define success metrics and evaluation parameters.
- Instant Access: Vendors were onboarded under NDA on Day 1, enabling immediate configuration and testing.
- Synthetic Data Training: Chatbot models were trained and tested using synthetic claims data, ensuring privacy and compliance throughout.
- Hands-On Evaluation: Vendors were benchmarked on ease of integration, response accuracy, compliance alignment, and customer experience impact.
- Accelerated Delivery: The entire evaluation cycle was completed in just 3 weeks – a 75% reduction compared to traditional pilot timelines.
The PoC provided clear evidence of which AI chatbot solution best balanced automation efficiency, regulatory safety, and customer satisfaction.
Impact Metrics
PoC Timeline Reduction
3 weeks with NayaOne vs 12 months traditionally
Time Saved in Vendor Evaluation
1+ year
Decision Quality
The bank gained hard evidence on whether AI could modernise claims processes and ease call centre pressure.
KPIs
- Average Handling Time Reduction (%): Decrease in time taken to resolve common claims queries.
- Call Centre Load Reduction (%): Drop in inbound call volumes post-chatbot deployment.
- Customer Satisfaction (CSAT) Score: Improvement in user feedback and experience ratings.
- Automation Rate (%): Percentage of claims interactions handled without human intervention.
- Response Accuracy (%): Accuracy of chatbot responses to claims-related queries.
- Compliance Alignment (%): Adherence to internal data privacy and regulatory requirements during chatbot operation.
Validate GenAI Claims Chatbots Safely Before Deployment
Use NayaOne’s secure sandbox to test and compare GenAI-powered claims chatbots with synthetic data – measuring accuracy, compliance, and customer experience improvements before integrating into live claims systems.
