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.