Member Experience & Operations

A Trusted Foundation for Every Decision

AI can generate answers, but your insurance rules provide the source of truth. We turn policy wording, benefit tables, exclusions and procedures into a secure, governed repository that supports consistent, reliable decisions. 

Coverage & Benefits Assistant

Provides transparent plan explanations and guided next steps for members, call centres and brokers.

Non-Integrated Plan Assistant: Deploys quickly to provide grounded answers on plan benefits, exclusions, limits, and pre-authorisation requirements.

Personalised Plan Assistant: Connects securely to member systems to provide personalised benefit reminders, claim status and network navigation.

Service-Team Augmentation: Equips call centre agents and account managers with instant, traceable plan logic and next-best actions.

AI Beings: Interactive Onboarding at Scale

Interactive AI Beings present new health plan benefits, guide members through enrollment steps, and answer questions in real time in multiple languages.

Scale Onboarding: Deliver consistent, insurer-approved plan presentations to large employee populations without manual HR/broker presentation effort.

Interactive Q&A: Members can ask natural-language questions about coverage, dependents, pre-authorisations and direct billing.

Legacy Contact Centre AI Augmentation

A modular AI layer designed to improve contact-centre productivity and conversation quality without replacing core telephony or administration platforms.

Capabilities: Real-time agent guidance, call/chat summarisation, automated CRM note drafting, enquiry classification, and 100% automated QA review.

Controlled Pilot Approach: Test selected use cases in a controlled environment to measure Contact and Sales Rates, Average Handling Time (AHT) reduction, First Contact Resolution (FCR) improvement, and QA gains before scaling.