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success story

Revolutionizing case management: Leveraging AI for enhanced efficiency and customer satisfaction

A leading insurance organization faced challenges in efficiently managing customer inquiries and cases, leading to increased handling time and decreased productivity among specialists. With a commitment to delivering superior customer service and optimizing internal operations, the organization sought a solution to streamline its case management process.

The Challenge

The organization faced several critical challenges with its existing case management system:

  • Inefficient case handling: The legacy system created a new case for each customer's email, resulting in a chain of cases and emails. This approach led to duplication of effort and inconsistency in case resolution, as multiple specialists often handled the same case at different points in time.
  • Manual email review: Specialists spent a considerable amount of time manually reviewing emails to understand case history and identify relevant information. This manual process was time-consuming and prone to errors, impacting overall efficiency and productivity.
  • Lack of a unified view: The absence of a unified view of case history made it challenging for specialists to prioritize tasks and make informed decisions. Without a comprehensive understanding of the case context, specialists struggled to provide timely and accurate responses to customer inquiries.
The Solution

To address these challenges, the organization partnered with Virtusa to implement a comprehensive solution leveraging Pega's generative AI capabilities:

  • Automated email summarization: The solution utilized Pega's AI capabilities to extract and summarize all emails from case chains automatically. By generating concise summaries of email communications, specialists were provided with a comprehensive view of case history, enabling them to understand the context and identify key information more efficiently.
  • Action item identification: Pega's AI technology was leveraged to identify action items from emails, such as tasks or follow-up actions required. By automating the identification of action items, specialists could prioritize tasks more effectively and ensure timely resolution of customer inquiries.
  • Data privacy compliance: The solution incorporated Pega's Generative AI Connect Gateway to handle personally identifiable information (PII) data securely. This ensured compliance with data privacy regulations and safeguarded sensitive customer information throughout the case management process.

The solution provided specialists with the tools and insights needed to streamline case handling, improve efficiency, and deliver exceptional customer experiences.

Revolutionizing case management
The Benefit

The implementation of the solution yielded substantial and quantifiable benefits for the organization:

  • Optimized specialist efficiency: The solution resulted in an impressive 80% reduction in the time spent researching cases and reviewing email attachments. Specialists could now focus their efforts more efficiently, leading to faster case resolutions and improved overall productivity.
  • Increased agent productivity: Despite multiple agents handling the same case at different times, the solution significantly decreased case-handling time. Individual agent productivity saw a marked improvement, allowing them to handle more cases effectively within the same timeframe.
  • Enhanced accuracy and consistency: With a comprehensive view of case history and predefined action items extracted from emails, specialists could now approach case resolution with greater accuracy and consistency. This led to a notable uptick in customer satisfaction and loyalty, as issues were addressed promptly and precisely.

The partnership between the organization and Virtusa exemplifies the power of innovative technology solutions in driving digital transformation and delivering exceptional customer experiences.


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