CUSTOMER STORY | WARRANTY AND CLAIMS

Moving initial claims inquiries out of an hour-long hold queue.

Illustration of two claims operators connected through a phone workflow in a records environment
Claims intakeThe first inquiry moves faster while claims decisions stay with people.
More than 1 hourCustomer-reported prior hold time
Initial claimsAI-supported first conversation
Human claims teamResolution and judgment
[ BEFORE AIM AI ]

The operating problem before the deployment.

According to the customer account, long holds created frustration before the claims process had properly started. The same claims staff responsible for moving files toward resolution also had to manage the repeatable first inquiry.

  • Customers reported waits of more than one hour before receiving assistance.
  • Initial claim questions competed with claim-resolution work.
  • The customer experience was affected before the claim moved forward.
  • Phone volume made it harder for the claims team to stay focused.
Workflow change

The workflow that changed.

AIM AI was assigned to the initial claims-inquiry path. The agent answers the first call, follows the approved intake or service sequence, collects the required information, explains the configured next step, and routes exceptions to the claims team.

  • Receive initial claims inquiries without waiting for an available adjuster.
  • Collect the approved customer, contract, claim, and contact information.
  • Keep coverage, authorization, adjudication, and sensitive exceptions with people.
Human claims role

What remained with the claims team.

The deployment was not positioned as automated claim adjudication. People remained responsible for decisions, exceptions, disputes, and claim resolution. The AI reduced the repeatable phone work around the first inquiry and prepared a clearer starting point.

  • Coverage and authorization decisions.
  • Adjudication, investigation, disputes, and exceptions.
  • Sensitive customer situations and complaints.
  • Claim resolution and follow-up requiring human judgment.
Customer-reported outcome

The result the customer described.

The customer reported that callers received assistance faster and the claims team had more room to focus on resolving claims.

The current source does not provide a numeric post-launch hold time, completion rate, savings figure, or implementation duration.

In the customer's words

What the customer published about this deployment.

Game-changer for data collection!

Integrating AI into our claims process has made a significant difference. Previously, our customers frequently endured hold times of over an hour, which was frustrating for both them and us. Now, those lengthy waits are behind us. The AI system efficiently manages initial inquiries, enabling us to assist customers quickly and concentrate on resolving claims more effectively. This has greatly enhanced our workflow and improved the overall customer service experience.

Tim S.Headstart Warranty Group
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