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The rapid growth of AI technology across financial services has resulted in significant opportunity for insurance organizations, who are facing increased customer expectations of rapid service alongside an imminent talent shortage, with 50% of the current workforce approaching retirement within the next 15 years. 

Implementing Agentforce for Insurance automates previously manual processes to give customers the support they need at the speed they expect, reducing the strain on human agents so that they can focus on building relationships. From updating policies to assisting with claims and annuity product applications, AI agents are helping insurance organizations gain a competitive edge while adhering to compliance regulations. 

Last week, we explored three high-value, low-risk AI agent use cases for banking, lending, and wealth management. In this showcase of Agentforce for Insurance, we’ll outline four scenarios for the insurance industry, guide you through the Agentforce interaction steps, and detail the benefits of implementing these agents. 

Insurance Coverage Servicing Agent

Insurance companies face challenges with high customer service demand and prolonged response times for simple policy updates and transactions like address changes, cancellations, or quotes for new coverage. Requiring human agents to handle these tasks increases costs and impacts the customer experience. Additionally, manual processes for handling sensitive insurance data can lead to errors and inefficiencies.

The Agentforce interaction steps

A policyholder moves to a new apartment and wants to update their renters insurance coverage. They need to update their address, cancel their old renters insurance policy, and get a quote for a new policy tailored to the new address. 

  1. Identify client by name and confirm identity: Greet customer, request verification details (policy number, phone number, last four digits of SSN, or a secure code), and match input against Salesforce CRM records.
  2. Update client record (address change): Prompt the user for the new address. Validate and update the address in the client’s Salesforce record.
  3. Retrieve current coverage: Display current renters insurance details, including coverage amount, premium, and expiration date.
  4. Cancel current coverage: Process cancellation request for the old renters insurance policy after confirming customer intent.
  5. Offer coverage for new address: Suggest new coverage options tailored to the new address based on underwriting rules or predefined policies.
  6. Quote new coverage: Provide a real-time quote for the new renters insurance coverage based on inputs such as property type and coverage preferences.
  7. If necessary, transfer to a human agent: Escalate to a human agent for tasks requiring underwriting review or digital signatures, such as final approval for high-risk coverage.

Agentforce benefits

  • Ensures seamless self-service for most insurance servicing tasks while leveraging escalation pathways for complex transactions.
  • Reduces service wait times, improves policyholder satisfaction, and frees up human agents for higher-value work.

Insurance Claim Assistance Agent

Insurance companies struggle with high volumes of claims that require significant manual input to gather necessary information, create cases, and provide updates to customers. This manual effort can lead to delays, poor customer experience, and higher operational costs. Ensuring accuracy in collecting incident details, verifying coverage, and setting appropriate customer expectations is critical but time-consuming for human agents.

The Agentforce interaction steps

A policyholder is involved in a car accident and needs to file a claim. They initiate a conversation with the insurance company’s chatbot to report the incident and expect clear guidance on next steps and prompt confirmation that the claim has been submitted. They prefer a fast and automated process but expect human involvement if approvals or complex reviews are required.

  1. Identify client and confirm identity.
  2. Retrieve and summarize coverage: Display details of auto insurance coverage, including policy limits, deductible, and expiration date.
  3. Confirm vehicle details: Ask policyholder to confirm details of the insured vehicle (make, model, year) to ensure accuracy and eligibility.
  4. Obtain incident description and supporting info: Collect information about the accident (date, time, location, and a description of the incident). Prompt policyholder to upload photos of the damage via the chatbot interface.
  5. Create a case and assign to human agent: Create a claim case in Salesforce, pre-populate it with the collected details, and assign it to the appropriate claims agent for review and next steps.
  6. Send case confirmation to customer: Notify policyholder that they claim has been successfully submitted and provide a case number. Send confirmation via email or the company’s mobile app.
  7. Instruct customer on next steps: Provide clear next steps, such as waiting for claim review, providing additional information if required, or contacting customer support for urgent updates.

Agentforce benefits

  • Reduces the workload on human agents, accelerates claims submission, and improves the customer experience. 
  • Customers gain timely updates and clear instructions, improving trust and satisfaction.

Annuity Product Application Agent

The process of onboarding customers for annuity products is often manual, time-consuming, and prone to delays due to the need for extensive document collection, financial data review, and advisor assignments. This creates inefficiencies for providers and frustration for customers who expect seamless digital experiences. Moreover, ensuring accurate data collection and compliance with financial regulations can be challenging without automation.

The Agentforce interaction steps

A policyholder wants to use their insurance provider’s chatbot to apply for an annuity. They need help gathering information, uploading documents, and submitting the application. The AI agent will verify identity, access financial details, and assign an advisor if necessary. The policyholder expects clear instructions, status updates, and guidance throughout the process. 

  1. Identify client and confirm identity.
  2. Retrieve and summarize current financials: Display policyholder’s current financial accounts or products managed by the company, including account balances or existing annuity plans if applicable.
  3. Collect supporting documentation: Prompt policyholder to upload required documents (photo ID, proof of income) via the chat interface and store them securely in Salesforce.
  4. Create an opportunity and assign advisor: Create an opportunity record for the annuity application, pre-populate it with the collected data, and assign a financial advisor if necessary.
  5. Process application and send confirmation: Process application and send a confirmation email or in-app notification with a reference number and status updates.
  6. Instruct customer on next steps: Provide clear next steps, such as advisor consultation, additional requirements, or waiting for approval.

Agentforce benefits

  • Streamlines annuity applications by verifying identities, collecting documents, and retrieving financial data, enabling human agents to focus on complex tasks and approvals.
  • Provides faster service, increased accuracy, and a better customer experience.

Annuity Advisor Onboarding Agent

Annuity onboarding involves repetitive administrative tasks, leading to inefficiencies and potential errors. Advisors spend significant time on manual data entry, compliance checks, and managing communications. These inefficiencies impact customer experience, slow down approval times, and create a heavy workload for advisors. Tasks requiring human oversight, such as underwriting, are delayed when advisors are bogged down in process-heavy activities.

The Agentforce interaction steps

A financial advisor helps customers navigate complex annuity products. The onboarding process is labor-intensive, requiring extensive back-and-forth with the customer to gather information, review regulatory disclosures, complete paperwork, and submit applications. Advisors often spend significant time manually tracking the application status and communicating with insurance providers, leaving less time to focus on strategic advisory work.

  1. Retrieve and summarize annuity application: Summarize key application details (customer profile, annuity type, premium amounts) in a concise format for the advisor to review.
  2. Generate a next-steps plan for the advisor: Generate a clear action plan (review attached documents for completeness, share disclosures with the customer, submit application to underwriting if required).
  3. Gather and collate necessary disclosures: Identify compliance requirements based on the annuity product type and customer location, retrieve pre-configured disclosure templates from Salesforce Knowledge Articles, and prepare a disclosure packet to be shared with the customer.
  4. Submit the annuity application for approval: Validate the application for completeness (mandatory fields, required attachments) and submit to the insurance company via a pre-configured API integration.
  5. Draft customer and insurance communications: Draft and schedule email, push, or SMS notifications for both the customer and the insurance company.
  6. Escalate to human advisor for underwriting or complex cases: Escalate task to ensure all data and documents are pre-organized for a seamless handoff if underwriting or complex decision-making is required.

Agentforce benefits

  • Streamlines data handling, ensures compliance, and speeds up approvals.
  • Improves customer satisfaction through proactive communication.

Start your Agentforce journey with Mphasis Silverline

The Mphasis Silverline Financial Services team can guide you through every phase of your Agentforce for Insurance implementation journey, from identifying and resolving data gaps to unifying customer profiles and setting clear organizational expectations to inform your specific use cases. Our team leverages insight acquired through thousands of engagements, along with real-world expertise gained across the Financial Services industry. 

Watch our webinar, “Accelerating Agentforce Development and Rollout,” to learn more about implementing Agentforce at your organization. If you would like to schedule a workshop for your organization, you can reach out to Aman Gulyani directly.