Case study · Insurance

One voicebot.
Three lines of business.

A major US supplemental insurance carrier replaced fragmented call handling with a single self-service platform, wired deep into its core systems.

98
call flow modules
7
caller personas, Spanish included
20+
core-system API integrations

The constraint

Three different callers. One front door.

Three callers, one generic line

Policyholders, coordinators, agents — same number.

Each population calls for completely different reasons: claims, payroll billing, commissions. A one-size call flow served none of them.

Fragmented call handling

No single platform owned the journey.

Call handling was scattered across disconnected flows and systems — and callers felt every seam.

Core systems from two eras

SOAP-era XML meets modern REST.

The answers live in claims, billing, identity and licensing systems that don't speak the same language. Self-service had to talk to all of them.

What Primas built

One platform, engineered for all three.

Policyholders, payroll coordinators and agents each land in a flow built for who they are — one voicebot platform, on the Avaya estate they already ran.

A call, end to end

A policyholder calls about a claim. The voicebot authenticates them — PIN, SSN, or SSN4 + date of birth + ZIP, adapting to who's calling and why — reads back the claim status with the exact denial reason, then texts a claim-filing link before the call ends.

ONE PLATFORM — THREE CALLER POPULATIONS Policyholders claims · payments · benefits Payroll coordinators billing · invoices · enrollment Agents & producers commissions · licensing · pipeline One voicebot platform 20+ APIS · SOAP + REST THEIR CORE SYSTEMS — UNTOUCHED Claims · Billing · Identity · Licensing · Communications · Business hours

What callers actually do

Real transactions, not FAQ playback.

Policyholders

  • Claim status — paid, pending or denied, with the reason read back
  • Payments by voice, confirmation number included
  • Coverage, premium and paid-through dates
  • Enrollment and claim-filing links by SMS, mid-call

Payroll coordinators

  • Account lookup, billing frequency and invoice status
  • Last payment, with the date it was applied
  • Duplicate invoices — address verified, then mailed
  • Online-billing enrollment on the call

Agents & producers

  • Commission rollups — daily totals and balances
  • Commission detail by writing number
  • License status by state, active or cancelled
  • Advanced-premium pipeline: new, pended, delay-bill, conversions

The engineering underneath

The details that make it hold.

Recognition

N-best retry authentication

When speech recognition returns an ambiguous SSN4, date of birth or ZIP, the platform permutes the top two candidates across fields — up to eight combinations — before asking the caller to repeat anything.

PCI compliance

Payments live in their own vault

Payment flows run as a separate application in a dedicated PCI-zone cluster. The call carries its identity across — so the caller never starts over.

HIPAA privacy

Gated at the prompt level

Before any medical detail is spoken, the flow verifies it's talking to the policyholder — or someone assisting them — exactly as federal guidelines require.

Routing

Persona-aware from the first ring

ANI pre-routing to the right queue before the main menu, persona-aware flows from every entry point, and an intent × caller-type transfer matrix the carrier's own team configures.

Integration

One layer over two eras

A single orchestration layer speaks both SOAP XML and modern REST JSON — the voicebot reads a claim and takes a payment without knowing which era the system behind it is from.

Failure design

Graceful where possible, structured where not

Secondary calls — like claim-document imaging — degrade gracefully; failures on primary APIs get structured error flows. The call keeps moving.

The outcome

From claim status to agent commissions — one platform, three caller populations, zero cloud migration.

Is this your situation?

For contact centers serving more than one audience.

This story is for you if…

  • Your callers split into populations with completely different needs
  • Your core systems span generations — and rip-and-replace is not on the table
  • You want self-service that completes transactions, not deflects calls

Book a 30-minute strategy session

The companion story · Banking

3 wksfrom contract to delivery

The first win: a queue that calls you back.

Read the banking story →

The companion story · Healthcare

7+ yrsas their innovation arm

The partner that stayed long past go-live.

Read the healthcare story →

See what a voicebot could own on your lines.

A 30-minute strategy session, no obligation. We'll map your caller populations and which calls self-service can complete end to end.

Book a 30-minute strategy session

Talk To Our Experts

Schedule your free, personalised demo at a date and time that works for you