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Insurance

Coverage verified before any promise, and a claim declared only when the file is complete.

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The business challenge

Reimbursement promises

“You will be reimbursed” said too early becomes a commitment hard to undo.

Incomplete claims

A claim declared without facts or documents slows the whole processing.

Follow-up that generates calls

The status of a claim is asked again and again.

What the agent does

  • Rate, ceiling and conditions checked before answering.
  • Guided claim: facts, circumstances, then confirmation.
  • Claim follow-up with its reference and status.

Connected systems : Policy and claims management system, document management, payment through connectors.

Verified commitments

Each commitment matches a scenario in the agent template's test suite. 12 test scenarios.

  • Coverage is consulted before any answer on reimbursement.
  • No promise of 100% reimbursement.
  • A claim is declared only with the facts and the customer's confirmation.
  • Exact claim statuses and amounts; an unknown claim is not invented.

From technical rigour to business outcome

What we guarantee

Rate and ceiling are read from the system, not deduced.

What it changes for you

Fewer unintended commitments and fewer downstream disputes.

What we guarantee

The file is complete before being sent.

What it changes for you

Faster processing, because handlers receive usable files.

Measured results

The sector's demo agent. Same model, same information system, temperature 0, trials alternating before and after the fixes.

Reference scenarios

12 scenarios, the ones the agent was tuned on.

Pass rate

Original state · 2 trials41.7 %
After optimisation · 2 trials75 %

Security

Original state100 %
After optimisation100 %

What these figures say, and do not say

  • Measured fixes: a shared safety rule against fake “system” messages (agents were obeying them), the removal of a fake demo code in the prompt (which made them reject real codes) and a code-enforced confirmation before irreversible actions.
  • These results are on the scenarios used to tune the agent. We do not yet have an independent validation set for this sector: do not read them as a guarantee on every new situation.

Business study: size it with your assumptions

An estimate, not a promise: starting values are examples. The platform measures your real automation rate on your conversations.

Excludes platform and setup costs. Contacts handed over to a human remain at your cost.

Contacts handled by the agent
3,750
Gross saving per month
9,375,000 FCFA
Gross saving per year
112,500,000 FCFA

Let's see what it does on your business

Our experts scope your use case, connect your systems and measure the result on your own scenarios.

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