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Case Study

Aflac reshapes the customer experience with AI and automation

  • 25+ applications delivered on Pega Cloud
  • 33% reduction in handling time for claim form requests
  • $4M saved with virtual agents handling more than 75% of inbound chats

“Pega Customer Service captures and tracks everything that happened during that interaction. Representatives no longer have to spend their time typing up the lengthy notes after each call. Now they can spend time on serving our customers – which is what they want to be doing.”

The Business Issue

Aflac is the leading provider of supplemental health insurance in the U.S. With a focus on bridging the gap for unexpected medical costs, Aflac is on a mission to provide its policyholders with peace of mind during the moments that matter.

Protecting more than 50 million people worldwide meant the company dealt with a high volume of inbound calls that resulted in long wait times, created high abandonment rates, and damaged the customer experience. Homegrown legacy applications and disparate manual processes further hindered the company’s ability to respond quickly to customers. These multiple, disjointed servicing applications created higher staffing requirements and led to long training lead times to bring new hires on board.

Aflac recognized the need to transition to a more customer-centric business architecture, seeking a comprehensive 360-degree view of each customer while leveraging the potential of AI and other digital technologies.

The Solution

Aflac used the Pega Platform™ and Pega Customer Service™ to consolidate systems and transform the service experience. This included:

  • Policyholder Chat powered by natural language processing (NLP) to understand customer queries and direct them to automated solutions
  • Email bots to automate work and resolve incoming inquiries
  • Guided agent experience streamlines employee activity and reduces training times
  • Automated resolution of common requests, enabling support staff to dedicate time to high value and complex requests
  • Process orchestration across applications, reducing the swivel chair effect and aiding in efficiency and reduced handle times

The initial focus was on automating and improving email processing, but Aflac soon expanded its efforts to consolidate multiple applications onto the Pega Platform. The company used Pega Cloud® to accelerate its transformation, incrementally replacing legacy systems and automating workflows – leading to improved customer care, faster training, and streamlined processes.

With Pega Customer Service, Aflac created a unified and streamlined approach to customer service across phone and chat channels. The platform integrated with various back-end systems, providing a complete 360-degree view of each customer. Representatives no longer had to juggle multiple systems and manually log detailed notes after each call. Instead, they could focus on delivering personalized and efficient support.

Aflac embraced AI and automation with Pega to achieve efficiency gains and enhance customer experiences. Virtual agents were integrated across major customer experience platforms, providing self-service options for policyholders, payroll accounts, and producers.

The Results

  • 25+ applications delivered on Pega Cloud
  • Shorter wait times for customers and more streamlined workflows for employees
  • 33% reduction in handling time for claims form requests
  • 65% reduction in effort for client authentication
  • $4M saved with virtual agents handling more than 75% of inbound chats
  • 100% compliance with regulatory requirements by automating the recording of required voice authorizations
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Défi: Service client Groupe de produits: Plateforme Industry: Assurance
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