Demystifying automation in insurance

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How to ensure compliance in chatbot conversations

4 min read

Insurance is one of the most heavily regulated industries in the world. And one of the most critical aspects of this industry is compliance.

Presently, conversational process automation (CPA) is beginning to be adopted in the market by top-tier companies. But, how are the conversations carried out on these technologies compliant and abiding by regulations?

To begin with, though...


What does it mean to be compliant?

In the insurance industry, compliance is implemented as a means for prevention, safety, and surveillance. As per a report by Accenture, the specific focus is on “transparency, correctness of behavior towards customers, contractual information, and contracts execution.”

When it comes to Conversational Process Automation, the challenge is to ensure that every chatbot conversation is compliant with the insurance company’s policies, that the chatbot will execute the process in the way it has been designed, and that the flow of every conversation is under control and can be tracked.

In other words, the role of CPA is to empower compliance departments of insurance companies to be comfortable that their checklist is complete. Compliance departments often give the go/no-go for technological solutions to go live.

The chatbots created need to fit into insurance compliance requirements as if they’d always been there.


How automated conversations can remain complaint

Ensuring the compliance of automated conversations happening through chatbots is simple but not easy. Once you define the aim of the conversational process, building on top of a solid and compliant logic is like ascending from one stair to the next. Here are the fundamentals you need to keep in mind (and keep ensuring during the time you deploy CPAs):


  1. Conversations must be auditable

    Automated conversations are personal which means that individuals interacting with chatbots will create almost unique conversations. It poses a challenge to ensure that all conversations are auditable. Thus, it is necessary for a chatbot’s conversational logic to be examined and reviewed every time before it is published. Validating the logic ensures that the conversations are created in a compliant way and do not divert towards unapproved directions. Regardless of the level of automation, a human needs to be a part of the process at one point at least.

    Indeed, this audit can be performed through the execution of lean processes and with the aid of specific software designed to keep track of conversation versions and test all the possible scenarios of conversations.

  2. Design smart (and ethical) data management strategies

    Performing checks and review of the conversation between the chatbot and users is crucial for informing and validating that the chatbot is working as expected. However, the data used to do such checks needs to be managed carefully. As expected, there are different strategies to ensure secure data management. 

    The starting point is to collect and store the bare minimum amount of customer data required to perform the goal assigned to the chatbot. This is ethical and in alignment with GDPR. In addition, all the collected information must be secure, encrypted, and not identifiable to any individual or entity.

  3. Provide a secure communication channel

    This follows from the previous point but is worth mentioning alone again. In an exploratory interview study presented at the Fifth International Conference on Internet Science, security and privacy were reported as crucial factors for customers in trusting a chatbot. Customers wanted the chatbot to clarify what it was storing, how the stored information was being used, and store as little personal data as possible.

    Thus, the interaction between the customer and the chatbot must be safe, secure, and leverage encrypted communication.

  4. Execute extensive testing before going to production
    Testing is a critical and necessary activity for ensuring the quality of any digital solution, chatbots included. A well-designed but bug-riddled service is as good as non-existent. There are some risks that simply cannot be taken at this stage before going live. Hence, it is always better to prepare for the worst-case scenarios, especially those relating to compliance, and test a service thoroughly before release.

Alberto Pasqualotto, co-founder and CTO at Spixii says:

“The process to buy an insurance product or notify a new claim can be stressful, time-consuming and confusing, and so it is paramount that tools which connect insurers with their customers are resilient and capable of delivering immediacy, transparent communication, and professionalism. In a world that is becoming increasingly virtual, the role of CPAs and chatbots is critical for the insurance industry.”

These increasingly critical technologies, however, need to be watertight in security and compliance.


The start of something new

Iosif Itkin, co-founder, and CEO of Exactpro, said:

“Insurance is a highly regulated sector, and it is imperative that companies constantly look to enhance the resilience of their technologies in order to stay both competitive and compliant.”

Because of this commonality in beliefs, Spixii has recently partnered with Exactpro to create more peace of mind for insurance and financial institutions. This has been done by adding a further quality assurance layer to the chatbots built on the Spixii platform. It is truly an exciting addition that has leveled up the quality of Spixii CPA.

You can read more about the partnership here and then inquire about how they can be uniquely integrated into your business.

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CPA allows end-to-end processing through chatbots and leverages advanced analytics to continuously improve both the underlying process and the conversation with the end-user.

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