- Challenge: Insurance contact centers face dual challenges of ensuring compliance with strict regulatory standards, such as GDPR and Solvency II, while also detecting and preventing fraudulent activities like identity theft and phishing. Agents must adhere to compliance scripts during sensitive financial interactions, and any lapses can result in regulatory penalties. At the same time, fraudulent activities during claims or policy interactions can lead to significant financial losses if not identified early.
- Solution: COMPASS provides a comprehensive solution by analyzing conversations for both compliance adherence and potential fraud detection. It monitors interactions for proper disclosure of policy terms and flags deviations from compliance scripts using customizable scoring criteria. Simultaneously, COMPASS leverages GenAI to identify suspicious language patterns, inconsistencies, or mismatched account details, flagging them for further investigation. This dual functionality enables real-time oversight and post-call audits for actionable insights.
- Benefit: COMPASS helps mitigate compliance risks by ensuring agents meet regulatory standards during every interaction. It also enhances fraud prevention by detecting potential threats early, reducing financial losses and protecting customer trust. These capabilities foster a culture of accuracy, security, and accountability.
- Concrete Example: A health insurance provider uses COMPASS to monitor conversations for proper GDPR disclosures while simultaneously flagging calls with mismatched claim information. This dual application ensured compliance across interactions and helped uncover fraudulent claims, saving the insurer significant regulatory and financial costs.