Handling insurance claims for death benefits is a delicate situation, not only because of regulations about who can be told what, depending on the location of the person who died and the person getting the benefits. There's also a need for sensitivity and care in the choice of words; after all, people being told they are eligible for benefits might not know of the death.
The company struggled with making sure the many regulations bound in printed manuals were being followed and had to invest considerable time in training staff to handle a wide range of possible circumstances. Despite the training, calls often took too long and failed to capture the information needed to continue the process. The company also found it hard to capture what had been learned about doing the process well.
To manage calls, a decision service applies business rules to information about the policy and scheduled call information. The rules control the entire death claims process, including call scripting, data acquisition, and data validation. The decision service applies the right subset of rules automatically, based on information about the person being called, the policyholder, and more. As policies or regulations change, the company incorporates them quickly by updating the decision service's business rules. Staff training focuses on empathy and interaction skills, not mechanics of the regulations. As a result, calls focus quickly, but not disrespectfully, on the information needed to continue the process.