Nurix AI: Clarifying Policies & Payments for Health Insurance Customers

Give policyholders clear answers, faster. Improve CX, reduce costs, and scale effortlessly with Nurix AI.

The Problem: Policy Questions Overloading Support Teams

Health insurance providers often face high volumes of routine queries from customers, particularly around policy inclusions, exclusions, premium breakdowns, and claim eligibility. Support agents spend significant time clarifying basic information that is often already available within internal systems. This not only increases operational costs but also leads to longer wait times and reduced customer satisfaction.

To improve customer experience and streamline operations, the provider looked for a scalable way to automate policy-related interactions. The goal was to ensure customers received instant, accurate answers through their preferred channels without increasing call center headcount or compromising service quality.

By introducing AI-powered automation, the provider aimed to offload repetitive queries, reduce response times, and allow human agents to focus on more complex customer needs, ultimately driving both efficiency and satisfaction.

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The Use Case

Policy Detail Clarification

Premium & Payment Breakdown

Claim Eligibility Assistance

Routine Customer Query Handling

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The Solution: Always-On AI Agents for Policyholder Support

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Detailed Policy Clarification

Explained key aspects of individual policies such as coverage, inclusions, exclusions, and renewal timelines with clear, personalized responses.

Real-Time Premium Insights

Provided instant breakdowns of premium structures and payment details by retrieving data directly from the customer's specific policy.

Smart Automation with Human Escalation

Resolved repetitive queries automatically while including a flagging mechanism to escalate complex or sensitive cases to human agents when needed.

Always-On, Scalable Support

Provided 24/7 assistance—even after hours, day and night, reducing response delays and ensuring consistent service without increasing headcount.

Seamless System Integration

Integrated with policy administration systems to deliver accurate, real-time information without disrupting existing workflows, and with 100% of the heavy lifting handled by Nurix.

“What used to take hours and multiple touchpoints is now resolved instantly—24/7. Nurix AI gave us faster resolution, happier customers, and major cost savings.”

— Head of Customer Experience, Leading Health Insurance Provider

The Impact: Faster Support, Lower Costs

75%

of policy-related queries

were fully resolved by the AI—no human needed.

3X

faster response time

across chat and call channels, significantly improving satisfaction scores

30%

reduction in support costs

thanks to automation and fewer escalations.

15–20

agent hours saved

weekly, redirected toward claims, retention, and complex support

Stop handling policyholder queries manually. Start delivering faster, smarter support.

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Let Nurix AI turn every customer interaction into a clearer, more efficient experience.

Experience our solution