Microsoft Scenario Library Financial Services Insurance – Process a claim

Available with: Microsoft 365 Copilot and Copilot Studio

Financial Services scenario: Insurance – Process a claim

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Scenario

For Insurance simplify the claims process with improved data access and communications,

1. Summarize customer support issues

Develop a Power Automate workflow to notify claims agents of issues with their customers.

Power Automate icon

Copilot in Power Automate

Benefit: Prioritize customer issues from a given time period.

Use Copilot to update a claims form based on information in an email.

Microsoft Copilot icon

Microsoft 365 Copilot Chat2

Benefit: Quickly update claims forms without having to search for specific content.

Use a custom agent built using Copilot Studio to find answers to common questions.

Copilot Studio icon

Copilot Studio Agent

Benefit: Quickly get answers to questions about policy coverages.

Summarize claim content prior to a settlement discussion.

Microsoft Copilot icon

Microsoft 365 Copilot Chat2

Benefit: Quickly summarize documentation across internal documents and customer calls and emails.

Generate call transcripts from Teams Phone and create summaries of first notice of loss (FNOL) calls.

Microsoft Teams icon

Copilot in Teams

Benefit: Ensure call transcripts are captured and important points are captured in a summary.

Ask Copilot to draft a response to a customer claim based on the available documentation.

Microsoft Copilot icon

Microsoft 365 Copilot Chat2

Benefit: Quickly draft email content with the appropriate tone and depth.

KPIs

Opportunity to impact key functional area KPIs

Generate insights and content within the everyday flow of work, expedite investigations, and communicate more effectively to prevent and remediate compliance issues.
Speed data analysis and reporting
  • Quickly analyze trends
  • Generate informative charts
  • Create strategy presentations

Improve productivity by leveraging automation to quickly prioritize and accomplish daily tasks, optimize processes, and save time and effort on daily tasks.
Boost productivity
  • Rapidly research customer interactions
  • Create first drafts faster
  • Check for similar issues and resolutions
  • Quickly send follow-up communications

Differentiate customer interactions from competitors to help increase market share; Reduce the time for comprehensive portfolio evaluation with change recommendations reflecting market dynamics; Build trust and confidence among clients leading to increased number of active investors. 
Improve customer meetings
  • Research company information
  • Learn how to pitch the product
  • Organize information from past interactions
  • Completely focus during the meeting

Streamline operations for faster resolution of customer issues, providing tools for decision-making and strategy development. This can lead to higher customer satisfaction, increased customer lifetime value, and maximized customer investment portfolio.
Improve customer satisfaction
  • Diagnose a problem quickly using
    external and internal databases
  • Automated analysis using customer data and knowledge base
  • Quicker and more accurate draft responses
    based on historical resolution data
  • Proactive and personalized follow-up communications

The content in this example scenario is for demonstration purposes only. You should evaluate how Copilot aligns with your organization’s business processes, regulatory requirements, and responsible AI principles.