Autonomous AI Agents for Customer Support
Median resolution time
CSAT improvement
Scale at constant headcount
Autonomous AI Agents for Customer Support
Median resolution time
CSAT improvement
Scale at constant headcount
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What Is Agentic Customer Support Automation?
Customer support in insurance is high-volume, exception-heavy, and compliance-sensitive. Traditional automation digitized fragments of it: chatbots, routing rules, ticket triage. But humans still reconciled messy data, interpreted policy language under pressure, and made every judgment call. The process stayed manual.
Otera replaces that patchwork entirely. Specialized AI agents run the full workflow autonomously: classifying requests, verifying coverage, generating compliant responses in 100+ languages, escalating exceptions, and syncing every action to your systems of record. Governed end-to-end, not patched together. The result: resolution in minutes, not days, at unlimited scale.
Meet Otera’s AI Agents for Customer Support
Our agents are built for insurance-grade customer service operations, trained on domain-specific data, and deployed with governance and explainability at their core.
The impact
Every mis-routed request costs twice: a specialist wastes time on a routine case while a genuinely urgent one sits undetected. Under volume, even a small misclassification rate compounds into thousands of wasted hours and measurable CSAT erosion. This agent eliminates that hidden cost at the source.
How it works
- Decomposes multi-intent, multilingual, emotionally charged requests into distinct governed workflows, including a customer simultaneously disputing a charge, asking about coverage, and threatening to cancel
- Classifies intent, urgency, risk, and emotional intensity in parallel
- Routes each request to autonomous resolution or the right specialist tier with full context
Why it matters
Classification shapes the entire support journey. When it fails, simple cases escalate, urgent cases wait, and your most expensive people spend their day on work that should never have reached them. This agent ensures every request enters the correct workflow from first touch, protecting specialist capacity and enabling autonomous resolution at scale.
The impact
Every downstream decision is only as good as the data beneath it. Incomplete fields, blurry scans, and inputs scattered across channels cause silent failures that surface as rework, re-contact, and resolution delays. This agent transforms that upstream chaos into governed, machine-ready data.
How it works
- Reconstructs complete customer context from fragmented inputs: a blurry damage photo in one email, a policy number in a follow-up chat, a handwritten form faxed separately
- Reconciles contradictions between what customers type and what their attachments contain
- Structures every input into normalized, auditable data objects with confidence scores and source lineage
Why it matters
In many support operations, manual data correction consumes up to 40% of handling time. That is pure waste: no value to the customer, no use of judgment, just re-keying. This agent eliminates it, ensuring clean data enters the workflow from the start so autonomy scales without rework or quality erosion.
The impact
A human agent spends several minutes per policy lookup: finding the right clause, verifying coverage, interpreting exclusions. Multiply that across thousands of daily requests and policy review becomes one of the largest hidden capacity drains in support operations. This agent replaces that friction with instant, deterministic coverage reasoning.
How it works
- Interprets multi-clause coverage questions, overlapping exclusions, and conditional endorsements, including edge cases like a claim falling under two exclusions but partially reinstated by a mid-term endorsement
- Applies identical governed logic across thousands of reviews per day, eliminating interpretation drift across shifts, teams, and regions
- Produces audit-ready decision context with the specific policy language and logic path behind every determination
Why it matters
Policy interpretation is where consistency breaks down at scale. Human judgment varies most in exactly the edge cases where precision matters most. This agent removes that variability entirely, shortening resolution cycles, eliminating coverage disputes caused by inconsistent answers, and freeing your team for interactions that genuinely require human care.
The impact
Responses are where customers feel the outcome of your entire operation. A correct decision delivered through a confusing or impersonal message still erodes trust and generates repeat contacts. Under volume, response quality is the first thing to degrade. This agent ensures every response is governed, personal, and resolution-complete.
How it works
- Generates responses reflecting the customer’s full history: prior interactions, complaint patterns, policy changes, and open items, so customers never repeat themselves
- Applies governed communication standards defined in plain language by your team, ensuring compliance without per-message human review
- Proactively resolves adjacent issues before they generate follow-up contacts
Why it matters
Each additional exchange in a back-and-forth costs handling time, delays resolution, and measurably reduces CSAT. In many teams, reviewing and rewriting messages consumes significant capacity while quality still varies by shift. This agent standardizes every response at source, driving higher first-contact resolution, fewer repeat contacts, and a consistent experience that builds retention.
The impact
Escalation decisions today depend on whoever picks up the case: their experience, their read on urgency, their familiarity with routing rules. That variability is expensive in both directions. Missed escalations create regulatory incidents and customer attrition. False escalations flood specialist queues with routine work. This agent replaces that inconsistency with adaptive deterministic routing.
How it works
- Evaluates risk signals in real time: regulatory sensitivity, customer lifetime value, complaint history, emotional intensity, and authority matrix alignment
- Distinguishes between a frustrated customer venting about a delayed refund and a regulatory complaint requiring legal review within 48 hours
- Feeds escalation outcomes back into routing logic, continuously tightening the boundary between autonomous and human handling
Why it matters
In high-volume environments, no human can hold the full decision matrix across hundreds of daily cases. This agent ensures specialists receive only cases requiring their expertise, with complete context, while routine requests resolve autonomously. The result: protected specialist capacity, zero SLA breaches, and a governed audit trail that satisfies both internal compliance and external regulators.
The impact
When regulatory guidance changes, it can take weeks for every agent across every region and shift to internalize the update. In the interim, customers receive inconsistent answers, and some create compliance exposure. This agent ensures every response reflects current approved guidance from the moment it changes.
How it works
- Performs semantic retrieval across approved content, surfacing specific guidance for each situation rather than generic FAQ matches
- Extracts regulatory-mandated language and disclaimers that must appear verbatim in certain response types
- Refines retrieval ranking from agent corrections and escalation outcomes, becoming more precise with each cycle
Why it matters
Knowledge fragmentation is a structural problem that training cannot solve. During crises, media events, or sudden request spikes, hundreds of agents answering the same question differently creates uncontrolled risk. This agent centralizes knowledge retrieval through governed, continuously updated semantic search, ensuring consistent, compliant responses regardless of channel, agent, or whether the relevant guidance changed yesterday.
Autonomous Agents for Customer Support
Adaptable Across All Support Scenarios
Claims-Related Inquiries
Status checks through settlement communication, governed end-to-end in one flow.
Policy Questions
Coverage, exclusions, and mid-term changes resolved with consistent, explainable logic.
Billing and Payment Support
Discrepancies, refunds, and allocations validated against policy and transaction data instantly.
Onboarding and KYC
Identity validation and document processing across regions, jurisdictions, and customer types.
Fraud and Escalation Cases
Risk signals detected and sensitive cases routed deterministically with full audit trails.
Renewals and Endorsements
Eligibility checks, modifications, and customer communication executed without handoffs or drift.
Complaints and Feedback
Prioritized, responded to, and logged to meet regulatory requirements automatically.
Broker and Partner Requests
Multi-party documentation exchange and policy confirmation across channels and formats.
PR and Media Requests
Classified, validated, and routed to the right stakeholder with controlled escalation.
Multilingual Requests
Full resolution in 100+ languages with insurance-specific meaning and compliance preserved.
General Support
High-volume service questions resolved autonomously, humans reserved for true exceptions.
Crisis and Surge Events
Thousands of identical requests resolved consistently without staffing scrambles or quality decay.
Velocity for Your Automation Team, Governance for Your Support Team
For your Automation Team: High velocity, reusable building blocks
A unified platform where guardrails are defined once and applied everywhere.
Before Otera
- Fragmented automations that don’t compose
- One-off logic recreated per workflow
- Governance retrofitted after deployment
- Quarters from build to production
With Otera
- Reusable building blocks across all workflows
- Logic defined once, applied everywhere
- Governance embedded from day one
- Weeks from configuration to scale
Setup Time
Deployment Rework
Reusable Across Workflows
For your Support Team: Governed, consistent resolutions
A consistent support engine that resolves predictable inquiries instantly and handles complexity with clarity.
Before Otera
- Backlogs driven by manual review and rework
- Inconsistent decisions across agents and regions
- Limited visibility into why cases escalate
- Compliance dependent on individual judgment
With Otera
- Backlogs driven by manual review and rework
- Inconsistent decisions across agents and regions
- Limited visibility into why cases escalate
- Compliance dependent on individual judgment
Resolution Time
CSAT
Opex Savings
Get Unlimited Capacity at Lightspeed at a Fraction of Current OpEx
Achieve the highest possible straight-through resolution rate without compromising oversight.
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+20% higher CSAT
Requests resolved in minutes, not days.
Same-hour resolution at scale
End-to-end, without queues or handoffs.
Churn reduction at source
Consistent quality service removes friction driving attrition.
Exponential OpEx savings
Most requests resolve without human handling.
Interpretation drift eliminated
Governed reasoning replaces inconsistent human judgment.
Risk reduction by design
Every decision captured in audit-ready trails.
The Autonomous movement has already begun
The world’s most regulated industries already use Otera for proven 90%+ end-to-end automation on mission-critical operations:
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100+ Prebuilt Agents for Insurance Support
Deploy instantly across intake, triage, validation, and communication workflows.
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Claim Context Agent
Complete claim context from fragmented, multi-channel inputs.
Policy Review Agent
Deterministic coverage decisions across jurisdictions and edge cases.
Customer Identity Agent
Identity validation across damaged, expired, or non-standard documents.
Billing Document Agent
Invoice reconciliation across payment systems, currencies, and cycles.
Proof Of Funds Agent
Consistent funds validation regardless of format or jurisdiction.
Passport Agent
190+ passport formats understood, including non-Latin script.
Connect your existing infrastructure
Pioneering secure Agentic Automation
Trusted by leading Fortune 500 companies, Otera delivers best-in-class cyber security, data privacy and user trust with extensive encryption and infrastructure protection.
