Pega Customer Service for Insurance case types
Pega Customer Service for Insurance includes several standard case types. These case types are available for selection within the New Application wizard when you create your implementation application. Depending on your service needs, you might include all, none, or a subset of these case types in your application. In addition, you can create new case types to meet your service needs.
The following table lists the insurance service requests that are available with Pega Customer Service for Insurance. These service requests are created in the Insurance application and might be initiated in your front office or your back office. More complex service request processes that are initiated in the front office are ultimately routed to the back office for form verification, triage, approval, and resolution. Note that many service request types are available for selection in both the Personal Auto and Term & Whole Life bundles in the New Application Wizard. Regardless of bundle association, you can enable as many or as few of the service requests as you choose and mix from each bundle if necessary.
| Service request | Description |
| Change Dividend | A simple process that updates the current and secondary dividend options on a Whole Life policy. |
| Go Paperless | A simple process that facilitates the ability to receive standard policy documents for the selected policies electronically versus by standard mail. |
| Mid-Term Amendment | A guided process created in the Pega Underwriting for Insurance application and made available in Pega Customer Service for Insurance though Federated Case Management. This service request enables the user to initiate a Mid- Term Amendment for changes to the policy including its Drivers, Coverages, Vehicles, Named Insureds, and its Cancellation. Policy updates are passed to the Policy System of Record for additional rating and issuance. |
| Proof of Insurance | A simple, guided process that delivers Proof of Insurance cards for the selected vehicles to the policyholder. |
| Update Billing Frequency | A guided process that facilitates updating the billing frequency on one or more policies. |
| Update Customer Name | A guided process that updates the customer’s name. It can be initiated in the front or back office, and requires a thorough verification of the required form, which is conducted in the back office. |
| Update Lienholder | A simple process that updates the current lienholder information on an auto policy so that claims can be processed accordingly. |
| Add Driver | A simple process to support adding a new driver or editing an existing driver for an auto policy. The service case promotes the good student discount for drivers who are less than 21 years old and supports negotiation of a lower premium by selecting a higher deductible amount. |
| Auto Quote | A guided process created in the Pega Underwriting for Insurance application, which is made available in Pega Customer Service for Insurance through Federated Case Management. It enables the user to initiate a simple auto quote. If accepted, the quote information is passed to the Policy System of Record for additional rating and issuance. |
| Commercial Certificate of Insurance | A guided process, in a Business to Business interaction, to download or email a PDF document that contains the policy information for a Commercial Property or General Liability policy. |
| Travel Quote | A guided process that enables the user to initiate a simple travel quote. |
| Book a Hotel | A simple process that selects and recommends the best hotel accommodation and allows booking a hotel when a flight is delayed. |
| Send Policy Values | A guided process to send a PDF document that contains the policy information for a Whole or Term Life policy. The CSR can send either aprinted copy of the PDF by mail or an electronic copy by email. |
| Travel Claim | A quick claim process that enables the insured to easily report an incident, while traveling. This process is built so that the claim data is passed via an API to the Pega Claims for Insurance application, where the claim is adjudicated and settled. Currently, we support claiming meals and hotel expenses. |
| Add new organization | Add a new organization and have it linked to a parent organization, if applicable. Part of the business bundle of service cases, capturing common business-to-business use cases. |
| Create a new contact | Add a new contact and authorized role to an account. |
Create opportunity* *Requires Pega Sales Automation license | Add, view, and modify sales opportunities during a customer service interaction. |
| Exercise customer data rights | Support customer requests to exercise their rights to data (addressing GDPR or CCPA data rights for example) by making a request for data access and follow on requests (if applicable) to rectify, restrict, or remove personal data. |
| File a complaint | Capture a complaint regarding any account, product, or other issues reported by a customer. |
| Log general service request | Create an ad-hoc case to log a general customer request. |
Make a sales offer* *Requires Pega Customer Decision Hub license | Upsell or cross-sell to the customer with an offer suggested by Pega Customer Decision Hub. |
Negotiate an offer* *Requires Pega Customer Decision Hub license | Present a negotiate retention offer to a customer as suggested by Pega Customer Decision Hub. |
| Modify Organization Links | View and maintain a list of organizations associated with a contact or account. Part of the business bundle of service cases, capturing common business-to-business use cases. |
| Post conversation CES survey | Launches a post-chat survey that measures customer effort score (CES), which is a measure of the customer effort while interacting with your business to resolve an issue. |
| Post conversation CSAT survey | Launches a post-chat survey that measures customer satisfaction score (CSAT), which is a measures of the level of customer satisfaction with a product or service that your business offers. |
| Post conversation NPS survey | Launches a post-chat survey that measures net promoter score (NPS), which provides a measure of the customer's willingness to promote the products and services of a business to others. |
| Schedule appointment | Schedule an activity such as a follow-up conference call for a customer (including the call start and end date, topic, location, and owner) or routing to a Workbasket. This task and workflow are shared across Pega Customer Service and Pega Sales Automation. |
| Send correspondence | Send correspondence via email to a customer (contact or account holder). |
| Send statement copy | Submit a statement copy request on behalf of a contact. |
| Sends NPS Survey | Captures the Net Promoter Score rating received from the customer. |
| Start co-browse session | Collaborate in real-time with a customer by sharing a browser session and providing visual guidance on how to navigate a website. |
| Update contact profile | Update contact profile information such as first, middle, and last name, date of birth, and marketing communication preferences. |
| Update organization details | View and maintain information associated with an organization including name and tax ID. Part of the business bundle of service cases, capturing common business-to-business use cases. |
Previous topic Build for Change