For decades, healthcare and insurance contact centres have struggled to balance operational efficiency with genuine empathy. Customers want quick, accurate answers about their care, coverage or claims — but legacy manual workflows often make that difficult — and AI is here to change that, according to Ushur.
Traditional solutions such as increased headcount or outsourcing are no longer sustainable. Instead, AI-powered self-service tailored for regulated industries has emerged as a scalable alternative.
The goal isn’t to replace people but to eliminate the friction that prevents them from delivering meaningful, high-value customer experiences.
From chatbots to agentic AI
Most current automation tools remain reactive — chatbots that handle simple FAQs or ticket routing without understanding context or intent.
Agentic AI, however, represents the next stage of automation. It is designed for proactive, outcome-driven engagement, interpreting customer needs, retrieving contextual data and taking compliant actions that resolve issues rather than merely responding to them.
For instance, when a policyholder checks a claim’s status, Agentic AI can verify their identity, update records and trigger the next workflow automatically. This is automation with intent — improving efficiency while preserving trust and compliance.
AI-powered self-service in healthcare and insurance
AI-powered systems are transforming how service is delivered across healthcare and insurance sectors.
Call deflection allows customers to complete tasks via secure digital channels like Ushur’s Invisible App™ without waiting on hold. Proactive AI Agents remind patients about appointments or policy renewals, while document automation speeds up data processing. When human empathy is needed, the system transfers full context to live agents to ensure seamless support.
McKinsey estimates that AI can automate 30–50% of inbound contact centre tasks without compromising quality.
Many enterprises using domain-trained, compliant AI solutions are already outperforming those figures, reducing cost-to-serve, accelerating resolution times and enhancing customer satisfaction.
Real-world transformation
Leading organisations are already realising measurable gains from AI-driven transformation.
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A Fortune 250 group benefits carrier digitised its leave-of-absence process, cutting outbound calls by 42% and achieving an 85% engagement rate.
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Cigna automated claim status updates and email routing, reducing related call volumes by 40–50%.
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A major healthcare payer serving nearly two million members deployed Ushur’s AI Agent for 24×7 support, deflecting 21% of inbound inquiries to digital channels and improving after-hours service.
These results show how AI can combine efficiency with empathy — delivering compliant, reliable service at scale.
Looking ahead
The future of contact centres isn’t about replacing agents but restructuring around measurable outcomes.
The journey typically starts with automating high-frequency inquiries, establishing clear governance, and evolving toward an AI “command centre” that learns continuously.
For leaders, success depends on adopting AI responsibly — safeguarding compliance, trust and operational integrity.
That involves robust governance frameworks and readiness programmes, such as Ushur’s AI Agent Governance & Safety initiative. As the industry evolves, the organisations that combine intelligence with integrity will set the standard for customer care in the digital era.
Read the full blog from Ushur here.
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