Insurance — Billing Dispute

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INS-20260207-0847
Agent: Sarah Mitchell
Duration: 6:42
Category: Billing Dispute
0:00 / 6:42

Agent: Thank you for calling SafeGuard Insurance, my name is Sarah. How can I help you today?

Customer: Yeah, hi Sarah. I'm looking at my statement and there's a charge here for $47 that I have no idea what it is. My premium is supposed to be $189 a month and you're charging me $236.

Agent: I completely understand your concern. Nobody likes surprises on their bill. Can I get your policy number so I can pull up your account?

Customer: It's PH-4492-7731.

Agent: Thank you. I've got your account here. I can see the $47 charge — that's actually a mid-term policy adjustment fee. It was triggered when your vehicle information was updated on January 15th.

Customer: Updated? I didn't update anything! Nobody told me about any change. I've had the same car for three years.

Agent: I understand your frustration. Let me look deeper into this. It appears our system auto-updated your vehicle classification based on a DMV data refresh. Your 2021 Honda Accord was reclassified, which triggered the adjustment. I can see this wasn't something you initiated.

Customer: So you're telling me I got charged $47 because YOUR system decided to change MY policy without asking me? That's not right. I've been with SafeGuard for six years.

Agent: You're absolutely right, and I appreciate your loyalty. Six years is significant. Let me see what I can do. I'm going to reverse this $47 charge — you'll see the credit within 2-3 business days. And I'm flagging your account so this type of auto-adjustment won't happen again without your explicit approval.

Customer: Okay, that's better. But honestly Sarah, I was about to call Progressive. My neighbor switched and says he's paying $40 less a month for better coverage.

Agent: I hear you, and I'm glad you mentioned that before making a switch. We actually have a loyalty rate review program for customers with your tenure. Would you like me to run a quick comparison? It takes about two minutes and might save you more than that $40 difference.

Customer: Sure, go ahead.

Agent: Great. Based on your clean driving record and six-year history... I can offer you our Preferred Loyalty rate. That would bring your premium from $189 down to $167 per month — that's a $22 monthly savings, plus the $47 refund. Would you like me to apply that?

Customer: $167? Yeah, that's actually really good. Yes, please apply that. And make sure that automatic update thing doesn't happen again.

Agent: Done. Your new rate is effective immediately, and I've added the auto-update block. You'll receive a confirmation email within the hour. Is there anything else I can help with today?

Customer: No, that's it. Thanks Sarah, you actually turned this around. I was pretty upset when I called.

Agent: I'm glad we could resolve it. Thank you for your six years with SafeGuard, and don't hesitate to call if anything comes up. Have a great day!

87/100
Quality Score
Frustrated → Satisfied
Sentiment Journey
1 Violation
Compliance Flag
$264/yr saved
Customer Retained
✓ Resolved
First Call Resolution
😊 Sentiment Journey
Opening
Frustrated
Mid-Call
Cautious
Resolution
Satisfied
Close
Positive

Peak frustration at 2:14 — "That's not right. I've been with SafeGuard for six years."

⭐ Agent Performance — Sarah Mitchell
92
Empathy Score
88
Resolution Quality
85
Protocol Adherence
95
De-escalation
⚠️ Compliance Analysis
Identity Verified
Rate Change Disclosure
Refund Authorization
⚠️ Missing: Agent did not read required rate-change disclosure script when applying $167/mo loyalty rate. Regulatory risk.
💰 Business Impact
$2,268
Annual Revenue Retained
$47
Refund Issued
$264
Annual Discount Given
$1,957
Net Annual Value
🔄 Root Cause

System auto-updated vehicle classification from DMV data refresh without customer notification. Systemic issue affecting multiple policyholders.

Category: Billing / Auto-Update Error
Related calls this week: 47 similar
📝 Action Items
🔴 Train agents on rate-change disclosure requirement
🟠 Audit DMV auto-update process — disable until notification added
🟢 Flag 47 similar billing complaints for proactive outreach
🟢 Add Sarah Mitchell to "Top Performer" coaching program

That's ONE call. Now see what 4,127 calls look like.

Click "Yesterday" to see the full daily operations report.

Insurance — Daily Operations

Yesterday — February 7, 2026

Here's why your phone kept ringing — and what to do about it today.

4,127
Calls Analyzed
23
Compliance Flags
47
Churn-Risk Customers
72%
First Call Resolution
5.8 min
Avg Handle Time
$184,200
Annual Risk Flagged
847
Automation Opportunities
312
High-Risk Callers Identified
🔄 Why Customers Called Yesterday
Billing Questions
34%
1,403
Claims Status
22%
908
Policy Changes
18%
743
Coverage Inquiries
14%
578
Complaints
8%
330
Other
4%
165
⚠️ Compliance Violations (23)
TypeCountRisk
Missing rate-change disclosure9High
Identity verification skipped6Critical
Hold time disclosure missing5Medium
Recording consent not obtained3Medium
⭐ Agent Rankings
AgentCallsScoreFCR
Sarah Mitchell479289%
David Chen528985%
Maria Santos448782%
--- Bottom Performers ---
Kevin Park386154%
Lisa Johnson415849%
📝 Today's Action Items
🔴 6 calls with skipped identity verification — escalate to compliance team immediately
🔴 47 churn-risk customers identified — route to retention team today
🟠 Kevin Park & Lisa Johnson need coaching intervention — schedule by Friday
🟠 Billing auto-update issue drove 34% of call volume — IT ticket needed
🟢 847 calls could have been handled by IVR self-service — review automation roadmap

One day is a snapshot. See the patterns in 7 days.

Click "7-Day Trends" to see what's emerging across 25,847 calls.

Insurance — Weekly Trends

7-Day Trends — Feb 1–7, 2026

The patterns your QA team missed all week.

25,847
Calls Analyzed
142
Compliance Violations
289
Competitor Mentions
71.4%
Avg FCR
↑ 12%
Call Volume vs Last Week
$847,000
Weekly Risk Exposure
$124,500
Automation Savings Potential
$412,000
Revenue at Risk (Churn)
📈 Volume Trend (7 Days)
Mon
3,842
Tue
4,012
Wed
3,567
Thu
4,198
Fri
4,847
Sat
1,254
Sun
4,127

🔴 Friday spike (+23% vs avg) correlates with auto-payment failure batch processed Thursday night

🔄 Emerging Patterns
PatternCallsTrendImpact
Auto-pay failure complaints1,847↑ 340%$412K revenue risk
Claims processing delays >14 days892↑ 28%$189K
Rate increase confusion673↑ 15%$134K
Portal login/password issues521Steady$42K
Competitor comparison requests289↑ 67%$847K
👥 Agent Movement
AgentThis WeekLast WeekTrend
Sarah Mitchell9290
David Chen8987
Kevin Park6168↓ Declining
Lisa Johnson5863↓ At Risk
🟠 Kevin Park has declined 3 consecutive weeks — immediate coaching needed
📝 Weekly Action Items
🔴 Auto-pay failure is driving 7.1% of ALL call volume. Emergency IT fix needed — estimated $412K revenue at risk
🔴 289 customers mentioned competitors — retention campaign needed this week
🟠 Claims processing backlog creating repeat callers — 892 follow-ups this week alone
🟠 Kevin Park & Lisa Johnson need performance improvement plans
🟢 5,847 calls (22.6%) could be deflected to self-service — IVR enhancement ROI is $124,500/month

Weekly patterns reveal the truth. Now see the full picture.

The 30-Day Executive Report shows systemic issues, ROI, and your board-ready brief.

Insurance — Executive Report

30-Day Executive Summary — January 2026

108,492 calls. Every conversation analyzed. Here's what your operation looks like.

108,492
Total Calls Analyzed
487
Compliance Violations
1,247
Churn-Risk Customers
73.2%
Avg FCR
$2.18M
Total Value Delivered
$3.4M
Annual Risk Identified
$1.49M
Annual Savings Potential
$13,019
VoxAI Monthly Cost
167x
ROI
🎯 Top 5 Systemic Issues
#IssueCallsRevenue at RiskFix ComplexityRecommended Action
1Auto-pay failure + email-only notification9,847$1.4MLowAdd SMS notifications for payment failures
2Claims processing >14 days7,234$1.1MMediumAutomate status updates at 7, 10, 14 day marks
3Rate increase notification timing4,891$890KLowSend rate change notice 45 days before (currently 15)
4Portal login/password issues3,742$210KMediumImplement SSO + biometric auth on mobile
5Agent knowledge gap on new policy types2,891$340KLowTargeted training module — 2 hours
💰 ROI Breakdown
$890K
Churn Prevention
$480K
QA Labor Savings
$120K
Compliance Fine Avoidance
$2.18M
Total Monthly Value Delivered
VoxAI cost: $13,019 → 167x ROI
📊 Month-over-Month Trends
MetricDecemberJanuaryChange
Total Calls102,341108,492+6.0%
FCR Rate70.1%73.2%+3.1%
Avg Handle Time6.2 min5.8 min-6.5%
Compliance Violations512487-4.9%
Churn-Risk Customers1,0891,247+14.5%
CSAT (estimated)3.84.1+7.9%

Now cut to the chase. What should you actually DO?

The Director's Brief distills 108,492 calls into 5 decisions.

Director's Action Brief

If You Solve These 5 Problems...

VoxAI identified these from 108,492 calls. No sampling. No guessing. Here's your board slide.

108,492
Calls Analyzed
$3.94M
Total Revenue at Risk
$2.18M
Recoverable Value
3 Quick Wins
Low Complexity Fixes
🔴 Problem #1: Auto-Pay Failures Are Driving 9% of Call Volume
9,847
Calls/Month
$1.4M
Revenue at Risk
Low
Fix Complexity

Payment failures trigger email-only notifications. Most customers don't see them until statements arrive. By then they're angry, confused, and considering competitors.

Fix: Add SMS + push notifications for payment failures. Estimated 60% call deflection = 5,908 fewer calls/month. Implementation: 2 weeks.
🔴 Problem #2: Claims Take Too Long
7,234
Calls/Month
$1.1M
Revenue at Risk
Medium
Fix Complexity

Claims processing exceeding 14 days generates repeat calls. Customers call an average of 3.2 times before resolution. Each call costs $8.50 in agent time.

Fix: Automate status updates at 7, 10, and 14-day marks via SMS. Add self-service claims tracker to portal. Estimated 45% deflection.
🟠 Problem #3: Rate Increases Surprise Customers
4,891
Calls/Month
$890K
Revenue at Risk
Low
Fix Complexity

Rate change notices go out 15 days before effective date. 67% of callers say they "didn't have time to prepare" or "didn't see the letter."

Fix: Extend notice period to 45 days. Add multi-channel notifications (email + SMS + app). Include comparison showing what changed and why.
🟠 Problem #4: Portal Is Broken
3,742
Calls/Month
$210K
Revenue at Risk
Medium
Fix Complexity

Login and password issues force customers to call. Every portal failure is a missed self-service opportunity and an unnecessary $8.50 call.

Fix: Implement SSO + biometric auth on mobile. Add "magic link" passwordless login. Estimated 80% deflection of these calls.
🟢 Problem #5: Agent Training Gap
2,891
Calls/Month
$340K
Revenue at Risk
Low
Fix Complexity

New policy types launched in Q4 but agents weren't trained. 2,891 calls required supervisor escalation or callback due to knowledge gaps.

Fix: 2-hour targeted training module on new policy types. Estimated 70% reduction in escalations for this category.
🎯 Bottom Line for Your Board
$3.94M
Annual Revenue at Risk
$2.18M
Recoverable
$156K
Annual VoxAI Cost
14x
Annual ROI

Three of these five problems are low complexity fixes. Start there. The savings fund the harder ones.

This is simulated data. Imagine what yours looks like.

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