We built a WhatsApp-based claims communication platform over 12 weeks. Claims notification via WhatsApp (weeks 1-4): policyholders could initiate claims via WhatsApp by: sending a message to the insurer's WhatsApp number (+41 44 XXX XXXX), being guided through a structured claims notification flow: first, the system asked for their policy number (verified against the policy administration system), then the system asked for the type of claim (interactive list: property damage, motor accident, motor theft, liability, personal accident), then guided documentation collection based on claim type: property damage — photos of damage (minimum 3 angles), description of incident, estimated damage value, police report if applicable; motor accident — photos of vehicles, accident sketch or description, other party details, police report reference; motor theft — police report reference, last known location, vehicle details.
Each claim type had a tailored documentation checklist — the WhatsApp flow systematically collected each required document, confirming receipt and identifying any missing items immediately rather than discovering gaps days later during assessor review.
Automated status notifications (weeks 3-7): throughout the claims lifecycle, policyholders received WhatsApp notifications: claim registered (confirmation with claim reference number, assigned handler name, expected timeline — sent within 30 minutes of claim submission), documentation complete (confirmation that all required documents had been received — or notification of specific missing items with instructions on what was still needed), assessor assigned (assessor name, expected contact timeline, and — for property claims — available appointment slots for physical inspection, selectable via interactive message), assessment complete (summary of assessment findings, coverage confirmation, settlement offer — with interactive buttons: "Accept Offer" / "Discuss with Handler" / "Request Review"), payment approved (payment amount, expected payment date, payment method confirmation), and payment processed (confirmation of payment execution, reference number, bank statement expected date).
Proactive document collection (weeks 4-8): the system actively managed document collection via WhatsApp: day 1 (after claim notification) — automated reminder for any documents not submitted during initial notification (with specific list of what was missing), day 3 — follow-up reminder with simplified instructions and offer to connect with a human agent for assistance, day 5 — human agent outreach for claims with outstanding documents (the agent could see exactly what was missing and guide the policyholder through submission). Photo quality validation: when policyholders submitted damage photos, the system assessed image quality (resolution, lighting, focus, angle coverage) and immediately requested replacements if photos were insufficient — rather than the assessor discovering inadequate photos days later and requesting new ones.
Human agent integration (weeks 5-10): when conversations required human intervention (complex claims, complaints, negotiations, sensitive situations), the system routed to human agents: agent workspace — a web-based interface showing: all active WhatsApp conversations assigned to the agent, customer context (policy details, claim history, previous interactions), and conversation history (full WhatsApp thread including chatbot interactions). Language-based routing — conversations in French routed to French-speaking agents, Italian to Italian-speaking agents, German and English to the general team. Priority routing — high-value claims (above CHF 50,000), escalated complaints, and VIP policyholders (bundled commercial clients) routed to senior handlers. Agent response tools — templated responses for common situations (customisable per agent), quick access to policy and claims system (pull up claim details without leaving the WhatsApp interface), and internal notes (agents could add notes to conversations visible to colleagues but not to the customer).
Analytics and reporting (weeks 8-12): comprehensive dashboard showing: conversation volumes (by hour, day, claim type, language — enabling staffing optimisation), response times (chatbot response time, human agent first response time, resolution time — tracked against SLAs), automation rate (percentage of conversations fully handled by chatbot without human intervention), document collection metrics (average documents per claim, time to complete documentation, photo quality acceptance rate), and customer satisfaction (post-interaction CSAT survey via WhatsApp — simple 1-5 star rating with optional text feedback). Compliance and archiving: all WhatsApp conversations stored in the insurer's document management system (linked to the claim record in the claims management system). Conversations retained according to the insurer's data retention policy (claim-related communications retained for the statutory retention period). Personal data handling compliant with nDSG — privacy notice sent at the start of each conversation, data processing transparent and documented.