We designed the entire solution from the perspective of those it is intended for – self-employed individuals and voluntary payers. To capture attention, the chatbot immediately asks if the insured has forgotten to pay their premiums and gains attention with options like “Do I owe anything?” or “Should I pay in my situation?” As the conversation continues, the chatbot explains to the user whether there is an obligation for independent payment related to their situation or if this is covered by their employer or the state. When necessary, the chatbot points out that people often become voluntary payers even for just a few days, and due to ignorance of the regulation, they inadvertently find themselves among the debtors of the health insurance company. At this step, the chatbot also offers a novelty – the ability to identify a specific insured individual by entering their birth number and insurance number directly into the chat window to check if the specific insured person currently has a debt registered with the health insurance company Důvěra. If the insurance company records a debt, the chatbot user is given the option to resolve this situation directly in the chat window and pay the debt through bank transfer or credit card. Depending on the amount and type of debt, the chatbot may even offer the insured individual alternatives such as setting up a standing order or a payment schedule.

Our team diligently studied all the specifics and fine points of annual reconciliation, designed the solution logic, the tone and method of communication for the chatbot and developed the conversation scenarios for the respective types of insured persons. We worked with the client to process the most typical situations and FAQs so that to ensure the chatbot delivers maximum efficiency while answering exactly the questions the customers expect it to answer. The chatbot will thus explain whether the customer should expect to receive a reconciliation, how will he/she find it, what they should do in case of any reservations or errors. Large number of clients turns to the call centre every day, while most of them typically ask simple questions. They often ask what they should do with an excess payment or payment that is in arrears. The chatbot knows ins and outs of how this works, it has answers to many other questions too, and will provide equally competent advice whether you are an employer, employee, or a freelancer.

In the next step, we analysed and processed the largest possible number of various situations that clients of the insurance company may encounter. We then turned every situation into a fictitious dialogue in which we use simple and comprehensible form to advise the clients what they should keep in mind when sending notifications to their health insurance company as well as what is the fastest way to comply with the requirements.

We applied a chatbot on the Dôvera website which explains the clients in a relaxed and friendly language how they can apply for their dental benefit after activating the mobile app, what types of care come with this particular benefit as well as whether their dentist is contracted by Dôvera. The ‘Zdravé zuby’ benefit – Slovak for healthy teeth – belongs to the most popular benefits offered by the insurer to its clients. Under the scheme, clients insured in Dôvera can receive a contribution for dental care or dental hygiene treatment as many as four times a year.