The insurance industry is approaching an inflection point in customer experience. Expectations defined by digital-native industries have essentially changed what customers consider acceptable. Speed, continuity, clarity and empathy are now table stakes. Simultaneously, insurers are navigating rising claims severity, climate-driven volatility, medical inflation, increasingly sophisticated fraud and heightened regulatory scrutiny.
In this environment, customer experience is no longer solely a front-office concern. It has become a structural challenge that spans underwriting, claims, billing, finance, operations, technology and partner ecosystems.
Industry studies continue to highlight a disconnect between insurers’ perceptions and customer reality.
For instance, public findings from a recent J.D. Power auto insurance claims study indicate that a large majority of customers who report poor claims experiences express strong intent to switch carriers.1
This gap signals not a lack of intent but a failure to translate investments into consistent execution.
Nowhere is this more visible than in the contact center. Once treated primarily as a cost center, it has become the coordination nerve center of the insurance enterprise — often the only place where policy, claims, billing and customer context converge. Notwithstanding substantial investments in Customer Relationship Management (CRM) platforms, Contact Center-as-a-Service (CCaaS) modernization, digital channels, analytics and automation, insurers still struggle to deliver seamless, end-to-end experiences. Customers re-state details. Agents navigate multiple systems. Status updates lag reality.
The problem is no longer a lack of tools. It is a lack of orchestration.
The Realities of Insurance Customer Experience
Insurance CX is harder to modernize than most industries because journeys are long-running, regulated and inherently multi-party. A single claim may involve brokers, adjusters, medical providers, repair networks, legal teams, re-insurers and multiple internal operations groups.
Changing Customer Expectations
Customers now expect insurers to deliver seamless, omni-channel experiences. They expect fast, accurate answers without reiterating information. During times of stress, they expect empathy paired with accuracy. They expect insurers to already know who they are, what policies they hold and where things stand.
Most legacy architectures were never designed for this level of continuity. Many insurers still operate multiple policy administration systems, fragmented claims platforms, separate CRM instances and aging billing solutions. Agents are forced to navigate across multiple screens, manually reconcile data and piece together context in real-time. As digital engagement increases, these barriers become more visible and more damaging to customer confidence.
Operational and Financial Pressures
At the same time, insurers face mounting cost pressures driven by climate volatility, medical inflation, increasingly sophisticated fraud and sustained pricing competition. Manual processes slow claims resolution, increase leakage, inflate call volumes and erode productivity. Improving customer experience is therefore not simply a service priority; it is a financial imperative. Minimizing obstacles lowers cost-to-serve, improves accuracy, accelerates settlements and strengthens risk control.
The Rise of Digital-first Service Models
Digital-first does not mean doing away with human support. Instead, it signals a change toward journeys in which predictable tasks are handled digitally, while human expertise is reserved for complex, sensitive or emotionally intense interactions. Examples comprise automated First Notice of Loss (FNOL) intake, digital document submission, proactive claim status updates and AI-assisted servicing.
However, many insurers lack the architectural foundation to support these models at scale. Batch-driven data movement, inconsistent workflows and siloed teams constrain digital journeys. Without deeper integration and orchestration across systems, “digital-first” often remains limited to isolated touchpoints rather than end-to-end experiences.
Market Disruption from New Entrants
InsurTechs and embedded insurance players have raised the bar even higher for simplicity, transparency and speed. Their operating models are typically cloud-native, API-driven and designed around intuitive, low-friction digital journeys. While they may not yet match traditional insurers in product breadth, regulatory complexity or claims sophistication, they are re-shaping customer expectations, particularly for customer enrollment, quotes, servicing and FNOL.
For incumbent carriers, the challenge is not to replicate these models feature-for-feature, but to deliver the same continuity and responsiveness across far more complex products, legacy estates and multi-party ecosystems.
Journey Complexity
Insurance journeys remain inherently complex. This complexity is invisible to customers, but it creates significant execution challenges internally. When systems fail to stay synchronized, handoffs impede work, documentation gets lost and communication breaks down.
Contact centers sit at the center of this ecosystem, but they cannot deliver consistent outcomes without full visibility and coordinated execution across the journey.
Data Fragmentation and the Need for Real-time Intelligence
Insurance data is distributed across policies, coverages, assets, beneficiaries, claims, invoices, communications and external sources. Much of it remains siloed, batch-updated or trapped in documents rather than structured fields.
AI-powered customization, automation, predictive insights and compliance all depend on unified, well-governed, real-time data. Without addressing data fragmentation, AI remains limited and CX improvements plateau quickly.
Digital-first journeys fail when systems cannot move at the speed of the customer.
The Technology Paradox: Mature Platforms, Broken Journeys
Modern insurance customer experience is defined by a layered technology ecosystem. Each layer has evolved considerably over the past decade. Yet none can deliver an unbroken customer experience on its own.
True customer experience transformation depends not on strengthening individual layers, but on how effectively they operate together as a unified service architecture.
Why CRM and CCaaS Modernization is Inadequate
CRM platforms are now central to insurance CX. They unify customer views, support structured case management and provide agents with guided workflows. CCaaS platforms have modernized engagement across voice, chat, messaging and digital channels.
Collectively, they have materially improved interaction quality and agent productivity.
However, this pattern — strong gains at the interaction level followed by stalled momentum at the journey level — is not unique to insurance.
Enterprise AI research shows that while several organizations have deployed AI in specific functions, nearly two-thirds have not yet started scaling AI across the enterprise. 2
The primary barriers are not model performance, but data fragmentation and integration gaps across systems.
Insurance CX reflects this same execution challenge. Neither CRM nor CCaaS platforms were designed to own end-to-end insurance execution. CRMs depend on core systems for authoritative decisions. CCaaS platforms manage interactions, not long-running, multi-party processes. When work moves beyond the
interaction — into policy changes, billing adjustments, claims adjudication or third-party coordination — responsibility shifts elsewhere.
The result is a familiar pattern.Agents leave modern interfaces to complete work in legacy systems. Updates lag reality. Customers follow up for status. Escalations increase.
The issue is not platform capability. It is that no single layer owns the journey from intent to resolution.
Orchestration, Core Systems and ERP: The Missing Link in CX Execution
To fix the gap between interaction and resolution, insurers must treat orchestration and systems of record as CX enablers, not back-office plumbing.
Orchestration is where journeys are won or lost.
Workflow platforms can coordinate multi-step processes, enforce service-level agreements, reduce handoffs and maintain auditable execution across teams. This is essential in regulated environments, where the “how” of resolution matters as much as the outcome. However, orchestration succeeds only when connected to authoritative systems of record.
Core systems and ERP are the source of truth.
Policy administration systems define the contract — coverages, limits, deductibles, eligibility, endorsements and renewals. Claims systems govern operational implementation — FNOL through investigation and settlement. ERP platforms hold payment schedules, invoice history, refund information, collection status, reconciliations and fiscal amendments, which frequently drive customer communications.
When these systems are not integrated in real-time, CX becomes informational rather than executable. Agents can see, but cannot act. Digital channels can display, but cannot resolve. Automation becomes brittle when it operates on stale or partial data.
This is also why “AI-first CX” strategies frequently stall. The application of Agentic AI in insurance can summarize, classify, route and generate content. However, it cannot deliver reliable domain reasoning unless grounded in structured, real-time core data and governed execution paths.
Data Platforms and AI Foundations: Real-time Beats “More Data”
Modern data platforms such as Databricks and Snowflake enable insurers to unify structured and unstructured data, operationalize analytics and support AI at scale. They can power document intelligence, fraud detection, segmentation, next-best-action recommendations and personalization.
However, data scale is not the same as data readiness. The real constraints are:
This is why the shift from batch to real-time matters. CX requires live visibility into policy status, claim progress, payments and case states. Batch processes create latency that frustrates customers and drives avoidable inbound volume.
By 2026, best-in-class insurers will increasingly embrace event-driven architectures in which changes to core systems initiate instant updates across CRM, CCaaS, workflow and AI systems, accelerating resolution and proactive engagement.
The Orchestration Gap Holding the Industry Back
Despite modernization across CRM, CCaaS, workflows, the core platform and data, enterprises still face structural gaps that prevent truly orchestrated insurance journeys. The biggest ones are architectural, not tool-related:
The “360-degree view” is still a promise, not a real-time journey state.
CCaaS manages interactions, not multi-party execution.
AI often solves micro problems, not end-to-end journeys.
Workflow platforms rarely capture full insurance sequencing and compliance needs.
Data architecture remains the biggest constraint.
Unified desktops do not eliminate back-end fragmentation.
Explainability and auditability remain difficult without strong data lineage and governed workflows.
What AI-led Insurance CX Will Look Like in 2026 and Beyond
By 2026, insurance CX will increasingly evolve from reactive service to real-time orchestration driven by Agentic AI, unified data models, integrated workflows and event-driven architectures.
Key shifts will define this evolution:
Why Orchestration is Now a Leadership Mandate
The next era of insurance CX will not be defined by better channels, bigger platforms or isolated AI pilots. It will be defined by orchestration, the ability to unify engagement, workflow, systems of record, data and intelligence into a coherent service fabric.
Insurers that embrace architectural unification, real-time data flows and governed execution will deliver experiences that seem seamless, predictive and trustworthy while improving efficiency and reducing avoidable work. Those that do not will continue to modernize layers while CX outcomes plateau.
Insurance CX transformation is no longer a technology adoption challenge. It is an enterprise orchestration challenge and 2026 will reward the carriers that treat it that way.
Explore how AI is transforming insurance from core to edge.
References
-
https://www.jdpower.com/business/press-releases/2024-us-auto-claims-satisfaction-study
-
https://www.mckinsey.com/capabilities/quantumblack/our-insights/the-state-of-ai