AI in Insurance Call Centers: Balancing Compliance, Consent, and Performance

Key insights for insurance call centers using AI

• AI’s biggest win today is simple: Answering every call and replacing rigid IVRs with natural, intent-based routing.

• Compliance is non-negotiable: AI-generated voice is classified as an “artificial voice” under TCPA, requiring explicit consent, proper disclosures, and real-time revocation handling.

• Retention drives ROI: Beyond acquisition, AI creates customer loyalty by speeding up service interactions and removing friction that leads to churn.

• AI isn’t plug-and-play: Success requires training, monitoring, and refinement over 60–120 days—similar to onboarding a new employee.

• Vendor risk is real: Carriers must vet AI providers for data handling, compliance certifications, and accountability before deploying at scale.

• Start simple, scale smart: Begin with call answering and routing, then expand while tightening compliance and selecting the right partners.

How AI is reshaping compliance and performance in health insurance call centers

AI has moved past the hype and into real-world operations. Insurance carriers are using it to pick up more calls, route customers faster, and handle service tasks that used to tie up human agents.

As more carriers experiment with replacing outdated IVRs and automating service workflows, the conversation is shifting toward what it actually takes to implement AI the right way.

Performance is only part of the equation. Teams also need to think critically about compliance, consent, vendor risk, and long-term viability, especially as regulators take a closer look at voice AI.

In a webinar session, “How insurance carriers use AI to reach and retain consumers,” hosted by ActiveProspect, experts shared their front-line perspective on where AI is gaining traction, where it's creating risk, and what insurance organizations need to have in place before moving forward:

• Matt Fraser – GM of Insurance at ActiveProspect

• John Henson – Founder at Henson Legal

• Brandon Debenham – Sales Leader at Liberate

• Andrew Bailey – Content Strategist at ActiveProspect

Below is a recap of what matters most for call center teams putting AI into practice, backed by real use cases and firsthand experience.

AI’s most immediate win is answering the calls

When most insurance teams started exploring AI, they assumed the biggest gains would come from technical use cases like quoting, claims intake, and backend automation. But in practice, the simplest use case is delivering the most impressive results.

Replacing outdated IVRs with AI-powered voice agents is one of the easiest upgrades a carrier can make and one of the most impactful. Instead of pushing customers through rigid menus, AI can pick up and immediately ask how it can help, then route the caller based on intent.

It’s especially valuable in everyday scenarios that drive service friction. Think about a customer who calls in, presses the number for “service,” waits on hold, gives up, calls back, presses “sales” just to reach a live person, and then explains they’re actually trying to get an ID card or make a payment. That kind of back-and-forth burns time, frustrates customers, and clogs up teams that should be focused elsewhere.

With AI, that entire experience changes. Every call gets picked up. The system can scale as needed and triage requests accurately, without sending people down the wrong path or forcing multiple callbacks.

For health insurance carriers getting started with AI, this is the fastest way to improve the customer experience, and it doesn’t require ripping out existing systems or rebuilding the tech stack. Once teams see how much smoother the call flow becomes, it’s an easy decision to expand from there.

Getting consent right in an AI-Powered workflow

Here’s where a lot of teams are getting tripped up: they’ve added AI to their contact center, but haven’t updated their consent practices to match.

Most carriers still rely on broad opt-in language like “I agree to be contacted by an automatic dialer.” But that doesn’t cover AI-generated voice.

In 2024, the FCC formally stated that AI-generated voice is considered an “artificial voice” under the TCPA. According to Henson, that puts it in the same regulated technology bucket as robodialers, prerecorded messages, and other tools that come with strict compliance requirements.

That classification changes the rules. Just because someone agreed to be contacted by an autodialer doesn’t mean they agreed to receive a call from an AI. That’s a separate category of risk, and it requires separate consent.

And consent alone doesn’t cover all your bases. How you handle the call matters just as much.

The TCPA requires specific disclosures when using artificial voice, including rules about when those disclosures must occur. As Henson explained, the message has to start within two seconds of pickup. 

He gave a simple example of what not to do: an AI voice saying, “Hey, this is John Henson from John Henson Insurance. Make sure you call us for your 2025 insurance quotes,” and then hanging up. 

Even if you have consent from that consumer to contact them with AI voice, that kind of message puts your organization at risk because it skips the necessary disclosures and doesn’t offer an opt out. 

AI needs to recognize when a consumer revokes consent 

And even if you get consent right on paper, you also need to handle revocation correctly.

AI systems have to recognize when someone wants out, even if they don’t say it plainly. It’s easy to program for “stop” or “unsubscribe.” It’s harder to account for comments like “you people call me all the time” or “leave me alone.” But legally, those count as revocations too. If your system can’t flag those moments and take action, you’re at risk.

You also need clear “off-ramps” during the call. A consumer should be able to interrupt the AI at any point and say “take me off your list” or “I want to talk to someone,” and the system needs to respond appropriately.

Why TCPA carries the bigger risk

And when it comes to risk, not all regulations carry the same weight. The TCPA, in particular, creates direct legal exposure for companies that get it wrong.

“Most people default to TCPA…and the reason for that is TCPA has a private right of action. Meaning, [a consumer] can sue a phone company for calling [in violation of] the TCPA. They cannot sue someone for TSR violations,” Henson said.

That difference matters. 

While the TSR is enforced by the FTC or state attorneys general, the TCPA gives individuals the power to take companies to court, and that’s where the real financial and reputational damage happens. It’s why compliance teams prioritize TCPA protections, especially when AI voice enters the picture.

How inbound calls handle consent on the fly

In outbound campaigns, you have to secure consent before dialing. But for inbound calls, there's a narrow window to get it in real time. 

If a customer calls in and your system doesn’t already have documented consent, you need to present the necessary disclosures and capture permission during the call. Otherwise, you're legally barred from following up using regulated technologies like AI voice. 

This puts added pressure on scripting and call flow design, especially in scenarios where a consumer shows intent but doesn’t complete a transaction on the spot.

The bottom line on AI compliance

AI voice technology, or conversational AI, changes your compliance responsibilities. If your consent language, scripting, or call handling processes haven’t been updated in the last year, now is the time to take a hard look.

Retention is the engine of sustainable growth

Acquiring new policyholders often requires a mix of inbound marketing and outbound strategy. And effectively reaching those prospects depends on dialing technology purpose-built to increase live connections and optimize campaign efficiency, such as Convoso Ignite.

But retention is where you make the real money.

In insurance, that means keeping customers happy, responsive, and connected, especially after the initial sale. And increasingly, that’s where carriers are putting AI to work.

AI is driving value far beyond outbound calls, especially in key service interactions. Some of the most valuable use cases are happening behind the scenes: policy updates, claims follow-ups, billing reminders, and other service touchpoints where speed and accuracy matter. These are the moments that shape a customer’s perception of the brand.

“If you can have an AI resolve a request in seconds...then you're not just saving cost. You're strengthening the customer relationship and their experience with your brand,” Fraser said.

That level of responsiveness can make the difference between a customer who renews and one who walks.

It also helps eliminate everyday friction that creates churn. For example, a customer might call in with a quick question about their billing date, which is something simple that doesn’t require a live agent. 

Instead of waiting in a queue or navigating a phone tree, AI can handle that request instantly, freeing up staff to focus on more complex issues and keeping the customer experience smooth and efficient.

AI cleans that up. It can answer every call, scale on demand, and route people where they actually need to go. No transfers. No guesswork. Just a faster, cleaner experience that keeps people from hanging up or churning.

Retention isn’t a flashy AI use case, but it’s one of the most important. The economics back it up, and the customer experience speaks for itself.

AI is not plug-and-play

The fastest way to kill momentum with AI is to expect too much on day one. Teams bring in voice AI assuming it’ll work perfectly out of the box. When it doesn’t, they panic, pull back, or declare it a failure. But the reality is that success with AI takes training and tuning.

“The truth is there is training that needs to happen with any sort of an AI technology... One of the pitfalls early on is having an unrealistic expectation of what AI can accomplish day one,” Debeham said. 

He explained that teams need to test, train, and tweak their AI voice tools to really optimize the process. Expect this to take anywhere from 60 to 120 days, just like onboarding a new employee.  

AI systems also require ongoing attention. They learn, evolve, and improve through feedback. That means teams need to actively monitor conversations, flag issues, refine responses, and build in smart escalation paths for when things go off-script.

If you treat AI like a plug-and-play tool, you’ll be disappointed. If you treat it like a long-term capability that gets better with use, it can become one of the most powerful parts of your contact strategy.

What smart buyers ask their AI vendors

The demand for AI is growing, and the market is noisy. Vetting vendors is a key aspect of risk management, and smart carriers are treating it accordingly.

“I think there’s a lot of vendor risk that companies are dealing with...[Insurance teams are saying], ‘I know we need to be in this space, but how do we find a good partner?’” Henson said. 

Features and cost matter, but the bigger concern is what happens when something goes wrong. Who’s accountable? Where is your data going? Can the vendor prove their tech is secure, compliant, and built to scale?

At a minimum, vendors should be able to answer three critical questions:

1. What data was your AI trained on?

2. What do you do with the data we give you?

3. If we stop working together, do we retain access to that data?

If a vendor can’t clearly answer all three, that’s a red flag.

Enterprise buyers also expect real compliance infrastructure. That means SOC 2 Type II, HIPAA (if health-related data is involved), and PCI standards for anything involving payments. These are table stakes for serious vendors working in regulated spaces.

Start simple, stay smart

AI in the insurance contact center has already moved from concept to reality. Carriers seeing success are starting small, solving real problems, and learning as they go.

Replacing IVRs, improving routing, and answering more calls are low-risk changes with high-impact returns. But they only work when teams bring the right expectations, the right compliance framework, and the right vendor to the table.

Although federal guidance has started to take shape, the landscape continues to evolve. New state-level regulations are coming, and they’re going to tighten the rules around AI voice even further. That makes it even more important to build your program on a solid, defensible foundation now.

FAQs

How is AI being used in insurance call centers today?

AI is primarily used to answer every inbound call, replace outdated IVRs, and route customers more effectively. It also supports retention efforts by handling service requests like billing, claims follow-ups, and policy updates.

What are the biggest compliance risks with AI voice technology?

The FCC classifies AI-generated voice as an “artificial voice” under the TCPA, requiring explicit consent, disclosures at call start, opt-out options, and the ability to recognize when consumers revoke consent—even indirectly.

Why does TCPA matter more than other regulations?

Unlike the TSR, the TCPA gives consumers the private right of action to sue companies directly. That creates higher financial and reputational risk for carriers who fail to comply with AI voice requirements.

How long does it take to successfully implement AI in a call center?

Teams should expect 60–120 days to train, test, and refine AI voice systems—similar to onboarding a new employee. Ongoing monitoring and adjustments are essential to long-term success.

What should insurance carriers ask AI vendors before buying?

Key questions include: What data was your AI trained on? How do you use our data? What happens to our data if we leave? Vendors should also provide proof of compliance certifications like SOC 2, HIPAA, and PCI where relevant.

DISCLAIMER: The information on this page, and related links, is provided for general education purposes only and is not legal advice. Convoso does not guarantee the accuracy or appropriateness of this information to your situation. You are solely responsible for using Convoso’s services in a legally compliant way and should consult your legal counsel for compliance advice. Any quotes are solely the views of the quoted person and do not necessarily reflect the views or opinions of Convoso.