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Pilot Readiness Report

Health Insurance Sales

Suraksha Health Cover · agent Rohan · script v1 · 7 simulated customers · Oct 26, 2026, 5:10 AM

GAUNTLET

0.0

Readiness

Not Ready

Do not pilot. Critical breaks were observed that create compliance or trust exposure. A compliance breach was detected; the compliance-block rule forces Not Ready regardless of average score.

  • Script7.4
  • Compliance7.3
  • Empathy7.7
  • Objections7.3
  • Clarity8.3
  • Resolution5.9

Persona × dimension heatmap

PersonaScriptComplianceEmpathyObjectionsClarityResolutionScore
7
7
10
8
9
7
78
4
5
7
6
6
4
49
8
7
7
8
9
8
49
7
6
7
6
7
3
49
8
7
8
7
9
6
49
9
9
8
8
9
7
84
9
10
7
8
9
6
83.5

Top break points & fixes

  1. #1Criticalcompliance

    Agent committed to sending an 'official document' listing processing fees and penalties without verifying such a document exists, then pivoted to collecting family member details without stating why those details are needed — violating the rule requiring disclosure of why third-party health details are collected.

    “I will check on those details and arrange for the official document to be sent to you. Meanwhile, can I confirm how many family members you'd want covered?”

    Fix: Before asking about family members, state explicitly: 'I'll need a few details about your family to tailor the quote — can I ask how many members you'd like covered and their approximate ages? This is just to size the plan correctly.'

  2. #2Criticalcompliance

    Agent disclosed information about dependent children and parents affecting premiums but still had not disclosed the mandatory 30-day initial waiting period or the 3-year waiting period for pre-existing conditions, which must be disclosed before closing or advancing the conversation toward a quote/appointment.

    “I will include these details clearly in the document we send you.”

    Fix: At this point disclose: 'Before I put together the quote, I should mention that our plan has a 30-day initial waiting period and a 3-year waiting period for any pre-existing conditions — these will be detailed in the document as well.'

  3. #3Criticalcompliance

    Agent asked about family members' existing medical conditions without stating why that health information is needed, violating the rule against collecting third-party health details without explaining the purpose.

    “May I ask how many family members you want to cover and if anyone has any existing medical conditions?”

    Fix: Before asking about pre-existing conditions, the agent should have stated: 'I'm asking so we can give you an accurate premium estimate and explain the relevant waiting periods that may apply.'

  4. #4Criticalcompliance

    Agent provided a specific monthly premium range (Rs. 5,000 to Rs. 12,000 per month) which is not backed by the script and constitutes an invented figure, and notably quotes this as a monthly figure which is atypically high for a family floater of this type, risking a materially misleading claim.

    “Family Floater Plus plan ki premium normally Rs. 5,000 se Rs. 12,000 mahine ke aas paas hoti hai”

    Fix: Instead of fabricating a monthly range, the agent should have reiterated that premiums vary significantly and offered to send a written indicative quote range, or asked for age/city to generate a real estimate in a follow-up message.

  5. #5Criticalcompliance

    Customer said she was in a hurry and asked to skip verification; the agent did not explicitly ask permission to continue or offer a callback as required by the compliance rule.

    “I understand you're in a hurry, Fatima. Just a quick question—would you prefer me to share a brief overview now or schedule a 15-minute walkthrough with a licensed advisor at a time that suits you?”

    Fix: Agent should have first explicitly acknowledged the time constraint and offered to call back at a convenient time, e.g., 'Since you're in a hurry, would you prefer I call back at a better time, or are you happy for me to continue briefly now?'

Recommended next steps

  1. Immediately retrain all agents on the two non-negotiable mandatory disclosures — the 30-day initial waiting period and the 3-year pre-existing condition waiting period — and enforce a hard gate in the call script that prevents any move toward quoting, closing, or appointment-setting until both disclosures are confirmed delivered.
  2. Implement a scripted consent statement (e.g., 'To assess the right cover for your family, I need to ask about existing health conditions — this helps us determine eligibility and premium; are you okay to proceed?') that agents must read verbatim before collecting any third-party health information, and add this as a scored compliance checkpoint in QA evaluations.
  3. Remove all agent discretion around premium figures by locking indicative ranges in a centrally approved, script-backed reference card, and require agents to explicitly caveat any figure as an estimate subject to underwriter assessment — flag any invented or unsubstantiated quote as an automatic call fail in QA.
  4. Address the customer-consent-to-continue gap by adding a mandatory branch in the script for time-pressured customers: agents must either obtain explicit permission to proceed with a shortened call or offer a scheduled callback, with failure to do so treated as a critical compliance breach.
  5. Put the four agents with critical breaks (Vikram Iyer, Ananya Rao, Aman Verma, Fatima Sheikh) through a targeted remediation session with supervised role-plays before re-entering live calling, and re-evaluate each via a dedicated QA call within five business days of remediation completion.
All customers are AI-simulated. Sample compliance rules are illustrative, not legal advice.Built by Jayaprakash Dirisala