Member service for statutory and private health insurers on one platform: every channel up to video and secure messaging, guided benefit applications with upload, identification with the online ID card and AI agents for routine questions. Designed for social data protection and Art. 9 GDPR.
Member service on every channelGuided benefit applications with uploadSocial data protection under German lawAI agents, clearly disclosed as AI
The requests, rules and peaks that shape this industry – and how Univerx answers them.
One request, every channel
Phone, email, web messaging, app, secure messaging in the portal and video run into one queue. The case stays the same when the member switches channel.
Role rights per data field, recording only with consent, analytics that hold up to co-determination. Documents for your DPIA on request.
#Member service that works equally well everywhere
Members get in touch when something happens in their lives: an illness, a child, a move, a rehabilitation stay. They expect their health insurer to reach and understand them on every channel, without telling the story twice.
Sick pay, medical aids, rehabilitation, cost coverage: many applications first stall on missing documents. A guided flow asks only what the application needs, checks mandatory details and takes certificates by upload.
The application lands complete in the case. Task routing assigns it to the claims team with a deadline. When the member asks later, the agent sees the status at once.
Changes of address, bank details or family insurance follow the same path: in self-service, in chat or in the conversation, verified and straight into the policy system.
Before social data comes into play, the identity has to be clear. Authentication offers app confirmation, a one-time code or the online ID card, depending on the request. The digital identity that health insurers provide for health apps is an outlook as a further route.
AI agents answer routine questions around the clock: processing status, missing documents, opening hours. They draw on Univerx Knowledge, are disclosed as AI and hand over to staff with the context. They never make a benefit decision.
Health data belongs to the special categories under Art. 9 GDPR. German statutory funds are also bound by social data secrecy (§ 35 SGB I) and SGB X, including processing on behalf.
Two add-ons join when they are needed. Semantic² pre-checks hospital bills and provider invoices, so that the limited audit quota goes to the right cases. The insurer decides whether a case is audited; the medical assessment stays with the Medical Service.
The Univerx Channel combines identification with the online ID card and eIDAS signatures in one contact. Both are designed for, not promised.
Workshop: settle requests, channels, data categories, roles and co-determination.
Pilot: one benefit application or master data changes with one team.
Rollout: video, AI agents, appointment service and, if you wish, Semantic² and the Univerx Channel.
Optional add-ons
What helps on top here.
Optional add-ons that matter in this industry: built on the same platform and at home in the same case.
Add-on
Semantic²
Reads the documents behind every case. Findings in euros.
Invoice
Item 4 · deviating rate€184.50
FindingSample
€184.50
Rule
Rate × hours
Source
Invoice, line 4
Booking
Voucher 2026-0412
AcceptReject
Semantic² is an optional add-on to the Univerx platform. It reads the decision letters, contracts and invoices behind a case, checks them against rules and bookings and reports deviations as a finding in euros. The decision stays with people.
Every finding with a sourceAmount, rule, location in the document and booking sit side by side. Nothing has to be taken on trust.
Structured and scannedReads forms as well as scans and photos, marking the passage it read.
Rules you knowCheck rules are readable and versioned. What is checked can be explained.
People decideNo finding is booked automatically. Accepting or rejecting is an action with a log entry.
Add-on
Univerx Channel
Identity, signature and resolution in one contact.
Sign4 / 5
Online ID card✓ Identity confirmed
Shared view
SignatureSigned
An optional add-on to the Univerx platform: a link with no download opens a guided dialogue with a shared view. Identification with the online ID card and eIDAS signatures are the goal, and the result goes back into the case. One request, one contact.
A link, not an appNo download, no account: the Channel opens in the browser on phone or desktop.
Guided dialogueThe conversation follows the request, asks only what is missing and skips what does not apply.
Shared viewBoth sides see the same page or form, with video if wanted.
Upload documentsProofs are photographed or uploaded during the conversation and attached to the case.
Building blocks
The capabilities behind it.
These capabilities and add-ons carry the solution. Each one is described on its own – with flow, use and rules.
Univerx Contact Center
Secure messaging
Authenticated, asynchronous conversations inside the logged-in customer portal or your app. With scanned file exchange, a history per customer, notifications without content, and retention and deletion rules.
Video in the browser without a download, started from chat, messaging or a running call. One-way and two-way video, screen share, waiting room and appointments; recording only with consent.
Book, move and remind appointments online: on website, app, chatbot or voicebot, by video, phone or in person. Capacity comes from scheduling; reminders and a waiting list keep the slots filled.
AI agents understand the request, act in connected systems and hand over to people with context. On the phone as a voicebot, in chat as a text agent, always disclosed as AI.
Verify identity at the start of the contact: by app confirmation, one-time code, knowledge question or, with consent, voice traits. The status holds for IVR, bot and agent, and anomalies are flagged.
Build flows and guided forms without code: branching, data actions in connected systems, approvals, timers and error paths. In customer contact, self-service and the back office, with versions, test mode and release.
One knowledge base for employees, AI agents and self-service. With semantic search that understands what is meant, and generated answers that rest on your sources and name them.
Automated reminders and notices with no agent involved: appointment confirmations, delivery status, deadlines, outage information. By SMS, email, messaging or voice message, with a way to reply.
Every request on the right channel, with the right person, with the whole context. Routing, workspace, Univerx Assist and knowledge work together in one flow.
AI agents resolve routine requests on the phone and in chat, at any hour. They are disclosed as AI, act only in approved systems and hand over with context as soon as a person is needed.
Steer back-office work the way you steer customer contacts: task routing with SLAs, workbins and tracking. Semantic² checks the documents and returns findings in euros with their source. A person always makes the decision.
Close cases that need an identity or a signature within one contact: a link with no download, identification with the online ID card and eIDAS signatures as a goal in the Univerx Channel, and the result straight back into the case.
When everyone calls at once: inform proactively, offer callbacks instead of hold, let AI agents answer the most frequent question and reset teams with forecasting and short-term scheduling. In an order that has been planned in advance.
Rules & evidence
The regulations that apply here.
How Univerx meets the requirements is in the trust center – with a status per topic and documents on request.
GDPR
Processing under Art. 28 GDPR, documents for your data protection impact assessment, retention and deletion policies and role rights. What exists you receive on request; what is a goal we call a goal.
AI disclosure in dialogue, human oversight, logging and model approval: Univerx is designed for the duties of the AI Act. Which risk class your use case falls into, we work out together.
The Univerx Channel is designed for identification with the German online ID card and for eIDAS signatures – inside the running contact, with no app to download for the Channel. It is prepared for the EUDI wallet.
Since June 2025, Germany's Accessibility Strengthening Act has applied to many consumer services. Univerx sets accessible customer interfaces as a goal: WCAG 2.1 AA and EN 301 549 for web messaging, the Univerx Channel and self-service.
The goal: data and media stay in the EU region you choose. Hosting in Germany is planned. What lives where, and who can reach it, is set out in documents you receive on request.
Does Univerx suit statutory and private health insurers alike?
Yes. The platform is the same. Statutory funds in Germany are also bound by social data secrecy under SGB I and SGB X, private insurers by professional secrecy under § 203 of the Criminal Code. You set roles, recording and retention per organisation.
Does Univerx replace our policy or benefits system?
No. Policy, benefits and document systems stay in the lead. Univerx connects them through interfaces, reads the case and writes results back.
Do AI agents answer benefit questions too?
AI agents handle routine questions such as processing status, documents or opening hours, grounded in your approved knowledge base. They are disclosed as AI and hand over to staff. They do not make benefit decisions.
Can members identify themselves with the online ID card?
Univerx is designed for identification with the online ID card. Connecting the digital identity that health insurers provide for health apps is an outlook. We discuss the status in the demo.
How does Univerx relate to co-determination?
Analytics can be set to show topics and teams, not individuals. For the consultation with your staff council or works council we provide documents on data, roles and analytics.
Do we need Semantic² or the Univerx Channel?
No. Both are optional add-ons. Member service works fully on the platform; Semantic² and the Channel come in when invoice pre-checks or signing in the conversation are needed.
Disclosure, handover, permissions, logging, approval and measurement: what should be settled before an AI agent goes live in customer service – step by step, with a checklist for the project team.
Campaigns, notifications and collections within German competition law and the GDPR: which rules apply to which kind of contact, how to obtain consent that holds, and how to prove it in daily operations. With sources.
Which documents suit it, which checks make sense and which decision stays with people: a guide to introducing Semantic², from the first rule set to a pilot with a single document type.
What the GDPR, the EU AI Act and German co-determination mean for routing, recording and analytics – and how to answer the questions from procurement, privacy and the works council before the first contact runs on a new platform.
Social data needs more than a tick in the privacy notice. It needs roles that fit, recording with a reason, and analytics that show topics rather than people.
Someone reminded of an appointment does not need to call to confirm it. Someone who can move it with a reply does not need to call either. Proactive service starts with that simple logic.
ID copies, selfies, callbacks to the number on file: identification is often the slowest part of a request. With the online ID card it becomes one step in the conversation.
See Univerx on your own example.
In a demo we show the platform along your channels and requests, from AI agents to video, workforce scheduling and analytics.
