Case Compliance Surveillance Agent Icon

Case Compliance Surveillance Agent

Monitors, validates, and flags real-time case quality and compliance issues, automating audits and reducing manual reviews.

Maintaining consistent quality and regulatory compliance in case management is a persistent challenge for customer service operations. Manual spot checks are time-consuming, prone to human error, and often fail to catch every exception, leading to rework, missed compliance issues, and potential customer dissatisfaction. Organizations face operational inefficiencies, increased regulatory scrutiny, and difficulty producing audit-ready documentation.

The Case Compliance Surveillance Agent addresses these challenges by delivering continuous, automated oversight across case records, resolution logs, customer feedback, and compliance checklists. It evaluates both structured and unstructured data sources—including regulatory requirements, case communications, attachments, industry bulletins, and resolution notes—to validate adherence to compliance protocols. True exceptions are flagged and routed to human reviewers, while the agent automatically generates audit artifacts and closure documentation, ensuring every case is managed with traceability and regulatory alignment.

Using LLM capabilities, the agent interprets unstructured inputs, evaluates adherence to established protocols, and flags anomalies with accuracy. By automating routine case reviews, it reduces manual workload, supports consistent policy enforcement, and allows teams to focus on higher-priority tasks. The result is improved operational efficiency and reliable audit-ready case management.

Accuracy
TBD

Speed
TBD

Input Data Set

Sample of data set required for Case Compliance Surveillance Agent:

Case Resolution File: 735109

Case Summary

  • Case ID: 735109
  • Customer Name: Maria Garcia
  • Account ID: 8945-2341-6709
  • Assigned Agent: David Chen
  • Date Opened: 2023-10-26 14:15 UTC
  • Date Closed: 2023-10-26 16:48 UTC
  • Status: Resolved
  • Issue Type: Unauthorized Transaction Dispute

Agent Resolution Notes

14:15 UTC: Initial contact from customer Maria Garcia regarding a $450 transaction from "GlobalRetailers Online" she does not recognize. Customer sounded distressed.

14:20 UTC: Performed identity verification using security questions and two-factor authentication code sent to registered mobile. Verification successful.

14:25 UTC: Placed a temporary hold on the customer's card to prevent further unauthorized charges. Confirmed with customer.

14:40 UTC: Initiated formal fraud investigation case (Sub-Case ID: F-735109-A). Logged the disputed transaction details.

15:10 UTC: As per policy FIN-SEC-04B, a provisional credit of $450.00 has been issued to the customer's account.

16:30 UTC: Outbound call to customer. Informed her that a provisional credit has been applied and a new card will be issued within 5-7 business days. Confirmed her mailing address.

16:45 UTC: Customer confirmed understanding and expressed satisfaction with the quick action. Case marked as resolved pending final outcome of fraud investigation.

Customer Communication Log (Email)

From: support@stellarfinancial.com To: m.garcia.email@email.com Subject: Regarding your recent inquiry (Case #735109)

Dear Ms. Garcia,

This email is to confirm the details of our conversation today. As discussed with agent David Chen, we have opened an investigation into the disputed charge of $450.00.

A provisional credit for this amount has been applied to your account while the investigation proceeds. A new card is being dispatched to your address on file and should arrive within 5-7 business days.

We take the security of your account very seriously and appreciate your patience.

Sincerely, Stellar Financial Group Support

Attached Documents

  • ID_Scan_M_Garcia.pdf
  • Transaction_Record_XF4590.pdf
  • Customer_Voice_Auth.wav

Deliverable Example

Sample output delivered by the Case Compliance Surveillance Agent:

Case Compliance and Quality Audit Report

Case ID Status Recommendation
735109 Compliance Pass (Minor Exception) Flag for Supervisor Review

1. Compliance Checklist Validation

This audit cross-references case actions against internal policies (FIN-SEC-04B) and external regulatory requirements (Federal Banking Regulation Part 205).

Compliance Checkpoint Policy Reference Status Notes
Customer Identity Verification FIN-SEC-04B, Sec 1.1 PASS 2FA and security questions were used as documented.
Temporary Account/Card Suspension FIN-SEC-04B, Sec 2.3 PASS Agent placed a temporary hold on the card.
Provisional Credit Issuance Reg. Part 205.11(c) PASS Provisional credit was issued within the 10-day requirement.
Formal Investigation Initiated FIN-SEC-04B, Sec 2.5 PASS Sub-case F-735109-A was created.
Final Resolution Timeline Communication Reg. Part 205.11(d)(2) WARNING Agent did not communicate the mandatory investigation timeframe.
Required Documentation Attached FIN-SEC-04B, Sec 4.1 PASS All required documents (ID, Transaction, Auth) are present.
Customer Notification of Resolution FIN-SEC-04B, Sec 3.4 PASS Customer was notified via phone and email.

2. Quality & Anomaly Detection

  • Sentiment Analysis: Analysis of agent notes ("customer sounded distressed") and resolution ("expressed satisfaction") indicates a positive sentiment shift from negative to positive.
  • Process Adherence Anomaly: Minor Deviation Detected. The agent's notes and email correspondence fail to explicitly state the investigation will be concluded within 10-45 business days, as mandated by Federal Banking Regulation Part 205. While not a critical failure, this is a compliance gap that needs to be addressed through agent coaching.
  • Keyword Analysis: The terms "provisional credit," "fraud investigation," and "new card" were correctly used, aligning with standard procedures for this case type.

3. Automated Actions

  • Audit Artifacts Generated:
    • Audit_Trail_Case-735109.csv
    • Case_Closure_Summary_735109.pdf
  • Routing Decision:
    • Due to the identified WARNING on the compliance checklist, this case has been automatically forwarded to the Tier 1 Supervisor queue for a non-critical review.

Maximize Impact Across Core Functional KPIs

Regulatory Compliance
Risk Reduction
Employee Productivity

Ensures every case adheres to internal policies and external regulations by continuously monitoring data and automatically generating audit-ready documentation.

Automate Compliance Monitoring
  • Continuously scans case communications and attachments for policy violations.
  • Validates resolution notes against established compliance checklists and regulatory rules.
  • Cross-references case actions with industry bulletins and internal protocols in real-time.
Streamline Audit Readiness
  • Automatically compiles and generates comprehensive audit artifacts for every reviewed case.
  • Maintains a complete, traceable log of all compliance checks and their outcomes.
  • Flags incomplete or non-compliant documentation before case closure to ensure completeness.

Minimizes financial penalties and reputational damage by proactively identifying compliance gaps and quality exceptions before they escalate into larger issues.

Proactively Identify Exceptions
  • Identifies and flags true compliance exceptions from both structured and unstructured data sources.
  • Analyzes customer feedback to detect early signs of dissatisfaction or non-conformance.
  • Alerts supervisors to high-risk cases based on predefined rule sets and anomaly detection.
Enforce Consistent Quality Standards
  • Evaluates every case against a consistent set of quality and compliance standards.
  • Reduces human error and subjectivity inherent in manual spot-checking processes.
  • Provides objective data to support agent coaching and performance improvement.

Frees agents from time-consuming manual case reviews and documentation, allowing them to focus on complex resolutions and customer engagement.

Eliminate Repetitive Manual Audits
  • Automates the entire process of routine case review and quality spot checks.
  • Intelligently routes only true exceptions requiring judgment to human reviewers.
  • Reduces the time spent searching for and compiling information for compliance reporting.
Accelerate Case Closure
  • Automatically generates closure documentation to expedite final processing.
  • Confirms all required compliance steps are completed before a case can be closed.
  • Provides instant validation of case data, eliminating delays from manual verification cycles.

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