It seems random to me, but of course when I'm in User-mode I'm probably quite a poor observer.
I'm not a power user of VOIP, but these are my common scenarios:
1. At home, Skype and Google Hangouts. Hardware setup as above. 240 Mbps connection. Making calls to family abroad. This is the 1 in 3 scenario - we just keep trying till we get a connection that seems to work. Usually the call ends whenever the line finally "goes bad".
2. At work: Skype, Hangouts, Upwork. Mostly one to one calls with potential hires, colleagues, outsource people etc. WiFi. About a 20Mbps connection. Actually now I write it down Upwork is the best - which is weird because in general their systems suck. But Skype and Hangouts are both a consistent source of pain, dropped calls, bad quality, sudden total loss of audio etc...
3. At work: Company phones. Generally the quality is OK when calling out to landlines and mobiles (cell), but I have colleagues who I know are on VOIP at other end and these calls are like 1 in 2 where we just give up.
4. On mobile (4G): Viber, WhatsApp, Skype. Generally I'll call. Within a few seconds we'll be talking like people in a disco and I give up and call back on regular phone.
I also observe colleagues doing a lot of: "can you repeat that", "sorry repeat that" when they're using Skype at the office. Even hearing that contributes to my sense of VOIP-malaise.