AccountId: 011433970860
ContactId: 0b3f26cf-013c-47ba-a42c-607222839895
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1177020 ms
Total Talk Time (AGENT): 294507 ms
Total Talk Time (CUSTOMER): 675967 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/0b3f26cf-013c-47ba-a42c-607222839895_20250130T20:31_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from Associated. I'm calling for my client, [PII]. I want to see if APL received a claim and it was processed.
[AGENT][NEUTRAL] I can help you with that, [PII]. What is Mr.
[CUSTOMER][NEGATIVE] [PII] phone.
[AGENT][NEUTRAL] That one, yeah.
[AGENT][NEUTRAL] I was like, I knew it was a.
[CUSTOMER][NEUTRAL] I know. The names are kind of strange, right?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] What's his policy number?
[CUSTOMER][POSITIVE] Yeah, I got it.
[CUSTOMER][NEUTRAL] His policy number is 024.
[CUSTOMER][NEUTRAL] 55568
[AGENT][POSITIVE] Perfect. Thank you. And what is Mr. [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] His date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And then what is a good call back for you [PII], just in case I get we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And are you with [PII]?
[CUSTOMER][NEUTRAL] I'm sorry, with who?
[AGENT][NEUTRAL] You're with associates?
[CUSTOMER][NEUTRAL] Yes, associated.
[AGENT][NEUTRAL] You the agent's office.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Got you. OK.
[AGENT][NEUTRAL] What was the date of service for [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And this is for the policyholder or is this for his dependent [PII]?
[CUSTOMER][NEUTRAL] No, I, I don't know why you have him. He's only once. He's the, he's the dad, he's the employee. He, he doesn't have a dependent with his name.
[CUSTOMER][NEUTRAL] I, I noticed that when I pulled his ID card now to get the number to call and to get his policy number. Yeah, I don't know why the system has him listed twice, but it's only for him. He is the employee. He has no dependent named [PII].
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let's take a look.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Give me just a second.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] If you don't mind, I'm gonna pull up that application. Let's just see what's going on with this too.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] Does he have a dependent? Do you have their dates of birth?
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] Do you have 1 [PII]?
[CUSTOMER][NEUTRAL] Hold on, let me.
[CUSTOMER][NEUTRAL] A dependent on what date, what date of birth?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, I don't see it.
[AGENT][NEUTRAL] A claim for [PII].
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] It is for
[CUSTOMER][NEUTRAL] Let me see. It is for $1770 for
[CUSTOMER][NEUTRAL] HCA Florida University Hospital. So you don't have any claims for that date.
[AGENT][NEUTRAL] I don't.
[CUSTOMER][NEUTRAL] OK, I don't think they billed you.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, so you don't have any under his name.
[AGENT][NEUTRAL] I do wanna check one more thing. Let's see what's going on with this.
[CUSTOMER][NEUTRAL] Additional [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] This is the guy kind of got me.
[CUSTOMER][NEUTRAL] Maybe they filed it under that one, no, I don't know.
[AGENT][NEUTRAL] We do have a claim.
[CUSTOMER][NEUTRAL] You do?
[AGENT][NEUTRAL] Not for that date of service, but we do have a claim with [PII] with that date of er um, date of birth.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] From a provider.
[CUSTOMER][NEUTRAL] And it was processed under the other, the dependent [PII]?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] That's so weird.
[CUSTOMER][NEUTRAL] And what is the dependence [PII]'s date of birth?
[AGENT][NEUTRAL] That's the one I gave you.
[CUSTOMER][NEUTRAL] Well, that, that's not possible, like, right?
[AGENT][NEUTRAL] Hang on, I'm looking. Hang on. We gotta get to the bottom of this.
[CUSTOMER][NEUTRAL] It's getting weirder and weirder, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I was gonna say he just had a baby now, but it was a baby girl, and it was basically born this month.
[CUSTOMER][NEUTRAL] So, and I was thinking [PII] now.
[AGENT][NEUTRAL] Do you mind giving me just a minute, [PII]? Let me check with customer service and see, yeah, if you don't mind, hang on just a second. Let me, let me do a little dig and see what's going on here because we need to make sure we got.
[CUSTOMER][POSITIVE] Sure, no problem.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, but I can 100% well I just so that while I'm on hold I can answer him. You did not receive a claim for that date.
[AGENT][NEUTRAL] We do not have a claim for that date.
[CUSTOMER][POSITIVE] OK awesome. OK, I'll hold thank you.
[AGENT][NEUTRAL] OK, so what don't I'm gonna check with customer service and I'm gonna go back to one this last policy that he had with us and see if there's an application there. So bear with me just a second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey [PII], it's [PII]. I have, hello, [PII], I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] I'm so sorry, but I got a good one on this one.
[AGENT][NEUTRAL] So if you look at policy number.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Let me get the policy number she's calling. I've got one agent's office on the line, 245-5568 for [PII].
[CUSTOMER][NEUTRAL] 245-568. Am I missing a number?
[AGENT][NEUTRAL] 245-5568
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, I got it.
[AGENT][NEUTRAL] OK, so you see that participant for for [PII] that's the same.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Name is the policy holder.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So she's saying that he does not have a dependent named [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh, email change.
[CUSTOMER][NEUTRAL] OK, that seems like a newborn.
[AGENT][NEUTRAL] Yeah, well, that's what I asked and she said he, he just had a newborn and it's the um [PII] in July. I mean, um.
[AGENT][NEUTRAL] But not [PII], it's a, it's a guy. I mean, it's a girl.
[CUSTOMER][NEUTRAL] And that was in July?
[AGENT][NEUTRAL] Uh, just have, just had one recently, I think November, she said.
[AGENT][NEUTRAL] This has got my head spinning.
[CUSTOMER][NEUTRAL] OK, that that's OK, so probably um stock management didn't have the information of the um newborn like completely, and they just sent like [PII]'s newborn, sometimes they do that, um, and that's how we add it like that.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] There's probably a um claim for him for it for her.
[AGENT][NEGATIVE] We've got several claims.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] With his, with that date of birth that.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] If he doesn't have a dependent, and well, did he at least um knows that there's a lot of claims under that?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That is a tough one.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, and who's on the phone? Is it the insured or the?
[AGENT][NEUTRAL] Agent with associated associates, um, it's, I've got [PII] on the line, and she was calling to check the claim status for the insured [PII]. And when I asked, is it for the insured or the dependent [PII], she said he doesn't have a dependent [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I guess we will have to research it. I'm not sure, um.
[CUSTOMER][NEUTRAL] I'll take the call and let him know that um we will have to research and see because there's if there's claims already paid, there's no way we can um refund money.
[AGENT][NEUTRAL] But we have claims in that dependent's name with that date of birth.
[CUSTOMER][NEUTRAL] We do.
[AGENT][NEUTRAL] A [PII], yeah.
[AGENT][POSITIVE] This is what's, and she keeps going, this is just, it's blowing her mind too.
[CUSTOMER][NEUTRAL] And then yes, it will have to be researched a lot more of those claims. Uh, I'm pretty sure we will have to call back with an answer, um.
[CUSTOMER][NEUTRAL] I will, I can take it and let her, him or her. Is it him?
[AGENT][NEUTRAL] It's her. It's [PII]. Yeah.
[CUSTOMER][NEUTRAL] Let her, let her know about it.
[AGENT][NEUTRAL] It's just, it's crazy.
[CUSTOMER][NEUTRAL] It's weird because if he doesn't have a dependent then who is claiming those.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Or they're probably claiming them under another name who is applying. I can look and see who sent the um notification to add the newborn.
[AGENT][NEUTRAL] Yeah, because, um.
[AGENT][NEUTRAL] I mean, it's the same address.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] I got another claim pulled up.
[CUSTOMER][NEUTRAL] Oh right.
[AGENT][NEUTRAL] You know what?
[AGENT][NEUTRAL] What do you, when you shop.
[AGENT][NEUTRAL] I don't know. I, I'll tell you what.
[AGENT][NEUTRAL] Yeah, let me get her to you and.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm gonna
[AGENT][NEUTRAL] Yeah, if you can see who.
[AGENT][NEUTRAL] I'm sorry, I'm just kind of going blah, blah, blah.
[CUSTOMER][POSITIVE] No you're good.
[AGENT][NEUTRAL] I just don't know what to do with this other than we need to definitely.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Investigate who is claiming, putting some claims and um please add new warrant. Oh, this is even weird, it doesn't say who.
[AGENT][NEUTRAL] Yeah, see what's going on.
[CUSTOMER][NEUTRAL] Uh, the notes of the hub request doesn't have the name. Oh, [PII].
[AGENT][NEUTRAL] Who?
[AGENT][NEUTRAL] Never heard of that one.
[CUSTOMER][NEUTRAL] Uh yeah, it's [PII].
[CUSTOMER][NEUTRAL] Camera groups.
[CUSTOMER][NEUTRAL] The email.
[AGENT][NEUTRAL] Uh, I wonder if she's in imaging department.
[CUSTOMER][NEUTRAL] All right, then I, I, I will get the call and let her know.
[CUSTOMER][NEUTRAL] No, we will have to research this one.
[CUSTOMER][NEUTRAL] Um, does she, does she have the at least the, did you gave her the status of the claim, the one she was?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] We don't have, we don't have it on file. I took care of that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's for the insured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Alright. And give me just a second. Let me get her on the line. OK, thank you, [PII]. Thanks.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][POSITIVE] [PII], thank you for your patience. I've got [PII] in our customer service department. We've been looking in, in.
[AGENT][NEUTRAL] Um, I've been explaining to her the situation that insured [PII] does not have a dependent named [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] And no dependent born in um [PII].
[CUSTOMER][NEUTRAL] That is correct. His dependent children.
[CUSTOMER][NEUTRAL] Which the daughter was just born this month, so she hasn't even been added yet, but he has a dependent son, [PII], born [PII]. [PII], born [PII]. And then this year he added his wife [PII], and she was obviously born [PII], but she was just effective [PII], it was just him and the two children.
[AGENT][NEUTRAL] OK. Well, she's going to assist you further and again, I did check for that claim for [PII], for the insured, for the policyholder, the dad, [PII].
[CUSTOMER][NEUTRAL] Right, yeah, it's not that. No, yeah, yes, and I let him know, [PII]ight.
[AGENT][NEUTRAL] And no claim on file.
[CUSTOMER][NEUTRAL] The dad, not the dependent son that doesn't, that doesn't exist. Yup.
[AGENT][POSITIVE] That's right. All right, well, [PII]'s gonna speak with you further, and it's been such a pleasure to assist you, [PII], and thank you for calling APL. You have a wonderful day. Take care.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] No thank you.
[CUSTOMER][POSITIVE] Thanks you too. Take care.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Bye. Hi, [PII]. Hello. Good afternoon. All right. So, for this one, this is a new one for me. Um, what I would say is that I'm gonna go ahead and place a urgent ticket for this one because apparently we have multiple um claims for this dependent that it is um.
[CUSTOMER][NEUTRAL] Listed here.
[CUSTOMER][NEUTRAL] And for that date of birth? Mhm. Yes, that is why I was um just advising to Miss [PII] that we would have to for sure put an urgent request and have to research about um
[CUSTOMER][NEUTRAL] Yeah, because he doesn't have, he, he does not have.
[CUSTOMER][NEUTRAL] A dependent born in [PII] mm.
[CUSTOMER][NEUTRAL] And it's kind of curious because I was the one who added the uh newborn. I was the one who um was requested to do exchange um apparently newborn this [PII] um.
[CUSTOMER][NEUTRAL] He scar phone um with that date of birth, yes, I was the one who took care of adding the newborn, um, and how, how was the request sent? Cause maybe I can find it in mine.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] Our dog management department, they usually receive claims and um files, and that's when we go ahead and add newborns just for the 30 day at no period.
[CUSTOMER][NEUTRAL] Oh sorry, I know, yes, we do add newborns for the 30 day period at no cost. Um, we pretty much we just add them and drop them if the policy coverage is an individual or couple, um, there's no, um, change in their premium um mhm so that's why we add them and drop them, but since this policy already had dependents listed.
[CUSTOMER][NEUTRAL] Uh, yes, yes, yes, the dependent state, um, I have the notification, uh, pulled out. This was back in November.
[CUSTOMER][NEUTRAL] Yes, it was back in November, um, same date that those um claims came in, um, there's, there's definitely some paid already.
[CUSTOMER][NEUTRAL] And they were in [PII]? Mm um well I don't, I only can see that they were paid and that there's claims that's the only part I can see from it, um, only the claims department would have access to the documents that were sent to us and all of that, yes, um, so yes, definitely I will go ahead and put um.
[CUSTOMER][NEUTRAL] A ticket for this one. Yeah, definitely if it's a newborn, it, it can't be his because his wife just gave birth on January, the first week of January, she just gave birth to a baby girl, so there's no way he could have had 1 November 21. 0 yes, I know right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, goodness. OK. Um, other than that, I guess uh we would just keep an eye on it.
[CUSTOMER][NEUTRAL] Um, this will go to the claims department. Uh, I'm just customer service so they will not. Yeah, I just wanna make sure that they're not his that maybe they gave a wrong date of birth or or something because he's an attorney so God forbid we backtrack on a claim that's his because I don't know that's just so weird that the same exact name.
[CUSTOMER][NEUTRAL] Yes, it is different, uh, with what I was talking with Ms. [PII] was that, um, sometimes it happens that when the new, there's no information about the newborn and just newborn like that, we, we pretty much add the same name of the insured with the newborn's date of birth, but in this case there's no newborn until this month, so yeah.
[CUSTOMER][NEUTRAL] Yeah. OK. Um, all right. Um, we will
[CUSTOMER][NEUTRAL] Try to find out what it is. Um, is there any um email we should be responding back to that I can add to the ticket?
[CUSTOMER][NEUTRAL] Um, you can do mine, [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And then it's [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] That's funny because, you know, their HR department even reached out to me and goes, oh, I want an APL and they have [PII] listed as a dependent. That's wrong. And I'm like, she must be confused and now they probably tell me.
[CUSTOMER][NEGATIVE] I'm hoping that there's claims being paid on um him and not a.
[CUSTOMER][NEUTRAL] Other new because there is because there is claims for him with the same date um reported.
[CUSTOMER][NEUTRAL] So we just hope that if not um we will go ahead and remove that dependent.
[CUSTOMER][NEUTRAL] Or flag it at least.
[CUSTOMER][POSITIVE] OK. All [PII]. Thank you, [PII]. You're very welcome, Ms. [PII]. Is there anything else that I can help you with?
[CUSTOMER][POSITIVE] No, that's it for today. Thank you. All right, you're welcome have a nice day. Take care you too bye bye. Bye bye.