AccountId: 011433970860
ContactId: 357b9106-140a-47dc-8ff8-603293943a02
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 836719 ms
Total Talk Time (AGENT): 344578 ms
Total Talk Time (CUSTOMER): 291330 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/357b9106-140a-47dc-8ff8-603293943a02_20250212T20:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] in customer service. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] in claims. How are you?
[AGENT][POSITIVE] I good [PII]. How are you?
[CUSTOMER][POSITIVE] I am wonderful, thanks for asking. I have an individual on the phone. She is an insured and she's calling regarding uh policy 02461873.
[CUSTOMER][NEGATIVE] And she's called several times and she's feeling we're giving her to run around about the new policy. She should have a different policy effect of [PII], but it has not updated in our system.
[CUSTOMER][NEUTRAL] And she wants to know why and how long does the process take and
[CUSTOMER][NEUTRAL] Yada yada yada.
[AGENT][NEUTRAL] OK, so the, the group changed on [PII]?
[CUSTOMER][NEUTRAL] Is what she was told.
[CUSTOMER][NEUTRAL] So the benefits amount changed.
[AGENT][NEUTRAL] OK, hold on, let me pull up 3.
[AGENT][NEUTRAL] Give me just a second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me get all my ducks in the room real quick.
[CUSTOMER][NEUTRAL] Oh, no worries. Take your time. I'm sure she's not going anywhere.
[CUSTOMER][NEUTRAL] I just don't want to give her the wrong information.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] I mean, I'm not showing any changes in EMPL.
[AGENT][NEUTRAL] Their renewal was [PII].
[AGENT][NEUTRAL] And there's no changes in here, since I mean there's nothing in here for the renewal for [PII]. OK, hold on.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Cause she was told that she should, her benefits should go from 3000 to 5000 as of [PII], but I can only go by what I'm seeing in the system. I don't.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I don't have a clue about anything else.
[AGENT][NEUTRAL] OK, hold on.
[AGENT][NEUTRAL] What are their plans
[AGENT][NEUTRAL] OK, there is a 5000 plan on here.
[AGENT][NEUTRAL] But if we were, were we told that she was upgrading, is this group on a file feed? Yes, they are.
[AGENT][NEUTRAL] Oh boy.
[CUSTOMER][NEUTRAL] Mm, mm mm.
[AGENT][NEUTRAL] And this is one of my groups. Hold on, let me check and see if I have an exception report.
[AGENT][NEUTRAL] 6266.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I, I'm not showing.
[AGENT][NEGATIVE] Don't see her on that one.
[AGENT][NEUTRAL] OK, and you, it's [PII], right?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Mhm. She's not on that one either.
[AGENT][NEGATIVE] What in the world is taking my computer so long. Come on now.
[CUSTOMER][NEGATIVE] Mine's been slow all week.
[AGENT][NEGATIVE] No, it started yesterday and I thought it, it may have just been the weather, but I don't know, it's just been really agitating.
[AGENT][NEUTRAL] I do not see her in any exception report to change her plan.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's do this. Let me check the file feed, the actual file feed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I know only thing that's in that file feed is one dagu policy how in the world.
[AGENT][NEUTRAL] Alright, I'm gonna check one more place and then I'm gonna get you to transfer her because I may have to contact the group and all this other stuff to see an enrollment services because I don't see.
[AGENT][NEUTRAL] Anything.
[AGENT][NEUTRAL] Upgrading her policy 2461873 I'm checking the hub now to see if there's a request out there.
[CUSTOMER][NEUTRAL] And maybe she can better explain where she got that information from if it's not correct, and it's not changing.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, there is a request out here see a list of terminations.
[AGENT][NEGATIVE] My goodness, this is a mess.
[AGENT][NEGATIVE] Absolute mess. [PII]. OK, here she is.
[AGENT][NEUTRAL] We notice that the weekly files do not include all the records for current active APL policies. Could you please review to determine what has caused the records below to drop off the APL file feed? Please be aware that APL does not turn by omission. So if we are the term be a file fee, we need the term dates included in the files from [PII].
[AGENT][NEUTRAL] Mm yes.
[AGENT][NEUTRAL] Yeah, I don't see anything telling her, telling us to upgrade her benefits, so I guess go ahead and transfer her money and I'll talk to her and tell her that we don't have a request to change it, so I can't just change it off for word. It has to come from the group.
[CUSTOMER][POSITIVE] OK, thank you I appreciate it and that way if she does call back again then I'll know.
[AGENT][POSITIVE] No problem, yes.
[CUSTOMER][POSITIVE] Thank you I appreciate it. Here she comes.
[AGENT][POSITIVE] You're welcome thank you bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Hi, my name is [PII] in customer service. How are you doing today?
[CUSTOMER][POSITIVE] I'm good thank you how are you?
[AGENT][POSITIVE] I'm good. Thank you so much for asking. Um, Ms. [PII] was telling me that you were calling because your uh plan was supposed to change in January.
[CUSTOMER][NEUTRAL] Yes, and I talked to someone the other day that confirmed that they did have the um policy application for our group and that it was being processed it was but.
[CUSTOMER][NEUTRAL] Um, I, I'm
[CUSTOMER][NEUTRAL] It was supposed to be effective [PII]. I had put in my claim for my surgery, and they only paid me out up to my previous amount of the $3000 instead of the $5000 so I'm currently still out like almost $1900.
[CUSTOMER][NEUTRAL] And I'm lost on why it's taking a month and a half to process it when it was supposed to be effective [PII], so I was calling to see when that would be completed so that I can they told me to go ahead and put my claim in and they would pay me on my previous like up to the 3000 and then I could once it was processed then I could call in and have them relook at the claim so that I could get the remainder of my money.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right. Yes, ma'am.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] Um, so you, you made this change at open enrollment in January?
[CUSTOMER][NEUTRAL] Well, it was December actually when we had open enrollment [PII] I believe is what my [PII] shows is when the paperwork was signed but um yeah it was supposed to be for [PII] and like I said I spoke with someone at your company on Monday and she said that um she confirmed that they do have the application and then it's in processing.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that I can check back to see if you know that was completed yet so I logged on today and it's still just showing my other policy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you remember who you spoke with on Monday?
[CUSTOMER][NEUTRAL] I do not know her name, no.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, because I've been looking through, that's why it took me a minute to come back on the line with Ms. [PII]. I apologize, it took me a second. I do not see where they've sent us that your plan was changing, um.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Well I she couldn't see it either and then she put me on hold and she said that she could not transfer me to the department that that she was checking to see if she could transfer me to the department that does that or something but that I couldn't get transferred to there all of these notes should be in there too because she said she was making notes of all of it.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] And um that she was able to confirm that they have the application but it was on some kind it was on something something processing hold.
[CUSTOMER][NEUTRAL] And that she could not tell me how long that that would take.
[CUSTOMER][NEGATIVE] Like there was no she couldn't give me a time frame.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But that they do have it and it's being processed.
[AGENT][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] So I don't know who she put me on hold to talk to.
[AGENT][NEUTRAL] Yeah, I'm not sure either, Ms. [PII], and the last note I see in here was from [PII], so I do apologize. I don't see a note in here from this past Monday.
[CUSTOMER][NEUTRAL] I have no idea.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, let me see if I wrote.
[CUSTOMER][NEUTRAL] Any of it down.
[CUSTOMER][NEUTRAL] Renewal processing hold she said that it was that she gave me my group number which is 26,260. Policy number was the same one that I have right now, but she said that that policy number would change for a new policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And um I we're we use Hackmeyer Insurance Agency. I do know that and when she got back on the phone, I did write it down. She said it was um in renewal processing hold.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, that makes sense um now as far as when it will be completed, I do not know.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] That's what I'm not under I don't understand what that means, what renewal processing hold means.
[AGENT][NEUTRAL] So when we have a renewal come in.
[CUSTOMER][NEUTRAL] Uh, they've taken the money out of my paychecks for it since the beginning of the year and.
[CUSTOMER][NEGATIVE] Uh, I'm confused why it would take a month and a half to process. I don't get it.
[AGENT][NEUTRAL] It it all depends on when we receive the renewal, uh, paperwork, the files, and then it's for the entire group, so it has to be worked everybody's policies needs to be updated for the renewal file, so it, it can take a while, um, but I'm not sure on an actual um time frame.
[AGENT][NEUTRAL] Um, let me see if I, if I can get with somebody that can give me one, but I don't wanna keep you on hold, Miss [PII]. Can I give you a call back after I do some research on this and find out for you, um, if there is a tentative date? OK, OK. What is the best number to call you back at today?
[CUSTOMER][POSITIVE] Yes, that would be great.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] OK and you were supposed to be changing to the 5000 plan.
[AGENT][NEUTRAL] On [PII].
[AGENT][NEUTRAL] OK, and this is.
[AGENT][NEUTRAL] Group 26 to 60. OK.
[AGENT][NEUTRAL] Alright, Ms. [PII], I'm gonna do some research on this, get with somebody in the um processing department and see if I can get an update for you, OK?
[CUSTOMER][POSITIVE] That would be great thank you so much.
[AGENT][POSITIVE] No problem. Was there anything else I could do for you?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] All right, well, uh thank you so much for calling APL and I hope you have a wonderful rest of your day and I'll talk to you soon, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] Bye bye.