AccountId: 011433970860
ContactId: 386fdc81-5d54-45f7-9d75-f5439e3c0fd6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1019460 ms
Total Talk Time (AGENT): 495703 ms
Total Talk Time (CUSTOMER): 401938 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/386fdc81-5d54-45f7-9d75-f5439e3c0fd6_20250317T20:07_UTC.wav
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[AGENT][NEUTRAL] For contacting ATO. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I'm [PII] and the policy number is
[CUSTOMER][NEUTRAL] 00613353
[AGENT][POSITIVE] Yes, thank you. And how can I help you with your policy, sir?
[CUSTOMER][NEGATIVE] My, my dental office says my, I don't have no insurance with you because the bill wasn't paid.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you check and see when we last paid?
[AGENT][NEUTRAL] Yes, uh, while I'm looking this up, if I could just have your date of birth, sir, and the phone number so I can make sure I have the right policy. I'm just looking for it now.
[CUSTOMER][NEUTRAL] [PII], the phone number is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Yes, we received a word of that or we received uh.
[AGENT][NEUTRAL] Uh, I noticed that the policy lapsed as of, uh.
[AGENT][NEUTRAL] Excuse me, on [PII], uh, the policy was lapsed, um.
[AGENT][NEUTRAL] And uh that's the last I saw of that, so let me just check here.
[AGENT][NEUTRAL] which is.
[AGENT][NEUTRAL] Checking
[AGENT][NEUTRAL] So this is uh the LA school, uh LA school, is that correct? That's uh
[CUSTOMER][NEUTRAL] No, um,
[AGENT][NEUTRAL] Right, OK.
[CUSTOMER][NEUTRAL] But I'm [PII].
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] I just want to make sure I have the right, it's usually, do you pay for this policy yourself, sir? Is there, uh, because I'm
[CUSTOMER][POSITIVE] Yes I do yes I do.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, let's see.
[AGENT][NEUTRAL] I'm sorry, it's just showing it's showing an employer number that's the only reason I was looking at it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, the last thing that I show on this was in December and um we don't show that uh that the print, I mean, I don't show that anything else was done after that. So, so the policy lapsed as of December.
[CUSTOMER][NEUTRAL] We don't remember receiving anything.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so is this, do you, uh, when you pay this, does this come from, uh, is this taken from your check, sir, or is it, uh, or do you just pay the, the policy yourself, sir, that's, is that what has happened?
[CUSTOMER][NEUTRAL] Personal
[CUSTOMER][NEUTRAL] We pay it ourselves we pay it ourselves through a personal check.
[AGENT][NEUTRAL] Your personal check, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me check and I will be right back. Excuse me, just one moment, sir. I'll be right back, Mr. [PII].
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Yes, [PII], hi, this is [PII]. Um, can I give you a policy number, please, and you can maybe you can help me with, I'm sure you can cause I don't really know what to do here. It's 006.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Oh, can you repeat it again?
[AGENT][NEUTRAL] 1, yes, of course, 006.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 13353 and it, it looks like it's [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] All right. Give me just a second to look it up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, I got it what we have.
[AGENT][NEUTRAL] OK, so what we're doing is we're looking at the notes and.
[AGENT][NEUTRAL] Uh, he says that he pays this himself, um.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And uh because it's, it has an employer number for LA school for the visual impaired, but he says he doesn't work there anymore, so he's paying it himself. But if you look on [PII], it looks like this lapsed, um, overdue, uh, premium, overdue something, I don't know. So, um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] and
[AGENT][NEUTRAL] His policy has lapsed, but he is, he, he thought that he had been paying on it.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So I need to know.
[AGENT][NEUTRAL] What we need to do to get this uh reinstated, is he send in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. OK. Um, the last time we received the payment for his policy, um, was for the month of October. It has been over already, um, that 30 day period notification for him to, um, let us know that he wanted it to, um, continue the policy.
[AGENT][NEUTRAL] What does he do? Um.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEGATIVE] Yes, it, it's going way too back um.
[CUSTOMER][NEUTRAL] If he is willing to make a payment from November all the way to, um, we are, we will be billing this Friday for um
[CUSTOMER][NEUTRAL] April already. If he's willing to pay for all those months that go back, um, we can go ahead and reactivate his policy. Um
[AGENT][NEUTRAL] Where does he send the money? I mean, who does he send it to? Does he?
[CUSTOMER][NEUTRAL] Uh, he, he pays to us via check. He sends in a check. Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yeah, and how much is it each month? I mean, what, how, how, what's the amount? I know that he's gonna ask me for an amount.
[CUSTOMER][NEUTRAL] OK. He was paying semi-annually, um, and the semi-annually payment was for 19,680.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So that will pretty much mean uh uh I'm gonna confirm if it is semi annually or not. I don't want to get the wrong number.
[CUSTOMER][NEUTRAL] Yes, it is in my annual. OK, if it is 196.8.
[AGENT][NEUTRAL] So he owes $196 is that.
[AGENT][NEUTRAL] And uh he, he just send that into the [PII] or?
[CUSTOMER][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Uh, no, um, we will have to, uh, send a letter to him that he wants to, um, have his policy reactivated. And once we receive, um, the letter together with, uh, all that premium back, we will go ahead and um reactivate the policy.
[AGENT][POSITIVE] Great. I appreciate that. So I, I've got his address, uh, um, so I, I talked to this guy earlier. So, um, it's on [PII]. So if you're going to send him that letter, then I'll just tell him to look out for that, and then he can just send in his premium with that.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, uh let me see there's.
[CUSTOMER][NEUTRAL] Mm, OK. Um, I will go ahead and, um, request that letter for him, and he should receive it within 7 to 10 business days. But again, he will have to um send us a check with all that premium back to all the way to, um, currently, it will be April.
[AGENT][POSITIVE] April. OK. Great. OK, that's perfect. Great. Thank you very much. I'll I'll tell him that. Thank you.
[CUSTOMER][POSITIVE] All right. You're welcome.
[AGENT][POSITIVE] Thanks.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] Yes, Mr. uh Mr. [PII], thank you very much for holding. So what I did was I, I contacted our customer service department and, and they are going to send you, uh, a, um, uh, a bill or a uh, for those, uh, the month that, um, it looks like the last time that they received anything was in October. So what they're gonna do is, uh, ask, uh, excuse me, they're gonna send you a letter, um, letting you know, uh, where to send the premium and uh then we can reinstate the policy.
[AGENT][NEUTRAL] But that, that is what is happening right now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you check to see how it's payable, is it payable quarterly or twice a year or what the terms of it is?
[AGENT][NEUTRAL] Is it
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yes, it's it's biannually, yes, it's twice a year.
[CUSTOMER][NEUTRAL] Twice a year, OK, so that if you do miss a payment, then if you don't catch it up within what time frame you have to pay it prior to the lapse.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Uh, it's usually about 30 days.
[CUSTOMER][NEGATIVE] 30 days and this um notice sent out to let you know that it's about to lapse.
[AGENT][NEUTRAL] Uh, no, what they do is, is, uh, if they don't receive the uh the premium within 30 days and then it does lapse, but what they're doing right now is they're sending you a letter, uh, asking, uh, if you want to reinstate the policy, and then that's what we'll end up doing.
[AGENT][NEUTRAL] So it's, if you don't, if they don't receive the, the uh premium each month, they, they usually will um give you a certain period of time uh before uh lapsing the, the uh um the policy, and, uh, once we do that, then, then we just ask that you, that you, uh, confirm that you want to continue with the policy and then you just pick up the premiums from there. You, you just pay the premiums, um, that, that are, uh.
[CUSTOMER][NEGATIVE] But we don't, we don't remember to receiving a letter from you even asking for the premium.
[CUSTOMER][NEUTRAL] Do you, do, can you confirm that even?
[AGENT][NEUTRAL] Well, we're showing that they, I did talk to customer service and they did, they did show that they, they do um they did send a request for the premium back in October.
[CUSTOMER][NEUTRAL] OK. OK, in October, in October, and there was no response at all in October?
[AGENT][NEUTRAL] Yes, uh-huh.
[AGENT][NEUTRAL] Um, no, ma'am.
[CUSTOMER][NEUTRAL] And then is there like a final notice before the cutoff or is it just uh automatic that you uh cut off?
[AGENT][NEUTRAL] It they just cut it off because it sometimes people have changed their policies or, or they don't uh um.
[AGENT][NEUTRAL] You know, that's usually, uh, if it's, if you don't receive it, hear anything, then, um, they just assume that you wanted to stop the, the policy. And that way they're not, they don't keep billing you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Right, so you
[CUSTOMER][NEUTRAL] Right. Are you, uh, currently looking at our account?
[AGENT][NEUTRAL] Yes, ma'am, I am.
[CUSTOMER][NEUTRAL] OK, so how long did we have coverage with you?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] OK, looks like, uh, since [PII].
[CUSTOMER][POSITIVE] Now since [PII], listen to what I'm saying to you now, if I need to talk to a supervisor, I will, since [PII] to the current moment, we have not missed a payment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And why, why, why would you think we wouldn't pay?
[CUSTOMER][NEGATIVE] Why wouldn't somebody just get on the phone and say, look, these customers have been paying since [PII].
[CUSTOMER][NEGATIVE] But we hadn't received anything and obviously just something in the wrong.
[AGENT][NEUTRAL] So you didn't receive anything at all. Let, let me verify your address and make sure that we have that correct. If I could, Mr. [PII], do you mind uh giving me your address, please? I just verify.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, sir. OK, so we do have that. So, and you didn't receive anything at all in, in, uh, in November for the, for the billing. Nothing.
[CUSTOMER][NEUTRAL] We don't remember receiving anything. You may have sent something, but we don't remember receiving.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I see. OK.
[CUSTOMER][NEUTRAL] And we're the type of individuals that pay our bills. I mean, you can see the record we got with you.
[AGENT][NEUTRAL] Yes, sir. Yes, I see that.
[AGENT][NEUTRAL] Well, it's unfortunately that whenever, whenever we don't, whenever they um uh because these policies usually are with an employer, um, we usually will bill it uh uh.
[AGENT][NEUTRAL] For a certain period of time and then if we don't, if we don't hear anything, uh, then, uh, they do have that grace period. Uh there's there's like 30 days after that that date and then if we don't hear anything, then, then the policy is lapsed. Now, I don't know whether they sent the uh premium a request for premium twice or not. Uh, we do show your address is correct, um.
[AGENT][NEUTRAL] But, uh, and I do realize that you have paid uh since [PII] and I do apologize that that this has happened. Uh, but for whatever reason, um, once the, once that uh premium isn't, uh, isn't um received.
[AGENT][NEUTRAL] Because these are normally through an employer, we don't really know whether you're whether you still whether you got another policy or or whether um uh uh receipt or you know whether you wanted to keep this one or not and after they send out that that uh last premium, uh, you know, after that there's usually two that are sent out and if we don't hear anything from that period, then, then they do, they do lapse the policy so there would have been the the one that was sent in November and then they have a grace period of 30 days, um.
[AGENT][NEUTRAL] And we have your address correct, so I'm not really sure uh why nobody reached out to you for that and I do apologize, but um.
[AGENT][NEUTRAL] That is what normally happens. It's just, it's just something that, that, uh, it's very unfortunate that it happened in this case. But um
[AGENT][NEUTRAL] We can get that policy reinstated.
[CUSTOMER][NEGATIVE] I don't know if I even want it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If when we really need it, it's not there, and we have been, and you just documented.
[CUSTOMER][NEUTRAL] Uh, with you from [PII] and there is not a concern or alarm that says let's follow up and maybe not just send a letter in the mail, or customers who are loyal. We're going to have a manager or someone call them to find out what's going on.
[CUSTOMER][NEUTRAL] So I'm not even sure I want to continue with you. Uh, I now qualify for insurance through AARP and through other providers, and I'm seriously considering moving on, but I do appreciate you referencing it and letting me know because I'm looking back at all canceled checks. That's how long we've been with you guys and uh I don't even know if I want to continue with you anymore.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am. I'm very sorry. I wish that that uh were not the case, but it's, uh, they just don't have, we don't have any way of knowing. Um, this is all done electronically and I think that's probably one of the problems is that it's not something that uh someone actually cast an eye over. It's something that because it is all electronically, uh, it's not something that uh would have.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Even for reason, even for reasons why it's time for me to move on. [PII], what's your and what's your, what's your name, please?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] My name is [PII], and uh I am going to go ahead and have that, that uh notice sent out to you, sir. It's already going to be done, um, but if you don't want the, the policy, we, uh, you know, I do understand, um, you can just let us know that, but, uh, yes, I, I am sorry that that happened and um, it is unfortunate that in this case, yeah.
[CUSTOMER][NEUTRAL] And send your, your, your position you send is what?
[AGENT][NEUTRAL] I am an auditor.
[CUSTOMER][NEUTRAL] The what?
[AGENT][NEUTRAL] I'm an auditor, sir. I.
[CUSTOMER][NEUTRAL] You're an auditor, are you? OK.
[AGENT][NEUTRAL] Yes, sir. I, I, I process the claims and, and uh we, we maintenance the, the claims.
[CUSTOMER][NEUTRAL] Yeah, and you keep mentioning that um if you sent out to in in [PII] well I retired and they offered this to me.
[CUSTOMER][NEUTRAL] As a package, but I had to pay it first and you've been accepting this since [PII], so you know I.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] Yeah, that was the best you can do is send it out and we'll make a decision.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] OK, thank you, ma'am.
[AGENT][NEUTRAL] OK, well thank you for contacting API.