AccountId: 011433970860
ContactId: 3b359c1f-1077-4bb3-a4ca-a68a8584be41
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 943530 ms
Total Talk Time (AGENT): 332376 ms
Total Talk Time (CUSTOMER): 399537 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/3b359c1f-1077-4bb3-a4ca-a68a8584be41_20250624T17:36_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, ma'am. I was calling in reference to a claim.
[AGENT][NEUTRAL] Sure, I can assist you with that. Are you a provider or the insured?
[CUSTOMER][NEUTRAL] I'm the insured.
[AGENT][NEUTRAL] Can I have your name and the policy number?
[AGENT][POSITIVE] And I'll be able to assist you.
[CUSTOMER][NEUTRAL] Uh, my name is [PII]. My name is [PII].
[CUSTOMER][NEUTRAL] And my policy, I got a member ID number.
[CUSTOMER][NEUTRAL] A group ID number.
[CUSTOMER][NEUTRAL] And you said policy number.
[AGENT][NEUTRAL] It will be one this is.
[AGENT][NEUTRAL] So the policy number or certain number is listed on your card, er number?
[CUSTOMER][NEUTRAL] The policy number is what?
[AGENT][NEUTRAL] Is it listed on your card as a certain number or a policy number?
[CUSTOMER][NEUTRAL] No, I just told you I got a
[CUSTOMER][NEUTRAL] I got a uh.
[AGENT][NEUTRAL] So give me the member's number, sir.
[CUSTOMER][NEUTRAL] Me
[AGENT][NEUTRAL] That'll be fine.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] 682-452-713
[AGENT][NEUTRAL] That's too long. So, is this American Public Life card?
[CUSTOMER][NEUTRAL] Um, this, I, I don't know. I got two letters from American Public Life, both the exact same letters just came to my house today, uh, type the exact same date. Um, this insurance I have is
[CUSTOMER][NEUTRAL] A PHCS it's called.
[AGENT][NEUTRAL] Mm, give me, so let me get your full 9 digit of your social because this policy number you provided. Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And you said your name was?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm not pulling you up in the system with this social. Spell your last name.
[CUSTOMER][NEUTRAL] Yeah, I've never heard of
[CUSTOMER][NEUTRAL] Never, but I, and today I opened it up. I got two letters exactly the same.
[AGENT][NEUTRAL] Your last name is [PII] or [PII]?
[CUSTOMER][NEUTRAL] From [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And [PII]?
[CUSTOMER][NEUTRAL] Yeah, well, [PII] is, yeah, [PII].
[AGENT][NEUTRAL] What city and state do you live in?
[CUSTOMER][NEUTRAL] I live in [PII].
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] So I'll, so what does the letter say? cause I'm pulling you up. I'm trying to pull you up. I'm not pulling you up. I'm trying to pull you up by the social that you provided.
[CUSTOMER][NEUTRAL] Both letters are
[CUSTOMER][NEUTRAL] Both, both letters are exactly the same. Both came today, [PII], [PII], and then my address. Uh dear policyholder, we received a claim on your policy and a review of your claim has started.
[CUSTOMER][NEUTRAL] In some cases, additional information must be requested from you or your provider of medical service for the claim processing. We will contact you if you need more information. Thank you for trusting APL with your insurance needs.
[AGENT][NEUTRAL] So is there not a like a, they provide a reference number or a claim number?
[CUSTOMER][NEUTRAL] Always feel
[CUSTOMER][NEUTRAL] No, I, I never heard of, of this before. [PII], wait a minute, wait a minute. No, that's your phone number, claims department. But no, that's it. That's all that's on there.
[AGENT][NEGATIVE] There is no.
[CUSTOMER][NEUTRAL] Now, the other thing.
[CUSTOMER][NEUTRAL] No, ma'am, that's it. Um.
[CUSTOMER][NEUTRAL] That's the whole letter.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] That's fine.
[CUSTOMER][NEUTRAL] Now the only thing that I can think of, there is a woman.
[CUSTOMER][NEUTRAL] About 2 years ago, all of her mail started coming here.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And it was all bad, like, you know, you're being investigated.
[CUSTOMER][NEUTRAL] Even had some people stop by looking for her. I guess I'm sure they were, they were trying to find her, but it's all kinds of information and bank stuff. So I go to the bank, I tell the bank, I call people and
[AGENT][NEUTRAL] Hm.
[AGENT][NEGATIVE] It's scary.
[CUSTOMER][NEUTRAL] I don't know, but she never used my name. She just used my address and her name.
[AGENT][NEUTRAL] Right. And it is addressed to you. It says for [PII], correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, [PII], and then it has my address, yeah.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] And like I said, the weird thing is I got
[CUSTOMER][NEUTRAL] Opened the mailbox, had these two identical envelopes, open them up. I thought they might at least be different dates, but they were both the same date and said the same thing.
[AGENT][NEUTRAL] What's your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the callback number just in case the call is disconnected is the [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And so it looks like you have a policy here with us. Do you, could you verify your email address?
[CUSTOMER][NEUTRAL] Oh my God, my daughter, um, put that in. I never use my email.
[AGENT][NEUTRAL] Do you know it?
[CUSTOMER][NEUTRAL] It's its own
[CUSTOMER][NEUTRAL] I know it's on Gmail.
[CUSTOMER][NEUTRAL] I know that.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEGATIVE] I don't, I don't know. See, I've always had insurance my whole life through work. Then my insurance went up for some reason to $612 a month. And that was without.
[AGENT][NEUTRAL] Yeah, it looks like it's.
[AGENT][NEUTRAL] It says Business Workers of America.
[AGENT][NEUTRAL] So it looks like some someone submitted a claim on your behalf and it's we're currently waiting for it to be processed.
[CUSTOMER][NEUTRAL] This
[CUSTOMER][NEUTRAL] Business workers of America.
[CUSTOMER][NEUTRAL] That's not me.
[AGENT][NEUTRAL] That's not you?
[CUSTOMER][NEUTRAL] No, ma'am, I'm retired from the city. I was a police officer.
[AGENT][NEUTRAL] Verify your mailing address.
[AGENT][NEUTRAL] I know you're asking you a lot of questions.
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] I know, I know, now if you're trying to clear it up, just whatever you need [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] This, this is, it says [PII]. Your mailing address is correct. Your date of birth is correct.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, it looks like you have.
[AGENT][NEUTRAL] Benefits here with us, let me see.
[CUSTOMER][NEUTRAL] If they're trying to
[AGENT][NEUTRAL] Let me make sure, let me see.
[CUSTOMER][NEGATIVE] If they're trying to hack me, they're gonna be.
[AGENT][NEUTRAL] So what is your, what is this, give me your social one more time. I know I got it in the beginning of the call to look you up, but give it to me one more time.
[CUSTOMER][NEUTRAL] They're going to be
[AGENT][NEUTRAL] You can just give me the list.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] See this is two different, this is a.
[AGENT][NEUTRAL] This is a different social security number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, I'm the only one that lives here, and
[AGENT][NEUTRAL] Everything else is the is match. Everything else matches.
[CUSTOMER][NEUTRAL] I've been living.
[CUSTOMER][NEUTRAL] What's that?
[AGENT][NEUTRAL] Everything else matches, but
[CUSTOMER][NEUTRAL] Yeah, I've been here, I've been living here by myself since [PII].
[AGENT][NEUTRAL] The um
[CUSTOMER][NEUTRAL] In the businessman's Workers of America, that's, I have no clue what that is.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Business Workers of America, it just says Business Workers of America. That's the name of the employer.
[CUSTOMER][NEUTRAL] No, no, I work for the city of [PII].
[CUSTOMER][NEUTRAL] And uh I've been retired from that since, uh,
[CUSTOMER][NEGATIVE] I got injured in um
[AGENT][NEUTRAL] Unless that's the name of the um
[AGENT][NEUTRAL] Like you, you're retired unless that's the name of the
[AGENT][NEUTRAL] The COR company being that you're retired. I'm not sure, but
[CUSTOMER][NEUTRAL] No, I don't have any. The only ties I have with them is a pension.
[CUSTOMER][NEUTRAL] And as far as insurance, that's who I was insured through up until about I think 2 years ago.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] May I place you on a brief hold?
[AGENT][NEUTRAL] I'm gonna see if I can pull up your application and see what's going on. Hold on one moment, OK?
[CUSTOMER][NEUTRAL] Sure, mhm.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey [PII], how you doing?
[CUSTOMER][POSITIVE] Good, how are you?
[AGENT][POSITIVE] I'm great, thanks for asking. [PII]. I have a well, I have an insured on the phone by the name of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] He has a policy. Let me give you the policy number so you can look at it with me as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It is 249-951-4.
[CUSTOMER][NEUTRAL] OK, let me pull up.
[CUSTOMER][NEUTRAL] Alright, so I've got Mr. [PII] up. What's going on with him today?
[AGENT][NEUTRAL] So everything.
[AGENT][NEUTRAL] He gave me his name, his date of birth, that matches, the mailing address matched.
[AGENT][NEUTRAL] Um,
[AGENT][NEGATIVE] I had to find him in the system because he, he didn't have the correct policy number.
[AGENT][NEGATIVE] So then when I did find him up, find, pull him up, he was like, well, I've never heard of this before. He said he does not work.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So he wouldn't know how he gets some insurance to an employer.
[AGENT][NEUTRAL] So then I um
[AGENT][NEUTRAL] I go to the PIGHT screen asks him to verify his social. It did, it don't match the social that's in the system.
[AGENT][NEUTRAL] And then I asked him did the business, the employee name Business Workers of America sound familiar? He said no. He said because he's a retired police officer, he works for the city of um [PII].
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] That's weird.
[AGENT][NEUTRAL] And I'm not familiar with HR policies.
[CUSTOMER][NEUTRAL] That business workers of America.
[CUSTOMER][NEUTRAL] Yeah, the business workers of America is like a third party where like independent people like self-employed people can get insurance through.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So there's a contact phone number for them. I would tell him to contact them because that's who the plan is going through.
[AGENT][NEUTRAL] What's their number? Do you have their number? Is it listed on here?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's in guru, but I can give it to you.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Um, yeah, no worries. It's 877-247.
[CUSTOMER][NEUTRAL] 886 8.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, [PII], let me let him know because he's saying that he don't have a clue about this policy because he's retired.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, yeah, so it's not technically like BWA is not a technically like an employer it's just like a group um for members that can get insurance like if they're self-employed or something so just let them know that that's the contact number for them because they would have to cancel it.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I will let him know. Thank you. Have a good day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Yeah, you're welcome.
[AGENT][POSITIVE] Thank you for holding so I'm gonna give you a number to contact. Do you, are you self-employed? Do you have like your own business or anything? You just retired?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, ma'am. I'm, I'm retired.
[AGENT][NEUTRAL] OK, so let me give you this number.
[CUSTOMER][NEUTRAL] Alright, hold on, let me get my pen.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Let me, let me get a pen here. Hold on one second.
[AGENT][POSITIVE] Sure, take your time.
[CUSTOMER][NEUTRAL] All right
[CUSTOMER][NEUTRAL] OK, what's the number, ma'am?
[AGENT][NEUTRAL] [PII]. That's [PII] and this is Business Workers of America.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] You can contact them, contact them to verify.
[AGENT][NEUTRAL] This policy to see if it actually belongs to you or not.
[CUSTOMER][NEUTRAL] Well, I, I'm 100% it doesn't belong to me, man.
[CUSTOMER][NEUTRAL] I, I had uh my father's insurance when I was a kid, and when I was in the military, I had that insurance. And then in the police department, you have to have insurance and it was through the city.
[CUSTOMER][NEUTRAL] And now I'm the [PII]. I'm with the VA now.
[CUSTOMER][POSITIVE] That handles most of my stuff.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] You know, but, but they're saying that's me and um.
[AGENT][NEUTRAL] And the only thing that's different is the social.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] But the date of birth, the mailing address?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, are you, you're the, you're the claims division for this company, right?
[AGENT][NEUTRAL] Yes, we work for clients. We work in the claims department.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEGATIVE] Well, what I'm saying to you guys is don't pay anything because it's not me.
[CUSTOMER][NEGATIVE] All right, that's, that's what I'm, I'm telling you guys. Don't pay anything.
[AGENT][NEUTRAL] Right, but being that we're a third party administrator, you need to contact the number that I provided you with to verify if this.
[CUSTOMER][NEUTRAL] You can't
[CUSTOMER][POSITIVE] Well, I'm gonna listen, I'm gonna do that, but just like you guys, I don't know if it's you or whoever, you know, in that business, don't pay these whatever the claim is because it's not me. So I'm gonna hang up. Thank you for your help. I appreciate it. I'm gonna call these people right now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All [PII]. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's called business what is it called again? Business what?
[AGENT][NEUTRAL] Workers of America.
[CUSTOMER][POSITIVE] OK, I'll I'll get right on. Thank you, ma'am.
[AGENT][POSITIVE] You're welcome. Thanks for calling AP. Have a good day. Goodbye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] All right.