AccountId: 011433970860
ContactId: a733f67f-0a23-40fd-be04-8c526015455f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 538239 ms
Total Talk Time (AGENT): 166493 ms
Total Talk Time (CUSTOMER): 237930 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.1, CUSTOMER=-1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/a733f67f-0a23-40fd-be04-8c526015455f_20250624T21:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi. I was on the phone with somebody and we got disconnected, but I'm trying to figure out why, like what the status is of the claim that I submitted is and why I'm getting a check for $400 sent to me.
[AGENT][NEUTRAL] OK, do you have your policy number?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Policy number is 02578091.
[AGENT][NEUTRAL] OK, yeah, can I get your first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, uh, [PII], [PII].
[AGENT][NEUTRAL] OK, thank you, [PII]. And can you verify your address and email address?
[CUSTOMER][NEUTRAL] Address is [PII]. Uh email is [PII].
[AGENT][NEUTRAL] OK, and then lastly good callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Was it a claim for yourself?
[CUSTOMER][NEUTRAL] Yeah, it was for me. It was uh 2 claims for a hospital visit.
[AGENT][NEUTRAL] OK, let me pull up the claims and see what we.
[AGENT][NEUTRAL] Did, did you go to the hospital?
[CUSTOMER][NEUTRAL] Yeah, I had to go to the ER twice, once in November and again in December.
[AGENT][NEUTRAL] OK, uh, let me get it pulled up, just a moment.
[AGENT][NEUTRAL] OK, did you, um, upload the claims to our portal?
[CUSTOMER][POSITIVE] Yes, yes, I did.
[AGENT][NEUTRAL] OK. That's what the, that's for, it's for the ER visits, the one from [PII] and then [PII].
[AGENT][NEUTRAL] It's
[CUSTOMER][NEUTRAL] I'm sorry, you're, you're paying $400 out of the $20,000?
[AGENT][NEUTRAL] Yeah, this is a limited hospital indemnity plan. It's, it's not like a major medical policy.
[AGENT][NEGATIVE] It just has a very limited benefit.
[CUSTOMER][NEUTRAL] I had to go to the ER.
[AGENT][NEGATIVE] I, yeah, it's, it's a very limited benefit. It just pays $200 twice per calendar year for ER.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Do you have any other insurance?
[CUSTOMER][NEUTRAL] Uh, no, because at the time when I had to sign up for this insurance,
[CUSTOMER][NEUTRAL] I, oh my God.
[CUSTOMER][NEUTRAL] It's $20,000.
[CUSTOMER][NEGATIVE] I'm paying, I was paying more a month than what you paid for.
[AGENT][NEUTRAL] Yeah, like I said, it's just, it's a limited hospital indemnity policy.
[AGENT][NEUTRAL] And that and that's the benefit for the plan.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Oh my God. Like, I don't.
[CUSTOMER][NEGATIVE] What the hell did this insurance even cover? I'm, I paid $400 some dollars a month for this fucking insurance to pay $400 for a $20,000 bill? Are you kidding?
[AGENT][NEUTRAL] Ma'am, I, you'll have to stop yelling and please don't curse.
[CUSTOMER][NEGATIVE] You have got to understand, like, this is insane.
[AGENT][NEUTRAL] So you'd want to check with your employer on if you have questions about what type of policies they offer. This is a group policy.
[CUSTOMER][NEGATIVE] This wasn't through my employer. This was, I had to get this through a broker who clearly had no idea what they were doing and was giving me wrong information and not giving me a plan that was appropriate.
[AGENT][NEUTRAL] Yeah, I like I said, I'm, I mean, I'm part of the customer service team that I can help you with claim status.
[AGENT][NEUTRAL] Might want to speak with your broker.
[CUSTOMER][NEGATIVE] He's a waste. I've tried talking to him multiple times, and he has not been helpful. Like, I just wanna get this thing paid.
[CUSTOMER][NEUTRAL] God.
[CUSTOMER][NEGATIVE] This, this is absolutely insane. So that's all they paid for $20,000 is $400?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] Who
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] What? Oh my God. Oh my God.
[CUSTOMER][NEUTRAL] This is, this is insane. So that's it. That's it. $400.
[CUSTOMER][NEUTRAL] For $20,000.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] You're dead serious about that. That's all the insurance pays.
[AGENT][NEUTRAL] Yes, this is a very limited hospital indemnity policy. It just has a very limited benefit amount.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh my God.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] OK, so I guess there's nothing that can be done.
[AGENT][NEUTRAL] I, I mean, you might try.
[CUSTOMER][NEUTRAL] Is what you're telling me.
[AGENT][NEUTRAL] In regards to this policy, that's the max that it will pay.
[CUSTOMER][NEGATIVE] What, what does that insurance pay for? Because I don't understand how I was paying almost $500 a month for an insurance that didn't pay for anything.
[AGENT][NEUTRAL] Um, it looks like it's 7634 per month. Is there some other policy that you're, you're referring to?
[CUSTOMER][NEUTRAL] Nope, that must have been it. Something $700 some dollars. OK, just, my bad. I'm definitely off by a couple. So it was $77 something a month.
[AGENT][NEUTRAL] So so many
[CUSTOMER][NEGATIVE] To not pay anything. That's
[AGENT][NEUTRAL] Yeah, um, the premium I show is $76 a month, um, but it's, it's got just
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEGATIVE] That's hysterical. No.
[CUSTOMER][NEGATIVE] I was paying a couple $100 I was paying.
[CUSTOMER][NEGATIVE] Over $400 a month for a whole insurance plan. So I'm very confused because they told me that I had to contact you guys to get this claim submitted.
[AGENT][NEUTRAL] OK, I don't
[CUSTOMER][NEUTRAL] And I was paying a lot of money every month. Oh my God.
[AGENT][NEUTRAL] I don't, I don't show any other policies on file. That's what I'm saying. Maybe there's something else that you have other, some other policies are a different carrier, but we only have this policy and the premiums only always been $76 a month. So if you've been paying $400 a month.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] And it must be some other policy with someone else.
[CUSTOMER][NEUTRAL] This was
[CUSTOMER][NEUTRAL] This was through, what the heck was it called? Um
[CUSTOMER][NEUTRAL] This plan, oh my God, what was this plan called now? Um, GA Insurance 2004.
[CUSTOMER][NEUTRAL] This was like a BWA or something and I was paying, uh, I'm bringing it up right now, payment history.
[CUSTOMER][NEUTRAL] It it open.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] BWAmericare.
[AGENT][NEUTRAL] OK, this is not [PII].
[CUSTOMER][NEUTRAL] I was paid.
[CUSTOMER][NEUTRAL] I'm, well, so when I called them, they said I had to call you to get this stuff taken care of.
[AGENT][NEUTRAL] OK, yeah, I, I don't know if they must sell different policies, but the only one that I have with American public life is this limited hospital indemnity policy, which is just $76 a month. Not that that's cheap, I'm just saying it's, it's not $400 a month, so you must have some other coverage.
[AGENT][NEUTRAL] That it's through a different carrier.
[CUSTOMER][NEGATIVE] That's, that's why I don't understand because this was the, this, when I called that insurance, you're the one that they told me I had to call and submit this claim through.
[AGENT][NEUTRAL] If you
[CUSTOMER][NEUTRAL] Oh my God.
[AGENT][NEUTRAL] And I'm not sure what the Americare is because it's not, it doesn't have anything to do with our insurance. We don't have any policies that are called that.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] So, um, you might, like I said, you might try reaching out to your agent. Maybe they have access to some information that I can't see.
[CUSTOMER][NEUTRAL] Oh my God.
[AGENT][NEUTRAL] Because we, like I said, I just have this one policy, that's all I have on file.
[CUSTOMER][NEUTRAL] OK. All right.
[CUSTOMER][NEGATIVE] All right, OK, I, I'll clearly just gonna have to call him and he's the biggest waste of space and air ever.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Thank you for your help.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a good evening.