AccountId: 011433970860
ContactId: b113a113-5862-4cf7-bdfb-8b85ce95a906
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 836739 ms
Total Talk Time (AGENT): 309911 ms
Total Talk Time (CUSTOMER): 349207 ms
Interruptions: 3
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/b113a113-5862-4cf7-bdfb-8b85ce95a906_20250113T20:23_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Uh yes ma'am. My name is [PII]. I submitted a claim a couple of weeks ago.
[CUSTOMER][NEGATIVE] And I got a letter with an explanation on it today, but it didn't, it didn't pay anything.
[CUSTOMER][NEUTRAL] Could you
[AGENT][POSITIVE] Yeah, I can help look into that for you, [PII].
[CUSTOMER][NEUTRAL] Could you
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Do you have that policy number handy, my friend?
[CUSTOMER][NEUTRAL] OK, the policy number is 007346660.
[AGENT][POSITIVE] Perfect. And could you verify for me, please, your date of birth?
[CUSTOMER][NEUTRAL] A [PII].
[AGENT][POSITIVE] Perfect, thank you. And could you also verify for me, pretty please, your mailing address?
[CUSTOMER][NEUTRAL] Reference number.
[AGENT][NEUTRAL] Oh no, I'm sorry, your mailing address on file if you can please.
[CUSTOMER][NEUTRAL] [PII], OK, [PII].
[CUSTOMER][NEUTRAL] At [PII].
[AGENT][POSITIVE] Perfect. And then lastly, if you could just verify for me the phone number on file.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK perfect thank you so much um so I am looking at that and it just looks like the claim is pending um is what I have.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And so,
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] All right and it looks like we're just waiting for um information from your group um for eligibility and then we'll be able to continue forward with the claim so it's just on hold right now but it they'll process it either way and then they'll reissue you a letter.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, yeah, well, I retired from the state of [PII] and
[CUSTOMER][NEUTRAL] I've had this policy quite a long time.
[CUSTOMER][NEUTRAL] I kind of had a little lapse in coverage, but I thought I'd gotten straight on that.
[CUSTOMER][NEUTRAL] Oh, OK, you think, you think my claim will be paid or?
[AGENT][NEUTRAL] You know what, let me.
[AGENT][NEUTRAL] Let me pull some stuff up. Yeah, it looks like you're actually self pay, aren't you?
[AGENT][NEUTRAL] My friend
[CUSTOMER][NEUTRAL] Yeah, the premiums are taken directly out of my checking account every month.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My premiums are not deducted through uh through payroll.
[AGENT][POSITIVE] That makes sense. OK, let me actually take a look at that real quick then for you if you don't mind and see what I can find out.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And uh be sure my wife is covered on this policy also while you're checking.
[AGENT][NEUTRAL] Alright, I'll take a look at your wife's coverage as well. Give me one second. I can actually do that on my other screen.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, I'm actually not showing your wife as covered.
[AGENT][NEUTRAL] Um, let me see what's up there.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And she's supposed to be covered. That was my understanding that both of us were covered by this policy.
[AGENT][NEUTRAL] OK, yeah, do you mind? OK, I wanna look into that. Do you mind if I put you on a brief hold?
[CUSTOMER][NEUTRAL] Sure, go ahead. I, I'll wait.
[AGENT][POSITIVE] OK, perfect. Thank you so much.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] I think I have.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][POSITIVE] Thank you for calling APL. This is New Marine customer service. How may I help you?
[AGENT][NEUTRAL] Hi, this is [PII] with the care team. How are you doing today?
[CUSTOMER][POSITIVE] Good, how are you?
[AGENT][NEUTRAL] Hey, I've got maybe a couple of questions you can help me with. Um, I'm looking at policy number 7,346,660.
[CUSTOMER][NEUTRAL] OK, give me just a moment.
[CUSTOMER][NEUTRAL] All right, [PII].
[AGENT][NEUTRAL] Yeah, so originally why I called over to you is, um, his wife has lapsed and he said that he was under the impression his wife was on the account. It looks like it shows that the policy is for a couple, and I see on here that his wife was added in [PII], um, but I don't know why his wife says lapsed. Like it doesn't have a note that anyone termed her for any reason. And so I wanted to like know if you could help me look into that.
[AGENT][NEUTRAL] But then I'm also looking into it and it looks like this policy is a self pay and it's supposed to be it since the draft type is electronic, but it looks like we billed him in November but like we never received payment um and he's waiting on eligibility for a claim to go through and he doesn't understand because he thought his stuff was supposed to get drafted so there's those two things and I can call group billing if I have to, but.
[AGENT][NEUTRAL] Originally I called about the wife.
[CUSTOMER][NEUTRAL] OK, so the wife is um.
[CUSTOMER][NEUTRAL] Reactivated. I just added her back apparently when the policy lapsed before previously uh she just wasn't reinstated in that screen, um, but he is uh he does have couple coverage, so I have changed that and corrected that. um, now as far as the draft.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, he's not set up for a draft. He's set up for a quarterly bill.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEGATIVE] Oh, doesn't it, because I guess how, how does that work? So you can't draft on a quarterly bill. So when it says draft type e electronic, like it's not actually gonna do that.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right, because it's not set up to draft the so the mode of payment is how it determines what happens and so mode of payment too is a draft and so it will take the information uh at the bottom of the screen and draft that account but if it's not set up for mode of payment to it won't do that.
[AGENT][NEUTRAL] He thought he was being drafted monthly. OK, so he's being billed out that makes sense.
[CUSTOMER][NEUTRAL] Yes, he's being billed out quarterly.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And I can't update that for him, right? Like I can't change it to um if he wants to be drafting every month I can't change that.
[CUSTOMER][NEUTRAL] Uh, yeah, we can change that and hold on just a second, let me see.
[CUSTOMER][NEUTRAL] Reactivated uh I'm having to make a note.
[AGENT][POSITIVE] You're OK.
[CUSTOMER][NEUTRAL] OK. Let me go back and look.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] OK, so back in October.
[CUSTOMER][NEGATIVE] His account was compromised. He had to freeze the account and close it. He had a draft for September.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I sent him a new EFT and switched him over to direct bill until he could update his banking information.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] I don't see.
[AGENT][NEUTRAL] Where it was ever updated?
[CUSTOMER][NEUTRAL] Yeah, that's what I'm checking. Give me just another minute. Let's see.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I able to take payment over the phone.
[CUSTOMER][NEUTRAL] You mailed in a check for a quarterly payment.
[CUSTOMER][NEUTRAL] Hey how like you have to cycle all the way back through to read the.
[AGENT][NEUTRAL] Yeah, to go back to the top, it looks like the one right before, like the one right underneath you from [PII] says received insured's new EFT form and changed his bank draft info online, and it was put in 5 days after they sent him the new form.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah I see that now so yes if he if he wants to change it back to monthly we can.
[AGENT][NEUTRAL] OK, I think he thought when that form went in it was gonna get switched back on him because he's like, I pay every month.
[AGENT][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] Yeah, I think.
[AGENT][NEUTRAL] I just want to accept.
[CUSTOMER][NEUTRAL] Yeah, I think [PII] just forgot a step so um I mean we can change that back um he is only paid up to December though so we actually need to draft for.
[AGENT][NEUTRAL] December and then January.
[CUSTOMER][NEUTRAL] December and January. Mhm.
[AGENT][NEUTRAL] OK, perfect. I will, um, do, do I, I can let him know that um I don't know how to change I mean I'm assuming it's like CHG and then it's a 2 and a 12 and then yes to save.
[CUSTOMER][NEUTRAL] Uh, yes, that's how you would change it, yes, um, but I can do all that. Do you need me to talk? I can, did you need anything else like or just trying to get this fixed?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, he just wants to take this care of because he is, he got that explanation of benefits saying that he's pending eligibility, and he was like, I thought I paid so um I can let him know that when that form came through it didn't update that he was, we haven't had his January or his December payment, but we can switch it out and bill him for both and and then do I let him know like that is gonna be billed.
[AGENT][NEUTRAL] When would that come out?
[AGENT][NEUTRAL] It
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Hold on just a second, [PII]. I, I.
[CUSTOMER][NEUTRAL] If you don't mind just go ahead and transfer the call um yeah so that I can talk to him yeah I can talk to him about when we can draft because um with the billing schedule I could go ahead and draft him tomorrow for December and January and then his regular February payment I can switch it back to the first um so I just need to know if he's OK with that so I'll just talk to him about that and I'll let him know that um.
[AGENT][POSITIVE] Transform, yeah, OK, cool. There's a lot of things there.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That I've fixed everything else, so.
[AGENT][POSITIVE] OK perfect and then in the future that's how I would change it and um I appreciate your help, learned a lot today.
[CUSTOMER][POSITIVE] No problem [PII], you're welcome.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Hi [PII], are you still there with us?
[CUSTOMER][NEUTRAL] Mm yes ma'am I'm here.
[AGENT][POSITIVE] Hey, I really appreciate your patience while I looked into all of that for you. I have Ms. [PII] on the line, um, and she's going to be able to take over the call and help you out as far as making sure everything's set for your billing, but she was able to go ahead and reactivate your wife. That was just a, a technical error on our part, and she got that taken care of, so Ms. [PII] is covered, OK?
[CUSTOMER][NEUTRAL] And it's covered.
[AGENT][NEUTRAL] Yep, so she'll be all set and then it's [PII] on the line and she's gonna take over the call from here, OK [PII]?
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] It's my pleasure. Thank you.
[CUSTOMER][NEUTRAL] Goodbye.
[CUSTOMER][NEUTRAL] Hi, Mr. [PII]. My name is [PII]. How are you doing today? I hold.
[CUSTOMER][POSITIVE] Doing pretty good, I think. Good, good, glad to hear it. Uh, so [PII] was just telling me a little bit about what was going on and I was looking through the policy with her, um, like she told you just now. I have, um, fixed the fact that your wife was showing up as laps on there. I fixed that for you. I do apologize for that. Um, the other thing is we got your new bank draft information. I just need to talk to you about um.
[CUSTOMER][NEUTRAL] When we're gonna run the the draft, um, because you do still owe for December and January, so in order for us to switch it back to a bank draft, we need to get it called up to current.
[CUSTOMER][NEUTRAL] Um, you haven't mailed in a check or anything recently, have you?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I really it was supposed to be automatically taken out of my checking account was my understanding.
[CUSTOMER][NEUTRAL] But it seems like I did, I did mail one check a couple of months ago to catch up everything.
[CUSTOMER][NEUTRAL] Mhm