AccountId: 011433970860
ContactId: d77aacaf-5331-4a96-95d7-a014e2f4ac48
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1171939 ms
Total Talk Time (AGENT): 456743 ms
Total Talk Time (CUSTOMER): 440988 ms
Interruptions: 3
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/d77aacaf-5331-4a96-95d7-a014e2f4ac48_20250609T15:58_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is uh [PII]. Uh, my policy number, excuse me, um.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Is C like Charlie O like Oscar 931116.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let me pull it up. Let me see.
[AGENT][NEUTRAL] Mm, OK. Bear with me. Is that like an um
[AGENT][NEUTRAL] An old policy.
[CUSTOMER][NEUTRAL] Uh, no, ma'am.
[AGENT][NEUTRAL] No. Um, do you have any other numbers besides that one?
[CUSTOMER][NEUTRAL] The thing I would tell you is change the 0 to a 0 maybe.
[CUSTOMER][NEUTRAL] That looks like a no to me. I'm looking online at my certificate number right now.
[AGENT][NEUTRAL] OK, and that is the number under the certificate number. OK, let me change that to 0093. 1 moment.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] How do you spell the last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And you said the first name is [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the policy is with APL or APFA?
[CUSTOMER][NEUTRAL] APL
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, let me repeat the numbers I got here just to make sure I put it in correctly. OK, so I, I switched to C for a 0.0093116.
[CUSTOMER][NEUTRAL] There's not two 0s, it's C 0931116.
[AGENT][NEUTRAL] And we don't have letters in the.
[AGENT][NEUTRAL] Policies in the front unless it's a really old policy, um, one moment.
[CUSTOMER][NEUTRAL] [PII] old, ma'am, that's it.
[AGENT][NEUTRAL] OK. I'm just trying to find you, OK?
[CUSTOMER][NEUTRAL] Want my social name
[AGENT][NEUTRAL] If you don't mind, that'll be a lot faster. Mhm.
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm waiting on the system.
[AGENT][NEUTRAL] OK, for security, may I have your uh mailing address and email address on file?
[CUSTOMER][NEUTRAL] [PII]. Email is [PII].
[AGENT][POSITIVE] Perfect, thank you. OK, let me go ahead and give you the policy number so you have it for your records, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the policy number that I found with your social is [PII].
[AGENT][NEUTRAL] 752 3.
[CUSTOMER][NEUTRAL] OK, I, and I'm looking on the APL dashboard right now.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] At numbers what comes up.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Hm. Yeah, I'm not sure why.
[CUSTOMER][NEUTRAL] I don't know what's there it's just the the gift that keeps on giving here.
[CUSTOMER][NEUTRAL] So, um, I'm looking at the fact that I had to resubmit claims.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And I've got.
[CUSTOMER][NEUTRAL] 4 claims that are outstanding.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And on the
[CUSTOMER][NEUTRAL] Um, the website here.
[CUSTOMER][NEUTRAL] It is showing the insured is undefined undefined with that CO number.
[CUSTOMER][NEUTRAL] I filed this online.
[CUSTOMER][NEUTRAL] I filed it under my name.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I will tell you, ma'am, and I know you're you're just on the other end, this has been a world of problem and I'm a broker of 32 years, almost 33 now, and I do these policies daily.
[CUSTOMER][NEGATIVE] This has been an absolute nightmare.
[AGENT][NEUTRAL] Yeah, I'm sorry to hear that. Um, I, I know it's a little bit difficult sometimes, um.
[AGENT][MIXED] And submitted claims and um all the information that is needed to get the claim done. Um, it's a little bit frustrating. Um but yeah, it looks like we processed the claim and we needed additional documents and it looks like you just submitted some documents and I do see that it's under your name. Um, I see a submission on the [PII] and 3 submissions on the [PII]. Um, right now they're in line to be processed. They have not been processed yet. The normal processing time is 7 to 10 business days.
[CUSTOMER][NEUTRAL] So if we're looking at a review time frame it's not really gonna be until maybe the end of this week first of next week is that what I'm hearing?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] But you do show in the system where it says insured it's submitted under my name.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] System doesn't show that.
[AGENT][NEUTRAL] Mm. So, um, can you repeat again how it shows in the system so I can report that.
[CUSTOMER][NEUTRAL] Uh, it has open claim.
[CUSTOMER][NEUTRAL] It has no claim number attached to what I recently submitted.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] It has underinsured, undefined, undefined.
[CUSTOMER][NEUTRAL] And then that C0931116 number.
[CUSTOMER][NEUTRAL] There's no confirmation number.
[CUSTOMER][NEUTRAL] The amount paid has a dollar sign.
[CUSTOMER][NEUTRAL] Capital N lower case a a capital N.
[AGENT][NEUTRAL] Hm, OK.
[CUSTOMER][NEUTRAL] And that's what it shows on all 4 submissions.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yeah, and I'm sorry, they're trying to work on this new um online service center and trying to make it better, so um I'll go ahead and let them know how it shows and see what they can do about this. Um I know that um the claim number is not gonna appear until it's processed, so you're not gonna see a claim number until it's processed, OK?
[AGENT][NEUTRAL] Um, you should be able to see the, um, confirmation numbers. I'm not sure if you're able to see those, which is the OSC and the numbers on 99, like the last, no, you don't see that. OK, no confirmation. Yeah, and this, this is the second one I noticed that they say they don't see the confirmation, so I'll have to report that one for confirmation.
[CUSTOMER][NEUTRAL] Nope
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] I.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And undefined and OK.
[AGENT][NEUTRAL] OK, and you said there's a dollar sign, but there's nothing there, more than likely because it's not, it's not been processed yet. OK.
[CUSTOMER][NEUTRAL] A says power sign N A N.
[CUSTOMER][NEUTRAL] That's what says in the amount paid.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So, um, again, I do apologize, um, I'm gonna go ahead and um speak to the person that is working on this website and see why is it showing like that, and we need to, it looks like we, we need to address the, the information about the confirmation numbers because yes, it doesn't seem to be appearing on the website. So I'll go ahead and report this and see what we can do about that.
[AGENT][NEUTRAL] Now, um, the, the processing time again is 7 to 10 business days and once it's processed, then you will see a claim number in there and more than likely that um NAN is gonna disappear and have the amount that is paid if it's payable, if not, it's just gonna have like a um information.
[CUSTOMER][NEUTRAL] This is wellness ma'am.
[CUSTOMER][NEUTRAL] And and I've already had a fight with you guys over what was the wellness or preventative in the policy.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] And it was declined initially.
[CUSTOMER][NEUTRAL] But I had to point out in the contract where it's not.
[CUSTOMER][NEUTRAL] It's a payable event.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And to sit here and have to go 7 to 10 days.
[CUSTOMER][NEGATIVE] On top of is is ludicrous as well.
[CUSTOMER][NEUTRAL] I I don't know if you have any back way.
[CUSTOMER][NEUTRAL] Well, I'm not necessarily looking for any kind of special treatment.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I cannot put a client in this position.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] And I think it's absolutely ludicrous.
[CUSTOMER][NEUTRAL] To have 2+ weeks.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] From the well I even look at the fact that.
[CUSTOMER][NEUTRAL] Others that I've submitted.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] And it's the same information again.
[CUSTOMER][NEUTRAL] That I submitted on the [PII].
[AGENT][NEUTRAL] Mm, um, we have a department that process claims. Um, it is not our department, we just go ahead and handle the calls and what we see in um our system to, you know, route over to the members. Um, now, if you need to speak to somebody in our department, I have two options. Either I can go ahead and send a message for a call back or I can try to get somebody on the line for us.
[CUSTOMER][NEUTRAL] I mean if you wanna try to get somebody I mean that's fine.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Yeah, sure. I can do that. Um, mhm. Go ahead.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] I've spoken to [PII] uh on this first initial.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Oh, OK. I think she's the one that is available right now if I'm not mistaken. Let me see if she doesn't have a call. Um, let's see. I know I saw her this morning on the system, so I'm sure she is the one on that line.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, see.
[AGENT][NEUTRAL] OK, we have, well, we have 4 agents. Let me see if I can get one of them, OK? One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[AGENT][NEUTRAL] Hi [PII], how are you? This is [PII].
[CUSTOMER][NEUTRAL] Hi so how how are you?
[AGENT][POSITIVE] I'm good, it's Monday.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yeah, I have, uh, Mr. [PII] on the line. He said he's spoken with you before, so I'm, I'm really glad I got you. Um, but, um, yeah, the policy number is 2487523.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's about his claim. He said he submitted some more information and he just feels like, you know, he should not be waiting that long. He said he don't want no special treatment but he don't believe that he should be waiting that long for the claim to process and he wanted to speak to somebody in that department.
[CUSTOMER][NEUTRAL] OK, when did we receive his claim 63? OK, alrighty, and he's been verifying so correct?
[AGENT][NEUTRAL] Yeah, recently. Mhm.
[AGENT][NEUTRAL] It's been fully verified, correct, yes, mhm, yes, and he has some more um troubles about the website, but that one I can go ahead and report to [PII], so I'll go ahead and do that just in case he mentioned it. Just let him know that I'm reporting the information of the website, the problems he's having with the website.
[CUSTOMER][NEGATIVE] OK, and that's the OSC issues, so people are still having issues with, uh, like I had, I spoke to a customer on a side note, sorry, I spoke to a customer a little bit ago that on a hub request I had to call them back and she said she's able to access it but it just keeps spinning and won't advance and she can't view anything. Is that kind of what people are reporting generally?
[AGENT][NEGATIVE] Yeah, I have, yes, I have reported a few of those, even myself, I cannot view my claims. I cannot view my UOB, so I don't know what's going on there. And um, but also he's saying that there's like some information about um that is coming out on under under fine or something like that under his name and and there is no confirm they're not getting confirmation numbers no more, so I don't know. This is my 3rd call. They're not getting confirmation numbers.
[CUSTOMER][NEGATIVE] They're not OK. And so that is being um.
[CUSTOMER][NEUTRAL] OK, but that is being looked at, right?
[AGENT][POSITIVE] Yeah, I'm gonna go ahead and report the confirmation for the first time on my end. I'm not sure if anybody else has um reported that. So I'm gonna go ahead and report that one. So hopefully we'll get it fixed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got you, OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now do you know, so, yeah, do you know real quick, I'm sorry, um, if my customer that I called back, she said that she had already spoken to someone on the care team they didn't indicate it in the notes, but can I assume it that she was reported as well, do you know?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] And do you know who I would check with?
[AGENT][NEUTRAL] If it was
[AGENT][NEUTRAL] Uh, if it was not reported, if it was not notated, more than likely it was not reported, but I can go ahead and check on the list. What is the policy?
[CUSTOMER][NEUTRAL] 258.
[CUSTOMER][NEUTRAL] 2109.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it's [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And she reported it today?
[CUSTOMER][NEUTRAL] Well she called in in regards to a claim denial and wanted some further information because she they told her to to check her EOBs and of course she can't view them so she wanted further information and we wanted some more information regarding the attending physician form um so I sent that to her in an email but I did tell her I would inquire about her issues with OSC if I could find anything out.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK. All right. Um, yeah, we have to put in a spreadsheet and they go by that. Um.
[AGENT][NEUTRAL] Let's see if it's on the spreadsheet.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] And I did verify like I said, she is active um and like I said she can get in she just can't view anything it just spins.
[AGENT][NEUTRAL] And be the EOB, uh-huh, and it was processed like not recently or nothing like that. It was processed um a few days ago, right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, hers was actually.
[CUSTOMER][NEUTRAL] Well hers was actually processed on [PII], the claim itself.
[AGENT][NEUTRAL] 5:[PII]. OK, yeah, it should be there then, um, mhm.
[CUSTOMER][NEUTRAL] But she, like I said, she re-registered and was accessing OSC on 63. Like I said, I did verify that [PII] had helped her with that. She was able to get in. She just can't view anything now. Like I said, when she signs in, it just spins.
[AGENT][NEUTRAL] Got you. OK, I don't see the report here. I don't see that name or that person in the report. I can go ahead and just put it in just in case, OK?
[CUSTOMER][POSITIVE] That'd be great thank you so much, and you can go ahead and I'm sorry about that thank you so much.
[AGENT][POSITIVE] You're welcome. OK, no, it's OK. No problem. Here he comes. Have a good day.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you. Thank you for holding and being patient for me. I got Ms. [PII] on the line and she's gonna assist you from here, [PII].
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Hi [PII].
[CUSTOMER][NEUTRAL] Hi Mr. [PII], how are you? Um, I'm doing OK, [PII]. Seems like we're dancing again. I was just sharing with you that um you know your system is.
[CUSTOMER][NEUTRAL] Uh, not showing my name as the insured as far as the claims are submitted and.
[CUSTOMER][NEGATIVE] Um, it's, uh, it's really frustrating, [PII], honestly.
[CUSTOMER][NEUTRAL] Understood, um.
[CUSTOMER][NEUTRAL] Uh, yeah, I know they're working through those issues. I, I think [PII] might have, um, you know, let you know that information and she has added your name to their list because they're trying to iron out these issues that they're having as far as the website now she said that you had indicated um you needed some further information to about your claims.
[CUSTOMER][NEUTRAL] Well, I mean, obviously, so you guys don't have an automated system for your wellness at all it has to be manually touched.
[CUSTOMER][NEUTRAL] Um, right now, yes.
[CUSTOMER][POSITIVE] They are currently being manually processed that's right.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I, I just, I mean sorry hold on that's funny, um, I flipped over a screen on my computer and it comes up with that anyway, um.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I, I guess you know being a broker as long as I have this is has gotten really antiquated and.
[CUSTOMER][NEUTRAL] Um, that there's no checks and balances in place for you guys to, to basically take care of a client that's going through a long process or or deal like this.
[CUSTOMER][NEUTRAL] Uh, because the industry, I don't care what car.