AccountId: 011433970860
ContactId: e16bd9e4-c59f-4ed6-9883-7e0b6bd466fc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 681440 ms
Total Talk Time (AGENT): 377828 ms
Total Talk Time (CUSTOMER): 252747 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/e16bd9e4-c59f-4ed6-9883-7e0b6bd466fc_20250121T15:25_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEGATIVE] That I went to, I'm and I went to the dentist and she said that they uh refused to pay for cleaning.
[AGENT][NEUTRAL] OK, yeah, I, let me take a look at that for you. I'm so sorry. Let's see what's going on and we'll take a look at it. Um, do you have your policy number handy?
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] 00.
[CUSTOMER][NEUTRAL] 6.
[CUSTOMER][NEUTRAL] 34, 33.
[AGENT][NEUTRAL] 606-134-33 did I hear that correct?
[CUSTOMER][NEUTRAL] Right.
[AGENT][POSITIVE] Perfect, let me try looking that up for you real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, and.
[AGENT][NEUTRAL] Would you mind, and I know you said it when you first, when we first spoke, but would you mind um re-verifying for me your first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] RJ.
[AGENT][POSITIVE] Perfect, thank you so much, Ms. [PII] and.
[AGENT][NEUTRAL] I do just need to verify a few other little bits of information with you if you don't mind.
[CUSTOMER][NEUTRAL] OK, if I, if I remember.
[AGENT][NEUTRAL] But I, I bet you will. I'm rooting for you. Ms. [PII], could you just verify for me, please, your, um,
[AGENT][NEUTRAL] Your mailing address?
[CUSTOMER][NEUTRAL] Post office by [PII].
[AGENT][POSITIVE] Thank you and then perfect and then the other thing I was wondering is if.
[AGENT][NEUTRAL] I could just get a good call back number in case we get disconnected.
[CUSTOMER][NEUTRAL] Huh.
[AGENT][NEUTRAL] If I could just get a good call back phone number in case we get disconnected?
[CUSTOMER][NEUTRAL] call
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Alright, so,
[AGENT][NEUTRAL] Let me see the most recent claim I have on file I just showed that um the claim is pending.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So it doesn't show that it's been denied, it just shows that it's pending, but let me.
[AGENT][NEUTRAL] Look at this one a little further and then I'll look at the next one with you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then.
[AGENT][NEUTRAL] The one before that back from it looks like we received it in October it was from your October visit.
[AGENT][NEUTRAL] Let me take a look at that.
[CUSTOMER][NEUTRAL] Yeah, they
[CUSTOMER][NEUTRAL] They paid for that one.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] I'm like, what are they paid for? Wait a minute. That must be the one they didn't pay for.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I get it
[CUSTOMER][NEUTRAL] No, they paid for October. It's January it paid for.
[AGENT][NEUTRAL] January? OK, I just see January is pending. It hasn't been denied we haven't refused it. It's just um it's just a pending claim it hasn't been decided yet.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] So it's just in the review process and I'm sorry that's taking a little longer than normal um but it it will be processed um upcoming and then I'll I'd be able to let you know more information but right now it's just like.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's still in process.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Sometimes when it's been a long time in process they'll like send out a note saying hey it's still pending so people realize that we have it in the works instead of thinking like maybe it was never submitted or never came through.
[CUSTOMER][NEUTRAL] OK, cause it's, you know, I'm uh also so I'm confused. Now I got a life policy with you. So, uh, the, the at my policy.
[CUSTOMER][NEUTRAL] So I got to to cancel so I do, I need to stop payments on my check or what?
[AGENT][NEUTRAL] So I guess I'm trying to understand so.
[AGENT][NEUTRAL] You said with your other policies with us you're wanting, are you wanting to cancel? It looks like you have an accident policy with us. Maybe it's not, it's an IC 3. Let me look at that a little closer.
[CUSTOMER][NEUTRAL] Uh-huh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] But it, it's not uh uh uh they uh the the actual.
[CUSTOMER][NEUTRAL] I got a life policy.
[AGENT][NEUTRAL] Um, so it doesn't look like your life insurance policy is with APL. I'm not exactly sure who it's with. The other policy I have on here is a cancer policy.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, OK, I got it now.
[AGENT][NEUTRAL] So it looks like you have dental and cancer with us and it looks like at one point you had a third policy but we haven't had it since [PII].
[CUSTOMER][NEUTRAL] OK. Now.
[CUSTOMER][NEUTRAL] I got a life policy, is that with you?
[AGENT][NEUTRAL] No, I'm sorry.
[CUSTOMER][NEUTRAL] No, no, no, it's with protective life, I think.
[CUSTOMER][NEGATIVE] I think I got it mixed up.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] OK, I think with you I have uh [PII] and cancer, right?
[AGENT][NEGATIVE] So you have, yeah, you have your dental and your cancer with us.
[CUSTOMER][NEUTRAL] OK. So, if they refuse my uh
[CUSTOMER][NEUTRAL] If they feel they would uh uh oh wait a minute, get a Porsha.
[CUSTOMER][NEUTRAL] And a claim and then she said if she filed for the partial, it's gonna be denied or something.
[AGENT][NEUTRAL] Well, so I don't know just because it's still being worked unfortunately I don't process claims so like I don't review them or look at them um like I can I can see once they make a decision and let you know the decision that was made um but all I can tell you right now is they're still just working on the claim and so it doesn't say that it's gonna be denied or it's gonna be approved it doesn't say either way it's just like hey we're still working on this like.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and it's just kind of in a hold point at this moment until they finish it and so maybe they're backed up or maybe we have information we're waiting on that didn't come through over the holidays. I'm not really sure what the hold is, um, but I wouldn't, I wouldn't discount it yet. I don't know if that makes sense, you know what I mean like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] It could still it could still get paid, uh, they just haven't finished it.
[CUSTOMER][NEUTRAL] So you say I just need to wait.
[AGENT][NEUTRAL] I think yeah I think um in my I mean for what my opinion is worth, ma'am so you don't have to take it but in my opinion I would just wait for them to finish processing your claim and then yeah if they deny it and you feel like hey this isn't what I want, this isn't gonna work for me you know you can make your decisions from there but I would I'd at least let them finish processing the claim just because it's just on hold, you know what I mean so it hasn't been denied.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, they're just gonna, they have, they just need a little more time to work on it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so she said something about she was waiting the, the, uh, what she said, the uh.
[CUSTOMER][NEUTRAL] Uh, a what you call employee something. I say, well, for 20 years they been paying it.
[AGENT][NEUTRAL] Yeah, I mean, I see that you've had, you've had our insurance for a while and I see so many of these gay, yeah, 20 years. So I don't.
[CUSTOMER][NEUTRAL] So I
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] Yeah,
[AGENT][NEUTRAL] Again, I don't process claims so I can't tell you yes it's gonna be paid like I don't I can't you know that wouldn't be fair of me that wouldn't be right of me because I don't do that part of the job, um, but I do it I just see it's on hold, you know what I mean? I don't show it's been denied and so I think give them a little more time to finish it up and you know if you if you wanna make decisions after they come to their decision on the claim, but I'd give them time.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, cause I said if they I don't pay for anything, I need, but she didn't know, I said, well, I need to stop my pain and sit up.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And she didn't know.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] But I said it's no sense me let the they pay in this month cause I saw it in my bank statement. I said it's no sense to be paying it cause I don't have that kind of money.
[AGENT][NEUTRAL] Yeah, I understand. I would.
[AGENT][NEUTRAL] Yeah, I would just give them a little bit longer. It looks like they asked it was on the [PII] they asked for a little more time and usually these claims turn around a lot quicker than that and that's probably why they sent out that notice saying hey we're on hold, we need a little more time so people didn't think like it got lost or forgotten about on the way and so I am sorry it's taking a little longer.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I
[CUSTOMER][NEGATIVE] OK, well, because if they that I would crying.
[CUSTOMER][NEUTRAL] I owe him some money.
[AGENT][POSITIVE] Oh yes yeah you would wanna know I would yeah I would give us a little more time to process it and get it through if you wouldn't mind like.
[AGENT][POSITIVE] I would say, and I don't, I don't wanna put you off or make you wait even longer, but I would maybe try to reach back out to us, you know, Thursday around the [PII] of next week or next week that I'm sorry, the [PII] of this month, but it is about Thursday next week, um, and that should give them plenty of time to make whatever decisions they need to do but check back in with us in in about 7 to 10 days and see if we've been able to make any headway on that for you, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Oh, it's my pleasure, Ms. [PII]. Is there anything else I can do to help you today?
[CUSTOMER][NEUTRAL] No, because I got my, I thought I had that policy with you, but I think it's with another company.
[AGENT][POSITIVE] Oh yes, um, it's definitely got to be with another company, but if you ever have questions on your cancer policy with us, give us a call because we'll take care of you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you. Have a good day.
[AGENT][POSITIVE] Oh, it's my pleasure. Thank you. You too. Happy Tuesday. You take care, Ms. [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thanks.