AccountId: 011433970860
ContactId: e4e1b7fa-1bbf-40a3-8f2e-bc7e7db1f167
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 833770 ms
Total Talk Time (AGENT): 222409 ms
Total Talk Time (CUSTOMER): 426201 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/e4e1b7fa-1bbf-40a3-8f2e-bc7e7db1f167_20250416T14:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, I'm a, I'm a customer of APL. My name is [PII]. My name is [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Are you wanting to check on your policy or how can I help you, [PII]?
[CUSTOMER][NEUTRAL] Um, there's several things. Um, I just got through going to the doctor yesterday, um, Doctor, um, [PII], um, orthopedic in [PII], and I went to Doctor [PII] in [PII] right next door, and I just needed to let you guys know, uh, the, the, uh, secretary asked me to call you and tell you what we were doing.
[AGENT][NEUTRAL] OK, do you have your policy number?
[CUSTOMER][NEUTRAL] Um, I have a big piece of paper y'all gave me.
[CUSTOMER][NEUTRAL] It's a um
[CUSTOMER][NEUTRAL] Let me, I'm gonna look, OK? Is there any other easier way you can get to it?
[AGENT][NEUTRAL] Um, I can look it up by your last name or your social.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. I, I have an APL uh pamphlet in front of me.
[CUSTOMER][NEUTRAL] And, and it's really big and thick and I got the number off of there.
[CUSTOMER][NEUTRAL] Um, but I don't see the, I'm looking for the policy number.
[AGENT][POSITIVE] OK, I got you.
[CUSTOMER][NEUTRAL] Um, if you could be looking.
[AGENT][NEUTRAL] I got it. I got it. Uh-huh, yeah, let me get that pulled up. Hold on.
[CUSTOMER][NEUTRAL] You got it you got me?
[CUSTOMER][NEUTRAL] I, I, I, I, I see the policy hold number now.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] I I found it too.
[AGENT][NEUTRAL] OK, let's see
[CUSTOMER][NEUTRAL] But so every time we go to the doctor I'm supposed to call you, right?
[AGENT][NEUTRAL] And what
[AGENT][NEUTRAL] No, no, we don't, you don't have to call us, um.
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK, I was under the assumption that I needed to call you, um, so anyhow I wanted to call and touch base with you and let you know I was going to these doctors, um, and then I had a couple of questions for you.
[AGENT][NEUTRAL] OK, um, let me verify just a few pieces of information, [PII], if you don't mind. What is your birth date?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm [PII].
[AGENT][NEUTRAL] OK, and Mr. [PII], do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[AGENT][NEUTRAL] OK, thank you. And what's your address?
[CUSTOMER][NEUTRAL] I see my [PII].
[AGENT][NEUTRAL] OK, and then lastly your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK, and you say you wanted to check on some things on your plan?
[CUSTOMER][NEUTRAL] Yes ma'am, um, I just wanted to make sure everything was OK, um, on y'all y'all are getting my payment every month?
[AGENT][NEUTRAL] Uh, yes, I show your policy is currently active.
[CUSTOMER][NEUTRAL] OK, so you're getting $204 every month, right?
[AGENT][NEUTRAL] Um, let me see what your payment is.
[CUSTOMER][NEUTRAL] It's automatic
[CUSTOMER][NEUTRAL] I have it on automatic.
[AGENT][NEUTRAL] Um, this policy is $9.78 a month. Um, but do you have other policies as well? I can look. Let me see.
[AGENT][NEUTRAL] I've just got this policy. It's a hospital indemnity policy. It's $9.78 a month.
[CUSTOMER][NEUTRAL] I was under the assumption they were taking $204 a month.
[CUSTOMER][NEUTRAL] That's what it shows on my bank statements.
[AGENT][NEUTRAL] I don't know
[AGENT][NEUTRAL] Is it, does it show from who?
[CUSTOMER][NEUTRAL] Ma'am?
[CUSTOMER][NEUTRAL] Um, American public life.
[AGENT][NEUTRAL] Um, I just showed this policy. Looks like it's through.
[AGENT][NEUTRAL] Looks like it's through your.
[CUSTOMER][NEUTRAL] And what is that policy cover?
[AGENT][NEUTRAL] This is through your employer.
[AGENT][NEUTRAL] So this is through your job, this policy?
[AGENT][NEUTRAL] Um, it's a hospital indemnity plan and it covers, let me just pull it up. Hold on one moment.
[AGENT][NEUTRAL] So it's like a limited supplemental plan, um, not a guarantee of payment basic outline of the policy.
[AGENT][NEUTRAL] So, basically it covers, um, let's see.
[AGENT][NEUTRAL] So this covers
[CUSTOMER][NEUTRAL] And this is American public life?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] This covers, uh, if you're ever admitted to the hospital, it'll pay you $500 once per calendar year.
[AGENT][NEUTRAL] And then if you ever stayed in the hospital overnight, it pays $100 per day.
[AGENT][NEUTRAL] And a max of 10 days per calendar year.
[CUSTOMER][NEUTRAL] And that that's what you show that I'm, I am under.
[AGENT][NEUTRAL] Yes, this is through your your job. Business Workers of America, is that right?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Ma'am, I'm self-employed.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] Did you used to work for someone?
[CUSTOMER][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] No, ma'am, I've always worked for myself.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] What company do you show me working for?
[AGENT][NEUTRAL] Business workers of America.
[CUSTOMER][NEUTRAL] From where?
[AGENT][NEUTRAL] It's in
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] In [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] No, ma'am, that's not me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Ma'am, I was under, I was under the assumption that I had health insurance from American public life, OK? I was.
[CUSTOMER][NEUTRAL] I was um
[CUSTOMER][NEUTRAL] Somebody got a hold of me by email a year ago.
[CUSTOMER][NEUTRAL] And I, I told them that I wanted to get insurance, OK? Health insurance because I was having some problems.
[CUSTOMER][POSITIVE] With my help
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] And they're taking $204 a month out of my account out of my checking.
[CUSTOMER][NEUTRAL] And it says.
[CUSTOMER][NEUTRAL] When I talked to them, they said they are American Public Life. And I've got a pamphlet right now. It's got American Public Life, [PII]. [PII], [PII].
[CUSTOMER][NEUTRAL] That's me, OK.
[AGENT][NEUTRAL] Does it have a policy number on it?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It says policy holder policy number 25565.
[CUSTOMER][NEUTRAL] And it says insured [PII] insured.
[CUSTOMER][NEUTRAL] 861.
[CUSTOMER][NEUTRAL] Says employee says premium mode monthly.
[CUSTOMER][NEUTRAL] Certificate effective [PII].
[CUSTOMER][NEUTRAL] Certificate number 02459560 policyholder business workers of America.
[CUSTOMER][NEUTRAL] And it does say down here at the bottom just what you said $9.78.
[CUSTOMER][NEUTRAL] But I have someone's getting $204 a month.
[CUSTOMER][NEUTRAL] And I was under the assumption that I was paying American public life for health insurance.
[CUSTOMER][NEUTRAL] For $204 a month.
[AGENT][NEUTRAL] OK, and do you have bank statements that you can provide that shows that that's being drawn out from American public life? cause I don't, all we have is what we just discussed, the $9.78.
[AGENT][NEUTRAL] And that's through an employer.
[CUSTOMER][NEUTRAL] Well somebody's doing something wrong.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We would need
[AGENT][NEUTRAL] We would need information showing that.
[AGENT][NEUTRAL] American public life is taking out that one.
[CUSTOMER][NEUTRAL] I have a uh.
[CUSTOMER][NEGATIVE] I was, I was mailed an insurance card and when I for a year now since they've been taking this $204 a month I've been going to the doctor.
[AGENT][NEUTRAL] What was the
[CUSTOMER][NEUTRAL] I've been, you know, I've been, I show it it.
[CUSTOMER][NEUTRAL] I show it at the doctor's office. They take it, they accept it.
[CUSTOMER][NEUTRAL] They run it through.
[CUSTOMER][NEUTRAL] Now, after I started this last year.
[CUSTOMER][NEUTRAL] I reported
[CUSTOMER][NEUTRAL] That I was having knee problems, OK?
[CUSTOMER][NEUTRAL] I reported to American public life that I was having my right knee problems, OK?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I went and had a knee replacement.
[CUSTOMER][NEUTRAL] Under the assumption, I'm handing the hospital my American public life card that they, that y'all sent me.
[CUSTOMER][NEUTRAL] And they took it and I had surgery. I had a knee replacement.
[CUSTOMER][NEGATIVE] And I was under the assumption that y'all were paying it.
[CUSTOMER][NEGATIVE] And I just found out from the hospital that I owe $38,000 that y'all didn't pay anything.
[CUSTOMER][NEUTRAL] I've been giving them $200 a month the hospital to appease them.
[AGENT][NEUTRAL] OK, so let me, let me figure out who you would talk to.
[CUSTOMER][NEUTRAL] But I was under the, I was under the assumption because when I, when my knee was bad, I called American Public Life to report it that I wanted to, I asked them, I said, what doctor do you want me to go to? I live in [PII]. They said, we need you to go to Doctor [PII].
[CUSTOMER][NEUTRAL] In [PII] right next door to me.
[CUSTOMER][NEUTRAL] Uh, in the neighboring town.
[CUSTOMER][NEUTRAL] Said he, they said he was on their, on their
[CUSTOMER][NEUTRAL] Um, what do you call it? Their not their internet, they.
[AGENT][NEUTRAL] Their network
[CUSTOMER][NEUTRAL] He was under their network and they wanted me to go to Doctor [PII]. So that's who I went to and I had a knee replacement under the assumption that they were gonna pay for it and they haven't paid anything.
[AGENT][NEUTRAL] We
[AGENT][NEUTRAL] OK, yeah, we would never tell you what doctor to go to. That's because this isn't that type of plan.
[CUSTOMER][NEUTRAL] He
[CUSTOMER][NEGATIVE] Well then there's something, well there's something really horrible going on then.
[AGENT][NEUTRAL] So you don't have insurance through United United Healthcare or Aetna or?
[CUSTOMER][NEUTRAL] And I, I
[AGENT][NEUTRAL] Blue Cross Blue Shield or
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Ma'am, I'm, I'm holding a pamphlet in my hand that says American Public Life.
[CUSTOMER][NEUTRAL] And it says [PII], [PII], [PII]. That's me and it says American Public Life APL.
[AGENT][NEUTRAL] Right, we, yes.
[CUSTOMER][NEUTRAL] And I just gave you.
[AGENT][NEUTRAL] I, we just discussed that one, the, the, the $9.78. I'm trying to figure out the $200. This is the only policy we have for you is the $9.78 a month. It's a limited hospital indemnity plan. It's not major medical.
[AGENT][NEUTRAL] So I'm trying to figure out who do I get you to to get your help on this. And what, what I'm saying is, do you have bank statements that can show that you have $200 being deducted out of your bank account from American Public Life? I know that we'll need that.
[CUSTOMER][POSITIVE] I do have my bank statements, OK? Of course I do. I save all of that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, let me put you on a brief hold and I'll figure out who you can talk to, OK? Because I, I just, I just look at your claims and stuff like that, so I'm not sure about fraud. So hold on one moment, OK?
[CUSTOMER][NEUTRAL] Yes, ma'am. This is gonna be.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] Horrible.
[CUSTOMER][NEGATIVE] You are on hold.