AccountId: 011433970860
ContactId: e645a278-ee5c-4a7a-803e-0ad38f6d5e71
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 595309 ms
Total Talk Time (AGENT): 287956 ms
Total Talk Time (CUSTOMER): 299725 ms
Interruptions: 7
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/e645a278-ee5c-4a7a-803e-0ad38f6d5e71_20250509T17:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], it's [PII]. How are you?
[AGENT][POSITIVE] I'm good. How are you, [PII]?
[CUSTOMER][POSITIVE] I'm very thankful it's Friday.
[AGENT][NEUTRAL] I hear that.
[CUSTOMER][NEUTRAL] So I have a gentleman on the line who says he has received a letter from APL. It doesn't have any kind of policy number. It just says that we've received a claim, um, may need more information.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He had been, he was a big person and he had 4 policies.
[CUSTOMER][NEUTRAL] Uh, there's nothing in on base that I can find about this letter that he's read to me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] On any of the policies, but um.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] It just says from our claims department.
[AGENT][NEUTRAL] Give me, weird, uh, give me like one of the policy numbers.
[CUSTOMER][NEUTRAL] And he didn't even have an HR policy. OK, I mean, he had a group accident, a dental.
[AGENT][NEUTRAL] Oh, that's weird. OK.
[CUSTOMER][NEUTRAL] Sounding
[AGENT][NEUTRAL] Give me the accident policy.
[CUSTOMER][NEUTRAL] Do you want
[CUSTOMER][NEUTRAL] OK, it is 259-417-4 for [PII].
[AGENT][NEUTRAL] Da
[CUSTOMER][NEUTRAL] Now there's no phone number mhm there's no phone number in line for him and with it being big, you know we can't add that, but I can give it to you.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] But yeah.
[CUSTOMER][NEUTRAL] Uh, so his callback number if anything happens is [PII].
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But he says it doesn't reference a policy number. I mean it's, it's like a really generic letter.
[CUSTOMER][NEUTRAL] That's from APL and it's from claims department.
[AGENT][NEUTRAL] Yeah, clearly.
[AGENT][NEUTRAL] And it just says something about receiving a claim?
[CUSTOMER][NEUTRAL] Mhm, he'll read it to you. It's not that long, but and it's we've received a claim. Further information may be required.
[CUSTOMER][NEUTRAL] But it
[AGENT][NEUTRAL] Well, he didn't have any claims on his accident.
[CUSTOMER][NEUTRAL] Mm mm. No.
[AGENT][NEUTRAL] And he doesn't have any on his critical illness.
[AGENT][NEUTRAL] Or on his group life.
[AGENT][NEUTRAL] He does have claims on his dental.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But on my dental.
[CUSTOMER][NEUTRAL] Yeah, but that's
[CUSTOMER][NEUTRAL] I saw that.
[AGENT][NEUTRAL] But it's a refund letter.
[CUSTOMER][NEUTRAL] But the letter is dated.
[AGENT][NEUTRAL] And that, that went to the insured.
[CUSTOMER][NEUTRAL] Yeah, that's not, yeah.
[CUSTOMER][NEUTRAL] I went to the
[AGENT][NEUTRAL] Raw.
[CUSTOMER][NEUTRAL] But that's not what he's talking about. Mm mm.
[CUSTOMER][NEUTRAL] I went to the insured.
[AGENT][NEUTRAL] No, it went to the provider, sorry.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Well, this shows, as they say, prior, yeah.
[AGENT][NEUTRAL] Yeah, that was my bad. I meant to say insured our provider. Look, there I am again saying insured. I'll get it right eventually.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] He's real nice too.
[AGENT][NEUTRAL] OK, um, I mean, I, I'll take the call. I don't know what the heck to tell him, especially if it doesn't have.
[CUSTOMER][NEUTRAL] I don't know, yeah, I don't.
[AGENT][NEUTRAL] Anything, you know.
[CUSTOMER][NEGATIVE] I don't know. Maybe when you read the letter do you make, yeah, I mean, I don't know how it would have been sent or why it's not on base. This kind of thing is very frustrating. No notes, I mean it's just, yeah.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] For sure, cause there's not like a.
[AGENT][NEUTRAL] The only, do you know when it was dated?
[CUSTOMER][NEGATIVE] And my crystal ball's not been working for a long time.
[CUSTOMER][NEUTRAL] He said, and I think it was like maybe the [PII].
[CUSTOMER][NEUTRAL] But don't, don't make you'll need to verify that with him uh because I didn't jot that down, yeah, but it didn't match even that refund letter, I mean that refund on that claim on the dental policy didn't match that.
[AGENT][NEUTRAL] Of April.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, yeah, I'll take it and see what it says, but like you said, I have, I really and truly don't know.
[AGENT][NEGATIVE] What the heck?
[AGENT][NEUTRAL] We'll do about it. I mean, if it's.
[AGENT][NEUTRAL] Not
[CUSTOMER][NEGATIVE] I just told him that, you know, cause he says the references a medical claim, but I told him, you know, he, we went through the policies that he formerly had with us, and I explained to him he did not have a limited benefit plan with APO and told him what type of policies he had. He just don't understand why he got the letter. I don't want to say me either.
[AGENT][NEUTRAL] I mean, me either, my guy. Me either. I mean, the only quote unquote limited benefit would be the accident, but
[CUSTOMER][POSITIVE] Again, I'm glad it's Friday.
[CUSTOMER][NEUTRAL] But there's nothing under and that's the policy I'm making my note under. I initially pulled up his general, but I'm gonna make the I'm making my note under his accident.
[AGENT][NEUTRAL] Right, but there's, OK.
[AGENT][POSITIVE] OK, sounds good.
[AGENT][NEUTRAL] All right, well, I'll talk to him, see if, see if I can figure anything out, but it's not sounding likely.
[CUSTOMER][NEUTRAL] OK dokey.
[CUSTOMER][POSITIVE] OK girl, mm that sounded likely. Well, look, if I don't talk to you again, thank you for taking the call, but if I don't talk to you again, I hope you have a wonderful [PII] weekend, [PII].
[AGENT][POSITIVE] Yes, ma'am. You too.
[CUSTOMER][POSITIVE] Thank you so much. Alright, well, here comes Mr. [PII] then. All right, bye bye.
[AGENT][POSITIVE] Thank you. Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Ms. [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hey, this is [PII] with the claims department. How are you today?
[CUSTOMER][POSITIVE] Hi, very good, how are you doing?
[AGENT][NEUTRAL] I'm doing well. uh, Ms. [PII] said that you've received a letter from us, but it's, it doesn't have really any type of information on it, um, so I'm going to see if I can help, but I really don't know honestly.
[CUSTOMER][POSITIVE] Yeah, that's right.
[CUSTOMER][NEUTRAL] OK, I just wanted to make sure something fishy wasn't going on, you know, so.
[AGENT][POSITIVE] Yeah, for sure.
[CUSTOMER][NEUTRAL] Um, yeah.
[AGENT][NEUTRAL] Um, what was like, what was the date for the letter like when was it dated as far as when it was created?
[CUSTOMER][NEUTRAL] Yeah, um, [PII], and um I can read it to you. It's very generic. It says, Dear policyholder, we received a claim on your policy and a review of the claim has started. In some cases, additional information must be requested from you or your providers, uh, medical services for the claim to be processed. We'll contact you if more information is needed. Uh, thank you for trusting APL with your insurance needs, as always, call us uh sincerely claims department, and then this phone number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Wow.
[AGENT][NEUTRAL] That's weird.
[CUSTOMER][NEUTRAL] Yeah, it's weird. Uh-huh.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Definitely weird um because it has APL and it has our phone number and I'm sure [PII] told you this like we don't have any type of correspondence with you in our system.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, does it have any addresses or anything listed anywhere like as far as APL is concerned?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Nope, it's uh American Public Life, expanding the benefits horizon. That's your line, right?
[AGENT][NEUTRAL] Yes, it is.
[CUSTOMER][NEUTRAL] And this is, yeah, there's no other details. There's uh just my address and uh from [PII] to box and at the bottom. So it's on your letterhead.
[CUSTOMER][NEUTRAL] But I don't see any other details.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] I mean, I have the envelope here. Yeah, it's from APL Oklahoma City. It was sent on the [PII], or yeah, that's when it was mailed on the [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Yeah, we don't even have any claims like awaiting processing for you either so it's just like OK, but why would that be sent?
[AGENT][NEGATIVE] Um, I'll tell you what I'm gonna do. I'm going to suggest you disregard because we don't have anything that.
[AGENT][NEUTRAL] Indicates you need to contact us or whatever um we do have your contact number so I would say that if you know we found that there was something that was just maybe connected to your policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't know it doesn't even have a policy, so I don't know um but what I'm gonna do is I'm actually going to report this in a way just to make sure there's not some type of weird scamming something going out there um and then that way you know those those higher up than me are aware.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, but yeah, I would just say we don't have any claims waiting adjudication, we don't have any indication on any of your policies that we need anything, so I would just recommend you disregard if we find something to the alternative, we will contact you.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Directly like somebody will call you and be like, OK, we investigated this, this is what it was, you know, this is what it's in reference to, um, and then we'll kind of figure that out with you then, but if you don't hear from us, um, we didn't find anything.
[CUSTOMER][NEUTRAL] All right, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, cool. Well, I'll just file it away in the mystery cabinet and uh anything happens, yeah, I'll be able to give you guys a call back, figure it out.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right
[AGENT][POSITIVE] OK, I appreciate you letting us know because like I said that's that is very unusual um typically we would have what it is that we need or you know more information than that on our letters so um yeah definitely deserves some looking into so I appreciate the call.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, it's good if you have uh more people calling to start this record so that you can indicate, you know, generate that that this might be an issue, so. OK.
[AGENT][POSITIVE] Absolutely, absolutely.
[AGENT][POSITIVE] Yes, sir. Well, thank you so much. I hope you have a great day.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] You too, [PII]. Thank you for your help.
[AGENT][POSITIVE] Thank you. Yes, sir.
[CUSTOMER][NEUTRAL] OK. Bye-bye.
[AGENT][NEUTRAL] All right, bye bye.