AccountId: 011433970860
ContactId: eafb5779-2d88-43f1-ba10-8ba00cb68de3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 595280 ms
Total Talk Time (AGENT): 245898 ms
Total Talk Time (CUSTOMER): 341442 ms
Interruptions: 6
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/eafb5779-2d88-43f1-ba10-8ba00cb68de3_20250306T21:55_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], uh, this is [PII] calling you back from the Texas Department of Insurance. Can you, what did I send you?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] You sent me an email. Um, I received it today. Give me one minute. Um, hold on, let me get that email.
[CUSTOMER][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] Uh, it says, um, I received it today at [PII]. Good afternoon. Please provide a copy of the letter you sent to the customer about her claims and a copy of the EOB by tomorrow if possible.
[CUSTOMER][NEUTRAL] OK, we didn't your response that we received see this came was forwarded to us from, uh, which New York Department of Financial Services, OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, also we got Information Office of Consumer Affairs and Business. I don't know if that's [PII] or what, um, I don't know what's happening with this, OK? I just need to see a copy of what you, you, you responded to this lady's complaint, uh, [PII], but I still in the information that you sent us, I can't respond to her because I really don't know what your site is.
[CUSTOMER][NEUTRAL] So, and I was looking bear with me for a second. I'm just, let me see what you sent me here. I'm sorry, let's see.
[AGENT][NEUTRAL] Yeah, and I'm gonna look and this is in in October, correct? Are we, um, I'm looking.
[CUSTOMER][NEUTRAL] You're res
[CUSTOMER][NEUTRAL] Yeah, and yep, and we're working on our old ones right now and I'm very sorry we're behind so we the [PII] is a big state here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, that's OK. I get, I get that.
[AGENT][NEUTRAL] Uh, I understand and noticed it so much. I, I get it. I do get it. How, let me, let me pull up my information.
[CUSTOMER][NEUTRAL] Don't
[CUSTOMER][NEUTRAL] Uh, yeah.
[CUSTOMER][NEUTRAL] OK, here, here it is. Let me see, here it is. All you gave me was, uh, thank you for the correspondence. Let's see, uh, let's see here, TDI. OK, you said to whom it makes turn, can you hear me? It said, um.
[AGENT][NEUTRAL] Now you're
[AGENT][POSITIVE] Yes, I can.
[AGENT][NEUTRAL] I'm looking to see what I sent you. Hold on.
[AGENT][NEUTRAL] Are you here? All I hear is static.
[CUSTOMER][NEUTRAL] Yeah, I'm here, ma'am. I'm still here. um, can you hear me OK? Just the first that you said thank you for your, for your correspondence received on [PII], your request was forwarded to the APL claims department for review and a response. I'm not, I don't have a response. It says in your correspondence you're requesting an update.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can now.
[CUSTOMER][NEUTRAL] On bills, claims paid under this is a hospital indemnity plan. I just need to know. I really didn't get a copy of any response in your correspondence you're requesting an update on bills, claims paid under [PII]. I want to see how it, how it was responded so it.
[CUSTOMER][NEUTRAL] The hospital indemnity. I want to see she's got kidney stones. Is that going to be considered a preexisting condition? That's what I need to see so that I can close out my letter to her that she's maxed out everything. That's what I'm looking for basically. um also, I mean, even so if was and you answered questions that they didn't pay any um.
[CUSTOMER][NEUTRAL] The last, uh, the last update since the last, uh, response. I want a copy response that was sent to.
[CUSTOMER][NEUTRAL] Uh, the other Department of Insurance, whatever state [PII] or [PII], so I can see that it says yes, she's got a preexisting condition. [PII], that's what I need to see because she's, we know that hospital indemnity plan is not major medical and it's, it's limited benefits and she said that it was already, you know, she's, it's been maxed out. I want to see her decline letter.
[CUSTOMER][NEUTRAL] That you sent to her or or EOB or something like that is that a possible I can get from you?
[AGENT][NEUTRAL] Um, yes, so let me, I thought I had, I'm sorry, hold on, I thought I had already provided that information, but let me look and see.
[CUSTOMER][NEUTRAL] Nope, I got a copy of, I looked for letters. All I got was a copy of her poli policy, and I, I mean, she's, I mean, I'm ask, I mean, isn't [PII] a pre-existing condition and they wouldn't pay anything on it?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Well, this is a hospital in this is the hospital indemnity, so it's a limited policy. It wasn't had nothing to do with the preexisting. Um, I will have to let me do my research and review and I'll get back with you. It probably be in the morning, um, because for some reason, I thought I had provided you with more information than what you have.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and I want, and I know that, yeah, it has nothing to do with preexisting. Um, I believe that some of it was after her policy had been terminated. We did provide some benefits to her, um.
[CUSTOMER][NEUTRAL] Oh, you know, mhm, hold on, I'm seeing a second link here you might have, hold on, I didn't, I was looking just for your letter, but there was nothing behind it. Then I see a copy of what we sent to you. OK, then you replied that OK, OK, so you sent it to.
[AGENT][NEUTRAL] I'm just.
[AGENT][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] Yes, I still.
[AGENT][NEUTRAL] And you may have to.
[CUSTOMER][POSITIVE] Yes, actually I do apologize for that. There's information, but I wanna see a letter you see you sent me. I wanna see a letter to her. OK, wait, uh, [PII], yes you did on.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well
[CUSTOMER][NEUTRAL] [PII], that's an older letter.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah hello. OK, so let me just see.
[AGENT][NEUTRAL] Did I send you the email with the link, correct?
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] I'm not sure there's 70 pages here. I'd have to go through all of these to see, you know, if, if you could do this for me so we can just wrap it up and you're addressing TDI, the letter that you sent us, could you just say that um she's all the benefits have been paid or whatever, you know, everything she's maxed out everything for the year and does it start over every year or is it once a year? I mean this type of policy.
[AGENT][NEUTRAL] Yeah, that's from. OK, that's fine.
[CUSTOMER][NEUTRAL] If she had a hospital in [PII]?
[CUSTOMER][NEUTRAL] Does it start over for new benefits come out or is it a one time benefit?
[AGENT][NEUTRAL] Well, it it it's not a one time. It's just depending on, I have to look at the policy. I'm gonna have to pull all that information up and the policy has a limited benefit, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on here.
[CUSTOMER][NEUTRAL] Per year
[AGENT][NEUTRAL] Uh, some of it's per year, some of it's per day. Let me, let me look at this policy. Hold on.
[CUSTOMER][NEUTRAL] Because I don't see claims that she sent me.
[AGENT][NEUTRAL] Yeah, I had sent all of those claims, I believe, so hold on for one minute. Let me, let me pull up this information.
[AGENT][NEUTRAL] Uh, let me.
[AGENT][NEUTRAL] Let me get this policy program.
[CUSTOMER][NEUTRAL] Yeah I'm looking at page 20 of 62 of the certificate. It says what's covered, but see now when when I got a.
[AGENT][POSITIVE] Yeah, there should be good.
[AGENT][NEUTRAL] Yeah, hold on. OK.
[CUSTOMER][NEUTRAL] Yep, I got that, but.
[AGENT][NEUTRAL] Let me look, hold on here. I'm gonna, I'm pulling up this policy myself.
[AGENT][NEUTRAL] There we go. See, OK, on page, the page it says hospital indemnity insurance certificate schedule, description of coverage. Um, there's a daily benefit for hospital confinement. Um, there's a maximum.
[AGENT][NEUTRAL] Of 5 visits for treatment and, um, for outpatient sickness, $75 and
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and I believe in my letter I gave a breakdown of what was paid, so.
[AGENT][NEUTRAL] You're needing exactly um in your email, can you shoot me an email telling me exactly what you're looking for that's not addressed in my letter that I sent you?
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Well, your letter was only like 2 paragraphs to TDI, um, hold on here.
[AGENT][NEUTRAL] Mm, I think I had sent something else, but let me double check. Hold on here. And you.
[CUSTOMER][NEUTRAL] No, you've got um 1234 sentences, 4 new paragraphs which have like a sentence in each one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me do some research and I'll get back with you first thing in the morning, um, and see if I thought I had sent you more than that, and I apologize if I did, but I thought I did. So give me, um.
[CUSTOMER][POSITIVE] That sounds good.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Uh, yeah.
[CUSTOMER][NEUTRAL] That's fine. You go ahead and uh and we'll talk we'll hear from you tomorrow. You can email me, OK?
[AGENT][POSITIVE] OK, I sure will. Thank and thank you. Thank you for your patience. OK, thanks. Bye-bye.
[CUSTOMER][POSITIVE] All right thank you or call me alright bye bye. Goodbye.