Category: Criminal & Illegal

Making Wild Claims

| OR, USA | Criminal & Illegal, Money

(I work in an insurance call center for mental health and substance abuse. We get some real gems, usually regarding unpaid claims. This caller is asking about two claims that were paid inaccurately with the wrong amounts and wrong provider name.)

Me: “Okay, I see the issue. The claim form asked for the doctor’s tax ID number, and it wasn’t included. Because of that, our system searched by her name and paid according to this incorrect doctor’s rates.”

(Keep in mind, the actual check went to the patient, my caller.)

Caller: “I put it in there.”

Me: “I’m looking at the scan of your claim forms and you put in their license number.”

Caller: “But I also put in the NPI [National Provider Identification] number.”

Me: “Right, but that’s not the Tax ID number. We asked for the NPI later on the form and you filled that out perfectly, but on this line we needed the Tax ID.”

Caller: *seeing his error* “Oh, well, the provider didn’t include that on her bill.”

Me: “Some providers don’t give it out unless you ask. But we do need it to pay the claim.”

Caller: “But you paid the claim already, so it’s no big deal.”

Me: “Well, it is to your provider. Our systems need to show who we’re paying correctly so she can prove it on her taxes, just in case. Also, the incorrect provider will probably ask us to reverse the transaction so she doesn’t get incorrect info for her taxes.”

Caller: “But you paid me. So it’s not an issue.”

Me: “Right, but that’s because you paid your provider. So technically we paid for your service.”

Caller: “Oh. So can I call her and get the Tax ID and call you back and have you fix it?”

Me: “I’m really sorry, but we can’t take her tax info from you verbally. She can call it in and I can reprocess the claim, or you can resubmit the claim to us with it corrected.”

Caller: *annoyed* “So you trust me to submit it by paper, but not by phone?”

Me: “If you submit it to us on a claim, that’s a claim submission. If I tell you to go get it from her and call back, I’m soliciting her tax information from you. And that’s potentially fraud, and I’ve been told by my supervisor that our company is against fraud, even at the expense of our customer’s convenience.”

Caller: “Okay… Sounds like you’re punishing me for making a simple mistake.”

Me: “On the contrary. If you put in the time to get the claim submitted to us correctly, you will be rewarded with fraud-free payment of your service. If you decide not to, your provider could potentially sue you and us. So submitting the claim again is the opposite of a punishment.”

Caller: “Goodbye.” *click*

Presented With A Minor Problem

| Wellington, New Zealand | Criminal & Illegal, Food & Drink, Underaged

(A woman walks up to the counter with two twelve-packs of Vodka Cruiser RTDs, one light orange (passion fruit flavour) and the other darker (exotic fruits flavour).)

Me: “Hi there, just those for today?”

Customer: “I actually only want one of them; my friend told me to get the orange Vodka Cruiser, but these are both orange. If it’s the wrong flavour can I come back and swap it for the other one?”

Me: “I’m sorry but our return and exchange policy only covers faulty products.”

Customer: “But she’s, like, only just outside. Can I buy this one and if it’s the wrong one come straight back in and swap it for the other one?”

Me: “No, our exchange policy does not cover that. If your friend is just outside, she can come in and decide on the flavour herself.”

Customer: “Well, she’s 15, so she can’t buy booze.”

Me: “Is she your daughter?”

Customer: “No! Do I look old enough to have a 15-year-old daughter?”

Me: “If that is the case, I cannot sell you any alcohol.”

Customer: “Why not?! I’m 25. See, here is my I.D.”

Me: “You have just told me you will be supplying the alcohol to a minor. I cannot sell you any alcohol.”

Customer: “Well, can I buy this for myself, then?”

Me: “No, because I know you will be supplying it to a minor.”

Customer: “Don’t be such a b****; I’m allowed to buy booze!”

Me: “Not for minors you aren’t. I cannot sell you any alcohol, and I must ask you to leave.”

(Customer walked out of store yelling abuse and profanity.)

The Standards Of Falling Are Really Falling

| UK | Criminal & Illegal, Liars & Scammers

(I’ve been put through to a woman who would like to make a complaint about a department store of ours in the north of England.)

Me: “Hello, this is [My Name]. I understand you would like to make a complaint?”

Customer: “I was assaulted in your shop. How much money are you going to give me?”

Me: “My goodness. I’m terribly sorry to hear that. Are you all right?”

Customer: “No. Just tell me how much money you’re going to give me.”

Me: “I’m afraid I don’t deal with compensation; I can only log the complaint and begin the investigation.”

Customer: “You can’t help me! Put me through to someone who can get me my money.”

Me: “I’m as high as you can go in respect of what you want. Once I log the complaint however, and it has been investigated, we will contact you to begin the next step.”

Customer: *sighs* “Okay.”

Me: “Thank you. Could you please tell me which branch of [Store] the incident occurred?”

Customer: “Why do you need to know that?”

Me: “We need to know where it happened so we can investigate. Statements and CCTV footage of the day the incident occurred will be sent and checked.”

Customer: “Oh, umm…” *mumbles*

Me: “Sorry, I didn’t catch that.”

Customer: “…[Branch].”

Me: “Thank you.”

(I take the rest of the details and log the complaint. In general it’s a slipping on a wet floor where no signage was displayed, and, more seriously, the behaviour of the staff which injured her left eye. A week or so later I bump into one of our investigation team.)

Investigator: “Hey, [My Name], did you log the case for [Customer]?”

Me: “At [Branch]?”

Investigator: “We had the footage come in yesterday. You’ve got to see it.”

(He takes me into his office and shows me the footage. It shows a woman, presumably the customer, walking past a wet floor sign. She notices it, looks around, and produces a collapsible walking stick from her bag. She lays down on the wet floor, pushes the sign under a stand with said walking stick, and starts shouting. A worker comes and tries to help her up, and in the process the woman pokes herself in the eye with the handle of her walking stick. She’s eventually taken to the storefront and an ambulance is called, but she flees the store before it even arrives.)

Me: “…”

Investigator: “Ridiculous, don’t you think?”

Me: “She was hesitant in giving me the details.”

Investigator: “Well, here’s why. The store manager said she tried it a few years ago, but the cleaner hadn’t even started mopping yet. She just got back up and started shopping.”

(I haven’t heard much of the case since then, but I imagine a counter-case for fraud is being built against her.)

So Much Entitlement It Could Be Metered

| UK | Criminal & Illegal, Money

(I work for one of the major energy suppliers, dealing with accounts that haven’t been paid in 18 months and are in the process of being taken to court to get a warrant so we can fit a prepayment meter to contain the debt. I receive a call from a customer who is deeply unhappy about a letter which tells her we have been granted a warrant from the courts and are coming to her house next week to fit a prepayment meter.)

Customer: “You had better not fit that. If you fit it, I will sue. You do not have my permission; I don’t want one.”

Me: “Unfortunately we have been forced to go to court to get one in order to contain your debt. We have received no contact from you until today despite our many letters and calls. The only way to stop this from happening is to pay at least half the balance, and then set up a payment plan. You haven’t been paying your bill so we need a way to stop the debt getting bigger.”

Customer: “Well, I can’t afford to pay that. Look, I don’t give you my permission to fit that meter. My husband and I will be on a cruise in the Caribbean. We’re away for two weeks so we won’t be there.”

Me: “The warrant grants us entry whether you are there or not. They will call a locksmith, which you will be charged for. Unless you can get a friend to wait in for you while you are out who can let them in? I can also negotiate for the debt to be reclaimed through the meter over a number of years instead of over just one year if you like. I understand it would be hard to pay off such a large amount over just one year.”

Customer: “You are not listening! I DON’T WANT A PREPAYMENT METER! There, now you cannot fit it without my permission.”

Me: “A judge has given us permission. As I explained, it is to control the debt. You have not paid for your energy in almost two years. There is still time to fix this without the need to have the meter in. If you can pay at least half the balance and set up a payment plan, I can stop the warrant.”

Customer: “You didn’t tell me I had any overdue bills.”

Me: “You haven’t received any letters?”

Customer: “No.”

Me: “Let me just check the system to see what has happened.”

(I quickly check and see that we have sent her 12 letters informing her the bills were overdue — three were hand delivered by field agents. I also see that we tried to call her several times and each time she refused to talk to us, and when the field agents tried to talk to her in person, she refused to open the door even when they reassured her they were not bailiffs.)

Me: “We’ve sent you 12 letters—”

Customer: “Well, I never got any of them. Not my problem.”

Me: “Three were hand delivered. We know you got those.”

Customer: “You must’ve put those in the wrong letter box. I never got them.”

Me: “The field agent would’ve taken a photo of your door, including the number. But like I said, if you pay half the balance, I can stop the warrant. I can even set up a payment plan to spread the debt over two years instead of one, to make it more manageable.”

Customer: “Why should I pay if you never sent me any letters?”

Me: “Like I explained, we have been sending you letters. You haven’t paid for almost two years. If you weren’t getting your bills when we sent them, why didn’t you call to ask where your bills were?”

Customer: “It’s your job to make sure I get my bills. Why should I chase you?”

Me: “We did send you your bills; if they didn’t get there that is an issue with Royal Mail not us. We did everything we were supposed to do. You know you are using energy and you know you have to pay it. You have a responsibility to ensure you get your bills as well.”

Customer: “Well, I don’t want a prepayment meter. Nobody is going to be there to top it up and our electric will go off and if it does I will be sending you the bill for our fish! They will die without their pump and they cost £300 each!”

Me: “If you don’t want a prepayment meter, you will need to pay half your balance 48 hours before the warrant team are due to go out, and then set up a payment plan. They need 48 hours notice to cancel the warrant. If you can get the money to pay at least half the balance between now and then, I can stop the warrant and we can set up an arrangement for the rest of the balance.”

Customer: “I can’t get you that much money! My husband and I need that for our spending money; I told you we’re going on a cruise to the Caribbean.”

Me: “Well, then, I can’t stop the warrant action. They will be there next week, and will fit that prepayment meter. All I can suggest is to get a friend to wait in and also to top up to meter while you are out to save your fish.”

Customer: “BUT I DON’T WANT A PREPAYMENT METER! THEN I WOULD HAVE TO PAY FOR MY ELECTRIC!”

Me: “You have to pay for your energy whether you have a prepayment meter or not. If you had paid your bill, we wouldn’t be having this conversation. I have given you your options: pay half the balance between now and 48 hours before the warrant officers come out and then set up a payment plan for the rest, let them fit a meter and get a friend to wait in and top it up while you are away, or just let them fit it while you are on holiday and hope for the best. Do you have any questions?”

Customer: “Why are you making me have a prepayment meter?!”

Me: “Because you haven’t been paying your bills. Now, which option do you want to take?”

Customer: “…do you take Visa?”

(The customer paid half the bill and I cancelled the warrant visit, but I explained that if she defaults on any of her payments, the warrant is good for 6 months and they will come straight out and fit that meter and the only way to stop that will be to pay the rest of the balance. A few months later, the customer defaulted on her payment plan and the warrant team went out and fitted a prepayment meter. We sent 3 letters to the customer prior to this, one of which was hand delivered. The customer wrote in to complain saying that I told her if she paid half her balance, I would write the rest off and she would have nothing else to pay. She also said we killed her 6 £300 tropical fish and wanted us to compensate her – she wanted £1800 for the fish and £2000 for ’emotional trauma.’ She even sent in receipts proving how much they cost and they did indeed cost £300 each. Our manager obviously said no. The customer then said she was going to take this up with our CEO. We never heard anything about it so I’m not sure if she wrote to the CEO or not.)

Giving Asthma Sufferers A Bad Name

| North Little Rock, AR, USA | Bad Behavior, Criminal & Illegal, Health & Body

(I am working at our main circulations desk when three gentlemen come off the elevator. One of them is slumped over and is being dragged by two men at his sides. The middle man is rasping and is semi slumped over.)

Me: “Sir, is your friend going to be okay? Should I call the ambulance?”

Patron #1: “No, he’s fine. He needs his inhaler, is all.”

Patron #2: “We live right around the block. I think he can make it.

Patron #3: *wheezing* “No…” *wheeze* “…ambulance…” *wheeze*

(I’m a little dubious, but all three of them seem unwilling for emergency help. That sends warning signals off in my head.)

Me: “All right, but let me know if you need any help.”

Patron #3: *drops to the floor* “Can’t… breath…”

(Patron #3 is having a lot of trouble breathing. The other two guys ask that I call 911. At one point during the call Patron #3 passes out and stops breathing. My manager rushes down stairs and directs the EMT to the patron.)

EMT #1: “Sir, they tell us you think you’re having an asthma attack. I have to sit you up for a bit.”

Patron #3: *wheezes* “I can’t sit up!”

EMT #1: “Don’t worry, I gotcha.” *sits [Patron #3] up*

(The EMT checks the patron out but declares he is not having an asthma attack.)

Patron #2: “What the f*** man! You scared the s*** outta us and you ain’t even having an asthma attack!?”

EMT #2: “You’re not having an asthma attack.”

Patron #3: *passes out again*

Patron #2: “Calm down man. It could be something else, we don’t know yet.”

EMT #1: *lifts patrons #3 hand and drops it* “Look, guys, he’s not even passed out. Normally if he was, his hand would fall, but before it hits his face it hovers mid air.”

(We all turn to watch as the EMT lifts his hand and drop it an inch from Patron #3’s face. Of course the hand hovers before he hits himself.)

Patron #2: “What the f***?!”

Patron #1: “You gotta calm down. We’re in a library!”

EMT #2: “Has your friend taking any medication or drugs recently?”

(Both Patron #1 and Patron #2 look back and forth between each other but neither wants to say.)

EMT #2: “We’re not the cops; we just need to know where we should go from here.”

Patron #3: *springs back to life* “I… NEED… OXYGEN… YOU… AIN’T TAKING ME!”

EMT #1: “You’ve got to calm down. We won’t take you anywhere you don’t want to go, but we gotta figure out what’s wrong with you first.”

Patron #3: “I got asthma, that’s what’s wrong! D*** doctors don’t know anything!” *wheeze*

(Patron #3 starts screaming randomly. The EMTs are getting frustrated at the whole group when Patron #2 finally gives them a little bit of information.)

Patron #2: “He’s been drinking all day.”

Patron #3: “Ain’t been drinking! I haven’t had anything to drink!”

Patron #1: “Don’t lie, man. These guys are here to help you.”

EMT #1: “Is that all he’s had today?”

Patron #2: “Well… he’s had [illegal substance], too.”

(Patron #3 stands up and starts swinging at anyone close to him.)

Patron #3: “Get off me man!”

(The cops arrive and try to calm the situation down.)

EMT #1: “Look, we can take him to the hospital right now. They’ll be able to give him something to get his breathing regular.”

Patron #1: “Yah, that sounds good. Come on, [Patron #3], let them take you in, man.”

Patron #3: *takes a seat on the stretcher* “I…” *wheeze* “ain’t…” *wheeze* “going to no d*** hospital!”

EMT #1: “All right, all right… fine. If you can get up and leave under your own power we won’t take you to the hospital.”

(They un-strap him from the stretcher, and we all watch as he stumbles out of the library.)

Manager: “What was he on?!”

EMT #1: “[Illegal substance]. It’s pretty strong stuff. You’re lucky; 90% of the time when we get a call like this they’re are naked, afraid, and running.”

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