No Ma’m I will not commit fraud against your employer.

I used to work in a health insurance call center, processing enrollments, life changes, and general benefits questions. Seeing as how insurance is difficult as it is, I received calls of all types, ranging to what is my deductible to adding a newborn. The newborn calls were fun. This one not so much.

I had just started for a new client, a major healthcare provider taking calls for their employees. I worked early shift at 7am until 3pm. When someone called at 7am, it was usually a huge issue. Now this call was made outside any enrollment period so there was nothing I could do for this woman but she damn well tried.

Me- Me of course.

DAF- Dumb ass Fraudster.

Me- usual opening spiel about calling the benefits center.

DAF- blah blah blah security questions. I want to change my dental plan.

Me- Asks the usual questions about a life event like birth, marriage, divorce etc.

DAF- I have not had any of those but my daughter needs braces so I want to switch to the higher dental plan, right now I have the lower paying plan. (The dental plans each paid a certain amount toward braces ie. $500 or $1500. She wanted to move from the 500 to the 1500 dollar plan).

Me- Without a valid life event I cannot make those changes I apologize.

DAF- Well can you make one up for me? Say I got married and could make the changes?

Me- *stares blankly ahead because its 7am and I have not finished my first cup of coffee yet* No Ma’m because you just told me on a recorded line you did not have a life event. That would be fraud.

DAF- Well my daughter needs braces and I want the higher plan. I am going to make you change it for me or I will do it myself. ( I seriously doubt she knew how to do it herself. Half of our calls were asking to be walked through the terrible website my previous company used and even then it barely worked 10% of the time.)

Me- Ma’m like I said that would be fraud and I am not losing my job trying to defraud your employer.

It was at this point she said the magic words: “Get me your supervisor!”

My tone instantly changed to my cheery CS voice and I transferred to our supervisor line, and since it was so early in our shift, there was only one online right now. There was at least a 10 minute hold time while I was able to enjoy my coffee listening to the sweet sound of hold music.

Me- Explaining the situation to my super with DAF on hold.

Super- She knows she can’t change right?

Me- Yep I explained but she insisted on finding a reason and requested a supervisor.

Super- *tiredly states* Put her through then.

I do not know what happened the rest of the call but I know this supervisor was no non-sense and called people out on their shit so I assume it went well.

Transferred the call and looked up recipes while waiting for the next beep in my headset.

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