AccountId: 011433970860
ContactId: 03b89056-b1ce-4523-aefe-004bba451045
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 840679 ms
Total Talk Time (AGENT): 249492 ms
Total Talk Time (CUSTOMER): 228649 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/03b89056-b1ce-4523-aefe-004bba451045_20250529T12:13_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] in customer care.
[AGENT][NEUTRAL] Hey, I, you sound far away.
[CUSTOMER][NEUTRAL] That's what everybody keeps saying. I don't understand what's going on with my headset. Can you hear me? Like, I'm sorry.
[AGENT][NEUTRAL] I can hear you just sound far away.
[CUSTOMER][NEUTRAL] I'm sorry, um, OK.
[CUSTOMER][NEUTRAL] I have an insured who wants to talk to somebody on a plane, um.
[CUSTOMER][NEUTRAL] It's a denied it's a denied claim. Let me give you the policy number.
[CUSTOMER][NEUTRAL] It's 252-176-7 for Tanitra Sellers.
[AGENT][NEUTRAL] OK, and this is for her disability claim?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] So I told her that this recent one was denied because it was the [PII] through the [PII]. It was the 14 day elimination period.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And then she got all, you know, and she said up in arms and she said the claim was for the [PII] through the [PII]. I did pull the claim paperwork. I do see that on her paperwork it says [PII] through the [PII], which would be like a day's difference. um, anyway, she wants to talk to somebody about why the dates are wrong and why it wasn't paid like she's all frustrated.
[AGENT][NEUTRAL] OK, let me pull up the claim here. Give me one moment.
[CUSTOMER][NEUTRAL] Have had a bit of coffee.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] I'm gonna pull up the claim, so give me a second.
[CUSTOMER][NEUTRAL] No worries. And then she asked to speak to [PII], and of course, you know, [PII]'s not in yet. I was like, somebody can call you back, and she was like, no, she's like, I wanna talk to somebody right now and I'm like, OK.
[AGENT][NEUTRAL] No way that's medical records, so not that I'm looking for the claim form.
[AGENT][NEUTRAL] So did you find the claim from under that 3600236 mail?
[AGENT][NEUTRAL] Clean? OK.
[CUSTOMER][NEUTRAL] Yeah,
[AGENT][NEUTRAL] Oh here it is let's see.
[CUSTOMER][NEUTRAL] Yeah, yeah, pretty sure that's going on.
[AGENT][NEUTRAL] See when she actually went to the physician. Let's see here.
[AGENT][NEUTRAL] Mm, yeah, I probably gonna have to get with [PII] on this cause I do see the date, first day she, last day of work was
[AGENT][NEUTRAL] The [PII] and she did first day treated for the condition was on the same day.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Oh, wait, hold on. What it see.
[AGENT][NEUTRAL] Let me see something real quick.
[AGENT][NEUTRAL] OK, you can go ahead and send it to me. I'll probably have to get [PII] to get with her, but I can talk with her.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'm gonna put you on hold real quick and just let her know I'm gonna send her over, OK?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One second, here she comes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Claims department, this is [PII].
[CUSTOMER][NEUTRAL] Hi, I was, like I said, I was speaking to the other lady about my disability claim, and I see that it was completed, but there was no money attached. And she was saying something about the service date the time was wrong cause it was the [PII]. But my dates were the [PII] the [PII], not the [PII]. It's all my paperwork from my doctor.
[AGENT][NEUTRAL] OK, let me take a
[CUSTOMER][NEUTRAL] And my HR department is
[CUSTOMER][NEUTRAL] Yeah, that's the [PII], not the [PII].
[AGENT][NEUTRAL] OK, let me take a look at that Ms. [PII]. Give me one moment.
[CUSTOMER][NEUTRAL] And I resubmitted it cause that's making sure somebody like, whatever.
[AGENT][NEUTRAL] And was was [PII] also the same day that you worked?
[CUSTOMER][NEUTRAL] No, I had to serve you on the [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Morning.
[AGENT][NEUTRAL] So I do see on the claim form it has your last day of work was on [PII].
[CUSTOMER][NEUTRAL] No, my last name was a 2.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Which, which one to see that all.
[AGENT][NEUTRAL] I was looking on the statement of insured it in section B, um employment details. It has date last worked and any job was on [PII].
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] No, it was my last day was the [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] see if we have anything that indicates that. Give me one moment, I'm gonna put you on a brief hold.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Good morning. How are you?
[AGENT][NEUTRAL] Fine, I need some help looking at a disability claim.
[AGENT][NEUTRAL] It's on policy 2521767.
[AGENT][NEUTRAL] And I, she's calling, the insured is calling because it looks like we began her waiting period on [PII]. But as I'm looking at the claim form, she said that um it should begin on the [PII] instead.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] So I asked her on the claim form, it says her date of disability begin [PII]. Um, her last day of work was [PII], and she also see first treatment was on the same day. I asked her, did she, was her last day of work on [PII]? She said no. Her last day of work was [PII]. Is that possibly why we begin her elimination period at [PII]?
[AGENT][NEUTRAL] Because of her last day of work was indicated as [PII].
[AGENT][NEUTRAL] Yeah, that's what I was thinking. So we need an updated claim form to indicate the date or last day of work or we can or can we contact the employer to ve[PII] that?
[AGENT][NEUTRAL] OK, OK, that's why I want to double check and see.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding, Ms. [PII]. So it looks like on the claim information that we have, your last day at work was [PII]. In order for us to update, update that information, we'll need an updated completed form from your employer indicating your date of your last day of work was [PII] versus [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, let me um get with her and I'll get that submitted. But then, you know what, but I'm, oh, OK, well, let's just say even if she put the [PII], um, the [PII], I mean the [PII], that's still, that's still 14 days up until the [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, you'll still have your 14-day elimination period.
[CUSTOMER][NEUTRAL] OK. So now why was it denied? That's, so that's my question then, if that's the case. You understand what I'm saying? Cause it was completed and there was no money attached to that mean that it was denied, am I right?
[AGENT][NEUTRAL] Let me look here.
[CUSTOMER][NEUTRAL] But which I will have her correct that, but because my last day was the [PII], my surgery was on the [PII]. So I mean I can, I can have her correct that.
[CUSTOMER][NEUTRAL] But I'm saying even if, even if she said my last day was the [PII], that's still, that's still past 14 days. So I came back on the [PII].
[AGENT][NEUTRAL] 5, so, OK, so 5:14 to 527 is 14 days. So then that's why nothing was paid from [PII] cause that's a total of 14 days there. That will be your elimination period.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Well, no, I, I thought it, it's from the [PII] through the [PII], correct? That's 15 days.
[AGENT][NEUTRAL] The the elimination period was from [PII].
[CUSTOMER][NEUTRAL] Where are you getting [PII] from? That's what I'm saying, cause it's everything in my my paperwork says the [PII] or the [PII]. So I'm trying to figure out where the [PII] is coming from.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] I'm seeing on the claim that was processed, what the reason why it was initially denied it, it was calculating that 14-day elimination period, which was from [PII] to [PII], 527.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Which was either wrong either way because it was the [PII]. So what do I need to do? So I still need to have her to update it from put my last day was the [PII] and it starts on the [PII], is what you're saying?
[AGENT][NEUTRAL] Right, it'll, it'll pick your elimination period starting from the [PII] versus the [PII].
[AGENT][NEUTRAL] And then benefits will pick up after that 14 days. You see, and what day did you return to work?
[CUSTOMER][NEUTRAL] OK, but I
[CUSTOMER][NEUTRAL] All right, but
[CUSTOMER][NEUTRAL] Today, so it was the [PII] to [PII] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So yes, once we have that updated information, we can um update that as far as your elimination period and then consider those benefits up until your return to work date for those days.
[CUSTOMER][NEUTRAL] Alright, let me, let me call her and get this for you, OK.
[AGENT][NEUTRAL] OK. Is there anything else I can help you with today, Ms. [PII]?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] No, but just make sure you put that in my notes that um so when I do submit it, it ain't gonna be no delay because like I'm saying, I'm waiting this whole two weeks for my money cause I get no checks from work. I'm waiting on this money. You understand what I'm saying now is, is, it's a whole another process.
[AGENT][NEUTRAL] Yes, I'll make sure I note your account with that information.
[CUSTOMER][NEUTRAL] But OK.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] Bye