AccountId: 011433970860
ContactId: 03be9d5e-ec6c-48ac-814f-e76932344c7d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1143819 ms
Total Talk Time (AGENT): 104489 ms
Total Talk Time (CUSTOMER): 477092 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/03be9d5e-ec6c-48ac-814f-e76932344c7d_20250429T21:36_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is. How may I assist you?
[CUSTOMER][NEUTRAL] Hi good afternoon um I was calling to follow up on my claim and to make sure um all forms were turned in.
[AGENT][NEUTRAL] OK, sure, I can assist you with claims. So may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Of course. My name is [PII].
[CUSTOMER][NEUTRAL] And call back number would be [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the policy number?
[CUSTOMER][NEUTRAL] Policy number is 02419152.
[AGENT][NEUTRAL] OK. Thank you, Mr. [PII]. And may I have your date of birth, mailing address and email address for security.
[CUSTOMER][NEUTRAL] Um, you're breaking up a little bit. Uh, my date of birth is [PII], and what else did you need?
[AGENT][NEUTRAL] Mailing address and email address on file.
[CUSTOMER][NEUTRAL] Sure, mailing address is [PII] and email on file should be [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, let me check the notes really quick. One moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it looks like um the claim information was sent to EBS.
[AGENT][NEUTRAL] Um, let me just see what else is here. One moment.
[AGENT][NEUTRAL] Do you mind holding for me?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling Employee Retention Benefits, a division of ERB North America. You can dial an extension at any time. For sales, press 1. For customer claims services, press 2. For policy inquiries, press 4. For MetLife migration updates, press 5.
[CUSTOMER][NEUTRAL] This call will be recorded for quality and training purposes.
[CUSTOMER][NEUTRAL] Hi, you're calling Employee retention benefits. How can I help you?
[AGENT][NEUTRAL] Hi, um, this is so with APL. Um, I have a member on the line that he said he submitted a claim and it looks like it was sent to to this department and he's checking on that claim, um, but I don't have anything in my end.
[CUSTOMER][NEUTRAL] OK, um, you can transfer him over. Is that OK?
[AGENT][NEUTRAL] OK. Do you need any information of him before I transfer him?
[CUSTOMER][NEUTRAL] Uh, just his name. What's his first and last name, please?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] His first and last name?
[AGENT][NEUTRAL] Oh, OK, yes. And [PII].
[AGENT][NEUTRAL] Uh, OK, the last name is [PII]
[AGENT][NEUTRAL] The clerk
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, let's see here.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Sorry, um, cause I don't see him filing a claim either, but
[CUSTOMER][NEUTRAL] You can transfer him over if you'd like. That's OK.
[AGENT][NEUTRAL] OK, yeah, the only thing I got here is a note saying that um the claim was transferred over to ERB so um yeah, I didn't have anything to tell him. OK, here he comes. Have a good afternoon. You're welcome.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] Thank you. Thank you for holding and being patient for me, Mr. [PII]. I got a representative from EERB in the line. Um, she's gonna assist you from here. They're the ones that take care of the claims for you, OK?
[CUSTOMER][POSITIVE] Oh, you're welcome.
[CUSTOMER][NEUTRAL] From ERB
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] Um, you know, I checked with them initially.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And because of the date of my accident.
[CUSTOMER][NEUTRAL] Um, I was still under, um, your policy.
[CUSTOMER][NEUTRAL] Hi. Hi, can you hear me?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Hi. Um, I can go ahead and assist you. I know that you did speak with us beforehand, um, about a disability that happened in May of last year, right?
[CUSTOMER][NEUTRAL] Um, no, well, that's when I went off work was May of last year.
[CUSTOMER][NEUTRAL] Right. And then for the disability, because of the gray area kind of when we were transferring over to a new carrier, the disability wouldn't have been approved because it wasn't on the job injury. But then, um we did let you know about your accident and hospital plans that you can file for with your carrier five-star. Are you trying to reach 5-star by any chance?
[CUSTOMER][NEUTRAL] Um, wait a minute.
[CUSTOMER][NEUTRAL] This accident occurred in January.
[CUSTOMER][NEUTRAL] I waited until April to go see the doctor.
[CUSTOMER][NEUTRAL] But all the documentation I have for this.
[CUSTOMER][NEUTRAL] The injury happened [PII].
[CUSTOMER][NEGATIVE] And I know, I know that my, my policy number is the, the one that ends in 152, that policy was lapsed.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] After [PII].
[CUSTOMER][NEUTRAL] Of [PII], but it was in effect.
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][POSITIVE] To [PII]. But at the time of my accident, that policy was, was good. It was in effect.
[CUSTOMER][NEUTRAL] OK, no, because I do remember speaking to you. We spoke, um, a little bit earlier in April, I believe this month. I did recommend you calling 5 Star to file your accident and hospital claims. Did you ever get in touch with them to file?
[CUSTOMER][NEUTRAL] No, no, I'm trying to seek coverage on the disability claim right now.
[CUSTOMER][NEUTRAL] Well, when did you get put on disability? Cause the last time we spoke you said you got put on disability in May.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] But I was injured [PII].
[CUSTOMER][NEUTRAL] And no, I understand that. So with the injury, you can file for the accident and hospital indemnity claims that you have. But for disability, since you do have to be on disability to file a disability claim when your doctor puts you off. So since it happened in May, um, when we transferred over to the new carrier MetLife, and it's an on the job injury, that claim would have been denied due to some of the changes that APL was making.
[CUSTOMER][POSITIVE] So you wouldn't be able to file a disability, but you can still file for the injury. Um, and we went over this a little bit, uh, and I provided you with 5 stars information to file those claims.
[CUSTOMER][MIXED] Yes, you did provide me with 5 stars information, but as far as the disability claim.
[CUSTOMER][NEUTRAL] You're telling me that I have no disability claims?
[CUSTOMER][NEUTRAL] For this to happen in May, unfortunately, it wouldn't be approved. During that time, um, APR was making some changes with disability, and we had to find a new carrier to take over. And during one of, during that time when we were finding a new carrier, one of the changes APR was making was to only approve off of the job injuries, unfortunately. And since yours was on the job in that month of May, which is that
[CUSTOMER][NEGATIVE] Unfortunate gray area, um, it, it would, it would be denied.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Get
[CUSTOMER][NEUTRAL] OK, then why was I directed over to APL?
[CUSTOMER][NEUTRAL] And to file a claim.
[CUSTOMER][NEUTRAL] And to have my job fill out their portion.
[CUSTOMER][NEUTRAL] Of the claim and have my doctor fill out his portion of the claim.
[CUSTOMER][NEUTRAL] Only be told that I don't have a claim.
[CUSTOMER][NEUTRAL] Well, because we're on our conversation, I still advised if, if you wanted to file, you certainly could just to maybe see if they would approve it or not since the American public likes your direct carrier, which is the broker. Um, but all the paperwork that you have, I wouldn't be able to access it because I don't know where it was sent to. Do you, do you have the exact email or fax number that all your information was sent to?
[CUSTOMER][NEUTRAL] Um, well, the fax number, I know you received the fax from my doctor's office.
[CUSTOMER][NEUTRAL] When did you receive the fax from work? Well, my doctor's office sent it to me this morning.
[CUSTOMER][NEUTRAL] OK. Well, actually, no, if this was APL, I, I could look look it up and give you a date.
[CUSTOMER][NEUTRAL] But yeah because anything.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEGATIVE] But, but I've been paying.
[CUSTOMER][NEUTRAL] For policy.
[CUSTOMER][NEUTRAL] Monthly
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thinking that I had a disability policy.
[CUSTOMER][NEUTRAL] Well, you still do have it, it is active. It's just during that month when we had to find a new carrier that change that was made it.
[CUSTOMER][NEUTRAL] It was unfortunate with some of our clients and whoever went out on that month with any future disability claims that you didn't need to file, it would, it would be approved from there on out.
[CUSTOMER][NEUTRAL] Because the new carrier did take effect [PII].
[CUSTOMER][NEUTRAL] Well then, why, why does everybody make a big deal about, you know, wanting to know the date of injury?
[CUSTOMER][NEUTRAL] You have different policies. So the disability one is just for when you're first put on disability, and then the injury days for your accident and hospital indemnity one.
[CUSTOMER][NEUTRAL] OK, I'm gonna have to dig up my paperwork for APL.
[CUSTOMER][NEUTRAL] Yeah, because I am looking through our faxes right now. We haven't received anything from you, anything sent directly to American Public Life, I, I wouldn't be able to view through our site.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] But it is looking.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um, the [PII].
[CUSTOMER][NEGATIVE] That email does not work.
[CUSTOMER][NEUTRAL] So I had to send it to the care team at [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, are you with APL or are you with ERP?
[CUSTOMER][NEUTRAL] I'm with Eby.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] If you'd like, I could provide you with the fax number that's with American Public Life for you.
[CUSTOMER][NEUTRAL] Um, I have the fax number. It's [PII].
[CUSTOMER][NEUTRAL] So did you send the paperwork to that fax number?
[CUSTOMER][NEUTRAL] Um, that's who my doctor sent it to.
[CUSTOMER][NEUTRAL] And that's who we sent it to.
[CUSTOMER][NEUTRAL] OK. So since I'm not able to access it, I'm not directly with American Public Life. They're not saying they received it. I could, I could email somebody from their team who's more on the leadership team and fight.