AccountId: 011433970860
ContactId: 04f2f057-7276-4e04-a8d2-fbd5d24c34e2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 864710 ms
Total Talk Time (AGENT): 515388 ms
Total Talk Time (CUSTOMER): 199201 ms
Interruptions: 3
Overall Sentiment: AGENT=1.6, CUSTOMER=-0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/04f2f057-7276-4e04-a8d2-fbd5d24c34e2_20250108T16:53_UTC.wav
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[AGENT][POSITIVE] Hi, thank you for calling APL.
[AGENT][NEUTRAL] Can I help you today?
[CUSTOMER][NEUTRAL] Yeah, good afternoon. My name is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm, I'm call, yeah, I'm calling to find out something on my, my benefit because I, I did my surgery from uh, from [PII].
[CUSTOMER][NEGATIVE] And I have not received nothing from.
[CUSTOMER][NEUTRAL] My, uh, disability insurance, yeah.
[AGENT][NEUTRAL] OK, let me take a look at that and.
[AGENT][NEUTRAL] Um, do you have that policy number handy, sir?
[CUSTOMER][NEUTRAL] Yes ma'am, policy number is 0243.
[CUSTOMER][NEUTRAL] 2636.
[AGENT][POSITIVE] Perfect, give me one moment to get that pulled up.
[AGENT][NEUTRAL] All right. And then Mr. [PII], can you verify for me please your um date of birth?
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[AGENT][POSITIVE] Wonderful thank you so much and.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] I'm just going to verify some information with you before I can give you any information as far as the claims go, but I'd certainly love to help you with um looking at your benefits and your claim status. Would you be able to verify for me your.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Would you be able to verify for me please your mailing address?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My mailing address is [PII].
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] [PII]. The zip is [PII].
[AGENT][NEUTRAL] Perfect and then can you also verify for me please your email address on file?
[CUSTOMER][NEUTRAL] My email address on file is [PII].
[AGENT][POSITIVE] Wonderful. Thank you so much.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] And let me see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like the last thing we received from you we received 12:31 and I'm trying to pull that up so I can get a look at it. It looks like it was your.
[CUSTOMER][NEUTRAL] you can
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Signed statement. Does that sound right?
[CUSTOMER][NEUTRAL] Yes, yes, um, for my employer.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My employer
[CUSTOMER][NEUTRAL] On my company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, sure.
[AGENT][NEUTRAL] Alright, so it looks like um they reviewed the information you submitted and it was actually processed yesterday so something should have gone out in the mail this morning for you um to update you on it but I do see the update right here and it just says that they received your employer claim form but they didn't receive an updated insured statement signed by the insured on page 2 of the statement claim form.
[AGENT][NEUTRAL] Um, and so they're saying that it looks like they still need you to fill out page 2 of the claim form and submit it for the claim to be processed.
[CUSTOMER][NEGATIVE] Oh, I don't understand because they are, they are sent, they had sent it back for me, but they only had sent it saying that it was the employer.
[CUSTOMER][NEUTRAL] was to just fill out the part and return it, so I did that and
[CUSTOMER][NEUTRAL] That's all I received from them so far.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] From the employer.
[AGENT][NEUTRAL] Yeah, so
[CUSTOMER][NEUTRAL] And now, now they're going into.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[AGENT][POSITIVE] Let me, I'm so sorry. I can, I'm only pulling this up one at a time, but let me go back a little ways.
[CUSTOMER][NEUTRAL] Really.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sorry, it takes just some time to load.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] You know not to do that.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, yeah, so I'm seeing that.
[AGENT][NEUTRAL] I am seeing that it looks like it is the the statement of the insured that portion of the claim, um, that we're still waiting to receive. Um it does look like in the letter that went out on the [PII] it did request that um it had the two requests, one for the employer form and one for the statement of the insured, and then we received that employer form, but we're still waiting for that statement of the insured.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] But it should be pretty quick. It's just pages 2 and I believe 2 and 3. They like back up to each other on that claim form and you just need to fill that out and send it in and then they'll be able to make a decision regarding the claim.
[CUSTOMER][NEUTRAL] I, I don't know why, why it's like that because
[CUSTOMER][NEUTRAL] You know, I, I speak with someone from your office uh last week and they told me that they have received everything and it was in process.
[CUSTOMER][NEUTRAL] So I don't watch the whole lot.
[AGENT][NEUTRAL] Yeah, so.
[AGENT][NEUTRAL] When stuff's being processed we can't open it up to view it all we can see is that it's been received and then the examiner is able to view it and verify if everything's there and then they make the decision from there if they need more information um but until it's been reviewed, you know, we can't just go in and look at it and tell you if it's.
[AGENT][NEUTRAL] We can see that it's been received but we're not examiners so the examiner looks at it verifies that all the information that they need to process the claim is there or not and then from there we can just tell you the updates from the examiners.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I don't, I don't know why it takes so long that, you know, to get it cut because.
[CUSTOMER][NEGATIVE] You know, when it comes to paying, um, paying my insurance, it, it do, uh, you know, hold up, you know.
[CUSTOMER][NEGATIVE] But for them not to pay out, it's a whole lot, and it should not be like that.
[CUSTOMER][NEGATIVE] You know, because I got, I'm going there for 2 months now since going into 2 months since I did my surgery and nothing for my disability insurance.
[AGENT][NEUTRAL] I
[CUSTOMER][NEGATIVE] You know, I, I, I need, I need to pay my rent.
[CUSTOMER][NEUTRAL] And other different bills.
[CUSTOMER][NEUTRAL] You know, that's why I pay my disability insurance.
[AGENT][NEUTRAL] Absolutely, no, and I understand like the importance of having that, you know, it's there to protect your income in the case that you're unable to work. I do see that, you know, we sent a letter out on the [PII] stating we need that portion filled out. We sent another letter again on the [PII] requesting that information and then we'll send another letter went out in the mail today requesting that information, so.
[AGENT][NEUTRAL] I do see like where we've we've asked for it since it looks like the first time that letter went out was [PII]. It said the claim form submitted was incomplete in order for additional consideration to be given to your claim form. Please complete the statement of the insured, which is the employee's portion of the claim form in its entirety. Your claim will be as an active status until we receive the requested information. So we've definitely been reaching out as far as receiving that information, and we still just need to receive it.
[AGENT][NEUTRAL] To be able to process your claim.
[CUSTOMER][NEGATIVE] Well, I don't know why, why they, they should have sent it by sent by my email.
[CUSTOMER][NEUTRAL] I'm here to, to request this.
[AGENT][NEUTRAL] Well, our email is not secured so we're unable to send information like that through your email um we do have an online portal which I could send you some information on if you'd like it because you can be able to update your or view your claim status in real time as updates come through otherwise we do just send out those explanation of benefits through the mail in a letter.
[CUSTOMER][NEGATIVE] I see the mail, the mail that takes so long because I'm not received no mail from from time I send out.
[CUSTOMER][NEUTRAL] Got one back. I know see nothing since.
[CUSTOMER][NEUTRAL] So I don't know, I don't know what's what's going on. I had to call my company to find out something. I'm gonna call Train to find out what's going on.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It it's got to be some
[CUSTOMER][NEUTRAL] Some procedure more faster than this. It's too slow.
[AGENT][NEUTRAL] Well, the reason it's so slow is just because we've been waiting, you know, since then for this information to come through if we'd had it all at at the time the first claim was submitted at the start of December, I'm sure a decision would have been sooner, but we've been, you know, we've been requesting for that statement of the insured, and as soon as we have that we can process more information.
[AGENT][POSITIVE] Again I can help you with set up that online portal because once that's set up like you can just upload that statement on the online portal you don't have to wait for it to go through a fax or through mail and it really does speed things up and then you can view your claim statuses you can elect to get a text message when you're when there's an update so you know that there's an update and you can look at it and it does have a lot of functionality in there that really expedites the situation.
[AGENT][POSITIVE] And I'd love to help you get that going today if you want to, um.
[AGENT][NEUTRAL] And, and then that way you wouldn't feel like you're missing information or waiting on the mail. Um, but that is, that's all we need. It's just um the, the statement of the insured. So it's on pages 2 and 3 of that claim form and it looks like that's the portion we're missing.
[CUSTOMER][NEUTRAL] So, so could you set it up for me today?
[AGENT][NEUTRAL] I can't set it up for you, but I can talk you through setting it up yourself.
[AGENT][NEUTRAL] If you have access to a computer or if you don't have access to a computer at the time, I can email you a guide that is a step by step guide on how to set up the portal and then how to upload claims once you're in there and it will tell you how to do anything like change your address or update your banking like any of that.
[CUSTOMER][NEUTRAL] OK, well, OK.
[CUSTOMER][NEUTRAL] OK, OK, please send me that um.
[AGENT][NEUTRAL] OK, I will get that guide put together for you right now and I'll get it emailed out to you um I know we just confirmed your email, but I'm gonna read it back just to make sure I have the email correct and I'm not sending it to the wrong person. I have.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][POSITIVE] Perfect. The subject line is gonna say OSC guide_ APL, so if you need to search for it, you can just use the words or the letters APL to find it, um.
[AGENT][NEUTRAL] And then I'm going to attach that file for you right now and I'll hit send OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then I mean there is really a lot, a lot of functionality you're gonna find on the online portal that I think will be convenient and it will save you time and hassle um because it just makes it so convenient for you but I'm hitting send on that it should be coming your way.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then that claim form I should have asked because I could have included it in the same email but do you have a copy of that claim form or would you like me to email you a copy of that claim form that you can just fill out on your computer and upload automatically?
[CUSTOMER][NEUTRAL] Yeah, please, please send me a copy.
[AGENT][POSITIVE] Perfect so it will come as a separate email because I did hit send real quick, but let me go ahead and get a separate one and this one is just gonna say claim form underscore APL.
[AGENT][NEUTRAL] And give me 1 2nd to get that one put together for you, OK, my friend?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] And do do do do claim forms. I would recommend um you can never have too much information if you want to fill out every bit of this besides like the I would I would recommend doing pages. I'll even write it 23 and 5 just in just that way you're not even worried about missing um anything or having them like contact you saying oh we just need this one more page um pages 23 and 5.
[CUSTOMER][NEUTRAL] 23 and 5, OK.
[AGENT][NEUTRAL] Yep and I put that at the start of the email so it's right there at the top.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, sounds good.
[AGENT][NEUTRAL] All right my friend and I'm hitting send on that one right now for you as well so that should be coming through to your email as well OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] I am really sorry. I definitely understand your frustration and I am really sorry that the mail takes so long and that this whole process is taking forever, but we'll certainly get you taken care of as quick as we can once we have that, that filled out bit of the claim form.
[CUSTOMER][POSITIVE] OK then. OK then, thank you.
[AGENT][POSITIVE] Hey, it's my pleasure. Is there anything else I can do for you today?
[CUSTOMER][NEUTRAL] That'd be all for now.
[AGENT][POSITIVE] Alright perfect well thank you so much [PII]. I appreciate your time and if you need anything give us a call back and we'll help you through it, OK?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] My pleasure. Bye-bye.