AccountId: 011433970860
ContactId: 08355c49-0c88-48f3-858b-3b97aa3d55a7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 952979 ms
Total Talk Time (AGENT): 514179 ms
Total Talk Time (CUSTOMER): 293422 ms
Interruptions: 6
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/08355c49-0c88-48f3-858b-3b97aa3d55a7_20250528T17:12_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], I need your help and let me know if I'm not in the right place. I've got an insured spouse on the line. Um, she is covered under a group accident plan with her husband.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Long story short, he passed away due to an accident. Sounds like to the, to me, the group submitted a claim on her behalf, but then they told her to reach out to us because we needed more information. And she was actually transferred to me from the care team because they said that there was a guru card that they needed to send it to customer service for assistance on the claim.
[CUSTOMER][NEUTRAL] But I can't see what she needs as far as the claim is concerned. There is one out there, but I don't know what documents are needed or what's going on with it.
[AGENT][NEUTRAL] OK, so you have the insured spouse on the line and the insured.
[CUSTOMER][NEUTRAL] Can you help her?
[CUSTOMER][NEUTRAL] And she is covered.
[CUSTOMER][NEUTRAL] On the policy as well, but he, he apparently had an accident. Yeah, and there was a claim submitted in and there's something out there, but apparently the group told her she needed to contact us to see what else we needed to get it rolling.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Passed away
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, what's, um, yes, [PII], I can try and help, he transferred her to you.
[CUSTOMER][NEUTRAL] She said she was needing her name slipped out of my head.
[AGENT][NEUTRAL] That's fine. Um, what's, um, the policy number? Let me get that pulled up.
[CUSTOMER][NEUTRAL] 581-355. I'm gonna get with [PII] anyway because she said it was a guru card and confused me.
[AGENT][NEUTRAL] Right. Bye.
[AGENT][NEUTRAL] 581-355.
[CUSTOMER][NEUTRAL] 258135
[AGENT][NEUTRAL] Oh, I didn't hear any of that too. 2581355.
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh, and it's [PII], and he was fully verified before transfer, um, but it's Mrs. [PII], and I did give her the information so she could register onto online service center in case she wanted to go on there and do it electronically, um, as far as whatever she needs to send in.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright. Hang on one second, [PII], don't release that call since this lady's been transferred around like that.
[CUSTOMER][NEUTRAL] Uh, you
[CUSTOMER][NEUTRAL] Yeah, and I, I, I tried to tell the person, but I didn't wanna like not reject the call and I was trying to make sure that's actually what she needed as well.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] For
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Maybe she was cause she said something about she has the death certificate, but I don't know what's going on about the death certificate as far as the claims involved.
[AGENT][NEUTRAL] Yeah, is she, yeah.
[AGENT][NEUTRAL] Cause we haven't received that yet. The death certificates one. OK, uh, yeah, and this is [PII]?
[CUSTOMER][NEUTRAL] And that's what she
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, and like I said, I think that's, yeah, and I think maybe that's where the confusion came in that she didn't realize she's talking about the claim, not just the death certificate in itself.
[AGENT][NEUTRAL] That's on the line.
[AGENT][NEUTRAL] OK, what's the um what's [PII]'s callback number, [PII]?
[CUSTOMER][NEUTRAL] [PII], the one on the phone.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, I'll be happy to talk to her.
[CUSTOMER][POSITIVE] She's real sweet. All right. Here she goes. Thank you.
[AGENT][POSITIVE] Yeah, I'll be happy to talk to her. OK, thank you. All right, bye bye.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Hi, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hi, this is [PII]. How are you today?
[CUSTOMER][NEUTRAL] On the best I can be.
[AGENT][POSITIVE] I'm so sorry. Yes, ma'am. Um, my deepest condolences. Um, I understand that Mr. [PII] has passed away. Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so again, I am very sorry for your loss. Um, so the claim, [PII] said that you were needing some information on the claim that has been the information that we've received thus far, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am. Like, um, the, the HR department send in paperwork on [PII], and I haven't heard anything. I haven't received anything in the mail or anything regarding this claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] Mhm. OK, so this claim.
[AGENT][NEUTRAL] Yes ma'am, um, there is some additional information that is needed on this claim and an explanation of benefits was mailed out. It should have gone out on [PII].
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] On here we are, we've received the claim.
[AGENT][NEUTRAL] However, in order to provide further consideration for this loss, we need a copy of the death certificate.
[AGENT][NEUTRAL] And supporting documentation to evidence the date on which the accident occurred, which that should, um, that's part of what we're needing and also
[CUSTOMER][NEUTRAL] So, in other words, like the news article of what happened when the boat exploded?
[AGENT][NEUTRAL] His
[AGENT][NEUTRAL] Um, his death certificate is going to be one of the things that is needed. And then,
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, give me a moment to look at another remark on here.
[AGENT][NEUTRAL] And there was also a claim form that was mailed. Now, I know that you've been transferred a couple of times. I think there was some confusion, Ms. [PII], on exactly what.
[AGENT][NEUTRAL] What you were needing. Now, to verify, do you have the death certificate?
[CUSTOMER][NEUTRAL] No, ma'am, um, they will not issue a death certificate until I get the final, they get the final autopsy report.
[AGENT][NEUTRAL] OK, so we will not be able to move forward. Yes, ma'am, but we will not be able to move forward on processing this claim until that specific piece of information is received, that is required.
[CUSTOMER][NEUTRAL] But I do have a news article.
[CUSTOMER][NEUTRAL] Right, I mean, there is like news articles with his name and the date that the accident occurred.
[AGENT][NEUTRAL] Yes ma'am
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, he was in a crew boat.
[CUSTOMER][NEUTRAL] That exploded.
[CUSTOMER][NEUTRAL] Um, and there's news articles about that as well.
[AGENT][NEUTRAL] OK. So, given the nature of this accident that he was involved in,
[AGENT][NEUTRAL] I'm going to actually connect you again and I'm sorry to have to do that, but this is kind of an extenuating circumstance. Again, we will have to have the the uh for sure we're gonna have to have the death certificate before we are going to be able to provide very much information as far as the other supporting documentation.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Right, and I understand that.
[AGENT][NEUTRAL] Um, regarding
[AGENT][NEUTRAL] The accident. I'm gonna, they will be able to verify about these articles because honestly, Ms. [PII], I do not know that. I do not know the answer to that question and I don't want to tell you anything incorrect.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It because
[CUSTOMER][NEUTRAL] Right. Because I know that there's something in there about common carriers and it, and it, and, and it would should double and a crew boat should be listed as, you know, considered a common carrier.
[AGENT][NEUTRAL] And we, yes, and we're not gonna be able to go over any benefit information at this point.
[AGENT][NEUTRAL] Until we get the required information, but we are also, we, it states that we need a claim form completed.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Now, because of again.
[CUSTOMER][NEUTRAL] OK, and can I do that online?
[AGENT][NEUTRAL] Yes, we, our forms are online.
[AGENT][NEUTRAL] You can go to [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] When that page pulls up, Ms. [PII], you will see at the top where it says claims and forms.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You would click on that link, scroll down the page.
[AGENT][NEUTRAL] And it will start listing different types of claim forms. The very first one listed is the accident claim form and out to the right.
[CUSTOMER][POSITIVE] Yes thank.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] There is a blue button that says download form.
[AGENT][NEUTRAL] If you click there it will open up the claim form and the entire first page has all of the instructions for what is required.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So you can use that as a checklist.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But again in regards to what is considered acceptable on some of these documents that we are in need of um I'm going to connect you with someone who will be able to answer that for you.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] The supporting documentation.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Was there anything else that I can help you with before I do that?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I'm guessing not.
[AGENT][POSITIVE] OK, alright, well if you will give me just one moment, I am gonna get you connected with someone, OK? And again, thank you for your patience. I know you have spoken to several people today um.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] And I appreciate you understanding that.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] OK, yes ma'am, you're very welcome, so one moment.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] uh.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Ferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey, [PII], it's [PII]. How are you today?
[CUSTOMER][NEUTRAL] Fine, how are you?
[AGENT][POSITIVE] Oh, I'm all right. I'm ready for Friday, but I'm good.
[AGENT][NEUTRAL] OK, so let me give you the policy number 1st. 258.
[AGENT][NEUTRAL] 1355. [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] His spouse, [PII] is on the line.
[AGENT][NEUTRAL] And her callback number is the one that's up on the screen.
[AGENT][POSITIVE] OK, so she's been transferred multiple times. It's, she was talking with someone on the care team. The care team transferred her to customer service and the customer service transferred her back and I got her.
[AGENT][NEUTRAL] But it's regarding this claim for him because it looks like the group submitted it.
[AGENT][NEGATIVE] But he was, um, he was killed in a boat explosion at work.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] He said, she said he was on a crew boat that exploded.
[AGENT][NEUTRAL] So she doesn't have the death certificate yet because
[AGENT][NEUTRAL] She said that they're not gonna get that until the autopsy is completed.
[AGENT][NEUTRAL] But the other documentation that we're asking for, hm.
[AGENT][NEUTRAL] Um, one of them is a completed claim form.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] The wording on that is terrible by the insurer giving a detailed description.
[AGENT][NEUTRAL] Of the accident or diagnosis.
[AGENT][NEUTRAL] That's, and then the other one about needing the death certificate and supporting documentation to evidence the date on which the accident occurred.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] She's wanting to know, you know, she's talking about news articles and
[AGENT][NEUTRAL] You know what is acceptable supporting documentation.
[CUSTOMER][NEUTRAL] OK, so he's deceased?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] She said that he was um worked on a crew boat, part of a crew, and then the boat exploded.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And she, she don't have the death certificate yet.
[AGENT][POSITIVE] She's real nice. No, no.
[AGENT][NEUTRAL] Because they're gonna have, um, she said that's not gonna be available until the autopsy is completed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But she's just wanting to verify what this uh, you know, what's acceptable for other documentation, and I've never had a call like this, [PII], so.
[CUSTOMER][NEUTRAL] OK. Yeah, I'll have to check to verify exactly what other information can be submitted other than the death certificate.
[AGENT][NEUTRAL] Yeah, but she's she's grilling.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] I mean, cause it's asking for two things. We need, we will need the following one, a death certificate and 2, supporting documentation. So she's aware of the death certificate, but then like as far as filling out the claim form, and they have, she hasn't even gotten that in the mail.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that other remark talks about the enclosed claim form, but she's not received anything, so she was gonna get the claim form from, you know, but can she complete that?
[AGENT][NEUTRAL] Of the website.
[CUSTOMER][NEUTRAL] Is she the be let me see. Yeah, the yeah, the claim form is on the website.
[AGENT][NEUTRAL] Uh, she's covered. I mean, she's, yeah, I mean, I've given her that information. She's covered on this policy.
[CUSTOMER][NEUTRAL] Yeah, I see that, but we have to look to see who's actually the beneficiary of the policy.
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] With the spouse.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Let's see, yeah, I can check you can send it to me. I can check, check for checking to see what additional information can we use. I know we definitely do need a death certificate, but as far as additional supporting documentation, I can check into it and see what other information.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah, I mean,
[AGENT][POSITIVE] OK, thank you, cause, yes, I, I've never, yeah, I've never had a call like this. Poor lady, she's really nice, so.
[CUSTOMER][NEUTRAL] And that she's a spouse.
[AGENT][NEUTRAL] She is, uh-huh.
[AGENT][NEUTRAL] She's part two listed on the policy, yes.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK. OK. Thank you so much, [PII]. Have a good afternoon.
[CUSTOMER][NEUTRAL] You can send her to me, mhm.
[CUSTOMER][POSITIVE] You're welcome. You too.
[AGENT][NEUTRAL] OK, bye bye.