AccountId: 011433970860
ContactId: 0bf2a35d-1beb-4f54-8569-060c76133f8c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 297519 ms
Total Talk Time (AGENT): 118500 ms
Total Talk Time (CUSTOMER): 114904 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/0bf2a35d-1beb-4f54-8569-060c76133f8c_20250114T16:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII], it's [PII] with Rooney Insurance Agency. I have a member who comes into our office every couple of months and brings me his claim to file for cancer, and I fax it over to you guys. I sent one on [PII], and he said he still has not heard anything back from you, so I just want to check the status of that claim.
[AGENT][NEUTRAL] Hi [PII], I can assist you today with um claim status. May I have um callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] May I have the policy number of the member, please?
[CUSTOMER][NEUTRAL] Yes, it's oh the policy number 0074210 [PII].
[AGENT][NEUTRAL] Alright thank you one moment please while I pull up the member's policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Could you repeat that policy number?
[CUSTOMER][NEUTRAL] I don't know if I said this. This was for November and this uh huh, it's 0074210.
[CUSTOMER][NEUTRAL] And it was for November and December services.
[CUSTOMER][NEUTRAL] Not sure if I said that earlier.
[AGENT][NEUTRAL] No, um, I don't, when I pull up that policy number, you said um [PII], what?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yeah, that policy number that you provided me is not the policy number for the member um that you're calling about.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, that might be the problem then because that's what he had written on the claim. Let me, uh.
[AGENT][NEUTRAL] Let me look
[AGENT][NEUTRAL] Let me look it up by name. Oh, can you, um, let me get to that screen. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I have a social too if you need that.
[AGENT][NEUTRAL] Oh, yeah, that'd be easier. What's that number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] is his policy number 074210. That's what I've got written down. I don't know if that's.
[AGENT][NEUTRAL] And could you please provide me with the date of birth?
[CUSTOMER][NEUTRAL] Yeah, it's uh
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Alright, so thank you so much for verifying the information. I did find the member's policy and its 774,210.
[CUSTOMER][NEUTRAL] 774,210
[CUSTOMER][POSITIVE] I'll make a note thank you.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] That's not what was written on the claim, so that might be part of the problem.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He filled out the claim form. I just faxed it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so, um, I do see where the claim was received to us on [PII]. This claim was processed on [PII]. This claim did pay a benefit amount of $3000 and it was mailed to the address we do have on file, and I just checked and this check is still um outstanding.
[AGENT][NEUTRAL] So it hasn't been cached. Could you verify the member's address, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It it
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So you mailed it on [PII]?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, to the address we have on file.
[CUSTOMER][POSITIVE] And it's outstanding, it hadn't been cash.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, so what if he hasn't received it because he says he hasn't and it's been a month, so what's the process for if you had to do a stop pay reissue what's the, what do we need to do to do that?
[AGENT][NEUTRAL] He would need to call us and um let us know that he has not received it and then um we would then do, and it would, it would have to be um
[AGENT][NEUTRAL] So it would have to be either Friday or anytime after Friday's date.
[CUSTOMER][NEUTRAL] After Friday, Friday or after, so after, hang on, let me look at the [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Friday is the [PII]. Yeah, because it was, it was um processed on the [PII] and mailed on the [PII]. So it has to be after 30 days after we sent it out.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty I will call him back and let him know.
[AGENT][NEUTRAL] Alright, is there anything else that I can help you with today?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] You're so welcome. Thank you for calling APL. You have a great day. Bye bye.
[CUSTOMER][NEUTRAL] You too. Bye-bye.