AccountId: 011433970860
ContactId: 0e24bc42-104d-4f33-bf56-1f7951a7dfbd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 819650 ms
Total Talk Time (AGENT): 394747 ms
Total Talk Time (CUSTOMER): 270905 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/0e24bc42-104d-4f33-bf56-1f7951a7dfbd_20250217T20:39_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, Ms. [PII]. I was, uh, actually online and um I was trying to actually file an accidental claim on a few things and I typed my Social Security and everything online and it said user cannot be found.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] It's just probably.
[CUSTOMER][NEUTRAL] And I don't know if you can look into that.
[AGENT][POSITIVE] Absolutely, it would be my pleasure to assist you. We just need to verify your information that we have on file is correct, and we'll get that account created. What is that policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Do you have that available? If not, I can look it up by your social if that's easier.
[CUSTOMER][NEUTRAL] Hold on, let me see if I can.
[CUSTOMER][NEUTRAL] That's fine. You can look it up by my social.
[AGENT][NEUTRAL] And that number.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. And what is your name please, sir?
[CUSTOMER][NEUTRAL] Oh, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And Mr. [PII], let's verify your information. What is the, um, your date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Thank you. And what is your current mailing address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] All right, thank you, and what is your email?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It could be under 2. I don't know if it's um [PII] and [PII].
[AGENT][NEUTRAL] That's it, that's it.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] I didn't want you to give me another one because that's the one we have and I didn't need to know your other information. We try to keep your privacy. We protect your privacy and then what is a good call back number?
[CUSTOMER][NEUTRAL] No, that's fine.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] OK, so all that checks out. Let's verify your social. What's that?
[AGENT][NEUTRAL] [PII] you already gave it to me and I pulled up your account [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so when you were creating that account, did you log in as a new user?
[CUSTOMER][POSITIVE] Yeah, I did a new user and I put a, you know, my social security everything and then actually I'm do I can do it right now while I'm on the phone.
[AGENT][NEUTRAL] Now, on that
[CUSTOMER][NEUTRAL] Yes it swollen?
[AGENT][NEUTRAL] Question, did you choose that you were in, in, oh, you know what, you've already got an account.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] I thought I did. That's what it is. I thought I, I created one like a year ago.
[AGENT][NEUTRAL] Mhm and your username is [PII]
[CUSTOMER][NEUTRAL] Let me do it right now while we're on here.
[AGENT][POSITIVE] Absolutely. I wanna make sure you can get in.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I may have to reset my password because.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] And just take your time, but I do wanna make sure that you can get in with no problem.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Let me reset it while we're on the phone then.
[AGENT][POSITIVE] Yeah, absolutely. Take your time.
[CUSTOMER][NEUTRAL] mobile phone.
[CUSTOMER][NEUTRAL] Reset my password. OK, verification code.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, let me reset it so let me do a new password.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] Invalid username, mm.
[CUSTOMER][NEUTRAL] Let me try this cake.
[AGENT][NEUTRAL] You just keep on going.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, she got me in there.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Let's see, signing information update. OK, question because I was actually talking to my HR and it was a couple of things I didn't know like.
[CUSTOMER][NEUTRAL] Just recently here, I was in um an accident, an automobile accident.
[CUSTOMER][NEUTRAL] And um I was looking at, and I was looking at um you know, some of the coverage and of course I had to go to the emergency room and all that. Do I take the information that the doctors gave me and submit that?
[CUSTOMER][NEUTRAL] And then, you know, it goes from there.
[AGENT][NEUTRAL] That's right. So, um, you can submit that, um, emergency, uh, you said you went to the emergency room or were you admitted?
[CUSTOMER][NEUTRAL] Uh, well, the, the, the ambulance came and picked me up and they, I mean, I don't know how they they took me to the emergency room.
[AGENT][NEUTRAL] Got you, got you. OK, yes sir, um, you can submit that itemized bill from the emergency room now we have a claim form. I wanna make sure you can get in the portal because you can have access to that claim form there as well.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] You can also click on the policy number and review your policy benefits.
[AGENT][NEUTRAL] But we will need the itemized bill. um, we'll need the if it was an auto accident, if you can get that accident report, the motor vehicle accident report.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We'll need that as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then we'll need.
[AGENT][NEUTRAL] If you have the.
[AGENT][NEUTRAL] Discharge papers or something showing that you were seeing due to an a vehicle accident.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what your injuries were.
[CUSTOMER][NEUTRAL] OK, I got it. I just, I don't have the bill yet because it just happened on Thursday, so.
[AGENT][POSITIVE] Oh my goodness.
[CUSTOMER][NEUTRAL] Am I supposed to wait? Yeah, am I supposed to wait till I get the bill?
[AGENT][NEUTRAL] Yes sir, I would wait until you get that bill.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You know, the same for the ambulance, you may have to wait until you get that bill as well.
[CUSTOMER][NEUTRAL] OK, so I, I'll do it in like two other things because I didn't know and I was looking at it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] If I actually, my wife, she, if we, I got, now do I got the bill on that one, if I had a chip, chipped tooth.
[CUSTOMER][NEUTRAL] And then on hers she end up having like oral surgery on a, on a tooth too being but my my thing is this because I'm trying to understand how it works because I know I signed up for insurance just sub submit that anyway and the bill and then y'all pretty much go from there.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's what I would do, yes, sir. Um, you know, any injury, I'm looking to see on your policy if it does have dental coverage.
[AGENT][POSITIVE] And also while I've got you on the phone, there is a wellness benefit as well.
[AGENT][NEUTRAL] So, and you do have emergency dental and vision treatment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I would submit this, um, for each person though, you're gonna, or for each injury, there would need to be the claim form for the accident claim form.
[AGENT][NEUTRAL] And that is online.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you don't have to be in the portal to get that claim form. You can just go to [PII].
[AGENT][NEUTRAL] And go into the claims and form section if you want to print it out or you can send it to yourself by email or you know um but I wanna make sure you can get into the portal as well but you'll need a claim form for each person for each accident because it will ask you questions regarding that accident.
[AGENT][NEUTRAL] Um, also, there's the wellness claim form for you have a screening benefit.
[AGENT][NEUTRAL] It's one time per person per calendar year. It's $50.
[AGENT][NEUTRAL] Per year one time that we can pay.
[AGENT][POSITIVE] And that is for your wellness benefit.
[AGENT][NEUTRAL] And let me get back back to that. Don't forget that now your wellness benefit will be under a different claim form. It's gonna be the wellness claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I see that it says file wellness claims, and I clicked on it and it says file a well wellness claim and say who are you filing the claim for? And yeah, and I clicked on it got uh my family members' numbers, my wife and son. OK, I see it.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Exactly.
[AGENT][NEUTRAL] Mhm. And that includes things like the hemoglobin, the A1C test, um.
[AGENT][NEUTRAL] Stress test, bone density, weight reduction program, examination by a dentist or optometrist, your routine physical, so that is covered under your plan as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So don't forget about that one. A lot of people forget about that wellness benefit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And hey, $50 is $50.
[CUSTOMER][NEUTRAL] Yeah, I see that. So basically like.
[CUSTOMER][NEUTRAL] Yeah, it is OK. So service details and um so when I get ready to upload, you know, my stuff like with the accident, do I go on to upload files?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] And then I think I'm gonna do this on the computer because uh a phone, it looks like it's capable but then yeah.
[AGENT][NEGATIVE] Yeah, no.
[AGENT][POSITIVE] It's much better on the computer. In fact, the files are more compatible on the computer as well. You won't have.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] If you try to do it on the phone, it you, you're probably gonna run into problems, so if you can do it on a computer, much better.
[CUSTOMER][NEUTRAL] Yeah, I, I see that.
[CUSTOMER][NEUTRAL] OK, so I'll wait till um I get those bills in and I just start submitting, you know, sending stuff over there.
[AGENT][NEUTRAL] Yeah, but I see your policy has been active since [PII]. So if, if, oh,
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] You know, if you've had any checkups uh for your wellness.
[AGENT][NEUTRAL] You know, exams you can go ahead and submit those as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, uh, so check check ups and stuff. I, I gotta go online and look what do I, where do I look at online to see, you know, what's all covered and because my HR had printed something out for me and I lost it. So is there anywhere online or something?
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Not a problem.
[AGENT][POSITIVE] Absolutely. All you have to do is click on your active policy number.
[AGENT][NEUTRAL] And it will download your policy certificate.
[AGENT][NEUTRAL] And you can read through the policy. It's got your benefit amount. It's got the accidental, um, well, it's got everything that's covered and there's a page called a schedule of benefits page.
[AGENT][NEUTRAL] And everything is listed on that schedule of benefits page under that.
[AGENT][NEUTRAL] If you want to check further on those on each one of those, you can look further in the policy for those specific benefits and the like the um definition, you know, just to make sure but the.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The quick reference is under the schedule of benefits.
[CUSTOMER][NEUTRAL] OK, schedule of benefits. OK, I'm, I'm gonna look at that. I like I said, it's probably easier to look on my computer because right now I think it's kind of messing up on me and then uh I'll just go from there.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Now the policy is 44 pages long but you know if you wanted to print out just the schedule of benefits or for quick reference you can do that as well.
[CUSTOMER][POSITIVE] OK, I will do thank you.
[AGENT][POSITIVE] Well it's been a pleasure to assist you and I hope you're feeling better, Mr. [PII].
[CUSTOMER][POSITIVE] OK, thank you. I hope I feel better too.
[AGENT][POSITIVE] Yes, yes, sir, and if you need any further assistance, don't hesitate to give us a call.
[CUSTOMER][NEUTRAL] OK, bye-bye.
[AGENT][NEUTRAL] Bye bye.