AccountId: 011433970860
ContactId: 163b5e53-e7e9-4d53-acc9-e0f6df06c564
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 993109 ms
Total Talk Time (AGENT): 316595 ms
Total Talk Time (CUSTOMER): 231580 ms
Interruptions: 1
Overall Sentiment: AGENT=3.9, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/163b5e53-e7e9-4d53-acc9-e0f6df06c564_20250108T15:21_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Uh, yes, good morning. If I give you my policy number, can you check the status of the claim I filed?
[AGENT][NEUTRAL] Yeah, I can certainly help you with claim status today. um, what's that policy number, my friend?
[CUSTOMER][NEUTRAL] Uh, it's 00810367 and it's under company 22.
[AGENT][POSITIVE] OK, perfect. Give me one second to get that pulled up.
[AGENT][NEUTRAL] And your first and last name, please, and your date of birth?
[CUSTOMER][NEUTRAL] Is [PII] [PII].
[AGENT][POSITIVE] Perfect. I'm just gonna verify some additional information with you, [PII] if you don't mind.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Perfect. Would you be able to verify for me, please, your mailing address?
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][POSITIVE] Wonderful and then the email address and phone number on file?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] Perfect thank you and is that a good phone number to call you back if we got disconnected?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Alright, perfect. Thanks, I appreciate that.
[AGENT][NEUTRAL] All right, it looks like that most recent claim has been processed and it does look like I have an incomplete status on it. Let me pull that up and look a little further into that for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it does say the claim form submitted was incomplete. Please have the employer's portion and the attending physician's portion of the enclosed claim form completed and it's entirely in order for additional consideration to be given to your claim.
[CUSTOMER][NEUTRAL] OK, the doctor sent it in. She's the one that mailed it in.
[CUSTOMER][NEUTRAL] And uh on the claim form, the employer, there was no spot for employer uh I didn't see that.
[AGENT][NEUTRAL] OK, let me, do you mind if I look into it a little further for you?
[CUSTOMER][POSITIVE] I would love for you to look into it further.
[AGENT][POSITIVE] OK, perfect. Give me just a moment let me pull some things up and see what I can find out for you my friend, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, [PII], are you still here with me?
[CUSTOMER][NEGATIVE] Yes, I am because I, I went and got the paperwork that was sent to me because I actually called and you sent the paperwork to me even though I could print it off over the over the internet and I got pages 2 through 8 and nothing says anything about employer. It just says um I if I stop me if I'm wrong, the only thing they ask me about the employer is if I'm filing for workman's compensation, which I'm not because I don't need to file for workman's comp.
[CUSTOMER][NEUTRAL] Um, so I, if there's something I'm missing you, please let me know.
[AGENT][NEUTRAL] No, so I actually I can't see the original claim as it was sent in which I'm really sorry about, but I was also looking at uh a short term disability claim form and I'm not exactly I think I see the same thing you do so I'm not exactly certain what is missing but I'd really like to escalate this and have somebody who processes the disability claims reach out to you because they're gonna have more knowledge than I do is it OK if I submit this for a call back request and have somebody reach out to you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] ASAP, please, I'm not, I haven't gotten paid since the [PII]. I could use this money and, and uh yes, whatever could expedite this, I would love for them to give me a call because, uh, like I said, I filled out my portion and I handed to the physician. Uh, she, she's the one who faxed it in their office faxed in the paperwork that she had to fill out. So if there's something up, I really need to know because I really need to get paid.
[AGENT][POSITIVE] Absolutely.
[AGENT][POSITIVE] Absolutely, I understand that. I am.
[AGENT][NEUTRAL] Going to, if you don't mind, I'm gonna get this put in while we're on the phone together just to make sure I have all the information correct.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] I have no problem, no problem with that.
[CUSTOMER][NEGATIVE] And I wouldn't understand anyway what what does workman's comp have to do with me my separate disability, which has nothing to do with workman's comp. I truly don't understand that part.
[AGENT][POSITIVE] You know, I wish I knew the answer to that as well. Um, I'm sure someday I'll learn everything and I'd know all the answers. That's what I like to tell myself.
[CUSTOMER][NEUTRAL] Because this is a totally separate.
[CUSTOMER][NEUTRAL] OK. Yeah, no, because no matter what goes on, this is separate from my work, and, uh, I'm following it, and if the doctor is sending in all this paperwork and proof, what more do they actually need? It, it, it actually says on there when I'm gonna be out, how long I've been out, when I'm going back, approximately, because there's no definite thing. Um, I don't understand what else they might need. So yes, please, let somebody call me because I truly don't understand.
[AGENT][POSITIVE] Absolutely, and I am filling out the inquiry details now. One second.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Yeah, take your time. Like I said, I haven't got paid since the [PII] and uh I don't wanna end up in bankruptcy court because I can't get any money.
[AGENT][POSITIVE] I understand that absolutely.
[CUSTOMER][POSITIVE] And I apologize if I'm getting loud with you.
[AGENT][POSITIVE] No, you're OK. I understand how you feel and I, I wish I like genuinely wish I had the information or the knowledge or experience to help you further. And this is just one of those things where instead of wasting your time or my time like digging through something I'm not sure about, I just want to get you in touch with the right person who can help you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right, right, and I work for the government, which means the odds of them actually trying to fill out disability paperwork is like 0.
[CUSTOMER][NEGATIVE] Which once again, if the doctor sends all the all the required information and I don't know why my, my employer needs to be contacted at all.
[CUSTOMER][NEUTRAL] Unless I'm wrong, you can explain it to me differently. I don't understand.
[AGENT][POSITIVE] I don't know, but I will make sure I include that question in their thing so they can let you know kind of their process behind it absolutely.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEGATIVE] Because I'm not claiming this is I got hurt on the job.
[AGENT][NEUTRAL] Sorry, it's kinda long, but bear with me. I'm almost done.
[CUSTOMER][NEGATIVE] You take, please, take your time. I, I, the, the, the better you, whatever happens, I, like I said, I, I'm not doing anything. I'm just sitting here all day cause I can't do anything. So you take your time.
[AGENT][NEUTRAL] OK, I OK, I'm just checking for typos and then I'm gonna read it back to you and let you know what I have going to them.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so I wrote, um, insured called to inquire about theI claim and I listed your claim number. Claim remarks state that the claim form submitted was incomplete. Please have the employers, sorry, it only gives me this tiny little window to read out of the employers and portion and the attending physician's portion of the enclosed claim form completed and it's entirely in order for additional consideration to be given to your claim.
[AGENT][NEUTRAL] The claim form does not have the employer's portion to be filled out, so the insured is looking for clarification. The insured states that the doctor was the one who faxed the claim on his behalf, and the information from them should have been included. I cannot see the original claim form in Ona to help them with this. Insured would also like to know why his.
[AGENT][NEUTRAL] Employer information is needed if it's not a work comp case and would like clarification about how the employer would have any bearing on the claim. I was unable to provide an answer. Insurer would like to call back with further direction and support so that he can get any information needed to expedite this process. Please reach out to insured at [PII].
[CUSTOMER][NEUTRAL] That definitely works. That sounds great, fantastic. You should have been a writer.
[AGENT][NEUTRAL] No thanks, um, and it looks like the way I'm reading this is whatever information that they did need it looks like because they will send you a letter, right? Any time something comes through it looks like they sent you a letter with because it says um like they attached an enclosed form for you so if you get something in the mail, it might have that information in it.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][MIXED] And I wish I knew exactly what that information was or why we needed it, but they will still reach on out to you.
[CUSTOMER][NEUTRAL] Yes, I would please because I need, like I said, I haven't got paid since the [PII], and I know you guys only cut checks on the [PII] of each month, and I can't afford to go two months without a pay with any any any kind of money. So the, the quicker the better. Yes, please have if they, I really need them you know sometime today what the heck is going on.
[AGENT][POSITIVE] OK, absolutely, I definitely got that put in and processed. I think it helps that it was early in the morning instead of later in the afternoon. Um, they do say 24 hours typically for a call back, but it's so early in the day. I really hope that somebody gets in touch with you, um.
[CUSTOMER][NEUTRAL] Mm
[AGENT][POSITIVE] Like quickly, quicker than that, but I definitely, I have it in queue for you and so I, hopefully someone picks it up real quick and reaches out.
[CUSTOMER][NEUTRAL] Yeah, yeah, I.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] [PII], it's been a pleasure um I'm sorry I didn't have more information, but is there anything else I can do to help you today?
[CUSTOMER][POSITIVE] No, no, that's all you've been very helpful as it is thank you.
[AGENT][POSITIVE] Hey, it's my pleasure. Thank you so much for giving us a call. You have a wonderful day and hopefully we hear back from somebody real quick.
[CUSTOMER][POSITIVE] Thank you. I hope so too. Thank you.
[AGENT][POSITIVE] My pleasure. You take care. You too. Bye-bye.
[CUSTOMER][POSITIVE] Have a great day.
[CUSTOMER][NEUTRAL] Bye bye.