AccountId: 011433970860
ContactId: 17253e37-debe-445a-a3e4-40db79141326
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 375760 ms
Total Talk Time (AGENT): 191755 ms
Total Talk Time (CUSTOMER): 172539 ms
Interruptions: 4
Overall Sentiment: AGENT=0.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/17253e37-debe-445a-a3e4-40db79141326_20250304T23:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes ma'am. My name is [PII] and um I reached out to my HR person, um, with the school district I work with, and it was to my understanding that I um was needing to proceed with filing an accident claim with you guys. um, I, there was confusion of who was covering what and so she informed me that that would be you guys and I just wanna know if I could have some assistance with that.
[AGENT][POSITIVE] Oh, absolutely you can have assistance with filing a claim. I can help you with that. What is your, um, policy number?
[CUSTOMER][NEUTRAL] That I do not know the top of my head. I'm so sorry, can you look it up a different way? Yes, I'm sorry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am. I can look it up with your social.
[CUSTOMER][NEUTRAL] OK, it's uh [PII].
[AGENT][NEUTRAL] OK, let me pull in your policy for us real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, Ms. [PII], I'll need for you to verify your policy for me. Can you please give me your date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and your email address, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] It looks like I have your work email.
[CUSTOMER][NEUTRAL] Oh, it's [PII].
[AGENT][NEUTRAL] OK, yes ma'am. And then one last verification, can you please give me your phone number?
[CUSTOMER][NEUTRAL] It's uh area code [PII].
[AGENT][NEUTRAL] Thank you ma'am and then if our call is disconnected, is this a good number to call you back on?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, thank you Ms. [PII]. OK, so you need to file a claim. What I'm going to do is refer you to our website.
[AGENT][NEUTRAL] It is, let me give you that address. It's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] When you get to the website and you've got it pulled up in the top right hand corner is a space that says claims and forms.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You're gonna click on the claims and forms.
[AGENT][NEUTRAL] And then you're going.
[CUSTOMER][NEUTRAL] OK. I, I.
[CUSTOMER][NEUTRAL] I'm sorry. Yes, I have filed a claim before so I kind of know how to navigate through the portal. Um, I guess I just needed to verify if the benefits to file for accidents were active because there was like, I had called a few weeks back and I was told from a different representative that.
[AGENT][NEUTRAL] OK, OK, yes ma'am.
[CUSTOMER][NEGATIVE] All of the policy, everybody on the policy has lapsed. There was no coverage. And so then I called HR and I kind of started freaking out cause I'm like, well, who am I paying accident coverage to? And so then they verified that it was you guys for accident and it was a different vendor for hospital indemnity. And so I just need to verify that for accident, my policy is active.
[AGENT][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, ma'am. Um, looking at your policy.
[AGENT][NEUTRAL] And that is you won't be able to use the portal because the policy is no longer active effective [PII].
[AGENT][NEUTRAL] So your coverage is from [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK then OK then OK well let me see.
[CUSTOMER][NEUTRAL] OK, so then I guess I'm just confused because my HR people told me that y'all are covering, y'all cover for accident in Hartford, which is a different vendor is covering for our um
[AGENT][POSITIVE] I love that.
[CUSTOMER][NEGATIVE] For our um hospital indemnity, so you guys are saying we're not, I'm not covered with them anymore. I'm not covered with you guys for accident?
[AGENT][NEUTRAL] No, ma'am. Um,
[AGENT][NEUTRAL] The group lapsed the policy [PII] and you don't have a hospital indemnity policy with us. I just checked that to see, um, now you can file claims still from.
[AGENT][NEUTRAL] [PII], as long as the policy was active during that time of the date of service, you can still file a claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, that is gonna be the case because I did have my son who ended up having to have surgery for um another an accident he was in, but I guess I'll call HR and see where, who is who is the vendor from [PII] moving forward because I'm not, I mean, I was told a whole different um situation, so I'm just trying to figure out what's going on.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] I understand, yes ma'am, I understand and just know because the policy is lapsed, you won't be able to use the online service center the portal that you were used to using, you'll have to do your claim um and submit it by mail or fax.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So that claim form that is um you can get your claim form on that website that I was given to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh, uh-huh.
[AGENT][NEUTRAL] At [PII] and once you click on claims and forms, it's going to be the first form that comes up and it says accident claim form and so you'll need to have that claim form.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK, I will, uh, reach out to HR and see who I am paying my accident coverage to then because they told me it was you guys.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am, I unders.
[AGENT][POSITIVE] Yes. Now, look, do you have the claims filing, the mailing address or the fax number to send your claims? I can give those to you. OK, good, good, good. Awesome. OK, I want to make sure you had everything you needed.
[CUSTOMER][POSITIVE] I do. Yes, I do have them. Yes, I do. OK. All [PII] then.
[AGENT][POSITIVE] OK. Well, you have a good night. Bye-bye. Thanks for calling APL. Bye-bye.
[CUSTOMER][POSITIVE] Yes, OK. Thank you. Uh-huh, bye-bye.
[CUSTOMER][POSITIVE] You too thank you bye bye. Yes, uh huh bye bye.