AccountId: 011433970860
ContactId: 18cf9ee8-6860-4c38-8e95-64adbd4f3eff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 945380 ms
Total Talk Time (AGENT): 570751 ms
Total Talk Time (CUSTOMER): 298242 ms
Interruptions: 5
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/18cf9ee8-6860-4c38-8e95-64adbd4f3eff_20250528T17:00_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII] in the customer service department. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] with the care team.
[AGENT][NEUTRAL] Hey.
[CUSTOMER][NEUTRAL] At APL, I have a [PII] on the line. Um, her husband just passed away, um, and she was trying, I see that they have a claim for the accident that someone else filled out for her because I guess it was at work and um they're needing more documentation and I was wondering if you could help her out with that.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] She needs more documentation for a claim.
[CUSTOMER][NEUTRAL] Yes, and then whenever I was looking at our little guru card, it's just to transfer to customer service, but I don't know what all she needs like I see that she needs certain things.
[CUSTOMER][NEUTRAL] But um I was told to transfer to you.
[AGENT][NEUTRAL] What's your policy number?
[CUSTOMER][NEUTRAL] OK. The policy is 25.
[CUSTOMER][NEUTRAL] 81355
[CUSTOMER][NEUTRAL] And she is verified.
[CUSTOMER][NEUTRAL] Because it's showing that the claim.
[CUSTOMER][NEGATIVE] Uh, it was processed, but she never got anything in the mail and I, I guess it was sent to someone else. I wasn't able to look up the documents in Onase.
[AGENT][NEUTRAL] Well, I can't look them up either because we don't, customer service doesn't have access to any claims or what's going on with it. um.
[AGENT][NEUTRAL] And you said she got something.
[CUSTOMER][NEUTRAL] Why is it asking me to send it to you?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You said she got something saying we needed more information?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's probably an EOB denial code.
[AGENT][NEUTRAL] Um, you can transfer, but I'm gonna have to send her to claims.
[AGENT][NEUTRAL] Cause I'm not sure what's going on with it. They'll have to help her further with.
[CUSTOMER][NEUTRAL] OK. And
[CUSTOMER][NEUTRAL] Yeah, I'm sorry, I just saw that our little guru card says to transfer to customer service and they'll review with the caller on documentation. This is, I, I'm new, so I'm, I go based off of whatever the little card tells me to.
[AGENT][NEUTRAL] It's, it's OK. No, it's OK. Um, and I'll have to check into that with [PII] because it should be a little bit more detailed on that one it's regarding claims, but no, no worries. Um, go ahead and send them. What's the callback number?
[CUSTOMER][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what was her name again?
[CUSTOMER][NEUTRAL] Her name was [PII].
[AGENT][POSITIVE] OK. All right. I'm ready for it. Thank you.
[CUSTOMER][POSITIVE] Right, thank you.
[AGENT][NEUTRAL] Good afternoon, Ms. [PII]. This is.
[CUSTOMER][NEUTRAL] Hey, [PII], I
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Go ahead
[AGENT][NEUTRAL] I was just, um, this is [PII] with customer service department. I've got your information pulled up and how can I help you?
[CUSTOMER][NEUTRAL] Yes sir, I'm trying to figure out, find out what I need to do to complete this claim.
[AGENT][NEUTRAL] OK, so you recently submitted in a claim and you're wanting to see what documentation we need, is that correct?
[CUSTOMER][NEUTRAL] OK, so the HR department of his company submitted the claim, um, like they started the claim.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Under my name and I was told that.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I needed to contact y'all that like she gave me y'all the the.
[CUSTOMER][NEUTRAL] Our, my email and stuff, but she, she messaged, she, I just come back with her because I haven't heard anything. So she said um she updated, she did update my phone number before uploading the documents. She said she started the claim online with my information, but the form needed to be signed by me and notarized and sent with a copy of the death certificate, and she just gave me the phone number to call you guys and the policy numbers, so.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I don't, I need to know what y'all need, what I need to do.
[AGENT][NEUTRAL] Specifically regarding the claim, OK, got you, and I am showing that.
[CUSTOMER][NEUTRAL] To process this claim.
[CUSTOMER][NEUTRAL] So like I never got it, I'm
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] Never received an email from you guys or anything on.
[CUSTOMER][NEUTRAL] So that's why I'm reaching out.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so we are showing that something did come in. There was a claim that was reported on [PII]. Um, I do apologize, but I'm limited to what I can see on the details and normally if we need something or something's done, we do send out an explanation of benefits. So I wanted to check with you, Ms. [PII], that the address that we have on file is correct, um, just to make sure because we do correspond by mail, we don't do emails, um.
[AGENT][NEUTRAL] On the policies, so what's your mailing address?
[CUSTOMER][NEUTRAL] OK, it is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you for that and that is what we have on file. So what I'm gonna do, Ms. [PII], and I do apologize for the confusion of everything, um, I'm gonna let you speak to someone in the claims department. They can physically see your information and see what we got and what exactly we need, and they'll also be able to provide the details on how you can submit that in. Now, do you know if Mr. [PII] had an online service center access or not?
[CUSTOMER][NEUTRAL] Uh, what's, uh, what's that?
[AGENT][NEUTRAL] Online service center access do you know if he ever registered or created an account with us online?
[CUSTOMER][NEUTRAL] Well, no, we never, no, I never did create the account with the APL because this was just, they just switched to APL like in January and I don't think I'm on uh access the online account yet.
[AGENT][NEUTRAL] OK, and you.
[CUSTOMER][NEUTRAL] So we never
[AGENT][NEUTRAL] He never did it. OK, I was just gonna suggest if he did that you could probably submit claims and um actually by registering on the online service center you can view what's going on with the claims once it's finalized explanation of benefits is out there. Um, if you wanna set that up, you can, but you'll have to do it under his name and it'll only be visibly available while the policy's active. So um once we get notification from the group.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah,
[AGENT][NEGATIVE] That he's, what's going on, it won't be active anymore, so you won't have access.
[CUSTOMER][NEGATIVE] Yeah, well, because, I mean, like I say, I asked her to send me the information to register to get online and they never sent me anything to do that.
[AGENT][NEUTRAL] OK, I can give you the email address. Mhm.
[CUSTOMER][NEUTRAL] Um, and when you say active, I mean,
[CUSTOMER][NEUTRAL] The accident, the accident happened just over a month ago. So I don't know how many days, you mean in how long he's active in their system or as long as this claim is
[CUSTOMER][NEUTRAL] Active.
[AGENT][NEUTRAL] No, no, as long as it, we, so right now what I'm showing he's active and he's paid to May it looks like we've been notified due to the circumstances that he's no longer with us, um, and the policy is not gonna be enforced after [PII]. We've already have a future lab date in here so you will still have access to everything and benefits will still be feasible within the policy guidelines, um, since.
[AGENT][NEUTRAL] it's gonna be paid to June. Anything that happened before June is still reviewed. So I'm just letting you know that once the group pays May and the policy will no longer be active effective [PII], you'll no longer have access to the online service center.
[AGENT][NEUTRAL] But you can still
[CUSTOMER][NEUTRAL] Which that's only just a couple of days.
[AGENT][NEUTRAL] Well, it just, well, it really depends on when the group sends the premium. Right now we're waiting on premium and they generally have a 60 day window so it could be that we get the premium next month. So, um, I just didn't want you to go out there and then one day it's not available and you don't realize why. Well, if it's no longer active in the system, you won't have access. But what I can do, Ms. [PII].
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So how would I
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] I was, I was just gonna say what I can do is give you the email address so you can set that up. Um, just keep in mind when you're registering, you're gonna have to put all his data in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. So let me know when you're ready, Ms. [PII], and I'm gonna give you the email address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I'm I'm ready.
[AGENT][NEUTRAL] It's gonna be secured SEC.
[AGENT][NEUTRAL] [PII]
[AGENT][POSITIVE] So that's secured.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes ma'am, and once you go out there, um, you're gonna see a message pop up because we are going to be integrating a new system at the end of this month on the [PII], um, it's just a heads up you you will probably have to create a new account again then.
[AGENT][NEUTRAL] But um you can just click OK and once you click OK, the home page is gonna, it's pretty direct. It shows login and new user. You're gonna go under new user and elect I'm an individual with APL insurance.
[AGENT][NEUTRAL] And once you elect that it's gonna ask for the demographics of Mr. [PII], um, and that's just to authenticate who's registering the account and then you'll be able to create a username and password. Um, the user name is usually short and brief it's not gonna take an email right now um our new system will, so again you'll probably have to reset that up next week. I do apologize for that, but.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It'll be a little bit more user friendly the new system starting next week. And once you create the username, like I said, it could be something short and brief, no email, make sure it doesn't have any relevance to the password as far as sequence of letters or numbers or it won't recognize it won't accept it, but pretty much it'll be a security thing. um, your password, your password does have to have one cat one number and a special symbol like the exclamation sign.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it should allow you to access that information and again once we get that claim rolling, you'll be able to go out there and see what's going on with it and once it's finalized and where we're at with it. um, so it'll be helpful too if you can download that there if it's easier for you versus faxing that information in.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so back to your initial question, Ms. [PII], what we're gonna do is let you speak to our claims department so someone can assist you further with the details of what's going on and what we need. Is it OK if I transfer you for further assistance?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] And I will make sure I get someone so you won't have to repeat everything, and I do apologize for having to transfer you again. Is there anything else I can help you with before you go?
[CUSTOMER][POSITIVE] That'll be all. Thank you so much.
[AGENT][POSITIVE] Thank you for calling APL and you have a wonderful day as well, Ms. [PII]. Hold please.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] The accident.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[AGENT][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. 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.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] 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.
[AGENT][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] Can you help her?
[CUSTOMER][NEUTRAL] OK, so you have the insured spouse on the line and the insured.
[AGENT][NEUTRAL] And she is covered 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.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Passed away
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, what's, um, yes, [PII], I can try and help he transferred her to you.
[AGENT][NEUTRAL] She said she was her name slipped out of my head.
[CUSTOMER][NEUTRAL] That's fine. Um, what's, um, the policy number? Let me get that pulled up.
[AGENT][NEUTRAL] 581-355. I'm gonna get with [PII] anyway because she said it was a guru card and confused me.
[CUSTOMER][NEUTRAL] Right. All right.
[CUSTOMER][NEUTRAL] 581-355
[AGENT][NEUTRAL] 258135
[CUSTOMER][NEUTRAL] Oh, I didn't hear any of that too. 258-1355.
[AGENT][NEUTRAL] It's OK.
[AGENT][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.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Alright, hang on one second, [PII], don't release that call since this lady's been transferred around like that.
[AGENT][NEUTRAL] Uh, you
[AGENT][NEUTRAL] Yeah, and I, I, I tried to tell the person, but I didn't want to like not reject the call and I was trying to make sure that's actually what she needed as well.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] Sad.
[CUSTOMER][NEUTRAL] Uh
[AGENT][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.
[CUSTOMER][NEUTRAL] Yes, is she? Yeah.
[CUSTOMER][NEUTRAL] Cause we haven't received that yet. The death certificates one. OK. Uh, yeah, and this is [PII]?
[AGENT][NEUTRAL] And that's what she
[AGENT][NEUTRAL] Yeah.
[AGENT][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.
[CUSTOMER][NEUTRAL] That's on the line.
[CUSTOMER][NEUTRAL] OK, what's the, um, what's [PII]'s callback number, [PII]?
[AGENT][NEUTRAL] [PII]. The one on the phone.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] She's real sweet. All right. Here she goes. Thank you.
[CUSTOMER][POSITIVE] Yeah, I'll be happy to talk to her.
[CUSTOMER][POSITIVE] Yeah, I'll be happy to talk to her. OK, thank you. All right, bye bye.
[AGENT][NEUTRAL] Mhm.