AccountId: 011433970860
ContactId: 278891d2-8d07-41ac-8587-b024b767a344
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1136449 ms
Total Talk Time (AGENT): 372825 ms
Total Talk Time (CUSTOMER): 294592 ms
Interruptions: 7
Overall Sentiment: AGENT=0.6, CUSTOMER=-1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/278891d2-8d07-41ac-8587-b024b767a344_20250317T15:02_UTC.wav
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[AGENT][POSITIVE] Morning, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEGATIVE] Hey, so, it's [PII]. I see you're getting back to back calls like me, but nothing compared to you, nothing compared to you. I, I even said that like me. Um, and I did try to go somewhere else and everybody signed up, apparently.
[AGENT][NEUTRAL] Hey.
[AGENT][NEUTRAL] Yep.
[AGENT][NEUTRAL] No, it's fine. It's good, it's fine. How may I help you?
[CUSTOMER][NEUTRAL] Alright darling I'm sorry let me give you the policy number because anyway, um, it is 259-7994.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I can't pronounce the last name. Think think think bone. He, he says it very well, but I cannot. I have verified all Mr. [PII]'s information, OK.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. Mhm.
[CUSTOMER][NEUTRAL] All right. He just found out he's diabetic. He is in, and he is in the hospital now.
[CUSTOMER][NEUTRAL] About to have a body part amputated.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So he needs to know his benefits.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Benefits. OK, so this is a disability. Let me check and see.
[CUSTOMER][NEUTRAL] Yes, disability. I, I even tried to go to the disability website up there where, you know.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEGATIVE] But they wouldn't even answer, you know, the one that's HI uh what everybody there was cancer DI HI whatever.
[AGENT][NEUTRAL] Oh yeah, they have already merged to care team um and you only get them like if you go to the um claims uh what's that name, um, something cute claim support, um, they're all in the claim support now. um, but yeah, but they only take calls if it's like something like related to a claim being processed, not processed correctly and the member wants to speak to one of them.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh my gosh, OK.
[CUSTOMER][NEUTRAL] OK, apparently I don't see that.
[AGENT][NEUTRAL] But other than that, yeah, other than that, they all come to us.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] I know, I started with you all first, but you all were busy. Y'all were all getting back to back freaking phone calls. Excuse my French.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] I understand, trust me, because yeah, it's like lately and that's what I was telling um [PII], we have been like really like getting a lot of calls, yeah, like it's picking up and we can see it's picking up right now, like before it wasn't like this, so yep, um let me go ahead and pull the certificate for him really quick. Um, so he's needing to know benefits for the amputation.
[CUSTOMER][NEUTRAL] Swamp.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Well, for I, for his disability, I guess what I, you know, what all he's gonna, can you, I don't know how to word things and claims, um.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You know, his disability benefits, let me put it that way.
[AGENT][NEUTRAL] OK, so he needs his disability. OK, let me pull up the disability again. I pulled the.
[CUSTOMER][NEUTRAL] That's the other thing he's asking me about at the moment. Now, you may ask about the HR that he has as well.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Got you. OK, so let me pull the benefits here before you transfer him so I can be right. OK, and the callback number is the same one in the system or is it different?
[CUSTOMER][NEUTRAL] Well, actually it's what he's calling from is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK dokey.
[CUSTOMER][NEUTRAL] But he verified the one in the system as a good number, so you know.
[AGENT][NEUTRAL] OK, no that's fine. We just need that callback number, make sure we can call him back if we get disconnected. Alright, uh huh.
[CUSTOMER][NEUTRAL] When I was in
[CUSTOMER][NEUTRAL] OK, darling, but he is completely verified.
[AGENT][NEUTRAL] OK, so I'm ready for Mr. [PII].
[CUSTOMER][NEUTRAL] And please apologize for him for me keeping on hold so long if you would give him this policy number. I don't think I gave it to him. I know, I didn't.
[AGENT][POSITIVE] OK, alright, sure, no problem. You're welcome. You too. OK, bye bye.
[CUSTOMER][POSITIVE] Right, thank you, dear. Have a good day. So bye honey. the middle, go with.
[AGENT][POSITIVE] Good morning. This is so in the caring department and this is Mr. [PII].
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I do have your information pulled up. And how may I assist you today with your disability?
[CUSTOMER][NEUTRAL] My disability, I just took it out here recently and I was checking on what it covers because.
[CUSTOMER][NEUTRAL] I'm a diabetic and I am getting an unplanned toe getting ready to get cut off.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm like waiting on an MRI right now.
[AGENT][NEUTRAL] All right. Um, so let's see, um, let me check on the benefits and let me see if there, because I know there's an elimination period on it which I can give that information to you, but let me check and see if there's a waiting period, um, because you, you just got this policy on [PII]. Um, let me check and see, one moment.
[AGENT][NEUTRAL] All right
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm still looking for it. All policies are different, so I just need to make sure yours doesn't h[PII]
[AGENT][NEUTRAL] A pre-existing condition or anything like that that may affect. OK, one moment.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so you have a preexisting clause of 12 months, um.
[AGENT][NEUTRAL] Under the policy.
[CUSTOMER][NEUTRAL] What does preexisting clause mean?
[AGENT][NEUTRAL] If it's due to a preexisting sickness or preexisting or something that has happened in the past.
[CUSTOMER][NEUTRAL] Well, it hasn't. I have bone infection. It's called a certain thing and I'm laying in bed now.
[CUSTOMER][NEUTRAL] Waiting on an MRI to decide how the extent of it, so I had no idea until.
[CUSTOMER][NEGATIVE] Yesterday in the hospital that I even had a bone.
[AGENT][NEUTRAL] OK. OK. So yesterday was today the day. OK. OK. So it's, it's fine. Um, what we can do, uh, I cannot guarantee any payments over the phone, so I'm gonna go ahead and give you the benefits of your policy and you can submit the claim and let them look into it and see what we can do. Um, I just needed to let you know that that is one of the costs in the policy, um.
[CUSTOMER][NEUTRAL] Infection.
[AGENT][NEGATIVE] And let me go ahead and give you the benefits. And again, this is not.
[CUSTOMER][NEUTRAL] I haven't
[AGENT][NEUTRAL] Guarantee your payment, just a verification of coverage.
[AGENT][NEUTRAL] There is a monthly benefit disability of $650 not exceeding 60% of your monthly compensation. Um, the maximum disability benefit is um gonna be a period of 90 days.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you have an an elimination period of 7 days. So we don't pay for the 1st 7 days, we start paying on the 8th day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So if you sit, are you gonna sit, I'm laying in a hospital bed, so
[CUSTOMER][NEUTRAL] Could you send that to my address?
[AGENT][NEUTRAL] Mhm, yes, I can send the policy.
[CUSTOMER][NEUTRAL] And then it'll it'll backdate it'll backdate from when I fill it out or call you.
[CUSTOMER][NEUTRAL] With the right now I'm in the hospital and you don't, do you have a pen and paper?
[CUSTOMER][NEUTRAL] Yeah, you, well she ain't gonna wanna wait on the phone.
[AGENT][NEUTRAL] OK. Do you want me to send you the form um through um email if that's easier?
[CUSTOMER][POSITIVE] Yeah, you could do that. Yeah, you could do that.
[AGENT][NEUTRAL] OK. All right. So let me go ahead and send a claim form to your email. And um let me have that email just um make sure I got it correctly in the system.
[CUSTOMER][NEUTRAL] I believe it's [PII].
[AGENT][NEUTRAL] OK, thank you. All right. And you will like your policy certificate information as well?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. All right. Um, do you mind holding for me while I send this email right now while I got you on the line?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] They terminated me to keep me a.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Mr. [PII].
[CUSTOMER][NEUTRAL] I'm sorry? What did you say?
[AGENT][NEUTRAL] Thank you for holding. Um, do you want to check and see if you received the email I sent?
[CUSTOMER][NEUTRAL] Yeah, I'm checking right now.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hang on, I'm holding two phones at one time here.
[AGENT][POSITIVE] It's fine. Take your time.
[CUSTOMER][NEUTRAL] Just go to emails go back to the.
[CUSTOMER][NEUTRAL] Because it might be on my other email.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, yep, I got it.
[AGENT][NEUTRAL] OK. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, I appreciate it. Is is the instructions on here to email it back to file the.
[AGENT][NEUTRAL] Mhm. Yes, um, if you open the claim form, the first page is the instructions, the second page, uh, or the next pages are for you to fill out. But yeah, the first page is the instructions.
[CUSTOMER][NEUTRAL] OK, so it would probably be better if I waited until after.
[CUSTOMER][NEUTRAL] I got my MRI and got the whole surgery done and all that and then file.
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] And it starts from the first day that I went to the emergency room and they
[CUSTOMER][NEUTRAL] They've done the initial I needed to go to a podiatrist since it's all connected.
[AGENT][NEUTRAL] It's gonna be um based of what the doctor and what day the doctor said you become um disabled and you cannot go back to work. So, um, that information is on the form where the doctor has to fill out a part of it and that is a base of the date that he put in that form is when we're gonna start counting that 7 days starting on the [PII] is the payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that would, that would make sense. And then you will, how would
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Just because I don't wanna call and be on hold so long. If, if it does get approved, will you?
[CUSTOMER][NEUTRAL] The the first payment payments after that will be to put into my.
[CUSTOMER][NEUTRAL] Into the same account that you pull out the premiums or do you send it in a check to the house or what?
[AGENT][NEUTRAL] It's gonna be a check um if you don't send us the claim um the the direct deposit form. uh direct deposit form, you can find it in the website. I did send you a link so you can go to the website and click on uh claims and forms. There is gonna be a direct deposit form that you can fill out and send back to us as well.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] OK, well, I'm sure I'll have more questions, but if I do, I'll call back. I appreciate your help.
[AGENT][NEUTRAL] Sure. No problem. Is there anything else I may help you with today, Mr. [PII]?
[CUSTOMER][POSITIVE] No, just have a good night and day.
[AGENT][POSITIVE] You too. Thank you for calling APL.
[AGENT][POSITIVE] I feel better.
[CUSTOMER][NEUTRAL] All right, bye-bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] I don't know how to shut your phone.
[CUSTOMER][NEUTRAL] So did you hear what she said?