AccountId: 011433970860
ContactId: 2aa6cfcc-6a88-47a0-9e4a-76ee41b7fa84
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 962140 ms
Total Talk Time (AGENT): 335924 ms
Total Talk Time (CUSTOMER): 407201 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/2aa6cfcc-6a88-47a0-9e4a-76ee41b7fa84_20250306T18:11_UTC.wav
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[AGENT][NEUTRAL] Thank thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, [PII], my name is [PII], and I was, I need your help.
[AGENT][POSITIVE] OK, I can help you.
[CUSTOMER][NEUTRAL] Alright, I'm trying to file a claim because I just had hip surgery. I had a hip replacement.
[CUSTOMER][NEUTRAL] And I, I just need to, I just need to make sure I do it correctly.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] OK, [PII], I'll help you file a claim. Uh, can you please give me your policy number, sir?
[CUSTOMER][POSITIVE] I'm gonna pass the phone to my wife. She'll give it to you, OK, thank you so much.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Her name is [PII].
[AGENT][NEUTRAL] Ms. [PII], OK.
[CUSTOMER][NEUTRAL] Hi [PII] speaking.
[AGENT][POSITIVE] Hi, Ms. [PII]. Thank you. I appreciate that. I'm sorry to do that.
[CUSTOMER][POSITIVE] Bless you.
[CUSTOMER][NEUTRAL] OK, the that's quite right. The policy number is 02521406.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] OK, so I'm going to need um.
[AGENT][NEUTRAL] [PII], real quick just to verify his date of birth, address, and phone number, uh, that's on the policy.
[CUSTOMER][NEUTRAL] OK, uh, my, my date of birth is [PII].
[CUSTOMER][NEUTRAL] And my address is [PII].
[AGENT][NEUTRAL] Thank you and then can you verify your email address and the phone number that is on the policy, sir?
[CUSTOMER][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] And my phone number is [PII], but my other phone number is [PII].
[AGENT][NEUTRAL] OK, thank you, and then the number that you just provided for me, the [PII], is that a good call back number if we get disconnected?
[CUSTOMER][NEUTRAL] I know I'd rather you call the other number. It's [PII].
[AGENT][POSITIVE] OK, thank you sir. I appreciate you verifying your policy for me and you can go ahead and put Ms. [PII] on the phone now.
[CUSTOMER][POSITIVE] OK, dear, have a good day. Thank you, bye.
[AGENT][POSITIVE] You too, Mr. [PII], thank you.
[CUSTOMER][NEUTRAL] OK, so I have um
[CUSTOMER][NEUTRAL] Pages
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 1 through 7.
[CUSTOMER][NEUTRAL] Have been completed. 6 and 7 are the doctor and he has done all that and signed off on that.
[CUSTOMER][NEUTRAL] Then I'm looking at page 8.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Now, page 8.
[CUSTOMER][NEUTRAL] I'm looking at the premium information.
[CUSTOMER][NEUTRAL] And it's uh a summit section K4.
[AGENT][NEUTRAL] OK, let me pull up the claim form on my end so that I can look at what you're looking at.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a second while it pulls up.
[AGENT][NEUTRAL] And you said you were on page 8, section K. Is that correct?
[CUSTOMER][POSITIVE] That's correct. That's correct.
[AGENT][NEUTRAL] OK for premium information.
[CUSTOMER][NEUTRAL] Yes ma'am, so it says is the premium contributions paid by the insured on a pre-tax or a post tax. I don't know, pre-tax I guess.
[AGENT][NEUTRAL] So through his employer is his policy pre-taxed or is it post-tax for his premium that comes out of his pay?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I suppose that
[CUSTOMER][NEUTRAL] [PII] thinks it's post.
[AGENT][NEUTRAL] OK, after
[AGENT][NEUTRAL] OK, so that's what that's asking, um, you would check that post tax?
[CUSTOMER][NEUTRAL] And then it says what percentage, if any, of disability premiums are paid by your organization that's 0, isn't it? Yeah, they don't, that's 0.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Then, uh, organization name.
[CUSTOMER][NEUTRAL] I is that for rig runner?
[AGENT][NEUTRAL] Yes, that's going to be um.
[AGENT][NEUTRAL] The employer
[CUSTOMER][NEUTRAL] So I'm gonna have to take this over to the office.
[CUSTOMER][NEUTRAL] Why?
[AGENT][NEUTRAL] Right, you can
[CUSTOMER][NEUTRAL] Because it says organization and.
[AGENT][NEUTRAL] You just
[CUSTOMER][NEUTRAL] Yeah, sorry, go ahead, dear.
[AGENT][NEUTRAL] That is just asking for the name of his employer, the contact number, and the fax number.
[CUSTOMER][NEUTRAL] You sure and then
[AGENT][NEUTRAL] And then below that it says printed name of person completing form so you're gonna put the name of the person that's completing the form.
[AGENT][NEUTRAL] The title and the contact number and the author yes you're gonna have to take it to the organization because that is.
[AGENT][NEUTRAL] The employers' part that they have to fill out.
[AGENT][NEUTRAL] That is going to be their signature and the date that they sign.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then it says uh salary continuation well.
[CUSTOMER][NEGATIVE] We don't get paid from them like already we're in the negative.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So can I, can I just put down salary continuation and I would say 0?
[AGENT][NEUTRAL] Yes, that's what, yeah.
[CUSTOMER][NEUTRAL] OK, so then there's one more question.
[CUSTOMER][NEUTRAL] Yeah, let me see where I was.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So I have a Social Security income. I put that in. I have no unemployment, no sick leave, no VA benefits, no retirement, no group disability.
[CUSTOMER][NEUTRAL] Seems to me unless I'm missing it.
[CUSTOMER][NEUTRAL] Do I have to put my current
[CUSTOMER][NEUTRAL] Year to date somewhere, year to date salary.
[CUSTOMER][NEUTRAL] I think I maybe I don't, I don't know. Let me see, double check this.
[AGENT][NEUTRAL] Let me look and see.
[AGENT][NEUTRAL] I'm looking at it myself to see if there's anything on there.
[CUSTOMER][NEUTRAL] I don't think so.
[CUSTOMER][NEUTRAL] So cap salary continuation I know is 0.
[AGENT][NEUTRAL] Now is this, this claim is for [PII], right?
[CUSTOMER][POSITIVE] That's correct, yes.
[AGENT][POSITIVE] OK, good.
[AGENT][NEUTRAL] OK on that first um page of the claim form do you see that cheat sheet that um instructions for the insured?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] No, ma'am, hold on.
[CUSTOMER][NEUTRAL] OK, yes, I'm on page one.
[AGENT][POSITIVE] Yes ma'am, that's a good page because that tells you everything that you need to have for your claim when you file it.
[AGENT][NEUTRAL] And the documents that you need to send in with it.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] So I've done A through H.
[CUSTOMER][NEUTRAL] It's not a continuing, so I don't have to do that part.
[CUSTOMER][POSITIVE] Section I is not required. However, it says it's a good thing to have it done. Let me get the section I, and I think I did it.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, section I is signed and dated, OK.
[CUSTOMER][NEUTRAL] So the first part is done, I is done.
[CUSTOMER][NEUTRAL] Policyholder statement should be completed by an authorized party of the organization enrolled in benefits when filing a claim for initial disability. So that must be that um section that we just talked about.
[AGENT][NEUTRAL] Right. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so that's OK, so I need to go over there and get K done.
[CUSTOMER][NEUTRAL] Attending physician statement, that is done.
[CUSTOMER][NEUTRAL] Workman's compensation or denials, not workman's comp.
[CUSTOMER][NEUTRAL] Award or denial.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's not worried about that. Award or denial letter for identified deductible sources of income.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] What where would I get that from?
[AGENT][NEUTRAL] That's gonna come from the employer so that um that's all the documents that you need to attach with it which you've got the policyholder statement which you're filling out you'll need the attending physician statement completed if he needed to do it on more than one page, you'll need to, you know, of course bring the other page the workman compensation deny letter stating that it's not covered under workman's compensation.
[CUSTOMER][NEUTRAL] Well, I'm not making uh any kind of claim for workman's comp, so it's it it's further into the paperwork it says is this a workman's comp and I said no so that's, that should cover that, correct?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I don't know what
[AGENT][NEUTRAL] And then the
[CUSTOMER][NEUTRAL] Sorry, go ahead.
[AGENT][NEUTRAL] The award or denial letter for I5 deductible source of income, so um.
[AGENT][NEUTRAL] If there's a source of income that can be fight as deductible, then we'll need an award or denial letter stating.
[AGENT][NEUTRAL] Any source of income.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Well, the only source of income we have um is Social Security.
[CUSTOMER][NEUTRAL] So I did put the dollar amount in from Social Security.
[AGENT][POSITIVE] Good.
[CUSTOMER][NEUTRAL] Is, is that sufficient or do you need a letter from Social Security?
[AGENT][NEGATIVE] I think that's going to be behind um.
[AGENT][NEUTRAL] As long as you filled out that portion for Social Security.
[AGENT][POSITIVE] And then if, if you have anything um that you can attach showing that that's your income, that would be awesome too that way you can have.
[AGENT][NEUTRAL] All the documents there to support that you are only making this much money from Social Security.
[CUSTOMER][POSITIVE] OK, I, I can dig those up.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, because it's, when, when it says total source is now, is that just my husband's source of income or do I have to put mine down?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No this is for because he's the policy holder.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I need to change that because I added mine in there too, so just his.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then once I get all this together.
[CUSTOMER][NEUTRAL] What do I do with it, ma'am?
[AGENT][NEUTRAL] OK, you can um fax it if you wanted to fax it in. Let me give you the fax number.
[CUSTOMER][NEUTRAL] I, I, I would rather email it if I could.
[AGENT][NEUTRAL] Now we don't accept them by email only because that's not a secure source um you have so much private information on these forms that we don't do it by email we don't want anybody to get their hands on it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you can mail it in. Let me give you the mailing address.
[CUSTOMER][NEUTRAL] I wrote back to them.
[CUSTOMER][NEUTRAL] OK, let me take the, the fax number and the the mail address please.
[AGENT][NEUTRAL] OK, alright, the fax number is [PII].
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 9423. OK.
[AGENT][NEUTRAL] And then the APL claims address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, [PII]. And the phone number, I'm gonna repeat it for the fax. It's [PII].
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK [PII].
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Well, perfect.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I understand what what the company what we have to get them the company. We have to get them to sign it says on page.
[CUSTOMER][NEUTRAL] 8
[CUSTOMER][NEUTRAL] It's the organization's name, organization's contact, fax number, the person completing the form their title, authorized signature, and the date they do it.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, and all of that is very important as long as uh your portion, the physician's portion and the employer's portion because if you don't do it, then you're gonna get a letter stating that it needs to be completed and it just makes the process a lot longer.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] Gotcha, gotcha. OK. All righty. I think that's everything. I thank you, [PII]. I appreciate all your help.
[AGENT][POSITIVE] You're very welcome. You're so very welcome. I hope you both have a wonderful day.
[CUSTOMER][POSITIVE] Thank you so much now you too thank you so much bye bye.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome, [PII]. Thanks for calling APL you both have a great evening bye bye.
[CUSTOMER][POSITIVE] You too dear. Bye-bye. Bye.
[AGENT][POSITIVE] Bye-bye, sir. I hope you feel better.