AccountId: 011433970860
ContactId: 2ca50f28-da49-4101-9ab5-c2017c97b5bc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 642960 ms
Total Talk Time (AGENT): 348216 ms
Total Talk Time (CUSTOMER): 153816 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/2ca50f28-da49-4101-9ab5-c2017c97b5bc_20250114T13:02_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hey, [PII]. I had a question um
[CUSTOMER][NEUTRAL] About my claim.
[AGENT][NEUTRAL] OK, you are the insured and you have a question regarding a claim for yourself. Is that correct?
[CUSTOMER][NEUTRAL] Yes, whenever they take you to say that it's been completed and there's an amount on your term.
[CUSTOMER][NEUTRAL] Is that the amount, like the one time amount if you're out for 3 bucks or?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well, I can help you with this, but I'll have to pull up your policy first, verify several things with you for security. So first off, who am I speaking with, please?
[CUSTOMER][NEUTRAL] I don't know how
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And Ms. [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, and your policy number?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] 2444
[CUSTOMER][NEUTRAL] 735
[AGENT][POSITIVE] Thank you. One moment, please.
[AGENT][NEUTRAL] OK, and Miss [PII] also any information that is provided today will be a verification of benefits and not a guarantee of payment. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Also your home mailing address, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is the same as the one that you provided for me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And lastly, your email address, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. So give me a moment, Ms. [PII], to get this most recent claim pulled up for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so on this most recently processed claim, I do see that this was processed for a few days in December.
[AGENT][NEUTRAL] There was also
[AGENT][NEUTRAL] And this
[AGENT][NEUTRAL] Shows your premium amount for January.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give me a moment to look at the remarks.
[CUSTOMER][NEUTRAL] So when I'm sorry.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so the remark on your explanation of benefits, Ms. [PII], um, one of them relates to your elimination period on the policy.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] The other remarks states that this payment includes your disability benefit for this month.
[AGENT][NEUTRAL] Please contact our office immediately if you are released from your doctor's care or if you return to work so that your claim does not become overpaid.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] There was a
[CUSTOMER][NEUTRAL] What's eliminating be?
[AGENT][NEUTRAL] You have an elimination period of so many days that you have to be off of work before the disability.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Benefits begin. Your elimination on this policy shows 7 day.
[AGENT][NEUTRAL] And a 3 day.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh, I got you.
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh. And then there is a
[AGENT][NEUTRAL] Give me one moment to go back to the other screen. I'm sorry.
[CUSTOMER][POSITIVE] So when it says completed, it automatically works out my checks for the 2 more months that I'm out, correct?
[CUSTOMER][NEGATIVE] Like I said in a doctor's note, I will not be returning work till uh [PII].
[AGENT][NEUTRAL] Now each month you do have to submit your portion of the claim form. The only time that you would need to submit the doctor section, any additional information would be if it were extended beyond what he has initially placed you off of leave for.
[AGENT][NEUTRAL] Or rather place you on leave for?
[CUSTOMER][NEUTRAL] So when do I put, so every month it's gonna have a 7 day grace period.
[AGENT][NEUTRAL] No, ma'am. That's just for the first time of the payment. That's the first elimination period on a disability.
[CUSTOMER][NEUTRAL] From
[CUSTOMER][NEUTRAL] Why would I have to send in a a new one every month? That's just weird.
[AGENT][NEUTRAL] That's just the rules.
[CUSTOMER][NEUTRAL] That's crazy.
[AGENT][NEUTRAL] Every disability policy has to have an employee, your section each month.
[CUSTOMER][NEUTRAL] Just by section.
[AGENT][NEUTRAL] Yes, ma'am. The only time is if he were to be extending your doctor or he or she, if they were extending your policy.
[AGENT][NEUTRAL] Uh, if they were extending your time off.
[AGENT][NEUTRAL] And yes, they would have to complete a new section as well.
[AGENT][NEUTRAL] Now, I see on here the last remark on your claim.
[AGENT][NEUTRAL] It states please complete the statement of the insured, and this is the part I was just talking about, which is the employee's statement and return to our office. It is not necessary for us to receive the attending physician's statement or the policyholder, which is your employer's statement, which is the organization.
[AGENT][NEUTRAL] Um, or employer, please contact our office immediately if you are released from your doctor's care or if you return to work so that your claim does not become overpaid.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Now with this claim,
[CUSTOMER][NEUTRAL] So when did I, sorry.
[AGENT][NEUTRAL] No, no, ma'am, you're fine. All disability claims are processed around the [PII] of each month, so, and it's a [PII].
[AGENT][NEUTRAL] The window of time for review. So obviously the sooner that you can get it in each month, the better.
[CUSTOMER][NEUTRAL] So do I send one.
[AGENT][NEUTRAL] I'm so sorry, your voice.
[CUSTOMER][NEUTRAL] And I just got there.
[CUSTOMER][NEUTRAL] If I just got this one I need to send another one in for February so I need to send it in like [PII].
[AGENT][NEUTRAL] Get them because this shows your benefit was paid for January so I mean, you know, earlier, the earlier the better that you can send it and.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Like I could do it after I receive this first check or or I do it [PII].
[AGENT][NEUTRAL] Once again there is some processing.
[AGENT][NEUTRAL] Less
[AGENT][NEUTRAL] Well, the claim was actually processed uh last night, it looks like.
[AGENT][NEUTRAL] It shows process 113 so that goes in through our over.
[AGENT][NEUTRAL] For night.
[AGENT][NEUTRAL] So you and I see that you're set up for direct deposit as well.
[CUSTOMER][NEUTRAL] OK, so I, I should be able to do it.
[AGENT][NEUTRAL] Ma'am.
[CUSTOMER][NEUTRAL] Yeah, so I can do it now or I wait till I get my first payment.
[AGENT][NEUTRAL] I would wait until close to the, you know, the [PII] of the month because it's for each month that you have to submit it, that you're out.
[CUSTOMER][NEUTRAL] OK, OK, I got it.
[AGENT][NEUTRAL] Mhm, yes ma'am. And then in your portal too, you will, if you can't already see it, Ms. [PII], you will be able to see the comments on the explanation of benefits they're on page 2.
[CUSTOMER][NEUTRAL] That.
[AGENT][NEUTRAL] And those EOBs for APL are in your portal as well.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I can't never see anything like this portal is like outdated.
[CUSTOMER][NEGATIVE] Like I can't even get to.
[AGENT][NEUTRAL] If you're trying to do it from your phone, that is why you have to use to do all of that from a computer.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Mobile functionality is very limited in the portal.
[CUSTOMER][NEGATIVE] Yeah, I'm on bedridden right now, so I can't get to that.
[AGENT][NEUTRAL] Oh, I'm sorry. Oh, I'm sorry, but that, that's part of the reason. Now, you should also be receiving an explanation of benefits and starting in the mail. But again, because this claim was just processed last night, you know, it's gonna be a week or so before you'll receive that in the mail.
[CUSTOMER][NEUTRAL] Now
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][POSITIVE] But if you have any other questions, yes, ma'am. If you have any other questions that you think of, you can call us back and we'll be more than happy to, to help you.
[CUSTOMER][NEUTRAL] I understand it more now.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] Well, you are certainly very welcome and is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][POSITIVE] OK. Well then, thank you again for calling Ms. [PII] and I hope you get to feeling better really soon.
[CUSTOMER][POSITIVE] Thank you so much. Bye-bye.
[AGENT][POSITIVE] Yes, ma'am. You're welcome