AccountId: 011433970860
ContactId: 311b5ebd-cf71-41da-a6fd-26f5064e3e51
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1331910 ms
Total Talk Time (AGENT): 466751 ms
Total Talk Time (CUSTOMER): 452157 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/311b5ebd-cf71-41da-a6fd-26f5064e3e51_20250509T14:05_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] I see, I was calling. Sorry I didn't cut my fan off.
[CUSTOMER][NEUTRAL] I was calling with a few questions, um.
[CUSTOMER][NEUTRAL] And trying to file a claim. Um, so I was kinda trying to read, I do have um internet access to like my account and whatnot. So I was kinda trying to read over a couple of things, but I did have a few questions. um, and one of them was like the time period to file a claim, and I'm asking that because
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I was under the exception that my school, I work for a school. I was under the assumption that my school filed the claims for us, so I was submitting stuff to them thinking that I was waiting and then she informed me like a week ago that I needed to do it.
[CUSTOMER][NEUTRAL] And so I have claims from like a long time ago um that were never filed.
[AGENT][NEUTRAL] OK. So you're the insured and you're wanting to find out about a filing limit for filing your claims with APL is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am, I can help you with that. But first I'll need to pull up your policy information and verify some things with you for security. So first off, who am I speaking with, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, Ms. [PII], what is a good call back number for you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, and your policy number, please?
[CUSTOMER][NEUTRAL] Um, it's a couple of different policy numbers because I'm calling about two different things, but the first one I'll do is the hospital, um, which is 222.
[CUSTOMER][NEUTRAL] 4412.
[AGENT][NEUTRAL] OK, thank you. Give me a moment please to get that policy information pulled up.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, [PII], any information also that I provide for you 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] Yes, ma'am.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. And your home mailing address, please?
[CUSTOMER][NEUTRAL] Mailing address is [PII].
[AGENT][NEUTRAL] OK, thank you. The phone number that we have on file for you is the same as the one you gave me, so this, um, that is the best number we should have rather, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, and lastly your email address please.
[CUSTOMER][NEUTRAL] My email address is going to be [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so this is your hospital indemnity policy. And with APL Ms uh [PII], there is not a timely filing limit.
[AGENT][NEUTRAL] So you can file your claims.
[AGENT][NEUTRAL] Your policy went into effect [PII]. So, any claims that you have from that date forward, yes, ma'am, you can still file those with us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you, can you see if anything was filed because I didn't receive payment, but I don't know if they, can you see if anything was filed? I gave a live birth in uh [PII].
[AGENT][NEUTRAL] The only claim, yes, we, let's see.
[AGENT][NEUTRAL] The only claim that's on file for you was for a date of service back in [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Oh funny.
[AGENT][NEUTRAL] [PII] and [PII].
[AGENT][NEUTRAL] And that was paid directly to.
[CUSTOMER][NEUTRAL] [PII] or [PII]?
[AGENT][NEUTRAL] [PII]. Your policy wasn't active in [PII] with APL.
[AGENT][NEUTRAL] You filed a claim with us um for data service [PII] and [PII]. It looks like you were in the hospital then.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's the only claim that we have on file for you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, that was in [PII]. Uh, OK, I thought it was for [PII] and I don't.
[AGENT][NEUTRAL] And you should be, uh, you should be able to see that in your portal too, Ms. [PII] up under your.
[CUSTOMER][NEUTRAL] Yeah, it's not, it's not popping up, yeah.
[AGENT][NEUTRAL] And well actually let's see when because it only will show for 24 months.
[AGENT][NEUTRAL] Well, really, uh, so yes. So this claim was processed back in [PII], so that's gonna be why you can't see it.
[CUSTOMER][NEUTRAL] And when was the claim processed?
[AGENT][NEUTRAL] Ma'am.
[CUSTOMER][NEUTRAL] Yeah, I'm just trying to see cause I was going through. I said that it was processed in like [PII].
[AGENT][NEUTRAL] Yes, but for your date, the date, the date of service was [PII]. We didn't receive that claim until [PII], the end of [PII].
[CUSTOMER][NEUTRAL] And was that along with another claim, I think?
[AGENT][NEUTRAL] No, ma'am. That's the only claim. We only have the one on your hospital indemnity plan.
[CUSTOMER][NEUTRAL] OK, and that's for on the hospital. OK, OK, right, right, that's, that's, that's correct.
[AGENT][NEUTRAL] Correct. Uh-huh. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. And I, I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then can we
[CUSTOMER][NEUTRAL] OK, I just wanted to make sure because I, so that one I did through the school.
[CUSTOMER][NEUTRAL] And she helped me submit to you guys. I do remember that, um, but I just didn't know if.
[CUSTOMER][NEUTRAL] That one was paid out because, OK, so um in my account on my account, the only thing that I see paid out from APL it it says 2800 was that from that claim?
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh, it was.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Can we take a look at the group uh accident now? You know that's a different policy number.
[AGENT][NEUTRAL] Yes, ma'am, give me just one moment to do you need any other information on this policy though before I finish my note on it?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I kind of can look through it um because I did, I know that's for
[CUSTOMER][NEGATIVE] [PII] and [PII], but I stayed in the hospital for two days after that. Um, I don't know if that's included in that claim. And then also I had to go back to the hospital because they did my epidural wrong and I had to go back and get an epidural plug uh afterwards and I probably should have filed for that too.
[AGENT][NEUTRAL] So this is from the [PII], it looks like to the [PII].
[AGENT][NEUTRAL] I mean, there was an
[CUSTOMER][POSITIVE] Oh well, yeah, that's right.
[AGENT][NEUTRAL] So yes, that's all under this one claim that's currently on file for you.
[CUSTOMER][NEUTRAL] I'm trying to look up.
[CUSTOMER][NEUTRAL] OK, it should all be on there then because I didn't file it until.
[AGENT][NEUTRAL] So now this is, I'm still looking at your hospital indemnity policy.
[CUSTOMER][NEUTRAL] February.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So did you need any other information related to that one claim?
[CUSTOMER][NEUTRAL] I guess I would assume because I filed it in February, everything was included with it. I just wanted to make sure.
[CUSTOMER][NEUTRAL] So that claim should be good.
[AGENT][NEUTRAL] OK. So do you want to move on to your other call?
[CUSTOMER][NEUTRAL] And I don't have any other, um, yeah, I don't have any other hospital.
[AGENT][NEUTRAL] Oh, I'm so
[CUSTOMER][NEUTRAL] Hospital stays since then.
[AGENT][NEUTRAL] OK, all right. So give me just a moment. Uh-huh.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Well, yeah.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] Oh, that's it? OK. All right, one moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so, um, your accident policy, we do not have any claims on file for you.
[CUSTOMER][NEUTRAL] Well, I did a claim, I did a claim for
[CUSTOMER][NEUTRAL] And I thought it got paid. I see.
[CUSTOMER][NEUTRAL] I did a claim for my husband.
[CUSTOMER][NEUTRAL] Around the same time?
[AGENT][NEUTRAL] Oh, I'm looking at you. OK, there's one claim on file.
[AGENT][NEUTRAL] From that we received and processed in [PII].
[AGENT][NEUTRAL] Go ahead and verify your husband's name and date of birth for me.
[CUSTOMER][NEUTRAL] His name is [PII]. His date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] So that was around the same time as
[CUSTOMER][NEUTRAL] That I filed the other one?
[AGENT][POSITIVE] Yes, that is correct.
[CUSTOMER][NEUTRAL] And lastly, do you know if they were paid out together?
[AGENT][NEUTRAL] Well, it would have been paid on separate payments. It was separate checks, but yes, ma'am, this one was paid to you and the benefit amount was $300 for him.
[AGENT][NEUTRAL] And that was for dates of service for him for [PII].
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] Like there was a [PII], and a [PII] and a [PII] on that claim.
[CUSTOMER][NEUTRAL] For the details going to the hospital and stuff.
[CUSTOMER][NEUTRAL] Alright, so
[CUSTOMER][NEUTRAL] Two more questions, I promise.
[AGENT][NEUTRAL] OK, you're fine.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I understand that and I'm reading the policy. I see that only in myself.
[CUSTOMER][NEUTRAL] Um, my husband and our son is listed. I had a daughter in [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Um, and apparently my, I, I read on the policy that you have like 60 days, like after the live birth to like add, add the kid. Again, I thought my job added her, but they did not. Um, so how do I go about making sure, because I mean, I pay for family anyway, so I know she would just be included. I just need to make sure I add her for future references.
[AGENT][NEUTRAL] OK, what is your daughter's name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Last name [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And what, what is her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so regarding that, you will have to contact your HR department, Ms. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Because we can't just add.
[AGENT][NEUTRAL] A child.
[AGENT][NEUTRAL] So they, you will have to get with them about when, when you can add her.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then the last thing is
[CUSTOMER][POSITIVE] Um, I have two accidents to report, uh, 2 files a claim from this year. Um, we've been pretty, everything has been pretty copacetic for us for like the last year, so [PII] was a good year for us. Um.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] But then this year,
[CUSTOMER][NEUTRAL] In February.
[CUSTOMER][NEUTRAL] Um, I was kind of just walking down the street and I kinda lost my footing.
[CUSTOMER][NEGATIVE] Um, and my ankle got messed up.
[CUSTOMER][NEUTRAL] I'm walking up the stairs at work actually. And I kinda lost my footing and my ankle got messed up. Um, I didn't go to the emergency room, but I did go to an urgent care.
[CUSTOMER][NEUTRAL] And I had to get a walking boot for a little while. Um, so I need to put a claim in for that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. And do you have the accident claim form? Because the accident claim form, uh, Ms. [PII] Hampton does have all of the instructions on page one for completing the form and also what additional documentation you will need to provide to us.
[CUSTOMER][NEUTRAL] And I can get that from the website, right?
[AGENT][NEUTRAL] You can. Mhm. If you go to [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] That is our main web page and you can actually you can get your claim form there you can also get to your online service center log in page from there but when that page pulls up you'll see at the top where it says claims and forms.
[AGENT][NEUTRAL] And if you will just click there and scroll down.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] It will start listing out different types of claim forms and the accident claim form I believe is the first one that's listed and out to the right there's a download form button and you just click there and it'll open up the claim form for you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then do you have I know you're signed up on the portal, but have you ever received the user guide that gives you some additional information and like how to upload documents and the different things you can do within the portal?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Have you ever been emailed that?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] OK, so let me just pull that up and I'll go ahead and send that to you, um, one second.
[AGENT][NEUTRAL] OK, and that email that you're gonna get will come from [PII] at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I did put APL online service center portal in your subject line so that that's easy for you to recognize.
[AGENT][NEUTRAL] I don't think it will go to your junk or spam folder, but you, if you haven't received that within just a few minutes, you might want to check one of those too.
[CUSTOMER][NEUTRAL] Pulling it up now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you receive it?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yep, got it.
[AGENT][POSITIVE] OK, good deal then.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, is there anything else, Miss [PII] I could help you with today?
[CUSTOMER][NEUTRAL] So the only other thing was, well, I guess I have to file separate for myself and for my husband. So, uh just uh one more question. For, for my husband and I were involved in a car accident on [PII] of this year. Um,
[AGENT][POSITIVE] Correct. That's.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And as I was reading through like the claim documents, it's a lot of stuff that's involved in it. Do I have to like list out everything that's involved or can I, or when I send the
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] So I guess, OK, let me see. All right. For example, we got into an accident.
[CUSTOMER][NEUTRAL] Um, and the next day, you know, when we got into the accident, they totaled out our car. The ambulance came, but I did not leave with them. I went home. And then the next morning, my husband and I went to the doctor's office. So I know that going to the doctor's office is uh an accident claim because we had an accident.
[CUSTOMER][NEUTRAL] When we got to the doctor's office, of course, they had to do X-rays. Do I have to do like a separate claim for going to the doctor's office and then getting the X-ray and then physical therapy? Like do I have to do separate claims for all of that?
[AGENT][NEUTRAL] No, it would be for this one accident and then you would just use that claim form. One, of course, it will be one claim for you and one claim for your husband. So you'll have to provide that information for each of you.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And then just use that page one that has all of the instructions on there as your checklist for what you will need to provide.
[AGENT][NEUTRAL] Based on, you know, your accident.
[CUSTOMER][NEUTRAL] I say it.
[CUSTOMER][POSITIVE] Perfect. Thank you so much.
[AGENT][POSITIVE] Well, absolutely. You're very welcome.
[CUSTOMER][NEUTRAL] I'm going to use the user bag.
[AGENT][NEUTRAL] Ma'am.
[CUSTOMER][NEUTRAL] I said I'm gonna go ahead and use the user guide so I can uh.
[AGENT][NEUTRAL] Uh, yeah, because that just gives you some information on how to upload and like the types of files, size of files, and just gives you some general information on how to locate your policy information. But again, you're already signed up, so you know, the part of that's not gonna be applicable to you at this point, but.
[CUSTOMER][NEUTRAL] And get this done.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so, so much.
[AGENT][POSITIVE] Oh well you're certainly very welcome Miss yes ma'am, you are very welcome. So again, is there anything else that I could help you with at the moment?
[CUSTOMER][NEUTRAL] For all of your help today.
[CUSTOMER][NEUTRAL] I think that's it.
[AGENT][POSITIVE] OK. Well, thank you so much for calling APL and I hope that you have a very wonderful weekend.
[CUSTOMER][POSITIVE] Thank you. You do the same.
[AGENT][POSITIVE] Thank you very much.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.