AccountId: 011433970860
ContactId: 38fccaf4-89a6-4ccd-bcd5-dc2252725223
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1301050 ms
Total Talk Time (AGENT): 351102 ms
Total Talk Time (CUSTOMER): 445733 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=-1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/38fccaf4-89a6-4ccd-bcd5-dc2252725223_20250512T19:32_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, how you doing? My name is [PII]. I'm calling in reference, uh.
[CUSTOMER][NEUTRAL] I have a policy with you guys and uh I went out of work. I had surgery on the [PII]. My last day of work was [PII] and I got a form here, but I'm really not familiar with this form. How do they still continue to take money out of my check for the policy since I'm out injured? I had surgery?
[AGENT][NEUTRAL] Uh, what is your policy number?
[CUSTOMER][NEUTRAL] I don't know that it's through the town of Pearl River.
[AGENT][NEUTRAL] Let me one moment. What's your social?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] A lot of paperwork to do here.
[CUSTOMER][NEGATIVE] Confusing.
[AGENT][NEUTRAL] OK, and verify your date of birth, mailing address and email address for me please.
[CUSTOMER][NEUTRAL] It's [PII]. I live at [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And my email is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And Mr. [PII], do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's for a short-term disability policy and you're, uh, and I apologize, you're wanting to know what again?
[CUSTOMER][NEUTRAL] Well, I'm, I'm trying to figure out how to start this file and also I noticed they still taking a little money out of my check for the policy even though I'm out injured should they be doing that?
[AGENT][NEUTRAL] You're talking about your employer?
[CUSTOMER][POSITIVE] No worries, I'm out on disability now and.
[CUSTOMER][NEUTRAL] Uh, yeah, I guess somebody's taking the money for my for the insurance because uh.
[CUSTOMER][NEUTRAL] It's coming out of my check.
[CUSTOMER][NEGATIVE] I don't know if it should come out since I'm out on disability, uh, after this month I don't get it. I don't get it.
[AGENT][NEUTRAL] Uh, that would be.
[AGENT][NEUTRAL] OK, um, as far as being any deduction, you have to contact your employer.
[CUSTOMER][NEUTRAL] But I don't wanna lose
[CUSTOMER][NEUTRAL] Huh?
[CUSTOMER][NEGATIVE] OK, but if they stop taking out the deduction, then I'll lose my coverage, right?
[AGENT][NEUTRAL] Uh, that I'm not sure. You just, uh, could still have coverage depending on when you have your return to work date, um.
[AGENT][NEUTRAL] And it sounds like you have one of our claim forms.
[CUSTOMER][NEGATIVE] I don't have a return
[CUSTOMER][NEUTRAL] I have one, but I'm very confused with it, yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, well, to file a claim, you need to fill out your portion. Your physician needs to fill out their portion and your um employer fill out their portion of the claim form.
[CUSTOMER][NEUTRAL] OK, what numbers do I need to fill out the document and work so I can try to get that done, you know?
[AGENT][NEUTRAL] I'm sorry, say that one more time.
[CUSTOMER][NEGATIVE] I, I know this is 1 to 8 pages. What pages does they have the employee have to fill out and what pages do I have to bring to the doctor and what pages am I responsible for?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, um, on the claim form we should have a first page which is just, um, instructions to the insured. You will complete portions A through H.
[AGENT][NEUTRAL] Your physician will fill out the portion that states, um, give me a moment, attending physician statement?
[AGENT][NEUTRAL] And your employer fills out the policyholder statement, which is the last page of the claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Last page?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It should say policy movement.
[CUSTOMER][NEUTRAL] OK, who do I know? Who do I need to speak to to see?
[CUSTOMER][NEUTRAL] OK, policy, let's see, hold on, I got these pages.
[CUSTOMER][NEUTRAL] That's that's page 8, right? Policy statement policy holder?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] So they need to fill it out, right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, and the doctor needs up with page.
[AGENT][NEUTRAL] 6 and 7.
[CUSTOMER][NEUTRAL] 6 and 7.
[AGENT][NEUTRAL] The title of the page 6 was the instructions to physicians, and it has attending physician statement at the top.
[CUSTOMER][NEUTRAL] OK. Oh, page 6 of 8, so 6 and 8 and uh 78, the doctor shows out?
[CUSTOMER][NEUTRAL] No, I'm sorry.
[CUSTOMER][NEUTRAL] Oh boy, I got confused. OK, the 7 and 8, doctor shows out, right?
[AGENT][NEUTRAL] No, sir. Pages 6 through 7, the uh doctor will fill out. Page 8 is your employer's portion of the form.
[CUSTOMER][NEUTRAL] OK, the rest is mine?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, 8 is work.
[CUSTOMER][NEUTRAL] 6 and 7 is a doctor.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Now I see they answer a lot of personal questions on here. I thought when I bought this policy if I got hurt in short term disability, they want to know if I get Social Security if I get this and get that. Is that necessary?
[AGENT][NEUTRAL] Uh, yes, sir. If you're receiving any other additional income.
[CUSTOMER][NEGATIVE] Well that should have nothing to do with the separate policy I purchased, right?
[AGENT][NEUTRAL] Uh, that I'm not sure. I can let you speak with an examiner and they can verify, uh, the reasons for needing additional income information.
[CUSTOMER][NEGATIVE] I was told I was hurt.
[CUSTOMER][NEGATIVE] Alright, because when I, when I bought this policy, they told me it was a short term disability and so much a week for this amount of money and if you have to go out in the short term, that's what you collect. Nobody told me nothing about because I get a pension from from another department and I get Social Security that I had to claim that. I, I thought I, I was starting to get a certain amount of money, you see what I'm saying? That's what I need to clarify.
[AGENT][NEUTRAL] OK, well, like I said, I can transfer you to a claims representative and they can verify that to you.
[CUSTOMER][POSITIVE] I appreciate that very much, ma'am.
[AGENT][NEUTRAL] OK, hold on one moment, please.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Alright, you're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] G.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] And thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey, Ms. [PII], it's [PII]. How are you doing?
[CUSTOMER][POSITIVE] Hey, good. How about you?
[AGENT][NEUTRAL] I am so sleepy. I didn't get to take a nap at lunch. I stayed up the whole time. Yeah. I've been trying to take a nap during lunch here recently, but I couldn't, I didn't today because [PII] told me I'm starving him by not giving him snacks for school. So I'll go get him some snacks.
[CUSTOMER][NEGATIVE] Oh no.
[AGENT][NEUTRAL] A little turd.
[CUSTOMER][NEUTRAL] Don't starve him.
[AGENT][POSITIVE] I know, so I bought him some Nutrigrain bars. I'm sure he'll love that, so.
[AGENT][NEGATIVE] Yeah like he's starving to death without having snacks at school and they're almost done. They got 1 more week and it'll be end of the school year, 2 more weeks, I'm sorry.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] When you say you still need his snacks.
[AGENT][NEGATIVE] Yeah, he needs his snacks and they're not gonna do anything all week. I don't know.
[AGENT][NEUTRAL] I don't know what he's need a snack for.
[AGENT][NEUTRAL] You don't need that many snacks. Anyway, um, I had an insured on the phone and I explained to him what we need in order for him to file a claim. He has the claim form and he has a question about the section where it's asking for if he's receiving any additional income and he asked if he has to fill that out and I told him he did and he wants to know why because when he bought the policy, they didn't say that they would be taking out any money if he's receiving any other um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Benefits
[CUSTOMER][NEUTRAL] What coverage does, does he have? What's the policy number?
[AGENT][NEUTRAL] Uh, 255-2846. It's a short-term disability.
[AGENT][NEUTRAL] I'm trying to look on the policy, see.
[AGENT][NEUTRAL] I can give him a concrete answer.
[CUSTOMER][NEUTRAL] Um, I think there should be some type of verbiage. Let me see.
[AGENT][NEUTRAL] The of.
[AGENT][NEUTRAL] I be.
[AGENT][NEUTRAL] Then he asked if um they're gonna be taking out premium or deducting premium since he's on disability so I can do that's something you need to contact your employer about.
[AGENT][NEUTRAL] But I'm assuming so. I mean, you gotta have a policy just because you don't able to work doesn't mean you can't pay the dis I mean you pay the premium.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] People crack me up, I swear.
[CUSTOMER][NEUTRAL] Yeah, and the policy it has um.
[CUSTOMER][NEUTRAL] Where in the definitions it says.
[CUSTOMER][NEUTRAL] Disability payment means your disability benefit minus any deductible, deductible sources of income as outlined in section 3, so then when you go to section 3.
[CUSTOMER][NEUTRAL] See what it has in section 3.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 4 section 3.
[AGENT][NEUTRAL] Is your terminal illness.
[AGENT][NEUTRAL] The payments we provide.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh let's see, I'm trying to see where it has about.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm this has paid for less than that will be reduced.
[CUSTOMER][NEUTRAL] Though there was something that said something about other income. Let me keep looking.
[AGENT][NEUTRAL] I do not see.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, the stability earnings more than 80% of your monthly compensation.
[CUSTOMER][NEUTRAL] What is his monthly benefit? Let me see.
[AGENT][NEGATIVE] I'm so sick of all this rain.
[AGENT][NEUTRAL] I don't know about y'all, but it rained all day Saturday and started off Friday. Yeah. And then it was all nice, sunny, and pretty yesterday. And then it started back raining again today. It's like, come on, man, aren't you tired of it? The ground is just soaked.
[CUSTOMER][NEUTRAL] Did it?
[CUSTOMER][NEUTRAL] Oh, yeah, we had that moment when it was all of that rain.
[CUSTOMER][NEUTRAL] Let me pull up the disability form cause so I can see what the verbiage is on the form because that's the only way we're gonna determine if he follows suit with the requirements of his disability benefit.
[CUSTOMER][NEUTRAL] Because he can't exceed that amount, 80% of his um disability.
[CUSTOMER][NEUTRAL] C. 444.
[AGENT][NEUTRAL] And where you see that under?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'm still looking where it says exceed 80%.
[CUSTOMER][NEUTRAL] Um, that's on section.
[CUSTOMER][NEUTRAL] That's on page.
[AGENT][NEUTRAL] Available through.
[AGENT][NEUTRAL] Will be 10, not, not 60%.
[CUSTOMER][NEUTRAL] Oh, I was looking at the termination port where in 80, but let me scroll back to where.
[CUSTOMER][NEUTRAL] Yeah, that's on the um
[AGENT][NEUTRAL] And let's
[CUSTOMER][NEUTRAL] It says that the date of disability earnings are more than 80% of your monthly compensation.
[CUSTOMER][NEUTRAL] Disability earnings means the gross monthly earnings you receive while disabled and working.
[CUSTOMER][NEUTRAL] But that's what I see here. Mm.
[CUSTOMER][NEUTRAL] But yeah, and the, the first section of the scheduled benefits, it says that his, his monthly disability benefit cannot exceed 60% of his monthly compensation. So yes, in order to determine that, we need to know if he's receiving any other income to determine if he, he meets the requirements for his disability benefit.
[CUSTOMER][NEUTRAL] Yeah, because right there where where is your disability benefit is and it gives that $1500 amount and it cannot exceed that 60% of your monthly compensation.
[CUSTOMER][NEUTRAL] If applicable, your disability benefit will be reduced by deductible sources of of income.
[CUSTOMER][NEUTRAL] So that's where that section will come and play with him filling it out if he has any other income in order for them to determine that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Awesome.
[AGENT][NEUTRAL] OK, I'll uh let him know if you have any other questions. I probably call back we'll see.
[CUSTOMER][NEUTRAL] OK. Yeah, I would just tell him that and he also can refer to his policy on the schedule of benefits.
[CUSTOMER][NEUTRAL] That outlines that
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] OK. Thank you, ma'am.
[CUSTOMER][POSITIVE] Yeah, you're welcome.
[AGENT][POSITIVE] All right. Have a great one.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye.
[AGENT][POSITIVE] Uh, Mr. [PII], thank you so much for holding. I spoke with an examiner and under your policy, on the schedule of benefits, it does state that um,
[AGENT][NEUTRAL] If applicable, your disability benefit be reduced by deductible sources of income as outlined in your policy under section 3. So that's the reason why they need that information.
[CUSTOMER][NEGATIVE] Well, I need to, I, I was when I bought this that it was a $1500 policy. Now somebody misled me on because I'm paying each, each premium depends how much you was getting it, it went up every, every two weeks pay period. I'm paying like $80 something dollars a month for for this policy. So you're telling me this can be deducted? I don't think so. We, we need to talk to somebody. Somebody needs to resolve this problem because I was told.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] It was a short term disability up I think 6 months and if I'm out of work I would receive $1500 a month, not saying about deducted from my pay.
[CUSTOMER][NEUTRAL] You know, so who we need to speak to resolve this problem because this is the problem.
[AGENT][NEUTRAL] Well, it states that in your policy, but um,
[CUSTOMER][NEGATIVE] I have never gotten a policy.
[CUSTOMER][NEGATIVE] OK, I worked through the town of [PII] River the police department, and I've never gotten a policy, and I was told that's what I had. Now we got some miscommunications here or something because I'm paying $80 a month for this policy, and they go to deduct because of I make money. That's crazy.
[CUSTOMER][NEGATIVE] I would never bought it.
[CUSTOMER][NEUTRAL] You know what I mean?
[AGENT][NEUTRAL] I hear you. Uh.
[CUSTOMER][NEUTRAL] So who we need to speak to resolve this problem?
[AGENT][NEUTRAL] Uh, let me see. Hold on one moment, please.
[CUSTOMER][POSITIVE] Thank you, ma'am.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Why people make stuff so difficult.
[AGENT][NEUTRAL] Uh.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.