AccountId: 011433970860
ContactId: 39416662-a061-45e2-aef1-42d2e3b808a6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 837830 ms
Total Talk Time (AGENT): 232815 ms
Total Talk Time (CUSTOMER): 221991 ms
Interruptions: 4
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/39416662-a061-45e2-aef1-42d2e3b808a6_20250205T17:11_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm [PII]'s wife. Um, I have, I guess I'm, I called in to the right, um.
[CUSTOMER][NEUTRAL] Section I guess um I have a question about um a short term disability claim he was just paid on um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, should I give you the claim number? Would that help?
[AGENT][NEUTRAL] Yeah, we can start with that. What what do you have, [PII]?
[CUSTOMER][NEUTRAL] OK, 3559715.
[AGENT][NEUTRAL] OK, let me pull this up here.
[AGENT][NEUTRAL] OK, [PII], so I've got the policy pulled up here. Um, is he around so he can just verify I can speak with you in regards to the policy?
[CUSTOMER][NEUTRAL] Oh, I sent um.
[AGENT][NEUTRAL] Or did you send a form?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I sent a form in.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me take a look.
[CUSTOMER][NEUTRAL] It was that I'm looking through my paperwork here to help you out.
[CUSTOMER][NEUTRAL] Um, it was faxed in on [PII].
[AGENT][NEUTRAL] OK, let me see here.
[CUSTOMER][NEUTRAL] That might help you
[AGENT][POSITIVE] Sorry about that.
[CUSTOMER][NEUTRAL] That's OK, I understand.
[AGENT][NEUTRAL] OK, so I just need to get his date of birth and address on file please.
[CUSTOMER][NEUTRAL] Uh, date of birth [PII]. Address is [PII].
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] So I see it looks like the benefit payment on the claim was for 75951.
[AGENT][NEUTRAL] Did you have questions about the dates or?
[CUSTOMER][NEUTRAL] Well, I had questions only because, um, I know, I mean, I had a completely different short term disability policy. It was years ago, different location, everything different about it. And um my short term disability policy, of course, I got the, the, the weeks or whatever.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] And then um I was also able when I returned to work like for doctor's appointments and stuff or any time missed I was able to um use that for time miss because he's completely out of um.
[CUSTOMER][NEUTRAL] Uh, what do you call it, sick time.
[AGENT][NEUTRAL] Like paid, paid, like, OK, yeah, I was gonna say paid time off, yeah, yeah.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, um, is that possible with his policy?
[AGENT][NEUTRAL] Let's see if that policy, this policy carries anything like that. Let's see.
[CUSTOMER][NEUTRAL] I didn't see it and I told him it may be.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, let's see here.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Don't see anything yet, but I'm just scrolling through this policy to, to double check.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I don't see anything in there about like continuing coverage, you know, just for like a return to work, like office visit or, you know, anything in there that speaks to that, unfortunately.
[CUSTOMER][NEUTRAL] Now my second question is um.
[CUSTOMER][NEUTRAL] While he is back at work, he was not released to.
[CUSTOMER][NEUTRAL] His actual like full time actual job, yeah, he was released to like like he's an act he's a a police officer so he's not released to.
[AGENT][NEUTRAL] Jobs, yeah.
[CUSTOMER][NEUTRAL] Um, actual duty, like.
[AGENT][NEUTRAL] It's like a, right, it's like a light duty situation.
[CUSTOMER][NEUTRAL] Right, right, yeah, like you can go sit at a desk.
[CUSTOMER][NEGATIVE] And which is killing them, but
[CUSTOMER][NEGATIVE] He's like, this is not what I do. And I'm like, well, tough luck.
[AGENT][NEGATIVE] Right, this is, this is not what I signed up for, yeah.
[CUSTOMER][NEUTRAL] This is what you're doing.
[CUSTOMER][NEUTRAL] You had a massive heart attack. This is what you're doing for the next 3 to 4 months, buddy.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, yeah, yeah, yeah, I hear you.
[CUSTOMER][NEUTRAL] Yeah, but he's gonna have cardiac rehab and all that. And I'm like, well, you know, so um I was just, you know, open.
[CUSTOMER][NEUTRAL] Since he didn't get um that full.
[CUSTOMER][NEUTRAL] You know, back at duty.
[AGENT][NEUTRAL] Right, um.
[CUSTOMER][NEUTRAL] That there was something.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] I mean, they define active employment as doing in the usual manner regular duties or employment.
[AGENT][NEUTRAL] So I'm wondering if let's see.
[AGENT][NEUTRAL] Maybe if he's not able to perform like the actual job that might entitle him to continue it on.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] What I'm gonna do, [PII] is I'm gonna reach out to the actual claims department that processes these and ask them um because they just have more extended knowledge um and see what they say do you mind if I place you on just a brief hold?
[CUSTOMER][POSITIVE] Oh sure that's fine thank you.
[AGENT][NEUTRAL] Yeah, not a problem, one moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII]. This is [PII] in customer care. How are you this morning?
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][NEUTRAL] I'm good. Hey, I just have a question and I'm hopefully you can help me. Um, do you know if on any of our disability policies if they haven't returned to their actual job like their light duty, is that something that they can continue a claim for?
[CUSTOMER][NEUTRAL] If they return on light duty or if they haven't?
[AGENT][NEGATIVE] Yeah, like they're not doing their actual job. They're a police officer and they've returned to work, but they're just light duty, like they're not performing their actual job.
[CUSTOMER][NEUTRAL] Yeah, the policies pay up to the return to work date once they return back to work even if it's light duty or um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alter schedule they'll still is returned to work so there's no, yeah.
[AGENT][POSITIVE] It, OK. OK. OK. I appreciate that info. I was checking, couldn't find it, so I appreciate that. Thank you so much.
[CUSTOMER][POSITIVE] Yeah, no problem, anytime.
[AGENT][POSITIVE] Have a good one.
[CUSTOMER][NEUTRAL] You as well bye.
[AGENT][NEUTRAL] [PII], thank you so much for your patience and waiting um so I did speak to a claims examiner and they say that um with our policies once you return to work it's a return to work so unfortunately there's no way to continue on with the claims.
[CUSTOMER][NEUTRAL] OK, well.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] She said they just read it as like a return to work, so no benefits are payable, yeah.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEGATIVE] Well, that sucks.
[AGENT][NEUTRAL] I'm sorry. I didn't have better news for you.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah, alright, well.
[CUSTOMER][POSITIVE] Thank you anyway for trying.
[AGENT][POSITIVE] You're very welcome. You have a good rest of your day.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You too, bye bye.
[AGENT][NEUTRAL] Bye bye.