AccountId: 011433970860
ContactId: 48486da1-f7a0-41ab-81fe-2abbed64e89b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 494100 ms
Total Talk Time (AGENT): 196268 ms
Total Talk Time (CUSTOMER): 180388 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/48486da1-f7a0-41ab-81fe-2abbed64e89b_20250221T22:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. How are you doing? I was calling to check claim status on um a claim that I submitted an appeal on. And um I submitted it like since [PII]. And so I'm kinda wondering what's going on with it.
[AGENT][NEUTRAL] OK, I can help you with your appeal on your claims or actually help you with the claim status. What is your name and your policy number?
[CUSTOMER][NEUTRAL] My name is [PII]. My policy number is 2439986.
[AGENT][NEUTRAL] OK, thank you, Ms. [PII] and then let me look that claim uh or the that policy up real quick.
[AGENT][NEUTRAL] And can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then also for security reasons can you verify your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] [PII] [PII]. Email that [PII].
[AGENT][NEUTRAL] Thank you and if our call is disconnected, is that phone number you just gave me a good number to call you back on?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the claim is on my husband. It's a critical care claim from October of last year. Um, and like I said, they initially declined it. I sent in the appeal information with a letter from his doctor. And it's been like 14 days at this point, like 14 business days.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, let me look real quick.
[AGENT][NEUTRAL] OK, let me see if who you need to speak to is in today.
[AGENT][NEUTRAL] Is your husband there for us to get the consent to be able to speak to him about this claim?
[CUSTOMER][NEUTRAL] Is your husband
[CUSTOMER][NEUTRAL] Um, no, it's my policy, but he's not with me right now. I mean, I could get him on the phone if need be.
[AGENT][NEUTRAL] Right, I'll need his consent to be able to talk about the policy.
[AGENT][NEUTRAL] About the claim itself, um, I know it's your policy you're the account holder, but we need his consent when it comes to claims, um, because he's over the age of [PII] and it's private information.
[CUSTOMER][NEUTRAL] Hold on, man.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Hold on, ma'am.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] I have the um claim people on the phone, Louis, um about your critical illness claim, but they need your permission to be able to speak with me.
[CUSTOMER][NEUTRAL] Oh, OK. Hey, how you doing?
[AGENT][NEUTRAL] Hey [PII], this is [PII]. Um, can I please get you to verify your date of birth for me, sir?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you sir, and do I have your consent to speak to Ms. [PII] about the results of your claim?
[CUSTOMER][POSITIVE] Yes ma'am, I do give you the permission to talk to Ms. [PII].
[AGENT][POSITIVE] Thank you I appreciate your help so much, [PII]. You have a good rest of your day. Thank you for taking your time out.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Yes ma'am thank you I appreciate you.
[AGENT][POSITIVE] Appreciate you, sir. Thank you.
[AGENT][NEUTRAL] Alright Ms. [PII], I'm trying to see if the lady you need to speak with is in and right now she's away from her desk, but what I'm going to do is I'm going to send her an email so that uh she can call you back and.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So what is the issue with the claim? What's the issue with the claim at this point?
[AGENT][NEUTRAL] Well I can't see it so there's um when it goes to appeal, it goes to a different department so I can't see the results of the claim.
[AGENT][NEUTRAL] Or the or what's going on with it you'll need to speak to a different department and I'm gonna send her an email with the phone number that you provided for me so that she can call you back.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. And what time do y'all close today?
[AGENT][NEUTRAL] We close at [PII] Central time.
[CUSTOMER][NEUTRAL] OK, so it's [PII] there now.
[AGENT][NEUTRAL] Right, [PII].
[CUSTOMER][NEUTRAL] OK, that's fine. I'm just trying to find out because it's like it's just lingering. Like, I don't understand. They received a letter from his doctor with the explanation, and I, all of the medical records have been submitted.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, but it went into appeal status, right?
[CUSTOMER][NEUTRAL] Yeah, initially when um I sent in all the medical records and the lady was like, well, um, you know, the doctor, you could get him to send a letter or whatever, um, because my husband had a stroke. And so he had a hemorrhagic stroke, so it says like an intracranial bleed and I guess because it didn't have the correct terminology, his doctor literally typed up the letter stating what he had.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes ma'am, I understand. I do see that there were um notes put in of course I can't read anything because it's an appeal status which is a legal status, but there was something done on [PII], but I just I need to have that department call you back and and talk to you about it.
[CUSTOMER][NEUTRAL] OK, that's fine. Um, so she is in today. She's just away from my desk.
[AGENT][NEUTRAL] No, ma'am, she's out of the office right now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, so it makes no sense for me to even call back today at this point. That's what I was trying to figure out because initially you said you away from my business.
[AGENT][NEUTRAL] Right, right, yeah.
[AGENT][NEUTRAL] Yeah she's out of the office she's left for the day but um she can return your call when she comes in first thing Monday morning she should be able to see that I've sent a request for her to give you a phone call within 24 hours.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Alright, thank you.
[AGENT][POSITIVE] You're so very welcome. I hope you guys have a great rest of your day. We thank you for calling APL.
[CUSTOMER][POSITIVE] You're welcome. Thanks, sorry, for your help.
[AGENT][POSITIVE] You're welcome. You take care.
[CUSTOMER][NEUTRAL] All right. Bye-bye.
[AGENT][NEUTRAL] Bye-bye, [PII].