AccountId: 011433970860
ContactId: 4bc47642-c88d-4d03-9f14-7b57a6e4d52a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 798690 ms
Total Talk Time (AGENT): 392108 ms
Total Talk Time (CUSTOMER): 361153 ms
Interruptions: 7
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/4bc47642-c88d-4d03-9f14-7b57a6e4d52a_20250514T17:47_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hey, so, this is my 2nd time talking to you today. You're the only one in the queue.
[AGENT][NEUTRAL] Probably
[CUSTOMER][NEUTRAL] So I have an insured on the phone. She's calling about her HI policy, so I gave her, she called about questions in regards to submitting the claim, so I helped her with it. But then she had a question about her accidental policy. She wanted to verify if there was some type of benefits for if she's limited to work and she can't work because she broke her shoulder or something.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK. I can check and see if there's a benefit. Um, what's the policy number? I'm ready.
[CUSTOMER][NEUTRAL] Let me know when you're ready for the policy number.
[CUSTOMER][NEUTRAL] Um, 244-515-7.
[CUSTOMER][NEUTRAL] It's 244-515-7 for [PII].
[AGENT][NEUTRAL] This in [PII], OK.
[AGENT][NEUTRAL] And you fully verify her.
[CUSTOMER][NEUTRAL] I don't see nothing on there. Mhm, I did. I verified all her information because she called in regards to submitting a claim.
[AGENT][NEUTRAL] OK. And um
[CUSTOMER][POSITIVE] For her HR policy and I helped her with it.
[AGENT][NEUTRAL] OK, and the callback number is the same one in the system or is it different?
[CUSTOMER][NEUTRAL] Yes, it's the [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK dokey. I'm ready for her.
[CUSTOMER][POSITIVE] Alrighty let me transfer over to you.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Hello [PII]. So I have [PII] on the phone. She's gonna better assist you with your questions in regards to your accidental policy, but thanks for calling APL, and you have a great day and take care. Thanks. Appreciate it. You're welcome. Yeah.
[AGENT][NEUTRAL] Good afternoon, Ms. [PII]. This is [PII] in the care team. Um, I have your information pulled up. She did provide me all the information and um she was telling me that you're trying to see if you have benefits for like disability. Is that correct?
[CUSTOMER][NEUTRAL] Like with, yeah, cause it said like when I was reading a little bit through the accidental, it said that it, I can possibly have something within that accidental or hospital one. I wasn't sure. I know when I requested um.
[CUSTOMER][NEGATIVE] The policy itself, they declined me due to me having a blockage in my heart.
[CUSTOMER][NEUTRAL] When I was gonna purchase the one myself, but I didn't know that there, if there was or wasn't something within the other policies that I purchased.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, got you. All right, um, let me check and see um.
[AGENT][NEUTRAL] OK. So basically, the benefit that you're looking for is uh like any benefits that is gonna be paid to you for not working, correct? Or is it?
[CUSTOMER][NEUTRAL] Yeah, basically, because they're, they're restricting the hours that I work and stuff and
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so yeah, alright.
[AGENT][NEUTRAL] OK, let me check um.
[CUSTOMER][POSITIVE] I feel good enough to work.
[AGENT][NEUTRAL] Mm, OK. So, has the doctor put you in full disability or he just said that you're restricted and you cannot go to work, um, or you can work just a little bit?
[CUSTOMER][NEUTRAL] Um, I could work from home remotely because I'm right-handed, but, uh, my restriction is no use of my left arm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Got you. OK.
[AGENT][NEUTRAL] Um, I do see that there is a disability. Let me check and see if it's active because it doesn't seem to be active. So let me double check with customer service to make sure that this is active and I'll go ahead and give you that answer. So if you don't mind holding for me, I'm just gonna go ahead and get in touch with the customer service and see if that disability policy should be active, OK?
[CUSTOMER][POSITIVE] OK appreciate it thank you.
[AGENT][NEUTRAL] No. You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], how are you? This is [PII].
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][NEUTRAL] I'm good, I'm good, thank you. Um, I have a question about a policy that I see has a D7 on it. All the rest of the policies are active, but this one has a D7 and I just wanna make sure that it shouldn't have been, you know, active or something like that, what happens with it. Um, so, uh, the policy is 2456538.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 653 8 OK and usually when you see that D7 it was issued in error usually but I'm looking to see.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Huh.
[CUSTOMER][NEUTRAL] She put policy declined due to miscellaneous. My goodness, what is that?
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] She said she has something about her heart. I'm not sure if that will stop her from getting that policy. I have no idea.
[CUSTOMER][NEUTRAL] If they don't have any.
[CUSTOMER][NEUTRAL] It very well could.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh, but that was in [PII].
[AGENT][NEUTRAL] Mhm, yeah.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII], I look and see.
[AGENT][NEUTRAL] And I don't see anything that I can tell her, oh yeah, you don't have it because I don't know.
[AGENT][NEUTRAL] this out
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes, let me see.
[CUSTOMER][NEUTRAL] See her application.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And you said she like answered yes to a heart condition or something like that?
[AGENT][NEUTRAL] Yes, uh-huh. That's what she said that she had to answer yes to a heart condition and that like she tried to do a policy by herself. That's what she said, and it was declined due to the heart health condition. So she went through her employer and got this one and um but she's now wanting to know if she has a disability because she was put off work because she had an accident. So it's not, it's not to do with the, nothing to do with the heart, but
[AGENT][NEUTRAL] She just needs to know if she has this ability because she had an accident, so.
[CUSTOMER][NEUTRAL] Oh right.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, OK.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, and she's on the phone right now.
[AGENT][NEUTRAL] She is. Mhm.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] real quick see if I can.
[AGENT][NEGATIVE] Yeah, I wish they put like, oh, not eligible or something like that because miscellaneous is a lot of things.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I'm messaging her, um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You think we should give her a call back?
[CUSTOMER][NEUTRAL] I'm sorry. Um,
[CUSTOMER][NEGATIVE] Maybe it might take a minute. Oh, I hate that, but.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I like um uh whatever you think I don't.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I mean, yeah, probably I, I'm thinking probably we'll have to because we don't know what's miscellaneous and probably uh [PII] will probably urge to see why she put miscellaneous and that may take a little bit for her to figure out what's the miscellaneous about.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Right. Exactly.
[CUSTOMER][NEUTRAL] Right. Yes.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Because this is 2024, it's been a long time, so I will not know what's that and I'm sure she will be like, oh, I don't know what's that.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah, so I think, yeah, I'm gonna go ahead and just tell her that we're gonna research and give her a call back about the disability, um.
[CUSTOMER][NEUTRAL] that.
[AGENT][POSITIVE] Yeah, I think that's the best thing I can do for her, because, yeah, I'm pretty sure it's gonna take a little bit for an answer.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK. She just answered and said she's gonna see if [PII] put a note in on [PII] and it's not. OK, so yes, um, probably gonna need to call her back.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yeah, that's what I'm thinking I guess they don't know. They have to research that miscellaneous.
[CUSTOMER][NEUTRAL] Cause I don't see anything in all day.
[AGENT][NEUTRAL] Oh boy. OK. All right. OK, let me just go, I'm gonna go back to her and let her know that we're gonna call her back. I is it OK if you call her back or do you, how do you want me to handle this one? um.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, yeah, yeah, um, will you just message me whatever, or do you want me to talk to her and
[AGENT][NEUTRAL] You can call her back.
[AGENT][NEUTRAL] I don't want to transfer her again because she was transferred from [PII] to me. So I'm trying to avoid transfer her in again. Um, so, um, yeah, just, I'm gonna go ahead and IM you her information like the policy number and the callback number, and yeah, if you can call her back please and let me know when you did so I can notate. You can, OK?
[CUSTOMER][NEUTRAL] Oh, OK. Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, [PII] did just answer me. She said it was declined due to her medical history. So it is with her having that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, so yes.
[AGENT][POSITIVE] The heart condition. Got you. OK. OK. Well, that answers it. So yes, she doesn't have disability. All right. Yeah. OK. Thank you so much.
[CUSTOMER][NEUTRAL] Uh, I mean.
[CUSTOMER][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Mhm. Thank you. Oh.
[AGENT][POSITIVE] That was that. You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] No, thank you.
[AGENT][NEUTRAL] Bye.
[AGENT][POSITIVE] Thank you for holding and being patient for Miss, Miss [PII]. Uh OK. So I checked my customer service and yes, um, it is correct. Uh, you do not have a disability policy, so there's no disability benefits under the accident.
[CUSTOMER][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] OK, OK. I just wanted to double check, yes, um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, I understand.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEGATIVE] I fell in what, now, here's my thing. I went to, uh, I tripped off a curb and I broke my shoulder.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Coming out of a concert. Um, and I'm in a different state of where I live.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I'm stuck up here. I, thank [PII], I have my family here to help, help me. Um, so my thing is, I'm, I want to get this going. I even forgot I have this for last year. I have to submit claims from last year too. However, I want to get this one done and over with while it's on my mind. Um, but I went to the emergency room like a couple of hours after.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then they did X-rays and then they told me to find a physician. So I saw a doctor for 2, I was following a doctor right after that for 2 weeks.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Then I had to go back to the emergency room. They admitted me, and then they did surgery. Um, do I still only fill out one?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hospital form and upload everything, all my labs, all my testing, everything.
[AGENT][NEUTRAL] Um, yeah, what you're gonna, um,
[CUSTOMER][NEUTRAL] They did a lot of stuff.
[AGENT][NEUTRAL] Yeah. What you're gonna send in is the accident claim form and then under the accident claim form, just go ahead and add any itemized bill of everything they did. That's the best thing to do because like that we can see which ones are payable, which ones are not, and it's a lot easier for us to determine how much we're gonna send if you just send everything and let us look into it, OK?
[CUSTOMER][NEUTRAL] OK, and then I pretty much do the same thing for the accidental claim as well?
[AGENT][NEUTRAL] Correct, yes. You will send 2. You will send one for the accident with the accidental claim form and you will send one for the hospital indemnity with uh the um claim from the hospital indemnity, OK?
[CUSTOMER][NEUTRAL] OK, and then just upload all the documents to both of them.
[AGENT][POSITIVE] Yes, one for each policy. Correct. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, OK, all right, I'll get working on that. Thank you very much.
[AGENT][POSITIVE] Thank you. You're welcome. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Uh, no, I guess it will be ongoing. So if I have any other questions, cause then I'll have to be doing physical therapy and different things like that, so.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] That's.
[AGENT][NEUTRAL] OK. Yes, I understand.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, cause I have no use of the left arm and for, I don't know now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, got you. OK.
[CUSTOMER][POSITIVE] So, OK. I, I'll see, I'll, if I have any questions, I'll, I'll continue to call. I appreciate you. Thank you.
[AGENT][POSITIVE] Uh, you're welcome and thank you for calling APL. Have a good afternoon.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.