AccountId: 011433970860
ContactId: 4c843602-919a-4629-a964-076511fb2353
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 744320 ms
Total Talk Time (AGENT): 155062 ms
Total Talk Time (CUSTOMER): 123399 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=-1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/4c843602-919a-4629-a964-076511fb2353_20250516T18:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, my name's [PII] and my policy number is 01557812.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And I just wanted to double check on this claim, hold on.
[CUSTOMER][NEUTRAL] Because I'm not the same number. I took a picture.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't get pulled up the claim number. I'm so sorry. um, anyway, it says there's a check date here and I just wanna double check because the, the remark on what I got back of explanation of benefits, I was confused, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, let's take a look at it. I just need to verify a few, yeah, a few things on the policy. Can I get your uh uh date of birth and address?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, date of birth is [PII], and my address is [PII], and I did find the claim number.
[AGENT][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] I just didn't have my picture, yeah, it's uh 360-1213.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and it was for [PII], correct?
[CUSTOMER][NEUTRAL] Yes, uh huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Yeah, I guess like I, I've, I've read through this while I've been on the phone with you. It says it does not appear that an accidental bodily injury occurred. Therefore, no benefits are payable. I don't, he definitely was hurt. There was like all kinds of bills and.
[CUSTOMER][NEGATIVE] Oh gosh, medical records, I don't know what else to give.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let's see
[AGENT][NEUTRAL] Yeah, I read the same thing. It's saying the policy provides benefits due to accidental bodily injury, which means physical damage to an insured person or covered person sustained on or after the effective date. And while this policy is in force,
[AGENT][NEUTRAL] Independencies.
[AGENT][NEUTRAL] All injuries sustained in any one accident, cases arising therefrom.
[AGENT][NEUTRAL] Based on the information received, it does not appear to be accidental.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Um, a car accident. Someone pulled out in front of him and he got and he anyway it was bad.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hmm, OK.
[CUSTOMER][NEUTRAL] So I don't, I don't
[AGENT][NEUTRAL] So yeah, I guess we need to see.
[AGENT][NEUTRAL] What if they didn't get something that they needed, or?
[AGENT][NEUTRAL] Um, OK, we can do this a couple different ways, whatever works best for you, [PII]. um, I can put in a call back and have a claims examiner call you, um, or if you need to speak to somebody now, I can try and get somebody on the line.
[CUSTOMER][POSITIVE] Um, I'm free right now, so if you can see if you can get somebody on the line, great.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Yeah, let's take a look here.
[CUSTOMER][POSITIVE] Thank for your help. I really appreciate that.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Let me see where she's in.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] Deferring.
[CUSTOMER][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey, [PII], this is [PII] in customer care. How are you today?
[CUSTOMER][NEUTRAL] I'm fine thanks how are you?
[AGENT][NEUTRAL] I'm good. Um, I have an insured on the line who has a question about an accident claim, and it was denied. I can't figure out why it was denied. I was hoping maybe you could help.
[CUSTOMER][NEUTRAL] OK, so I can take a look at it. What's the policy number?
[AGENT][NEUTRAL] 1557812.
[AGENT][NEUTRAL] Should be for [PII] is part one that comes up.
[CUSTOMER][NEUTRAL] OK, and just a second.
[AGENT][POSITIVE] No worry.
[CUSTOMER][NEUTRAL] Wait, this one that was for [PII]?
[AGENT][NEUTRAL] No, no, no, I'm sorry, the claim is for [PII] but part one is just the name I was giving you it's for [PII].
[AGENT][NEUTRAL] It's a claiming and ending in 1213.
[CUSTOMER][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] So it was a car accident that happened and I'm, I looked, I'm looked through everything she submitted. The only thing I could deduce was maybe she didn't submit any sort of like police report that I can see. Is that maybe the issue?
[CUSTOMER][NEUTRAL] Uh, bear with me just a second.
[CUSTOMER][NEUTRAL] OK, and what was their callback number?
[AGENT][NEUTRAL] It was [PII].
[CUSTOMER][NEUTRAL] OK, and you said it's Miss [PII] on the other line?
[AGENT][NEUTRAL] Yeah, we're talking with Ms. [PII], correct.
[CUSTOMER][POSITIVE] OK, I can go ahead and assist her. Thank you.
[AGENT][POSITIVE] OK, I'll send her over thanks one moment.
[CUSTOMER][POSITIVE] Thank you for holding this is [PII].