AccountId: 011433970860
ContactId: 4c992cb4-c4db-4978-b05f-d6bdc7461006
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 704710 ms
Total Talk Time (AGENT): 275541 ms
Total Talk Time (CUSTOMER): 228911 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/4c992cb4-c4db-4978-b05f-d6bdc7461006_20250127T15:26_UTC.wav
--------------------------------------------
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][POSITIVE] Yes, thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, how you doing?
[AGENT][NEUTRAL] Doing well how are you?
[CUSTOMER][NEUTRAL] I'm doing OK. Um, I have a, I have a short term disability claim filed. My name is [PII] and
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I was calling because after they paid the claim off, they sent me a letter showing me what they paid and the deductions, and on my letter, on the deductions, they took out like $258 for my premium. They took it out of my short-term disability.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I was calling because when I'm off work and I'm on a medical leave, my insurance is still paid through my job and I had this situation last year when I went back to work, I noticed that APL was taking the premium out of my
[CUSTOMER][NEUTRAL] Short term disability and my job was still paying my premium. My job pays my premium while I'm out.
[AGENT][NEUTRAL] I see, I see. OK, we can get that pulled up and take a look at that. Um, can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you and then do you have your policy number?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] OK, um, I could start using your social or um on the letter you received, do you see a claim number?
[CUSTOMER][NEUTRAL] I don't, I don't have the letter on me right now.
[AGENT][NEUTRAL] Oh, OK, no worries, um, yeah, I could just start using your social.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I'm just gonna verify some information really quick. [PII], can I get your date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Perfect. Last thing I need is the email address that we've got on file for you. uh, looks like it is a Gmail account.
[CUSTOMER][POSITIVE] OK, [PII].
[AGENT][POSITIVE] Perfect thank you so much for verifying that information. Alright, bear with me just a moment let me get this claim pulled up here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, just, I appreciate your patience. Um, if you don't mind, I'm going to put you on a brief hold and reach out to our claims specialist just so I can get some more information on this, and I'll get right back with you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right thank you one moment.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Ferring
[CUSTOMER][NEUTRAL] Thank you for calling APL. You're speaking with [PII]. How may I help you today?
[AGENT][NEUTRAL] Hi [PII], this is [PII] over on the care team. How are you today?
[CUSTOMER][POSITIVE] I'm good.
[AGENT][NEUTRAL] Glad to hear it. I've got uh an insured on the line. In short, um, she received her claim from us uh for disability and a portion of it went to her premium and she stated that, you know, she's really confused because it's being paid through her employer um I guess I've never really wondered, um, is it because we didn't receive it for the date of service and it would be reimbursed to her?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, what, well, the way it works, her premium come in through a group. It's like paying a light bill. They don't take her individual premium and send it to us. They send it as the whole group and it's like they pay a bill, so it.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] The time to process her claim, the group must have had not sent in the premium and the only way we could pay her we had to take our premium. Now if premium is paid, then it would be refunded back to her. But what's that policy number so I can tell you if it's been paid or not.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, OK, that's uh 02150345. That's what I was thinking, but I didn't wanna tell her without being certain.
[CUSTOMER][NEUTRAL] Uh, OK, so now it's paid to 21 and it's paid to 21 because I had to take out premium to no I took out premium to pay, yeah, to 21. So as of right now they have not paid anything yet, but if the group process, you know, pre pre premium come in and it weighs her up, then it would be uh.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, refund it back to her, but that would go through billing, you know, it wouldn't be through claims, you know, they would have to get through with billing and next time I get ready to pay her, if it has not, if you know, like say they say come in today and they roll it, then they pay her premium back and it's still at 21 when I get ready to pay her for February, it needs to be paid the 31. So if it's not paid the 31, I'm gonna have to take it out again, but you can just explain it to her. That's the way it works, OK.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] I completely understand. OK, yes, that, that clears that up. I really appreciate your help with that. So I will let her know. Thank you, [PII].
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] OK, you're welcome you have a great day alright bye bye.
[AGENT][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] All right, [PII], sorry about that wait, are you still with me?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I believe I understood, but I did want clarification before, of course I let you know um OK so the way that it works, your premium is still being paid through your employer. The reason that the premium was deducted from this claim is that um the way that.
[AGENT][NEUTRAL] Explain it is since the group is paying for it as a whole it's similar to like paying a light bill right? so we received the premium for some of the dates of service but not for the one that was um let's see that was [PII] we've not received that yet um so it's paid up until then excuse me, so they had just done that so as soon as they get that next premium payment it will be refunded back to you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and then we'll just have to see as soon as they get that paid so you will be getting that back as soon as your employer meets that next payment. Does that make sense?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I know it's a bit confusing, um, it's simply that they just hadn't at the time, um, at that premium and so of course in order to give you your benefits we just deducted it, um, but yes, once we do receive that from them you will be getting that back.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, and I have another question. The letter, the letter that I received.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Showing me that the premium was out. I didn't get that um form that I normally would fill out monthly. So I'm trying to see is it saying that I'm gonna be paid up until [PII] or [PII]. I turned back to work [PII], but I didn't get that paper that I had to fill out.
[AGENT][NEUTRAL] The [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, period. Let's see, give me just a moment. Let me take a look.
[AGENT][NEUTRAL] OK, um, yes, so for this, uh, a note here, uh, additional benefits will be released up to the return of work date, um, so if your disability should continue beyond that, all you'll need to do is let us know, uh, and get that information from your doctor, um, but you will be able to continue receiving those benefits typically, um, it's around the [PII] of every month that you receive, um, disability payments. So if your return to work date is you said the [PII], I'm sorry.
[CUSTOMER][NEUTRAL] Yeah, the [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yeah, so if you didn't receive anything additional, uh, it all looks good to go on my end.
[CUSTOMER][NEUTRAL] OK, yeah, I just wanted to make sure it's not a form I have to fill out because the last time I was out, I had to fill out a form every month.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, no, you're perfectly fine if we have the correct date in our system, which it appears that we do, uh, then you don't have to worry about that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so do you see the date in your system?
[AGENT][NEUTRAL] That the return to work date?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I just wanna make sure we're on the same page.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, I will have to get those forms pulled up. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Sorry, it's thinking about it. Give me just a moment.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][POSITIVE] All right, here we go. Sorry about that wait, my goodness, it was sure taking a minute to load that. Give me just a second.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK, yes, [PII]. Yes, ma'am, we've got it.
[CUSTOMER][POSITIVE] OK, good. OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Do you have any other questions for me?
[AGENT][NEUTRAL] And that could be a bit confusing.
[CUSTOMER][NEUTRAL] No, ma'am, that'll be it.
[AGENT][POSITIVE] OK, well, thanks for giving us a call. Yeah, I hope you have a great rest of your day. Let us know if you need anything else.
[CUSTOMER][POSITIVE] Yeah, thank you so much.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] OK.