AccountId: 011433970860
ContactId: 5194278a-f738-4c44-90eb-86f5fe2f4116
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 339450 ms
Total Talk Time (AGENT): 113420 ms
Total Talk Time (CUSTOMER): 205353 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/5194278a-f738-4c44-90eb-86f5fe2f4116_20250102T18:08_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I need some help. So I filed a claim and I'm sorry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me your name again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and before you get started, [PII], let me get some information that way I can pull you up in your policy information up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What's your policy number?
[CUSTOMER][NEUTRAL] Hold on a second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't, I don't, I don't remember it, um.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] OK right now.
[CUSTOMER][NEUTRAL] The policy number is 02209844.
[AGENT][NEUTRAL] And your phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let me get you verified and then we can proceed, OK?
[CUSTOMER][NEUTRAL] And you
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you can verify your date of birth, mailing address, and email address for me?
[CUSTOMER][NEUTRAL] Date of birth [PII] address [PII] um and you wanted my what my email address 12 so one is [PII], is that the one you have?
[AGENT][NEUTRAL] Email. Mhm.
[AGENT][POSITIVE] That's the one that we do have. Thank you for verifying and how can I help you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I, I, um, submitted a claim and then when I checked it, it said that the claim was complete, but I wasn't paid any money. So I want to know what information is needed. Maybe there's something that we didn't get.
[AGENT][NEUTRAL] What was the date of service of your claim?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, let me, I have to go back online to look to tell you, um, is it possible?
[AGENT][NEUTRAL] OK. Is it a disability claim?
[CUSTOMER][NEUTRAL] Yes, ma'am. Is it possible that you can find it or did you see it, or?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Well, I'm showing a payment made. I'm just trying to verify if you received a check for October, November and December it was for $30,050. This was issued.
[CUSTOMER][NEUTRAL] Or.
[CUSTOMER][NEUTRAL] If you
[CUSTOMER][NEUTRAL] No. No, I, I just.
[AGENT][NEUTRAL] Back in November.
[CUSTOMER][NEUTRAL] Yeah, I, I filed a claim this month. It was actually this month.
[AGENT][NEUTRAL] OK, so you did receive the one that we sent you in November?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yes, ma'am, I did.
[AGENT][NEUTRAL] OK, OK, got it.
[AGENT][NEUTRAL] So then I do show one that was received on the [PII] processed on [PII].
[AGENT][NEUTRAL] And did you receive an EOB in the mail from APL, an explanation of benefits?
[CUSTOMER][NEUTRAL] No, I did not. That's why I'm calling you. I'm calling you to find that.
[AGENT][NEUTRAL] OK, so,
[AGENT][NEUTRAL] OK, so it processed on [PII], so you may not have received it yet, but I can read the remark code. It says according to the information received, we have allowed benefits through the date you were released to return to work. So what day did you return to work?
[CUSTOMER][NEUTRAL] I have not returned to work yet so OK, let me, let me rephrase my question, um, documents received, did you receive anything from the doctor?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Cause then if you didn't receive that, I know to call the doctor. So did you, did you receive that? I know that I submitted my portion, and so, and, you know, there was a uh another form that the doctor is supposed to send you. Um, however, that, did you receive that from the doctor?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The last document that we received from the attending physician statement shows that you were to return to work um on [PII].
[AGENT][NEUTRAL] So we ended your, we paid you through [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It, it, it doesn't it, that's not, that's not, I don't, I don't know what the documentation says, but I, I know that's not what it says because I have a copy of it. It may have said I need to return to the doctor on [PII], but not to work because the doctor didn't release me to go back to work until um [PII]. I have that documentation as well, so I'm wondering did you that was the last documentation you received from you haven't received anything else that's what you're telling me, right?
[AGENT][POSITIVE] Correct, because we've ended it based on what we've received so far.
[CUSTOMER][NEUTRAL] Oh OK, OK.
[CUSTOMER][NEUTRAL] OK, well I'm going to um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, I'm gonna see what the doctor is saying, I mean, or, or get the, get the form and send that over to you. But you did receive my documentation, right, for this month. And as a matter of fact, you shouldn't have red, you should have received that document, um, because I didn't, I didn't get, I didn't, um, the doctor did not get that form to send to you until about the [PII] or the [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, so that tells me you have, did you receive mine?
[AGENT][NEUTRAL] The document that from you stating what?
[AGENT][NEUTRAL] Just the insured copy?
[CUSTOMER][NEUTRAL] There's a portion, there's a portion, yeah, there's a portion from APL that I'm supposed to fill out. Uh, there's a disability form includes um a portion for me and a portion from the doctor. Did you, did you receive my portion?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] When did you send that in, in December?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so we did receive your part.
[CUSTOMER][NEUTRAL] OK, but you didn't receive the doctor's. OK, that, that, that.
[AGENT][NEUTRAL] Not extending you through [PII], no.
[CUSTOMER][POSITIVE] OK, OK, alright, thank you very much now I know what I have to do.
[AGENT][POSITIVE] OK. All [PII].
[CUSTOMER][POSITIVE] All right, have a good day, OK?
[AGENT][POSITIVE] You're welcome and thanks for calling [PII].
[CUSTOMER][NEUTRAL] Bye-bye.