AccountId: 011433970860
ContactId: 586e32f1-130d-4b26-b201-2393bd53dbfd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 715119 ms
Total Talk Time (AGENT): 309134 ms
Total Talk Time (CUSTOMER): 199360 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/586e32f1-130d-4b26-b201-2393bd53dbfd_20250407T17:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], uh, my name is [PII]. I'm calling on behalf of my husband [PII].
[CUSTOMER][NEUTRAL] Um, regarding his short term disability claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do we have a claim number, policy number? What do we have?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, I have both. I have the policy number is 22605764.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] And I spoke with [PII] the other day last week.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] In claims and she was saying that they needed some additional information. I submitted that information so I'm just trying to check on the status because we're going into almost 6 weeks with him being off work.
[AGENT][NEUTRAL] OK, let's take a look here. One second.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] All right, on the policy, if you could just verify name, date of birth and address, please.
[CUSTOMER][NEUTRAL] [PII] [PII] address [PII].
[AGENT][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] I'm sure you can understand going. He's, he's had two back surgeries and so.
[CUSTOMER][NEUTRAL] We're kind of running a little tight now since he's been off work for so long.
[AGENT][NEUTRAL] Bye.
[AGENT][POSITIVE] Yeah, I, yeah, absolutely, and I, I apologize. I'm just reading the notes here, um, from when you called last week just to see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so let's see what's going on.
[AGENT][NEUTRAL] OK, and so you guys then.
[AGENT][NEUTRAL] Um, submitted whatever was needed and then when you spoke to her just trying to figure out, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, see, uh, we have 3 different things going on. There's 2 hospital indemnity claims and then 1 short-term disability. So she reviewed one of the hospital indemnity, and we actually had already submitted it, even though they had uh denied it, but they, we had submitted the correct information, so she went ahead and pushed that one through because the correct information was needed. Then one of them needed some additional one hospital indemnity needed.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] An itemized or a billing statement with the diagnosis code which I did submit that and then she said the
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, short term disability was looking for.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The his medical records from the [PII] for the past year.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, which I submitted that also.
[AGENT][NEUTRAL] OK, so the disability, uh, looks like it was updated and shows that um it's under review as of today.
[CUSTOMER][NEUTRAL] On last Thursday.
[AGENT][NEUTRAL] So there's no decision that's been made on it. It looks like it just shows under review.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] How long does that normally take?
[AGENT][NEUTRAL] Um, I would.
[CUSTOMER][NEGATIVE] And I'm just asking because we're going on 6 weeks with no income.
[AGENT][NEUTRAL] Right, I would say probably not that long honestly since they're just reviewing the information. I don't wanna give you a specific time, but let me ask and see if I can give you just kind of an idea. Mostly like claims usually take like 5 to 7 days, but this wouldn't be that just because we already have the claim information we're just um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, and it's been 2 or 3 weeks now.
[AGENT][NEUTRAL] Yeah, let me see.
[AGENT][NEUTRAL] OK, so let me see if I can get a more definitive response on like the time frame when they're reviewing that for the additional information.
[AGENT][NEUTRAL] Did you need me to also check on the hospital indemnity while I'm waiting on that, or?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] If you don't mind, yes ma'am.
[AGENT][POSITIVE] OK, yeah, absolutely.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, so there was a claim it looks like submitted the [PII] on the hospital indemnity.
[AGENT][NEUTRAL] And then it shows paid on the [PII] for $1000.
[AGENT][NEUTRAL] Did you guys already received that one?
[CUSTOMER][NEUTRAL] That was
[CUSTOMER][NEUTRAL] There should be 2, yeah, we received that one and there should be a second one.
[AGENT][NEUTRAL] OK, so there is a 2nd 1 and the 2nd 1 doesn't have a claim number yet. It looks like it's pending reviews, so that was submitted on the [PII], so that one.
[CUSTOMER][NEUTRAL] And it should have a claim number because they sent a, they had a thing saying that we needed the diagnosis another the statement with the diagnosis itemized with the diagnosis code so there should be a claim number attached to that one.
[CUSTOMER][NEUTRAL] Also.
[AGENT][NEUTRAL] Maybe, maybe what is showing submitted was just the additional information. Let me see.
[CUSTOMER][NEUTRAL] Cos it was
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] OK, so yeah, that was the additional um information that looks like submitted. So that one is still showing pending also.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] There's not been any decision.
[CUSTOMER][NEUTRAL] Is it possible to talk to somebody in claims to go ahead and process that through?
[CUSTOMER][NEUTRAL] Cause that was how we got it there the other day when somebody else looked at it and claims that uh well you know what I mean.
[CUSTOMER][NEUTRAL] The person that you would talk to.
[AGENT][NEUTRAL] Yeah, the examiners.
[CUSTOMER][POSITIVE] Yes, thank you.
[CUSTOMER][NEUTRAL] That was how I got to speak with [PII] the other day.
[AGENT][NEUTRAL] OK. Um.
[AGENT][NEUTRAL] Let me see if.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I can get somebody on the line that processes claims. I can't make any promises, [PII], that you know they'll go ahead and do it right now um I can just get them on the line and.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Mhm. But at least I can get a better idea.
[AGENT][NEUTRAL] Yeah, I mean, as far as the disability, um, you know, my help desk did advise that um when it's under review, unfortunately, with, you know, the doctor reviewing all the information submitted for the pre-existing, she did say to me that there's not a turnaround time, unfortunately that we generally advise, um, just that you can call and check on it.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] So, I'm not sure on the disability as far as what the time frame would be on it, unfortunately.
[CUSTOMER][NEGATIVE] That doesn't seem like a good answer.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] When you have your, when your mortgage and everything needs to be paid and you know that it was not a pre-existing condition.
[AGENT][NEUTRAL] Let me get somebody on the line in claims and see what they can do um to further assist with the the ones that are pending OK [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][POSITIVE] Good morning. Thanks for calling APO. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey, [PII], this is [PII] over in customer care. How are you doing this morning?
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][NEUTRAL] I'm good. Um, I have a spouse on the line. Her name is [PII], and she's calling on her spouse's policy. She has verified to speak on it. Um, she has some concerns regarding some claims, and I was wondering if you could help her out with that.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, can I get the policy number?
[AGENT][NEUTRAL] 260.
[AGENT][NEUTRAL] 5764.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh, what is her concern?
[AGENT][NEUTRAL] So this disability policy and then he also has a hospital indemnity policy. They submitted additional information that was requested and the hospital indemnity and the disability both claims are under process. I did advise her that there's no time frame, unfortunately. She can just call back and check on them.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Uh, frustrated with the amount of time it's taking, um, just concerned because he's been out of work, so wanting to expedite the processing on the claims basically.
[AGENT][NEUTRAL] And it looks like she spoke to somebody I think last week, and they did process one for her on the phone, and I told her I said, well, that's
[AGENT][NEGATIVE] Not normal.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, so it looks like another HR we made a payment on [PII], but the disability still under medical review. You can send her on over.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, thank you, here she comes.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Good morning. Thanks for calling APL. This is [PII]. How can I help you? Hi, [PII]. I am trying to get a little bit of information on my husband's, uh, two things, hospital indemnity and on his short-term disability, just getting a timeline.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, um
[CUSTOMER][NEUTRAL] So I'm looking at the hospital and then.