AccountId: 011433970860
ContactId: 67020ee2-11e1-4cbd-a37b-9d464df3ea6b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1145800 ms
Total Talk Time (AGENT): 319361 ms
Total Talk Time (CUSTOMER): 584391 ms
Interruptions: 6
Overall Sentiment: AGENT=0.4, CUSTOMER=-1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/67020ee2-11e1-4cbd-a37b-9d464df3ea6b_20250117T14:17_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thanks for calling Ael. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. How are you? This is [PII].
[AGENT][NEUTRAL] I'm doing OK, and yourself?
[CUSTOMER][POSITIVE] I'm good, I'm good, um, I have a map person on the other line.
[CUSTOMER][NEUTRAL] Um, let me go ahead and give you some information on what's going on. It's a disability policy. He has not received payments. Um, I see a note from [PII] saying that she left a voicemail asking for more information, but he said he never received that, um, and now he's not because we haven't paid his, um, disability. Um, the policy number is 249.
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] 904.
[AGENT][NEUTRAL] What's his callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, give me one
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, I was just trying to make sure [PII] was here because I'm trying to transfer to her. I mean, it's uh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's not
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and this is for Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] Yeah it looks like he was looking online and it says process so he thought it was gonna be paid.
[AGENT][NEUTRAL] OK, you can go ahead and send them through.
[CUSTOMER][NEUTRAL] OK, here he comes.
[CUSTOMER][POSITIVE] Thank you for holding and being patient for me, Mr. [PII]. I got Miss [PII] on the line. She's in the claims department and she's gonna assist you from here.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hi, good morning, Mr. [PII]. It's [PII] in the claims department. The rep was stating you had a question about your disability check.
[CUSTOMER][NEUTRAL] Yeah, yeah, um, I, I, I called yesterday.
[CUSTOMER][NEUTRAL] Uh, uh, or it might have been the day before yesterday, uh, and I, uh, I get my check. I usually get my checks on the [PII], and I could check online.
[CUSTOMER][NEUTRAL] You know, and sometimes it's been a little later than the [PII], but.
[CUSTOMER][NEUTRAL] You know, I, so I was just asking and um.
[CUSTOMER][NEGATIVE] Uh, today's the [PII] and I still hadn't gotten my check for this month and uh.
[CUSTOMER][NEUTRAL] So I was just wondering where's the check because, you know, Monday is [PII], so I'm not gonna get it Monday either.
[CUSTOMER][NEGATIVE] We have a winter storm coming and, and, and we're, we're dead broke. Shut the fuck up.
[CUSTOMER][NEUTRAL] Well, we're, uh, you know, and I need, uh, we need food, we need, you know, and I was just wondering what the check was, and I, the lady I was just speaking to said something about how, uh, we needed more paperwork from the doctor, but I'm looking at my website right here and it says this claim's already been processed that I'm just waiting for the check, correct?
[AGENT][NEUTRAL] So, it's showing the claim is being processed, but it's not showing the check was sent out. We, um, I'm looking into it, so give me one second. I'm just looking at the claim.
[CUSTOMER][NEGATIVE] So why when I called yesterday, nobody told me anything about more paperwork, and I've called 3 times about this claim and I said, so y'all got all the paperwork y'all need. You don't need any of the paperwork, right? I'm just waiting on the check, right? And I was told every time, yes, yes, yes, you're just waiting on the check and nobody told me anything about more paperwork and now here it is Friday.
[CUSTOMER][NEUTRAL] And I gotta get more paperwork?
[AGENT][NEUTRAL] So the last time I'm showing that you called was on the 15th, so it would have been on Wednesday. Um, it looks like at 99 o'clock in the morning and I'm showing at [PII], the rep, um, give me one second.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] There was a note put in here about the exam. So if you give me one second, I'm looking into um the document to see um and I can let you go. Give me one second.
[CUSTOMER][NEUTRAL] Just be quiet.
[CUSTOMER][NEUTRAL] Uh, I'm trying to talk to him.
[CUSTOMER][NEGATIVE] Get out of here. Get out of here.
[AGENT][NEUTRAL] I'm gonna put you on a brief hold, sir.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm
[AGENT][POSITIVE] So I'm doing OK, [PII] how about you.
[AGENT][NEUTRAL] OK, I have Mr. [PII] on the line, um.
[AGENT][NEUTRAL] Is excuse me, 249-6904.
[AGENT][NEUTRAL] Yeah, I see your notes, so, um, I'm looking at the claim form and is it showing on the claim form that he submitted that he's supposed to be term?
[AGENT][NEUTRAL] Back to work.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] No, I'm just asking, so where, I mean, so I see that.
[AGENT][NEUTRAL] Are you, um, which claim number are you looking at?
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Is it claim number 354-8372?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK, so, cause I'm just trying to see, oh, so you're looking at the original claim form where the doctor said he was supposed to be trying to work.
[AGENT][NEUTRAL] Oh, OK, I see what you're saying. So when he sent this in in December, he didn't send the doctor's portion to say when he's supposed to return to work. Oh, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The updated doctor form.
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] He updated documents. OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 31. OK.
[AGENT][POSITIVE] OK, I understand now. Thank you.
[AGENT][NEUTRAL] Bye.
[AGENT][NEUTRAL] OK, Mr. [PII], thank you for that. So, when you originally submitted your, your claim, um, the doctor put on there that your return to date, your return work to date was in [PII]. So the last check that we sent you, we sent, we paid you up to that date. So if the doctor is keeping it keeping you out longer, we need an updated physician statement showing what your new return to date is.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. OK. Is that that.
[CUSTOMER][NEUTRAL] OK, and I understand that. And, and when I called last month and asked y'all that y'all said you didn't need it because I asked when, when I called and turned in my paperwork for January because, you know, I gotta, I gotta turn in my my paperwork every month and I believe it was, uh, December, I think it was like it was right before [PII]. I had turned in my paperwork for January and I called y'all right after I, I, I sent it in.
[CUSTOMER][NEUTRAL] I, I, I, I filled the paperwork out. I scanned it, sent it in, and then I called y'all right after and I said, OK, is that it? Am I good for January? Do I need any more paperwork from the doctor? And y'all told me no. And I said, OK, well, thank you. And so I didn't take care of it. Then when I called on the [PII] and I asked again, do I need any more paperwork? Is everything OK? Are y'all waiting any paperwork from the doctor? Or, and the lady said, no, the, the, uh.
[CUSTOMER][NEGATIVE] It says here right here on the thing that it's been processed and you just, the, the, the check should be released after the [PII]. Nobody said anything about needing more paperwork from the doctor, which is fine, you know, I, I understand what you're saying, but when I asked the last two times, nobody told me that because I specifically asked that.
[CUSTOMER][NEGATIVE] And nobody told me that and that's why I'm a little upset right now.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] So when we process.
[AGENT][NEUTRAL] Um, give me one. So when we process your payment on [PII], we put a note on there.
[AGENT][NEUTRAL] Hold on, let me go pull up the the EOB. Give me one second.
[CUSTOMER][NEGATIVE] So my question is, is why when I called on the [PII] and when I called again on the [PII], why nobody told me anything about getting more paperwork from the doctor?
[CUSTOMER][NEUTRAL] When I specifically asked if that's what y'all needed, and the lady told me, no, everything's fine. I'm just waiting on the, so I said, OK, and I remember because I asked the lady, I said, so you're telling me everything's fine. I'm just waiting on the check, right? You don't need any more paperwork from the doctor, right? And she said, yes. It says right here on the, on the computer that it's the, the, the check has been will be released after the [PII]. That was her exact words to me.
[AGENT][NEUTRAL] So if you look at claim when we sent you out that last payment back in December, if you look at the EOB it shows on there that.
[CUSTOMER][NEUTRAL] But I
[AGENT][NEUTRAL] In order to assist you during the period, we would need an updated physician's form from your doctor to let us know when you turn for work. So when I saw that you called on [PII], the customer service rep.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, she stated that she didn't think anything would be needed. However,
[AGENT][NEUTRAL] Before, after, I mean, before you call, like I said, that information was on the claim that we submit that we paid you out to.
[CUSTOMER][NEUTRAL] Yeah, yeah, I, I, I understand what you're saying. I, I understand what you're saying. I understand what you're saying, but when I called and asked, I wasn't told, I didn't look at the what, what you're telling me, it was sent in an email or something. I, I'm sorry, but I didn't see that. I didn't.
[AGENT][NEUTRAL] No, it was not sent through email. When we sent you the payment back in December, we the
[CUSTOMER][NEUTRAL] When you send me the paperwork in the mail, you're right, you're right when you send me the paperwork in the mail.
[AGENT][NEUTRAL] Yes, and it showed on that we needed the updated information so we can't pay out for disability if a doctor originally said that you're returning to work. We have to have that updated information every time you send in that information.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, I understand that. I understand what you're saying, but why when I called and asked y'all, nobody told me that. That's what I'm asking you because I didn't see it on the paper and that's fine. I'm sure it was on the paperwork. I, I understand what you're saying because I get that paperwork every month and it always says the same thing that and that's why when I call and I ask y'all, I ask the same question. I say, hey, do y'all need any more paperwork or am I good this month? because I remember I asked the same thing last month and she said, no, you're good till December.
[CUSTOMER][NEUTRAL] You know, so, and, and I said, OK.
[CUSTOMER][NEGATIVE] Well, it's for and when I called for December for January, I said, do I need more paperwork from my doctor this month or do you just need the paperwork for me? And I was told twice, no, you're good this month. And I, I assumed it was the next month, but that, that's my. I'm just asking why when I called the last two times, nobody told me anything, especially when I called 2 days ago, because I could have got the paperwork for y'all. I could have got, I could have got the paperwork on the [PII].
[CUSTOMER][NEGATIVE] And, and, and sent it in for me from the doctor. That's no problem. But when I called and asked, nobody told me anything.
[AGENT][NEUTRAL] Yeah, I understand what you're saying. So I'm, so I'm looking in December, December the twenty-seventh was when you called at the end of December and the rep, you asked um if you needed to send in the paperwork for the month, and she said no unless anything has changed, meaning anything has changed from when we originally got, got the first application. So since something has changed with, I mean, which you would have known that the doctor had put on there that you were supposed to be returned to work in December. So since something has changed, so.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's the reason why we needed that paperwork and that's what I'm looking in the notes.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, OK, OK.
[CUSTOMER][NEGATIVE] When I called two days ago, when, when I asked them, is there any more paperwork that y'all need? and they told me no, that it has already been processed, that the, the check was to be released on the [PII], after the [PII] was her words after the [PII]. So when I called two days, I, I understand what you're saying.
[AGENT][NEUTRAL] Let me look at the one for, um, I'm looking at the note for Wednesday to see what that one. Hold on one second.
[CUSTOMER][NEUTRAL] Yeah, I, I specifically, I, I said, is there any more paperwork do y'all need?
[CUSTOMER][NEUTRAL] To get the or, or is the check just I'm just waiting on the check. That was my, that's what I asked her. Am I just waiting for the check? You don't need any more paperwork, right? And she said, yeah, it says right here on the computer that it'll be released after the [PII]. And I said, OK, so because I've had it happen before where it didn't get released exactly on the [PII]. It it it was a couple of days before we got it, which was fine. And I said, OK, so I'm just, I'm, I'm just waiting for the check, correct? And you don't need any more paperwork and she said, yeah, and I, and I was like, OK, thank you, and I hung up.
[AGENT][NEUTRAL] So when you called on the [PII] on Wednesday, the rep said the claim was pending to be released after the [PII]. So, I mean, she gave you the correct information. It was pending. The rep that handles the disability claims hadn't processed the claim. So I mean it was pending.
[CUSTOMER][NEUTRAL] No, she, she didn't say.
[CUSTOMER][NEUTRAL] Now when I called, it was.
[AGENT][NEUTRAL] And so once it was processed, when it was processed later that day, and the reps saw that the information was not updated.
[CUSTOMER][NEUTRAL] Yeah, when I call, when I talked to her.
[CUSTOMER][NEUTRAL] When I talked to her, it said it said processed on the uh it said when I called him and asked.
[AGENT][NEUTRAL] No, it was pending. It was pending to be released, meaning when, when you call in it says pending, that means the claim is pending for it to be processed and it hadn't been processed yet. It was pending, so she gave you the correct information on Wednesday.
[CUSTOMER][NEGATIVE] OK, uh, uh, uh, OK, we're going to talk circles again, OK, alright, so, so, so, so, basically I'm not getting any money until y'all get the paperwork from my doctor, but even if I get the paperwork from my doctor today, I, I'm, I'm, I'm not gonna get any money till.
[CUSTOMER][NEUTRAL] You know, probably Tuesday or Wednesday, correct? Or it might take even longer.
[AGENT][NEUTRAL] It just depending on when you get the, the documentation in. I mean, if you get it in today, yes, sir, it will be sometime next week.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah, of course, it, I guess I don't have any updates on my, my, my, my critical illness claim either, huh?
[AGENT][NEUTRAL] I would have to go to that policy. Give me one moment.
[CUSTOMER][NEUTRAL] I'm so
[CUSTOMER][NEGATIVE] I'm, I'm still waiting on that because uh the, the, the 20 test, blood tests that I, I sent in saying that I have MS wasn't enough. You'll need a, a spinal tap, which my doctor was supposed to send paperwork saying that that's not necessary for an inclusive uh uh uh a procedure like that to prove that I have MS.
[CUSTOMER][NEUTRAL] I'm just, I'm just.
[CUSTOMER][NEGATIVE] go home. I just wanna go back to work. I I never had this.
[CUSTOMER][NEUTRAL] Just going around this circle.
[CUSTOMER][NEUTRAL] And and what paperwork just so I gotta, I, I gotta get this paperwork filled out on a doctor and then sent back into y'all.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I mean, it's just, it's, it's more like the other day, she didn't say anything about pending. I specifically asked her, is there any more paperwork y'all might need? And she said, no. Everything, I said, and so I said again, my wife was sitting right there when I said it. I said, I said, so do, do I need any more paperwork? So I'm just waiting on the check, correct? Yes, yes, that's all. Do I need any more paperwork from a doctor or anything? No, you're OK.
[CUSTOMER][NEUTRAL] That's what I was told. If I had known there was a possibility that I needed more paperwork from my doctor, I'd gotten paperwork from my doctor.
[CUSTOMER][NEGATIVE] That's what's so frustrating about this.
[CUSTOMER][NEUTRAL] And and I have the claim number for the the critical.
[AGENT][NEUTRAL] So the claim for your critical ill and it it's pending um for more information. So it hasn't been.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Correct. Yes, they're supposed to be waiting. They're supposed to be waiting on the paperwork back from my doctor, which I talked to my doctor on the [PII], and he said he was, he, he, he was turning the paperwork in.
[CUSTOMER][NEUTRAL] I was just making, I was just calling to see if they had gotten the paperwork back from the doctor.
[AGENT][NEUTRAL] No, sir, we haven't received the information yet.
[CUSTOMER][NEUTRAL] Because uh I
[CUSTOMER][NEUTRAL] Alright, I, I, I, I'm gonna call my doctor, but I seriously doubt that because he told me on the [PII] he was gonna send it back in, and I've been waiting on this claim since November of last year.
[CUSTOMER][NEUTRAL] But whatever. alright thanks.
[AGENT][NEUTRAL] Yeah, it just depends on if you faxed it or mailed it into, but we haven't received it yet.
[CUSTOMER][NEUTRAL] Mm OK. Uh.
[CUSTOMER][NEUTRAL] Where do I get this paperwork that that I need to to to
[CUSTOMER][NEUTRAL] Where do I get this paperwork that I need to turn in?
[CUSTOMER][NEUTRAL] From the doctor.
[CUSTOMER][NEUTRAL] Oh wait, I think I have a copy.
[AGENT][NEUTRAL] When you sent in the original application, did you download it from the website?
[CUSTOMER][NEUTRAL] No, I got it. I got it from the paperwork y'all sent me in the mail.
[CUSTOMER][NEUTRAL] I'll find the doctor's one just.
[CUSTOMER][NEUTRAL] Whatever, I, I, I'll get it to y'all today and I'm, I'm assuming I'm not gonna get no money until late next week, correct?
[AGENT][NEUTRAL] Like I said, it just depends on, I mean, when you, when we get the paperwork again and we can process for the payment.
[CUSTOMER][NEUTRAL] Yeah, well, alright, whatever, right, thank you.
[AGENT][POSITIVE] No problem. [PII] was