AccountId: 011433970860
ContactId: 7563decf-2c39-4329-b8d1-3398db77ce35
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 824739 ms
Total Talk Time (AGENT): 342732 ms
Total Talk Time (CUSTOMER): 248609 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/7563decf-2c39-4329-b8d1-3398db77ce35_20250218T18:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Bye
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Who would I speak to regarding, uh, being a bene beneficiary? My son passed away, [PII].
[CUSTOMER][NEUTRAL] I need to file a claim.
[AGENT][POSITIVE] OK, yeah, we can definitely take a look. Do you have the policy number?
[CUSTOMER][NEUTRAL] Um, tell me, I have the card here in front of me. Hold on, and you have to tell me which one, which information you need.
[AGENT][POSITIVE] OK, no problem.
[CUSTOMER][NEGATIVE] Oh darn.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, here we go here. OK.
[CUSTOMER][NEUTRAL] OK, um, which number you need here?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] So there should be I believe a member ID number. Do you see anything like that or a certificate number?
[CUSTOMER][NEUTRAL] Member ID here we go.
[CUSTOMER][NEUTRAL] Number I see group number.
[CUSTOMER][NEUTRAL] Coverage I see policy number, member ID I see pay your ID.
[AGENT][NEUTRAL] So yeah, I need the policy number. If you see a policy number, that's what I would need. OK.
[CUSTOMER][NEUTRAL] I have that.
[CUSTOMER][NEUTRAL] 02570546
[AGENT][POSITIVE] Thank you so much give me just one moment please. Let me pull this up here.
[AGENT][NEUTRAL] OK, I've got this pulled up here and then for [PII], can you just verify with me the address we would have had on file and date of birth.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And so you're needing to file some file some claims under this, correct?
[CUSTOMER][NEUTRAL] Correct, I have no idea what I'm doing.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] It looks like what [PII] had with us was there was like a secondary plan that was like a gap coverage. um, so that would have covered any sort of cost, um, bridging the gap between like whatever the primary insurance was, um, and this would have picked up any other secondary cost, and then there was, let's see.
[AGENT][NEUTRAL] Look at this other one here.
[AGENT][NEUTRAL] And then the other one was, it looks like accident.
[CUSTOMER][NEUTRAL] Right, that's what the employer told me he had accidental insurance.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So let's see.
[AGENT][NEUTRAL] Alright, let's see here and so you're needing to file it under the accident one is that the one that we're needing to file under?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. Mm.
[CUSTOMER][NEUTRAL] They also mentioned he had a worker's comp claim as well.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] He got injured at work.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't see they had filed it underneath the accident uh claim.
[AGENT][NEUTRAL] For the accident policy?
[CUSTOMER][NEUTRAL] I don't think so. I, I don't think so cause she mentioned the gaba thing cause he was um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] It was, yeah.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] That was something that was done prior before the accident, before he expired.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Hm, let me see if I see anything.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah, I don't see any that have been filed under the gap plan.
[AGENT][NEUTRAL] Um, but if they, you know, if they still need to be filed, they definitely still can be, but I don't show any other, any claims that were filed under his secondary.
[CUSTOMER][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] So, um,
[AGENT][NEUTRAL] And as far as filing for under the accident policy, um.
[AGENT][NEUTRAL] First thing we'll need to do is get you a claim form. So let me get over to that portion.
[AGENT][NEUTRAL] Do you have um a good email address that I could send the claim form to?
[CUSTOMER][NEUTRAL] Yes [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. So, [PII], and then you said [PII]. Is that [PII]?
[CUSTOMER][NEUTRAL] One word, [PII], one word, yes.
[AGENT][NEUTRAL] OK, so the accident claim form is a total of 5 pages.
[AGENT][NEUTRAL] Um, the very first page is complete instructions as far as what needs to be submitted for supporting documentation depending upon what you're filing the claim under, um, and has a whole list, um, you know, if it's accident which resulted in death, you do have to provide a death certificate.
[CUSTOMER][NEUTRAL] OK, I'll have that.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And then the very first portion will be just statement about the insured, that would be [PII]. um, then it will ask for uh details of the accident.
[AGENT][NEUTRAL] And uh
[AGENT][NEUTRAL] The policy number looks like you have that.
[AGENT][NEUTRAL] Um, there is a portion, um, let's see.
[AGENT][NEUTRAL] For any attending physician also, it looks like, and that's the very last page, page 5.
[AGENT][NEUTRAL] Um, claim forms can be resubmitted back to us either via fax or you can do it in the US postal mail, and the mailing address and fax number are on the claim form, but if you'd like, I'm happy to give those to you also if you'd like to write them down.
[CUSTOMER][NEUTRAL] OK, I have a pen ready. uh-huh.
[AGENT][NEUTRAL] So the claims mailing address you would mail this to ATL.
[CUSTOMER][NEUTRAL] Let me ask you, um, looking at the.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Card.
[CUSTOMER][NEUTRAL] Oh, I thought maybe that was the address I saw here, but go ahead, I'm ready, sorry.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And it's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] So it's the address that's on the back of the card I see. American Public Life. Yeah, that's what I was confu.
[AGENT][POSITIVE] OK, great.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, quick question.
[AGENT][NEUTRAL] OK, yeah, I just wanted to make make sure you have the right one. Some of our cards have an old address in [PII], so.
[CUSTOMER][NEUTRAL] Mhm, go ahead.
[CUSTOMER][NEUTRAL] OK. Question, because he never left ICU trauma?
[CUSTOMER][NEUTRAL] There were several different doctors that attended to him.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So my question is, cause we, me and the family went through this with the other insurance, um, the death certificate was sufficient because it had the physician's signature and the cause of death.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Oh, OK, yeah.
[CUSTOMER][NEUTRAL] So did that other form have to be submitted or the death certificate was sufficient? Cause it has the, all the information there.
[AGENT][NEUTRAL] That
[AGENT][POSITIVE] Yes, ma'am. I apologize. That would be sufficient. Yes, ma'am.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, that's good. OK. OK.
[CUSTOMER][NEUTRAL] So, you said the best way is to fax it or email it back to you, to your email, or?
[AGENT][NEGATIVE] You cannot email it back to me unfortunately email is not secure so the quickest way to submit it would be via fax.
[CUSTOMER][NEUTRAL] Do we still have those? Go ahead. What's the fact? What's the fax number?
[AGENT][NEUTRAL] We do.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and that's the fax and I'll put the policy number I'm thinking as uh.
[CUSTOMER][NEUTRAL] OK, that's right here.
[AGENT][NEUTRAL] You can just mark if you decide to fax it, you can just mark it attention to claims.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Attention to claims, OK, was there anything else um we needed?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] No, ma'am, not that I can think of. Um, if you ever, you know, if you think of anything else or have questions or concerns, you feel free to, of course, give us a call. We're always here to help.
[CUSTOMER][NEUTRAL] Oh, how long is the process?
[AGENT][NEUTRAL] Generally ask once a claim is received that you give us a 7 to 10 days for the claim to be processed.
[CUSTOMER][POSITIVE] OK, alright, thank you. What's your name? You were so kind.
[AGENT][NEUTRAL] Oh, no problem. My name is [PII].
[CUSTOMER][POSITIVE] So, everyone has been so kind with the situation going on.
[AGENT][POSITIVE] Oh, I'm so sorry to hear about your loss and unfortunate situation.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, thank you so much. He was on the way to work, crossing the street, and the car hit him. You know, it's still dark here in [PII] at [PII]. It's still dark between those times.
[AGENT][NEUTRAL] No.
[AGENT][POSITIVE] Oh my, bless your heart.
[CUSTOMER][POSITIVE] But thank you so much, man. Thank you.
[AGENT][POSITIVE] Yeah, absolutely. If you think of anything else, like I said, [PII], please give us a call, OK?
[CUSTOMER][POSITIVE] Thank you. You take care. Thank you much.
[AGENT][NEUTRAL] You too, bye bye.