AccountId: 011433970860
ContactId: 76416ba6-b517-4efe-a273-0234c29096ca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 237839 ms
Total Talk Time (AGENT): 102847 ms
Total Talk Time (CUSTOMER): 89183 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/76416ba6-b517-4efe-a273-0234c29096ca_20250603T14:16_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII], how you doing? This is [PII]. I was calling. I have some questions about a claim I had.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and can I get your policy number, Ms. [PII]?
[CUSTOMER][NEUTRAL] 24
[CUSTOMER][NEUTRAL] I'm sorry, it's 0 024.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 49514
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify your your date of birth for me? I'm sorry.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and was that claim on you or is that the one for [PII]?
[CUSTOMER][NEUTRAL] But you show.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like that one was processed on um [PII].
[AGENT][NEUTRAL] And on this one it looked like the services were rendered prior to his effective date on the policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, because that's the hospital policy I knew because I didn't, yeah, I didn't add him to that policy until January, but he still was on an accident policy.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, alright, so.
[CUSTOMER][NEUTRAL] So that's what I'm trying to figure out.
[AGENT][POSITIVE] Well, whenever, whenever he has a claim to come in, they do put it on any any policies that you have that he's covered on they'll try to put it on any policies just so we can see if we can provide you benefits under each one in any of your policies so that way you won't miss any benefits.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that's the reason for that.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I'm, I'm confused because I don't know if
[CUSTOMER][NEUTRAL] That claim was denied because I got so many denial letters, I don't know, like so many letters saying it wasn't under that plan and
[CUSTOMER][NEUTRAL] So I don't know if this was the the last policy that they worked on or if they're working on another one to see if it's a is it covered on another one or just just is it.
[AGENT][NEUTRAL] No, this is under your hospital indemnity, so this would pay like for, you know, when he was in the hospital, you know, as long as he was covered at the time, this is your hospital policy, so let me see what they're doing with the accident policy. Give me one second.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Excuse me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK, and so under the accident policy we're still waiting on the medical records.
[CUSTOMER][NEUTRAL] OK, cause I'm so confused with all this because it's.
[CUSTOMER][NEUTRAL] Like I said, I didn't know if it was uh the the accident policy that they had worked on, but that was the hospital policy.
[AGENT][NEUTRAL] Mhm. Yeah, ma'am, it was the hospital indemnity policy.
[CUSTOMER][NEUTRAL] OK, yeah, because I know he, I know I didn't add him to January for that policy. That's why I knew he wasn't gonna be covered under that one. That's why I thought it was just under the accident, but now you I understand what you say it's for all of them. They do it for all of them.
[AGENT][NEUTRAL] Mhm, yes ma'am.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So they're still working on the one for the accident policy.
[AGENT][POSITIVE] Yes ma'am, yeah.
[AGENT][NEUTRAL] I wanna say that she requested the medical records from the hospital and also uh they requested I guess some more detailed uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Report from the police department. They did contact them and uh they told them they could request a more detailed report.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Alright, well thank you I appreciate it.
[AGENT][POSITIVE] OK. No problem.
[AGENT][POSITIVE] Alright, if there's nothing else, Ms. [PII], thanks for calling ATL and have a great rest of your day.
[CUSTOMER][POSITIVE] Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Alright bye bye.