AccountId: 011433970860
ContactId: 771dae12-84da-433e-8a27-960fe2834b48
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 594789 ms
Total Talk Time (AGENT): 269280 ms
Total Talk Time (CUSTOMER): 303972 ms
Interruptions: 3
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/771dae12-84da-433e-8a27-960fe2834b48_20250130T17:21_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, yes, I was calling. I had some questions. I am a, um.
[CUSTOMER][NEUTRAL] Um, I have, I believe I have this policy. Um, I don't believe, I know I have it, but I don't really know how it works. So I had to go to the ER because I fell down my stairs and um I'm gonna have to have surgery now. But I just, I'm not sure like what, I don't, what do I need to do? Or do I give the information to them, or is this something I file on my own?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Right
[AGENT][POSITIVE] Well, I can help you with that. And do you happen to, it's my pleasure. I'm sorry you fell down your stairs.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Um, OK.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] I am so sorry about that. What is your policy number?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mm, OK. See, I don't know where I would have that at.
[AGENT][NEUTRAL] Do you have an APL card?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] An APL card would that have been sent to me in the mail?
[AGENT][NEGATIVE] Yeah, it should have been sent to you in the mail.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] I'm seeing if maybe I got an an email about it.
[AGENT][NEUTRAL] I can look it up by your social as well, if you would rather.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah, let's do that. Um, it is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Good.
[AGENT][POSITIVE] Thank you. And what is your name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh my [PII].
[AGENT][POSITIVE] Thank you, Ms. [PII]. Let's see, bear with me just one second.
[CUSTOMER][NEUTRAL] I give you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I think it's so stupid.
[CUSTOMER][NEUTRAL] you.
[AGENT][NEUTRAL] And what is your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] Uh, it is, my date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And my mailing address is [PII].
[AGENT][POSITIVE] Thank you and what is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And finally, what is your email address, please, ma'am?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] It is [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] OK. So I am showing you do have an accident policy with us.
[CUSTOMER][NEUTRAL] Yeah sure.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And in order to file a claim, you would file the claim and we would pay you direct. And there's several options. We do have a portal if you go to [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You can log in as a new user and create a login and password you can get the claim forms online with the instructions and you can upload the documents directly online if you don't.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, and it's [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, got it. OK, alright, so go ahead.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] With that, um,
[CUSTOMER][POSITIVE] So I can just upload everything there.
[AGENT][NEUTRAL] You certainly can. And you can also check claim status, you can click on your policy number and view your policy benefits.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the claim form for accident claim form is online?
[CUSTOMER][NEUTRAL] So is it.
[CUSTOMER][NEUTRAL] OK, so is, um, that, so is it right that basically I would just get $500?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, alright, um, for each ER visit or just it's a one time?
[AGENT][NEUTRAL] It's per accident diagnosis.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, yeah, I was gonna say because it has to, the diagnosis has to,
[CUSTOMER][NEUTRAL] be an accident, right?
[AGENT][NEUTRAL] That's correct. I was fixing to make sure it make sure that they give you the the accident diagnosis. So a lot of times when you go to the doctor, if I sprain my ankle, I'll say, yeah, well, my left ankle hurts, and they'll give me a pain diagnosis. But you know, you're telling me if you fell and, and twisted your ankle, uh, then they should have an accident diagnosis due to the injury. So that would include the injury.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] just
[CUSTOMER][NEUTRAL] We.
[CUSTOMER][NEUTRAL] Let me look and see what they, I'm see what they wrote on here phone calls.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do they, do you have a diagnosis code?
[AGENT][NEUTRAL] Do you know what a diagnosis code looks like? It's gonna start with a letter followed by two numbers.
[CUSTOMER][NEUTRAL] Um, I was gonna look on here.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And then a decibel and large number, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, let me see, um, what they said. Oh, it just says you have an ankle injury, a fracture is treated with a splint. If the bones make up the ankle joint, um.
[CUSTOMER][NEUTRAL] OK, so I may need to reach out to the hospital then and get that.
[AGENT][NEUTRAL] They should have that it when you went for medical attention, you can also ask for the medical notes, and they should say something like, you know,
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Ankle fractured due to falling down the stairs or whatever, you know, um, the reason might be. So we need the reason that you were injured.
[CUSTOMER][NEUTRAL] OK, right, OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What happened?
[CUSTOMER][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] And so the accident claim form.
[CUSTOMER][NEUTRAL] 6
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the itemized bill with the diagnosis codes.
[CUSTOMER][NEUTRAL] OK. Um, I, I was just looking close, uh, OK, so right here it says you were seen today for closed right fracture ankle fall from slipping, tripping, or stumbling.
[AGENT][NEUTRAL] OK, you may wanna highlight that if you can just highlight it when you submit it that way they, they will see that what was due to a fall.
[CUSTOMER][NEUTRAL] Is that
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK. OK, well, maybe I will, I should probably get something from them, um, regarding all of that, but it says I have 60 days, right, to get all that in?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] There's actually no time frame. Now, there is a time frame to get medical attention.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But no, no, no time frame for submitting the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, well, thank you. I will set myself up an account then and um get that taken care of.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] And there's gonna be several options um once you create that account if you want to be, to receive a text message when claim has been processed.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Um, you'll have that text messaging option for that. Now, once it's processed, you'll you'll get a text message immediately when it's processed. It could take up to 24 hours to view in the portal. It has to go through the imaging processing and all that. Um, there's also an option for direct deposit for your benefits to go directly to your bank account.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] right.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Of course, to view your policy benefits, you would click on the policy number and you also have a cancer policy as well. You can view those benefits online also.
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][NEUTRAL] And do you want me to give you your accident policy number?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Yes, yes. Is that for this particular one that we're calling about?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] For this, that's right, for this accident policy number, it is 254.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 1500. That's available online as well, but just so you have it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Perfect. You're the best. Thank you so much for taking time to help me with that.
[AGENT][POSITIVE] Oh, it's been such a pleasure and if you have any questions or concerns, never hesitate to give us a call because we are here to help you any way we can.
[CUSTOMER][NEUTRAL] You want
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] It's been such a pleasure, Ms. [PII], and thank you for
[CUSTOMER][POSITIVE] You have a wonderful day.
[AGENT][NEUTRAL] I hope you do too, and I hope your ankle gets you feeling better.
[CUSTOMER][POSITIVE] Sounds good.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] And thank you for calling APL bye bye. You too, bye bye.
[CUSTOMER][POSITIVE] Have a good day.
[CUSTOMER][NEUTRAL] Uh-huh, bye-bye. OK bye. I see 1 to 20 characters in most contain.
[CUSTOMER][NEUTRAL] What that was a different one. I gotta call them. Please enter a valid user name.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Username must be 1 to 20 characters and they contain.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, so this just needs to be at.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEGATIVE] This is a pain in that
[CUSTOMER][NEUTRAL] Yeah but yes.
[CUSTOMER][NEUTRAL] Do not fall, do not get hurt.