AccountId: 011433970860
ContactId: 7f0c9696-c9d9-402e-bbbc-6450ed4ffaab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 556820 ms
Total Talk Time (AGENT): 173099 ms
Total Talk Time (CUSTOMER): 133793 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=-2.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/7f0c9696-c9d9-402e-bbbc-6450ed4ffaab_20250226T16:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling uh regarding my uh case I have open.
[CUSTOMER][NEUTRAL] Uh, with you guys?
[CUSTOMER][NEUTRAL] Um, I haven't heard back from you, so I'm calling back.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You're calling about a claim, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I can help you with your claim. What is your policy number, sir?
[CUSTOMER][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] 02283755.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, Mr. [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and I'm also going to need you to verify for security reasons, your address, phone number and email address.
[CUSTOMER][NEUTRAL] OK, so it is [PII].
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] My phone number is [PII].
[CUSTOMER][NEUTRAL] And my email address is [PII].
[AGENT][NEUTRAL] OK thank you I appreciate you verifying that information and the phone number that you uh just gave to me is that a good call back number if we get disconnected?
[CUSTOMER][POSITIVE] Yes, that is a good call back number.
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Alright, let me look and see what we got going on here.
[AGENT][NEUTRAL] OK, there is a remark on the claim.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] It says this policy provides benefits due to accidental bodily injury, which means physical damage to an insured person or covered person sustained on or after the effective date. And while this policy is in force, which is the direct cause of loss, independent of disease, bodily infirmity, or any other cause, all injuries sustained in
[AGENT][NEUTRAL] Any one accident and all complications arising therefrom and reoccurrence and complications shall be deemed to be a single injury. Based on the information received, it does not appear that an accidental bodily injury occurred. Therefore, no benefits are payable.
[CUSTOMER][NEGATIVE] No, it did, it did happen. I, I spoke to my doctor. They said to give you the, they said to give you the number of their office because they can tell you that it is a bodily injury. I know you guys are trying, you know, you guys are so smart using words and apparently the pain, I should have used better words when I went to the hospital. I should have told them it was a bodily injury, but since I went in they're saying that my back was hurting because of the accident I had, you guys are, you guys are clinging to that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] You guys are clinging to that to try and deny the claim. So I was told by my doctor to, for you guys to give them a call, and they would, and you guys would tell them and they would tell you that it is an injury. And I was out of work for a whole week, so I'm, I'm I'm, I'm very, I'm very shocked that you guys keep trying to decline the claim.
[AGENT][NEUTRAL] Yes, sir. OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and it just may be that we need the information that you were just talking about what I'm going to do is I'm going to send in a request from somebody from our claims department to have an examiner call you back so that they can get the information that they need from you um.
[AGENT][NEUTRAL] So I'm gonna put you on a brief hold.
[CUSTOMER][NEUTRAL] I was, I already went, I OK.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] I'm gonna put you on a brief hold so I can request that for you and then I'll be right back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] To booty.
[AGENT][NEUTRAL] 856-4845.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] Don't fucking time every check. That's the problem.
[AGENT][NEUTRAL] OK [PII], this is [PII] back with you again. I've got that request in so that somebody from the claims department and examiner can give you a call back within 24 hours.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Yeah, because I need this resolved. I, uh, it's already been like over a month and the bills are here, so I need, I need to get those paid up.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And I'm not, I'm not gonna pay out of pocket because that's why I'm paying for this insurance. Whether you guys wanna use wordplay of of of lower back pain or injury or bodily injury, it was an injury. You guys need to pay.
[AGENT][NEUTRAL] Yes, sir. I understand.
[CUSTOMER][NEGATIVE] Just like I'm paying every month, you guys need to do the same.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I understand, sir, and I've got that request and.
[CUSTOMER][NEUTRAL] Right, not even every month, it's every week.
[AGENT][POSITIVE] Right, I understand and I do have that request and so that somebody can give you a call back and talk about the claim with you OK? And you guys get worked out.
[CUSTOMER][NEGATIVE] Is there a way you can get them on the line right now? I can wait on the line because a whole another 24 hours it's, it's too long for me.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No, we, we don't do that, um, we have to send in a request for them to call you back and I've done that for you so you should be getting a phone call within 24 hours.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you so much, [PII]. I hope you have a