AccountId: 011433970860
ContactId: 8503f116-1b16-4123-852e-51425a3c4b49
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1070000 ms
Total Talk Time (AGENT): 532920 ms
Total Talk Time (CUSTOMER): 529819 ms
Interruptions: 13
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/8503f116-1b16-4123-852e-51425a3c4b49_20250407T19:04_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], my name is [PII].
[CUSTOMER][NEUTRAL] My policy number, are you ready?
[AGENT][NEUTRAL] Uh, yes, so you can go ahead and give me that.
[CUSTOMER][NEUTRAL] 2 I'm sorry 02597992.
[AGENT][NEUTRAL] OK, thank you. And I'm so sorry, [PII]. What was your last name again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Your phone, what's your phone number?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you. And while I'm getting your information pulled up, uh, how can I help you today?
[CUSTOMER][NEUTRAL] 9
[CUSTOMER][NEGATIVE] Yeah, I've filed for a disability, temporary disability. I got two toes cut off and now I'm literally getting IVs through a PICC line twice a week in the nursing home.
[CUSTOMER][NEUTRAL] And all my bills are come due. It's been over a month and I was just wondering what status of the insurance claim.
[AGENT][NEUTRAL] OK, so you're trying to.
[CUSTOMER][NEUTRAL] The doctors already sent their stuff off.
[CUSTOMER][NEUTRAL] Yeah, and I sent the paper for the direct deposit on Thursday or Friday.
[AGENT][NEUTRAL] OK, miss
[AGENT][NEUTRAL] OK, so you're calling to follow up to verify that we received your direct deposit information and also to check the status on your claim, is that correct?
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][POSITIVE] Yes ma'am. Yes ma'am.
[AGENT][NEUTRAL] OK, yes, well, I can help you with that. And first off, [PII], I will need to verify several things with you for security and also any information that I do provide would be a verification of benefits and not a guarantee of payment. So if you can first please verify your date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Also your home mailing address, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is also the same as the one that you provided for me. So again, that is your best contact number. Is that correct?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][POSITIVE] Thank you and lastly your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Now, the policy number that you provided for me, that is your hospital indemnity.
[AGENT][NEUTRAL] Limited benefit plan. Let me see what other coverage you have with us.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's the only one I've ever gave him and I've called in probably 10 times.
[CUSTOMER][NEUTRAL] life.
[AGENT][NEUTRAL] Yes, sir. Now, have you ever set up your profile because they're cross-referencing it is what it is, Mr. [PII]. They're using that one number to look at your other policies cause the one you gave me, again, that's your hospital indemnity plan. Your disability policy does have a different policy number. I can give that to you if you would like.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] If you're able to
[CUSTOMER][NEUTRAL] You got a pen and paper. My wife's getting a pen and a paper now.
[AGENT][NEUTRAL] To take
[AGENT][NEUTRAL] OK, and I'm also going to email you, yeah sure [PII] I'm gonna get email you our user guide for our portal so that you if.
[CUSTOMER][NEUTRAL] If you can give me just a second.
[AGENT][NEUTRAL] If you're able to set up your profile in the portal that will give you access to all of your information related to your policies that you have with APL and you'll be able to see each of your policy numbers and you can also look at your claims information in there as well so I'll email you that after we get done with our call.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm in the nursing home. I'm in the
[CUSTOMER][NEGATIVE] I'm in a nursing home with no help. I don't know how to set that up.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] If you would like for me to go ahead and still email and I can if you, if you don't think that you want to do that, or, you know, at any point, then that's fine as well.
[CUSTOMER][POSITIVE] I'm ready for the.
[AGENT][NEUTRAL] But your disability policy number is 02.
[AGENT][NEUTRAL] 59.
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] 59.
[AGENT][NEUTRAL] 79.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] 94.
[CUSTOMER][NEUTRAL] 79
[CUSTOMER][NEUTRAL] 9402597994
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] That is correct. So I can see that there was a claim reviewed for you the other day on the [PII] on your disability policy and that claim at this point has been denied. Give me just a moment to look up the remark as to the reason.
[CUSTOMER][NEUTRAL] You know.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so the reason at this point states the claim form submitted was incomplete. In order for additional consideration to be given to your claim, please have your employer to complete the employer's portion of the claim form in its entirety. Your claim.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] There is no way I can do that. I'm in a nursing home. I have not got an employer. My employer fired me with an emergency medical discharge. I have 6 months to heal and come back, but I was terminated. I explained this whole thing to the, the, I explained this whole thing.
[AGENT][NEUTRAL] OK, so for this.
[CUSTOMER][NEUTRAL] To them and they took it all down.
[AGENT][NEUTRAL] Who, when you say they, um, are you, were you speaking to someone at APL?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Oh that looks like that can be so nice sheer in there, but
[AGENT][NEUTRAL] OK, I do see where you had spoken.
[CUSTOMER][NEUTRAL] Just that
[AGENT][NEUTRAL] To someone on the [PII] prior to the claim being processed, but that is the required documentation.
[AGENT][NEUTRAL] Mr. [PII], that we have to have a further review.
[CUSTOMER][NEGATIVE] We were never sent out. We were never sent any.
[CUSTOMER][NEGATIVE] I've not been sent any of that and on top of it, I'm in a nursing home now with two toes cut off and fired from my job. I mean, I don't understand how you can take premiums and then whenever I really need this insurance, tell me I'm denied when I'm stranded and my rent can't be paid now. That's the whole reason I took the policy out. I'm literally going broke and was terminated.
[AGENT][POSITIVE] Now, benefits.
[AGENT][NEUTRAL] Benefits in a card, Mr. [PII], is who handles any of your premium deduction. Benefits in a card is the company that you enrolled with.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And they told me that I was
[CUSTOMER][NEGATIVE] And they told me that I was covered until April, and that's who I spoke to about me not wanting to lapse my coverage. But my coverage is no good anyway. That's why I'm in a nursing home because I am not in your circle.
[CUSTOMER][NEGATIVE] To get in-home care, so I got sent to a nursing home because I'm not in your circle of providers. So, I mean, it's kind of like stealing money from me, actually, because you took $147 a month in premiums and I'm almost a month out and still got denied on my disability and I'm living in a nursing home residing there.
[CUSTOMER][NEUTRAL] With getting terminated from the job that I was buying insurance from literally $147 a month.
[AGENT][NEUTRAL] So again, I think.
[AGENT][NEUTRAL] That the deductions for your premium, that is not taken by us. That is handled, and I'm sorry that you're going through all of this, but there are certain documents and certain pieces of information that are required.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] But the insurance that
[CUSTOMER][NEGATIVE] Then why haven't, why hasn't this company sent?
[CUSTOMER][NEGATIVE] OK, now you've talked. Let me talk. You've not sent me those documents. I've been asked 3 times. I've called you every time. I've got put in the hospital twice and got 2 separate toes cut off and called you immediately both times.
[CUSTOMER][NEGATIVE] You guys like the email stuff, but you won't send anything in the mail. I've not got one thing from you in the mail, and it's been 3.5 weeks. And I still, I signed everything I was supposed to sign and the doctor sent the papers in, and they told me that was the only forms I needed. How do you propose that I get 35 miles away whenever I'm in a nursing home in [PII] with no transportation to [PII] to the
[CUSTOMER][NEUTRAL] To my employer that terminated me on a medical separation.
[CUSTOMER][NEUTRAL] She must have hung up. Oh.
[AGENT][NEUTRAL] No, sir, I didn't hang up, but I was listening to you as you had asked if I would listen to you.
[CUSTOMER][NEUTRAL] OK. A lot of people.
[AGENT][NEUTRAL] So the claim form, the claim form that you had was a total I believe of 8 pages in length, and um there are sections labeled for you, your employer, and your physician. Those forms can be faxed to your employer.
[AGENT][NEUTRAL] But we have to have all three of those sections on a claim form in order to review for a disability claim.
[CUSTOMER][NEUTRAL] She sent us what? 334 papers.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I was like, so I just.
[CUSTOMER][NEUTRAL] In an email.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] because my nurse from the surgeon is the one that printed them off.
[CUSTOMER][NEUTRAL] And we send everything that they mailed us in an email to my doctor which printed them all off and I went and picked them up, signed mine and took them back to the doctor.
[CUSTOMER][NEUTRAL] There was nothing for the employer.
[AGENT][NEUTRAL] OK, so when
[AGENT][NEUTRAL] Where did your initial claim form came come from that you've completed? Did you print that offline or how did you obtain that? Because that's a total.
[CUSTOMER][NEUTRAL] today
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Email
[AGENT][NEUTRAL] Who emailed it?
[CUSTOMER][NEUTRAL] The same number that I called right now.
[CUSTOMER][NEGATIVE] Some lady, I don't know her name. I didn't get her name, but she emailed me stuff and then had me check and make sure there was stuff. And then I didn't get the direct deposit form until two weeks later and emailed it last Thursday. I had to call and get it mailed again because I was reading through the stuff and it said it won't get processed without the direct deposit form either.
[AGENT][NEUTRAL] OK. So I don't know if the confusion was on the fact that you were giving me a policy number that's not your disability policy. You said that's the only policy number you have been given.
[AGENT][NEUTRAL] When you call in, that's the only one you've ever given, so let me look at the notes on there because your hospital indemnity policy, which is the policy number you gave me.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That's the only one I've ever given.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] That has a completely different claim form.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] Than the disability.
[AGENT][NEUTRAL] That's 2 separate claim forms.
[AGENT][NEUTRAL] And I can see that you do have several things in line for review under your hospital indemnity policy.
[AGENT][NEUTRAL] I see the note regarding your direct deposit.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] I see all of that. Yeah.
[CUSTOMER][NEGATIVE] Well, I guess I need you to please email me all the papers I need to do this because I'm literally a month behind on my rent now.
[AGENT][NEUTRAL] So what I will do is.
[CUSTOMER][NEUTRAL] And I will call ISS and I will ask for their fax number.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, so yeah, OK, so what I will do when we get off of the phone is I will send you an email that is the complete.
[CUSTOMER][NEUTRAL] I guess
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Disability claim form.
[AGENT][NEUTRAL] So again according to what we already have received and reviewed it's just the employer section of that claim form but I'm sending you the full claim form, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, all right, the nursing home might be able to help me print all these off the social service workers.
[AGENT][NEUTRAL] And then I will also
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, cause you said that she helped you with some of your other stuff?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] She helped me with the uh direct deposit form.
[AGENT][NEUTRAL] OK. So yes, sir, if she was able to help you with that, she should be able, you know, I would think to pro probably be able to help you with this. And I can see that your direct deposit information has been placed on both of these policies.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. I have looked at both of them, your hospital indemnity and your disability. So,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] In addition to.
[AGENT][NEUTRAL] Attaching that claim form I'm also gonna go ahead and just attach that user guide for our online portal so that you know you will have that information.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] As well. The email that you're gonna receive. Oh, you're welcome.
[CUSTOMER][POSITIVE] Right. I appreciate it. I know that it's not your fault that this has happened.
[AGENT][NEUTRAL] And I'm not, no, sir. I'm not taking your, I understand that you're frustrated. I, I do. I'm not taking it personal at all. You have a lot going on. Um, yes, sir. It sounds like you have an awful lot going on. But um the email that you're gonna be looking for.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, good, I hold on.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And again you're gonna have this in just a few minutes we'll come from [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I will put APL.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] In your subject line so that that's easy for you to recognize.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, so you're sending, uh, let me get it right, you're sending the whole package, but the only thing I have left to finish my claim is the employer's part.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, and then it'll take another 7 to 14 days.
[AGENT][NEUTRAL] And if there is a way.
[AGENT][NEUTRAL] It depends on how long it takes, you know, I mean, yes, it's from the time the information is received. Disability claims are usually processed each month by the [PII]. That's when we review all disability claims, but it's gonna be depending on how soon your physician, I mean your employer rather, I'm sorry, your employer gets that back to us as well.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Probably worth
[CUSTOMER][NEUTRAL] Well, I just came home to get.
[CUSTOMER][NEGATIVE] My, uh, my car because of this disaster flood. I, anyway, I, I came to get this other car because I got transported straight there to the nursing home so I'll have a car if I can get these papers printed off, I will drive them directly because I'm like not.
[AGENT][POSITIVE] Mm, oh my goodness.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] All I have to do is be there for the IVs in the morning and the evening, so after I do my thing like Thursday I will drive them.
[AGENT][NEUTRAL] Yes,
[CUSTOMER][POSITIVE] Or tomorrow maybe even I'll drive it to [PII] and tell them that it's imperative that they do this so I can get paid.
[AGENT][NEUTRAL] OK, and there is a fax number that's on the bottom of the first page.
[AGENT][NEUTRAL] Of the disability claim form and that is our secured fax line so it could be sent to attention claims at that number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, is that's probably the same number that I was on the direct deposit form right here.
[AGENT][NEUTRAL] I'm sure that it was. I'm yes, sir.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] An 87 it's an [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, so the hard copies that I had that the doctor sent that I signed and took back into the doctor, I didn't get to keep those hard copies because the doctor kept them and faxed them for me or done whatever he done. I've got the hard copy of the of the direct deposit form and uh I, I guess I should copy the other ones that uh uh employer has, huh.
[CUSTOMER][NEUTRAL] Probably.
[AGENT][NEGATIVE] If you want to keep your records because we are unable to send things back.
[AGENT][NEUTRAL] Once we receive documents, we, we don't send them back out. Yes, sir.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] OK, so, uh, I guess I appreciate you sending, I appreciate your help. I'm sorry for the frustration. I just, my wife has got a lot going on with no money coming in.
[AGENT][POSITIVE] Oh, you're welcome.
[AGENT][NEUTRAL] No.
[AGENT][POSITIVE] Yes, sir. No, I, I did, you're fine. Uh, it's, it's, it's all good. OK.
[CUSTOMER][NEUTRAL] so
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] So I hope you get to doing better really soon. And it, you should have that email within the less than 5 minutes.
[CUSTOMER][NEUTRAL] OK, well I'll look for that email.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you very much. I hope you have a blessed day.
[AGENT][POSITIVE] OK. Well, I hope you have a blessed day too, and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Alright bye bye.
[AGENT][NEUTRAL] Bye bye