AccountId: 011433970860
ContactId: 85ad705c-d361-47ab-b9aa-759f3f8be71b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 472230 ms
Total Talk Time (AGENT): 175404 ms
Total Talk Time (CUSTOMER): 105353 ms
Interruptions: 0
Overall Sentiment: AGENT=1.6, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/85ad705c-d361-47ab-b9aa-759f3f8be71b_20250513T22:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, Miss [PII], I don't know if I.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEGATIVE] My, my phone had lost connection, but uh I'm back. Uh my name is uh [PII]. Yes, ma'am. I don't know who picked the phone up but it hung up. It lost connection. I'm sorry if it was you.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Oh, that's OK. No, it wasn't me, but I'll help you.
[CUSTOMER][NEUTRAL] OK. Um, I was calling to check on my claim. Um, I sent the paperwork in that I was told to send in.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] But I think some, yeah, I'm trying to see what else they need now cause that's all she said I needed.
[AGENT][NEUTRAL] OK, I can help you with your claim. Can you, um, give me your first name again, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK and then what is your call back number just in case the call gets disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, ma'am. And then may I also have your policy number?
[CUSTOMER][NEUTRAL] 1554482
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[AGENT][NEUTRAL] OK, Ms. [PII], can you please give me your date of birth?
[CUSTOMER][NEUTRAL] A [PII].
[AGENT][POSITIVE] Thank you. And then also your address, phone number and email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] [PII] um [PII] and then uh [PII].
[AGENT][POSITIVE] Thank you. I appreciate that very much. You update or giving me that information. All right.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] So I do see that there was a claim sent in on [PII]. Is that the one you're calling about?
[CUSTOMER][NEUTRAL] Yeah, it was the rest of the paperwork for the claim for [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I had called um Miss [PII] was telling me what I needed, the itemized bill and my direct deposit form. So I sent it in and I see it's still, they still denied it.
[AGENT][NEUTRAL] OK, so I do have a remark on the poli on the claim.
[AGENT][NEUTRAL] So, this is what the remark 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.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] is in force, which is the direct cause of the loss independent of disease, bodily infirmity, any other cause, all injuries sustained on any one accident, and all complications arising therefrom and reoccurrence and complications shall be deemed to be a single injury.
[AGENT][NEUTRAL] Based on the information received, it does not appear that an accidental bodily injury occurred. Therefore, no benefits are payable.
[CUSTOMER][NEUTRAL] OK, so it was a knee injury on the right and acute pain of the right knee.
[AGENT][NEUTRAL] OK, so what I can do for you is um I can send in a request.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] I think uh
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yeah, I sent them my diagnosis for it. It says acute pain of right knee, knee injury on right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so what I.
[CUSTOMER][NEUTRAL] And then I sent in the itemized bill, OK?
[AGENT][NEUTRAL] What I can do for you is I can send in a request for a claims specialist to call you and go over how they process the claim with you so that you guys can talk and um talk about the claim. Would that help you?
[CUSTOMER][NEUTRAL] Yeah, because I don't know what the difference from now are.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, I understand, I understand. So what I'm gonna do is I'm gonna put you on a quick hold while I get that um request sent in and then I'll get back with you on the phone just as soon as it's complete, OK?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right, thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you so much, Ms. [PII] for holding for me. I have that request sent in and you should be receiving a phone call back from a claims specialist within 24 hours.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, no problem. Thank you, Ms. [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're so welcome. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Uh, no, ma'am. That'll be all.
[AGENT][POSITIVE] OK, Ms. [PII], I hope you have a beautiful night and thank you for calling APL.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] You're welcome. Bye-bye, ma'am.