AccountId: 011433970860
ContactId: 8cdfd8ea-c70f-4d4e-a987-94512c0d4538
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 524770 ms
Total Talk Time (AGENT): 162038 ms
Total Talk Time (CUSTOMER): 248839 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/8cdfd8ea-c70f-4d4e-a987-94512c0d4538_20250402T14:56_UTC.wav
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[AGENT][POSITIVE] Good morning and thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. How are you? This is [PII].
[AGENT][NEUTRAL] I'm fine thanks how are you?
[CUSTOMER][NEUTRAL] I'm good, I'm good. Um, I have a, um, wife of a member on the line. He, he has passed away and she's trying to do all her, the claims and everything. We have received the death certificate. Um, but it looks like, um, she's stating that she sent all the information that we're requesting. I went over the EOB and asked her for everything we need, but she is saying that she already sent all that information that we're just overlooking.
[CUSTOMER][NEUTRAL] Um, so I don't know if you can assist her, and it is a big file, so.
[AGENT][NEUTRAL] OK, what was the policy number?
[CUSTOMER][NEUTRAL] I'm not sure if you can do that now. Yeah, it's uh 457182.
[CUSTOMER][NEUTRAL] But I did tell her that um I, we can give her a call back after, but she said she wants to speak to somebody.
[AGENT][NEUTRAL] OK. And did you verify the name of the insured and date of birth?
[CUSTOMER][NEUTRAL] So we you.
[CUSTOMER][NEUTRAL] Yes, uh-huh, it, it is for [PII], but I got Miss [PII] on the line because [PII] has passed away.
[CUSTOMER][NEUTRAL] And do you need the callback number?
[AGENT][NEUTRAL] Uh yes, please.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And she's also asking about why the check was sent out on [PII]'s name, if there's any way we can change it to her name. So I don't know if you can answer that as well for her, OK?
[AGENT][POSITIVE] OK, great.
[AGENT][NEUTRAL] OK, yeah, it's hard because we hadn't received the death certificate on.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Our end of let's.
[CUSTOMER][NEUTRAL] Yeah, we have.
[AGENT][NEUTRAL] OK, uh, yes, so I'll just let her know that that she can send it back to us.
[CUSTOMER][POSITIVE] Yeah, we have some. We probably got it after.
[CUSTOMER][NEUTRAL] Mhm, yeah, I think that's what I told her that she she can send it back to us but just in case because that was her first question um but yeah, I told her that more than likely she will have to send that back. OK, so let me put her through. Thank you.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Thank you for holding and being patient for Ms. [PII]. I got Ms [PII] on the line. She's in the claims department, OK? She will assist you from here, OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you for holding, Ms. [PII], and yes, how can I help you today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Uh, who am I speaking to? What's your name?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII]? OK, um, alright, I got a check from you guys, uh, for $75.
[CUSTOMER][NEUTRAL] OK, and it's sent to my husband, and on the report that I sent with all the pathology reports and everything, I guess you all missed the death certificate. He's no longer with us. He's deceased.
[AGENT][NEUTRAL] OK, yes ma'am, and I'm so sorry to hear about that. Yes, so if you would like, you can, you can send us back that check and then we can void it and then we can go ahead and reissue a separate check. um, let me just take a look here just to verify if we have a beneficiary on file, um.
[AGENT][NEUTRAL] Just to be sure that whenever we do reissue the check, we reissue it in the correct name.
[AGENT][POSITIVE] OK, I do apologize for that.
[CUSTOMER][NEUTRAL] But did you not see the, see the paper where it said he was gone?
[CUSTOMER][NEUTRAL] The death certificate, is it not in there?
[AGENT][NEUTRAL] Yes, ma'am. I do see that we, we did receive the, the death certificate. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and all those papers, there was not a because there's a list of things here that says that you didn't get, and they were all in that package which was about as big as a rim of paper.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] All of this was in there, the pathology report, all of that was in there.
[CUSTOMER][NEUTRAL] With the date and the amount and everything.
[CUSTOMER][NEUTRAL] was in there, but they said that you didn't get one.
[AGENT][NEUTRAL] OK, sure. Bear with me just a moment and I'll take a quick look at, look at that for you, OK?
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, so I do not show that a beneficiary was designated on the policy, so let me go ahead, um.
[AGENT][NEUTRAL] And get the next of kin information from, from you. So it looks like I see that you're the spouse, uh Ms. [PII], and then you have two children, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, I, I have 3, but they're all married and gone, I'm the only one.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm by myself.
[AGENT][NEUTRAL] OK, so you have 3 children?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so I see that there's a [PII], and there's a [PII], and what is the third child's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, can you, do you mind spelling that for me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] OK, and then [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Uh let's see here.
[AGENT][NEUTRAL] OK, so what we'll do is that we'll also when we're we're gonna go ahead and review this, um this claim for you, Ms. [PII], and let me get a good call back number for you so once we do review it, um, we can give you an update.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. It's uh.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And then also, um, whenever we are going to, uh, basically since we're not beneficiary directed on the file, we will go ahead and review with our legal department regarding the next of kin and then they'll let us know um who the check will be mailed out to. Uh, was there an estate on, uh, do you guys file for an estate by chance?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] No, no, no.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] No, uh, like, he just, when we started fighting, he was still alive.
[CUSTOMER][NEUTRAL] But then he passed away on [PII], if you notice on there, so that's how all this got started. We started getting the paperwork and everything ready, and then he got really sick. So I had to go back all the way to [PII].
[CUSTOMER][NEUTRAL] To start getting his papers that where that's where they diagnosed him that he had cancer. It was on that, it was June when they started the procedures and then the pathology was like in July somewhere in there. I can't tell you exact dates because I mailed it all to you guys, but it's a big old, I mean it's a big stack with everything up until.
[CUSTOMER][NEUTRAL] The month of, I believe it was August or September.
[CUSTOMER][NEUTRAL] The thing is that when they rediagnosed it that it was back.
[CUSTOMER][NEGATIVE] That's when it got really bad and so he passed away in December.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so yes, let me, um, uh, we'll go ahead and have, have the adjuster review this for you and then we'll give you a call back and to give you more information and just be able to let you know if we need any further information, OK?
[CUSTOMER][POSITIVE] OK, thank you. Mhm.
[AGENT][POSITIVE] OK, sure, thank you for calling APL.
[CUSTOMER][NEUTRAL] I now mail this back to you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, yes, ma'am.