AccountId: 011433970860
ContactId: 8fbb2553-d718-4255-87ac-2029b0c2f93a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 659000 ms
Total Talk Time (AGENT): 296676 ms
Total Talk Time (CUSTOMER): 240787 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/8fbb2553-d718-4255-87ac-2029b0c2f93a_20250306T14:41_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] What's your name man?
[AGENT][NEUTRAL] It's [PII] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, OK, I'm calling in regards to a claim that my husband filled out. Uh, I have a claim number. Do you need it?
[AGENT][NEUTRAL] Uh, do you happen to have the policy number?
[CUSTOMER][NEUTRAL] Yes, I have the policy number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You ready for it?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] 024.
[CUSTOMER][NEUTRAL] 846-08
[AGENT][POSITIVE] OK, thank you so much and your name is?
[CUSTOMER][NEUTRAL] [PII], he's here. He can authorize me to talk to you if you need to.
[AGENT][POSITIVE] OK, thank you, Ms. [PII], and give me a moment.
[AGENT][NEUTRAL] OK, and your husband's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And you say you have a claim number, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes, it's 356-827-1.
[AGENT][NEUTRAL] OK, thank you, ma'am. And may I speak to Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah. Mm.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Uh, yes, sir. Um, verify your date of birth, mailing address and email address for me, please.
[CUSTOMER][NEUTRAL] [PII] [PII], [PII].
[CUSTOMER][NEUTRAL] Uh, mailing address is [PII]. [PII], what what's your email is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much. And you're giving us permission to speak to your wife, Ms. [PII], in regards to your claim?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you so much, sir.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, Ms. [PII]?
[CUSTOMER][NEGATIVE] Yes, we received a um a certificate uh of um explanation of benefits, and we wanted, we, we're denying this because he wasn't on, he don't have workers' comp.
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And do you have a, um, can you email us a copy of that certificate? Because it's telling me to look at section 4, but I don't even have a copy of that certificate.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Of the policy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, let me pull it up. Give me one moment.
[AGENT][NEUTRAL] Sorry, my computer is taking a while. Just give me one moment.
[CUSTOMER][NEGATIVE] Oh, I can understand I can understand. I have that same problem here, buffing.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEGATIVE] It's always buffering.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Uh, do you know if Mr. [PII] has a set up on the online service center to where he can view his policy?
[CUSTOMER][NEUTRAL] No he's not, but we could we could pull it up if we can get started with that.
[AGENT][NEUTRAL] Yes, ma'am. Um, if you go to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Wait, wait, wait, [PII].
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] [PII] OK.
[AGENT][NEUTRAL] Yes, ma'am. And I
[CUSTOMER][NEUTRAL] And we can pull it up
[AGENT][NEUTRAL] Yes ma'am, um, when you go to the site select new user and then individual.
[AGENT][NEUTRAL] And then you should be able to um enter the information like the um name, date of birth, social, zip code and email address, and from there, um, set up a username and password.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I understand that. OK, what is this, is this policy a supplemental?
[AGENT][NEUTRAL] Uh, no, ma'am. Uh, it looks like just a, a short-term disability plan.
[CUSTOMER][NEUTRAL] Or it's a short-term disability plan.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, and
[CUSTOMER][NEUTRAL] And it's not no workman's comp, right?
[AGENT][NEUTRAL] Uh, no, ma'am. And looking on the policy, go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] OK, and
[CUSTOMER][NEUTRAL] And then when you say it's a short term disability plan, that means if he can't work, then he can draw that even if he's a a owner operator?
[AGENT][NEUTRAL] Uh, correct. If he's unable to work due to a sickness or an injury, um, let's say section 4 follow, um.
[AGENT][NEUTRAL] Was he denied worker uh workman's comp?
[CUSTOMER][NEUTRAL] Uh, he never, it wasn't even a worker's comp, uh, case.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We didn't file workman's comp. that's when we fill out the application, the policy statement. It's not a workman's comp case, but they're saying that um the certificate under which you are, are insured does not cover sickness or.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Actually, so I don't understand why, why is it denied or what, what does this mean?
[AGENT][NEUTRAL] Uh, well, if it's workers' comp, then it's not covered under the policy. Is he pending worker workman's comp or because that's what is on the application.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEGATIVE] Yes, yes, yes, no workman's comp at all.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I may have to transfer you to a representative so they can explain what other information they would need to go back and review. Do you mind holding for a moment?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, because it did say I need to submit another uh more information if it's not workless comp, so that's what I was just trying to find out what's going on with it, but uh you can transfer me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] And that extension where we, that extension where you just, just in case we get cut off, you have an extension?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Uh, no, ma'am, but do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, thank you so much. Give me one moment, Ms. [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey, Ms. [PII], [PII], Miss [PII], how are you doing?
[CUSTOMER][POSITIVE] Hey, good. How about you?
[AGENT][POSITIVE] I'm good. Happy Thursday, can't wait for Friday for sure.
[CUSTOMER][POSITIVE] Yes, I am there with you.
[AGENT][NEUTRAL] I think we all trying to be there, but um I have Ms. [PII], she's calling for her husband and I did speak with her husband and got permission from him to speak with her in regards to his claim. It's on a disability and it looks like we processed as um need to review their policy as far as workers' comp. It's on a short-term disability and if it's not just in a um
[AGENT][NEUTRAL] Oh Lord, my brain just went blank, a rejection letter, but she is saying that they're not on workers' comp or he's not on workers' comp, but I looked at the
[AGENT][NEUTRAL] The claim and it looks like they marked it as pending under the workers' comp, and I was trying to explain that to her, but I didn't know what other information they can provide to show that it's not a workers' comp claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What's the policy number?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] I'm sorry, it's a lot. It's 248-460-008.
[CUSTOMER][NEUTRAL] And is it on that first claim?
[AGENT][NEUTRAL] Uh, she gave me claim number 356-827-1.
[AGENT][NEUTRAL] But those are the same like um the is.
[AGENT][NEUTRAL] And I do have a callback number. Go ahead.
[CUSTOMER][NEUTRAL] So they, so they're saying that they, that was filled out incorrectly?
[AGENT][NEUTRAL] Well, I didn't, she, she is saying that it wasn't workers' comp, that they never filed workers' comp, so they don't have a like a rejection letter since it was never filed and since it wasn't a workers' comp um accident.
[CUSTOMER][NEUTRAL] On the phone
[AGENT][NEUTRAL] But she's want to know what information they would need to submit to show that it's not.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, I will have to probably call them back. I have to check with [PII] regarding that and give them a call back, have her give them a call back.
[AGENT][NEUTRAL] OK, I got the call her callback number, she is with her husband.
[CUSTOMER][NEUTRAL] OK, she's needing to speak with someone at this moment, or is she OK with someone when giving her a call back regarding that?
[AGENT][NEUTRAL] Um, I can ask her real quick. Do you want me to?
[CUSTOMER][NEUTRAL] Yeah, if, if so, you can check um then we'll have, we'll have somebody take a look at it and give them a call back if she says yes, if you just take her number and send a hub request.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And I
[AGENT][NEUTRAL] I'll stick it out there. All right, let me check with her.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Ms. [PII],
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Uh, thank you so much for holding. Um, I spoke with a representative and uh they need to do further research and ask me if it's OK if they can call you back.
[CUSTOMER][NEUTRAL] OK, do you know who's calling me back? You know the name?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] It may be a [PII] or it may be a [PII].
[CUSTOMER][NEUTRAL] Uh, [PII] or [PII]?
[AGENT][NEUTRAL] [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII], OK, alright, I'll just wait on the call.
[AGENT][NEUTRAL] OK, and you said the good callback number is [PII]?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, and is there any specific time that we not be able to call back?
[CUSTOMER][NEUTRAL] Um, uh, they can call me back, uh, after, after [PII] today. That's that's fine. Anytime after [PII] today.
[AGENT][NEUTRAL] OK, anytime after [PII]? OK.
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[AGENT][NEUTRAL] All right, Ms. [PII], I'll send them a request so they can give you a call back, OK?
[CUSTOMER][POSITIVE] Alright thank you very much.
[AGENT][POSITIVE] Thank you, ma'am. You have a great day. Thanks for calling. Bye.
[CUSTOMER][NEUTRAL] Bye you too bye bye.