AccountId: 011433970860
ContactId: 9e5ede8d-a7ec-4cf8-b05a-d6b50e5286e3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 340309 ms
Total Talk Time (AGENT): 157733 ms
Total Talk Time (CUSTOMER): 118724 ms
Interruptions: 3
Overall Sentiment: AGENT=1.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/9e5ede8d-a7ec-4cf8-b05a-d6b50e5286e3_20250131T19:30_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. With whom am I speaking? How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] in customer services. How are you?
[AGENT][POSITIVE] Hey [PII], I'm good and you?
[CUSTOMER][NEUTRAL] I'm good. I have an insured on the phone who's calling because her disability claim was denied.
[AGENT][NEUTRAL] OK, what's that policy number?
[CUSTOMER][NEUTRAL] 248-618-87
[AGENT][NEUTRAL] OK, alright.
[CUSTOMER][NEUTRAL] She said she talked to somebody last week who told her that her physician needed to fill out some forms, but she's saying it wasn't disability, it's maternity, so I don't know.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, no worries. OK, go ahead. What's her name?
[CUSTOMER][NEUTRAL] Her name is um [PII].
[AGENT][POSITIVE] OK, and everything is verified. OK, alright, go ahead and send it over thank you.
[CUSTOMER][NEUTRAL] And I heard
[CUSTOMER][POSITIVE] Yes, ma'am. Thank you.
[CUSTOMER][NEUTRAL] Mhm. Here she is.
[AGENT][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. Is this Miss [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK and I understand you're going regarding your claim that was denied.
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, so give me one moment. I understand your name, date of birth, physical address and email has been verified and is a good callback number for you. Uh, what, what would that be?
[CUSTOMER][NEUTRAL] The one, the my the [PII].
[AGENT][POSITIVE] OK, got it, thank you.
[CUSTOMER][NEUTRAL] [PII] yeah.
[AGENT][NEUTRAL] Thank you, so give me one moment to take a look at this and see what's going on, OK? May I place you on a brief hold?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][POSITIVE] Yes, of course, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for patiently waiting, Ms. [PII]. So the claim uh was denied requesting um we need additional information because you're subject to preexisting.
[AGENT][NEUTRAL] And the representative that last spoke to you on, let me go back to these notes.
[AGENT][NEUTRAL] On [PII] explained to you that you were, you were stating you was out on [PII], but she spoke to your employer and uh they had a different date. There was a difference in the dates and she explained to you that the employer that took you out on disability on [PII] needs to complete that position claim form that needs to be returned and then we need to rule out preexisting.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So I was out on that date for maternity leave. I had a baby.
[AGENT][NEUTRAL] Right, but it's still considered preexisting. That's the way the policy is for our policies are that way, as she explained it to you, mhm.
[CUSTOMER][NEUTRAL] Not
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, so, like, OK, so.
[AGENT][NEUTRAL] So, have you given that form to the doctor that took you out on [PII]?
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] So I actually hold on let me look at my calendar because I feel like I worked [PII] my actual start date was well I guess OK um so I had a team. What I have is a team of midwives, um, and so it seems like I just got induced.
[CUSTOMER][NEUTRAL] And they
[CUSTOMER][NEUTRAL] I guess I'm just confused. Like they would just say, they would just submit the form saying that I was out of work starting on that day, cause I got induced on the [PII]. I worked um
[AGENT][NEUTRAL] She called your employer and your employer, Ms. [PII] told her your last day of work was [PII].
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Correct. And I got induced on the [PII]. So we just, I just need a doctor from my, I mean, I know from my midwife that said I started that I was out getting in induced.
[AGENT][NEUTRAL] Not a note. You just need them to fill out the claim form that physicians, it says attending physician and there is a section for if you're pregnant and they just need to answer those questions and it needs to be turned in.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once she receives that she has to investigate preexisting as well so any doctor that you saw, um, well that would be the midwives that you saw she would need that information as well, their name, phone number, and address and fax.
[CUSTOMER][NEUTRAL] Uh, I like.
[CUSTOMER][NEUTRAL] Uh, uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] OK. Well, I will start working on that. Thank you.
[AGENT][POSITIVE] OK, and congratulations on the new baby and give us a call back if you have any other questions, OK? We're here to assist.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you, thanks for calling ATO, Miss [PII]. bye bye.