AccountId: 011433970860
ContactId: a65df7de-6902-422f-9e53-cf0081447252
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 422339 ms
Total Talk Time (AGENT): 106868 ms
Total Talk Time (CUSTOMER): 104942 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/a65df7de-6902-422f-9e53-cf0081447252_20250217T15:36_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thanks for calling AL this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I have, um, [PII], wife of [PII] on the line calling in regards to a question for the disability policy. Um, they have been fully HIPAA verified and she is authorized to speak.
[AGENT][NEUTRAL] OK. Can I get a callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] The policy number?
[CUSTOMER][NEUTRAL] 2117201
[AGENT][NEUTRAL] OK, you can go ahead and send it through.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Good morning. Thanks for calling Ali [PII]. Am I speaking with Miss [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, um, the rep said you had a question about um your husband's um disability policy.
[CUSTOMER][NEUTRAL] Yes ma'am. I wanted to know how long can he um do the, the disability claim.
[CUSTOMER][NEUTRAL] Because he has to have hip surgery and they said,
[CUSTOMER][NEUTRAL] 3 to 6 months. I just wanted to know.
[AGENT][NEUTRAL] OK, give me 1 2nd.
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] I'm just um.
[AGENT][NEUTRAL] Pulling up the information, give me one second.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so the, the hip, um, is that the original, um,
[AGENT][NEUTRAL] T
[CUSTOMER][NEUTRAL] The left hip, yes ma'am.
[AGENT][NEUTRAL] OK, so let me pull up the, the first claim that was submitted and just to see what it shows on there.
[CUSTOMER][NEUTRAL] OK, on that first claim, the last day of work was like December, I think it was the [PII].
[CUSTOMER][NEUTRAL] I'm going by memory. I don't have that claim in front of me.
[CUSTOMER][NEUTRAL] And they told me that I have to do another claim because
[CUSTOMER][NEUTRAL] He went to the, the chiropractor, and they couldn't help him, so they had to refer us back to, we went there for 3 weeks, then he had to refer us back to the doctor, our primary doctor. So our primary doctor saw him and then
[CUSTOMER][NEUTRAL] That's when they find out when he did the MRI that it, it's bone to bone to his hip, that's what's causing causing all the pain.
[CUSTOMER][NEUTRAL] And then they say they have to have a hip replacement because there's nothing that you can do for that.
[AGENT][NEUTRAL] OK, so looking at the policy, it is showing the maximum disability period is 180 days, which is about 6 months.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So, uh, this is the same claim that we're gonna do, so it's 6 months, huh.
[AGENT][NEUTRAL] Yeah, like I said, just looking at the policy, it's, um, it just shows the maximum disability period is um for injury and or sickness 180 days. So that roughly amounts to about 6 months, um, that he can receive for this, um, disability.
[CUSTOMER][NEGATIVE] So what happens if he's not well and can't work? You, you just out of luck.
[AGENT][NEUTRAL] Um, uh, let me see if it says that.
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so, so yes, the way it works is that I mean if he reaches that 180 days, um, to be able to get another disability um time frame, he would have to return to work, um, for a period of time.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and then placed back on um this bill to be able to.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Restart that time.
[CUSTOMER][NEUTRAL] But with his physical job.
[CUSTOMER][NEUTRAL] Well, if he's not up, he can't go back.
[CUSTOMER][NEGATIVE] So he'll just be out of luck.
[AGENT][NEUTRAL] And like I said, that's just I mean, I mean, how the policy work is this um I guess when he, the clinical policy that his job has, that's just the max that, that's allowed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] Hi Ms. [PII], was there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] No, that was it.
[AGENT][POSITIVE] Alright, thanks for calling A have a wonderful day.