AccountId: 011433970860
ContactId: a9b588a0-4ae6-4d73-a04b-2f0439f167df
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 726640 ms
Total Talk Time (AGENT): 353255 ms
Total Talk Time (CUSTOMER): 133680 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/a9b588a0-4ae6-4d73-a04b-2f0439f167df_20250529T12:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, wanted to find out um how do you go about making a claim for a disability.
[AGENT][NEUTRAL] OK, yeah, so claims can be filed 3 different ways. They can be done online. We have a service center. Uh, you can send them in the mail or you can fax them. Do you have a policy number for your disability policy?
[CUSTOMER][NEUTRAL] Uh, well, Mr. [PII], he asked for the policies to be sent out to me like 2 or 3 times, and we never received them yet, so he said he was gonna call again and try to get them, so he told me to just call you all he gave us the number.
[AGENT][NEUTRAL] OK, so you're needing like the policy number you need like how to file the claim, all that information?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I can look up the policy. I'll, I can look it up by name or social, whichever you would prefer to give me.
[CUSTOMER][NEUTRAL] OK, his name is [PII].
[AGENT][NEUTRAL] Alright, give me just a second.
[AGENT][NEUTRAL] What state does [PII] live in?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] What is his date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I think I found them here. I just need to verify what would be the physical address that we would have on file in [PII], please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect, thank you. OK.
[AGENT][NEUTRAL] Um, the email address that we have on here is [PII]. Is that still a good email?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So, um, if you'd like, what I can do is email um the information as far as the claim form. Uh, the claim form has instructions um as far as what is needed with the claim. It'll also have on the claim form our mailing address and our fax number which you can submit it back.
[AGENT][NEUTRAL] Both in the mail or fax, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You had said something about the policy. Do you need a copy of the policy?
[CUSTOMER][POSITIVE] Yes, please, uh, yes, I need that.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so give me just.
[AGENT][NEUTRAL] OK. So I am emailing all of that to you. You should have that here in the next few moments. Um, do you have any like other questions or concerns?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, what I wanted to find out because I don't have didn't have it to read over. I wanted to find out like once you.
[CUSTOMER][NEUTRAL] Submit everything back um how long does that usually take like for approval?
[AGENT][NEUTRAL] Uh, so we generally ask for the processing on short term disability claims. Um, they ask for 10 to 14 business days, um, for them to be processed.
[CUSTOMER][NEUTRAL] OK, 14 to 14, OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And like um so the payment, how do they calculate like the payment that.
[CUSTOMER][NEUTRAL] You oversee
[AGENT][NEUTRAL] So the payment would be mailed um in a check unless you go online and set up direct deposit. Direct deposit can only be done if you've set it up online.
[CUSTOMER][NEUTRAL] OK, and so the like the amount of the check, how do they like calculate that on like what he been paid every week at work?
[AGENT][NEUTRAL] Yeah, so
[CUSTOMER][NEUTRAL] Oh, how did, how does that be OK?
[AGENT][NEUTRAL] Let me pull this.
[AGENT][NEUTRAL] That would be in the policy here. Let me take a look.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So the monthly disability on this um plan looks like it's $3000. It cannot exceed 60% of your monthly compensation. So as long as that $3000 doesn't exceed the 60% of normal monthly compensation, it looks like that would be the benefit.
[AGENT][NEUTRAL] Um, there is a 14 day elimination period meaning wouldn't be paid for the 1st 14 days out and it looks like.
[AGENT][NEUTRAL] Uh, it's a maximum of
[AGENT][NEUTRAL] A year, I, it looks like on here.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] That's what I was gonna ask you because I know Mr. [PII] told me um.
[CUSTOMER][NEUTRAL] You had to be out for a while, uh, once we do the disability or something like that so it's a year.
[AGENT][NEUTRAL] Yeah, it looks like.
[AGENT][NEUTRAL] condition, let me see.
[AGENT][NEUTRAL] 8%.
[AGENT][NEUTRAL] Yeah, it looks like maximum disability period is one year.
[CUSTOMER][NEUTRAL] OK, so everything that I have we have to have is gonna be in the forms that you're sending.
[AGENT][NEUTRAL] Yep, so you'll have the um claim form and it'll include page one is instructions as far as what to include with the claim form and then I also went ahead and sent you a copy of the policy certificate so you can look at that as well that'll give you the benefit breakdown um it'll also give you the amounts as we just discussed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And again on that claim form if you look at the bottom you'll see that our mailing address is there and also our fax number um as well. I did also send you the user guide if you wanna log in online and maybe look at that um just as an option not not required though.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, so once I, once we, uh, we get everything, just we can fax it back to you all is that right?
[AGENT][NEUTRAL] Alright.
[AGENT][POSITIVE] Mhm, yep, absolutely, and we'll be um and then they'll start the process and working on the claim, yep.
[CUSTOMER][NEUTRAL] Is it a lot that they, they need that that we gotta go like round to?
[AGENT][NEUTRAL] Um, I do know it's not necessarily a lot, but there is paperwork that will need to be, so there's a statement of the insured that would be, of course, [PII], um, that has to be filled out. There's a portion that has to be filled out by the physician. So it will be getting that filled out by the doctor, of course, and then getting that signed and sent back. Um.
[CUSTOMER][NEUTRAL] And get
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's really just making certain that you have everything filled out on the claim form and signed and sent back um along with that, let's see.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So yeah, honestly, it's really just getting um everybody to fill out their portions and then get everything submitted back seems to be sometimes the the hardest for some individuals, uh, just because it's not something you, the insured can just fill out. It's, you know, having to get other people to fill out their portion as well.
[CUSTOMER][NEUTRAL] OK, so I know you said the doctor.
[CUSTOMER][NEUTRAL] So who's the other people?
[AGENT][NEUTRAL] It looks like it's just the attending physician or treating physician. They do want a physician's statement with it, so it says the attending physician's statement to be completed by your treating physician. So that's the only other portion that'll need to be filled out. Um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] He, he can do his portion and then return that and then the doctor can either submit it to us or you can submit it once they complete it, whatever works best. Um, so you can do it all at once or do it in pieces, however you want.
[CUSTOMER][NEUTRAL] OK, yeah
[CUSTOMER][NEUTRAL] OK, alright, well, we'll get on. I'll get on that today once you, um.
[AGENT][POSITIVE] OK, sounds good.
[CUSTOMER][POSITIVE] Alright thank you so much. No, I think that's it, OK.
[AGENT][NEUTRAL] Anything else?
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] All right. Have a good day. Bye-bye.