AccountId: 011433970860
ContactId: acdc0a80-f48a-44d4-be01-2adc286cbabc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2011829 ms
Total Talk Time (AGENT): 912121 ms
Total Talk Time (CUSTOMER): 794388 ms
Interruptions: 11
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/acdc0a80-f48a-44d4-be01-2adc286cbabc_20250623T14:47_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Um, yes, um, I have a claim, and I just wanna know if it's really worth it, and I just wanna know more about it. It's for, um, short term disability, and uh, I want to know more about the group accident or what that really covers and what is some of that stuff means. I know that's a different department. So I did start my claim. I didn't know if you need that number or if you just need my name.
[AGENT][NEUTRAL] Um, if you have the policy number or the claim number I can pull the information like that.
[CUSTOMER][NEUTRAL] OK, uh, is that where it says selected coverage or confirmation number?
[AGENT][NEUTRAL] Confirmation.
[CUSTOMER][NEUTRAL] Confirmation number is I think this is is it's a 0 S as in Sam C 99517.
[AGENT][NEUTRAL] OK, so this is electronic. OK, bear with me.
[AGENT][NEUTRAL] Do you see any other numbers starting with the 0 followed by 7 digits?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] See
[CUSTOMER][NEUTRAL] I'm sorry, I'm working with one hand here hold on.
[CUSTOMER][NEUTRAL] You said a 7 digit number? I'm sorry, what was that?
[AGENT][NEUTRAL] It's gonna start with this it's gonna start with the 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] So I have a confirmation number I guess I think that's a 0. I mean it's not a 0 it's a 0, but then I have to select the coverage number and that's the 2,558,880.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Dash.
[CUSTOMER][NEUTRAL] G A
[CUSTOMER][NEUTRAL] 508
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mm yeah.
[AGENT][NEUTRAL] May I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, Miss [PII], for security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] One moment. I'm having a pain. Hold on. It's, it's my, my date of birth is [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, I think the email address you may have is the work email address, which is, um,
[CUSTOMER][NEUTRAL] [PII] and what was the other one that you had said?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Uh, the mailing address.
[CUSTOMER][NEUTRAL] You say 3?
[CUSTOMER][NEUTRAL] OK, the mailing address is [PII].
[CUSTOMER][NEUTRAL] And that's [PII].
[AGENT][NEUTRAL] OK, thank you. All right. The, the email address we have is your um personal email address. Do you know which one is that?
[CUSTOMER][NEUTRAL] Oh, so it's my [PII], is it the [PII]?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Uh-huh, yes.
[CUSTOMER][NEUTRAL] For the [PII], so [PII].
[AGENT][POSITIVE] Perfect, thank you. OK.
[AGENT][NEUTRAL] So let's see.
[AGENT][NEUTRAL] OK, so you submitted a claim on [PII], and this was sent electronic through our website and it's still in line to be processed. It usually takes 7 to 10 business days for it to be processed. Now, do you have questions? This is your accident policy. Do you have questions about this one, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yeah, I just wanna know what it covers, um, like, because I'm trying to figure out if it's even worth filing it, you know, I don't know a claim. I have no idea. I don't know what the.
[CUSTOMER][NEUTRAL] Benefis are because I'm right now like I said I'm seeing right now.
[AGENT][NEUTRAL] OK. What type of service or
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah, what, what, what service like.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I, you know, I've read this stuff, but you know, all that legal boo boo is, is crazy, but.
[CUSTOMER][NEUTRAL] So me calculating, it's like, oh, cause I am um
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I am a contract worker and um I, I get paid, you know.
[CUSTOMER][NEUTRAL] By the hour per day.
[CUSTOMER][NEUTRAL] If I don't work, I don't get paid so I'm just trying to figure out is it worth it, you know, I might, you know, that's what my options are, are going around that so.
[AGENT][NEUTRAL] OK. All right, so that, that one is more regarding disability. So for the um accident, there are two separate policies. So for the accident, you just need to know how much it pays. OK. Um, OK, um, what type of accident did you have?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, yeah, I, yeah, I, I don't know what, yeah.
[CUSTOMER][NEGATIVE] I had a falling. I fell and I broke, I broke a few bones in my hand, um, my left hand, um, you know, right now, like I just had surgery. I have pins in my hand.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] And, OK.
[CUSTOMER][NEGATIVE] You know, very difficult, you know, to move around, maneuver, do my work because.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] You know, I type a lot.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, my job, I have to do typing and all of that, and it, I mean, even though.
[CUSTOMER][NEUTRAL] Uh, so that's the thing it's.
[CUSTOMER][NEGATIVE] It's a lot of typing and it's a lot of stress. And right now, um, with the pins in my hand.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] My doctor, you know, I have a close visit coming up at the doctor's all like, just relax and um you know, take it easy because, you know, I have bone, broken bones like th[PII]'re in pieces.
[AGENT][NEUTRAL] OK. All right. So, right now, let's go ahead and go over the accident and then we can go to the disability, but right now, let's do the accident first, um, which, um, based on what you're telling me, did you get treatment within the 72 initial hours?
[CUSTOMER][NEUTRAL] Yes, when it, yes, I got treatment when it first happened that, you know, there's a document where I went straight to urgent care.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, did you
[AGENT][NEUTRAL] Urgent care. OK. Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see urgent care here.
[AGENT][NEUTRAL] Let me see if this is any.
[AGENT][NEUTRAL] OK. Did they do any type of um imaging like um X-ray or anything like that?
[CUSTOMER][NEUTRAL] Yes. Mhm.
[AGENT][NEUTRAL] OK. OK. OK, so let me go ahead and give you the benefits that I see, and this is not a guarantee of payment, just a verification of coverage, OK. So under the accident, um, you do have benefits, um, for, uh, let's see, I don't see urgent care listed. I only have like hospital emergency room, physician's office, and emergency dental. Those are the only thing I see under the benefits for um the accident. Now, I do see a
[CUSTOMER][NEUTRAL] So you don't see the urgent care?
[AGENT][NEUTRAL] I don't see listed in urgent care. Um, I can check on the physician's office and see if urgent care is part of it, but
[CUSTOMER][NEUTRAL] Alright, I can put the urgent care on. I can put the urgent care on there. I don't have a problem with that because um.
[CUSTOMER][NEUTRAL] I thought I put all of them. I thought I put two documents on there. I thought I put the urgent care and um.
[CUSTOMER][NEUTRAL] And what was the other thing, the, uh, because the urgent care was on the [PII].
[CUSTOMER][NEUTRAL] But I, I can put it on there because I really thought I put it on there.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and I'm just, I'm, I'm not looking at what you send, OK? I'm looking at your benefits. I'm looking at your benefits, OK? I'm not looking at what did you, no, no, no. OK, all right. So, um, based on the benefits, I don't see an urgent care listed for benefit, but I can check on that to see if it's part of that physician's office now.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh, OK, my business, OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] I do see in medical imaging benefits, and medical imaging if if they do any X-rays, um, ultrasound, sonograms, anything like that, that is medical imaging, you have $100 for that medical imaging, OK? So let me go ahead and see if urgent care is part of this other benefit, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Bear with me.
[CUSTOMER][NEUTRAL] This is for the group Accidental, right?
[AGENT][NEUTRAL] Yes, I'm looking at the um accident policy. Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So will that be considered urgent care be considered emergency room?
[AGENT][NEUTRAL] No emergency unless it is an emergency room and it charged as an emergency room, not an urgent care, then it will be considered under the emergency benefits like emergency room benefits, but um I don't see here that it's listing the urgent care um.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] But let me check and see if it's part of another benefit. Let me see.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] not really that.
[AGENT][NEUTRAL] Yeah, I don't see any benefit for urgent care. Urgent care is not listed on the benefits, OK? So it looks like the only thing I see is that $100 imaging test. Um, so based on the information you send, um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The $10 OK, OK.
[AGENT][NEUTRAL] Mhm, yeah, it may be that may be just a benefit, but just go ahead and send everything you have and let us look at it and see um what else can we pay, OK? Um, and let me go ahead and pull your disabilities.
[CUSTOMER][NEUTRAL] So you don't get it for any outpatient treatment like um
[CUSTOMER][NEUTRAL] cough, um, office visits or anything like that?
[AGENT][NEUTRAL] Um, under the outpatient treatment benefits, if you go to an emergency room, there is a benefit of $250. If you go to a physician's office, it's $50 or if you, uh, if you do an emergency dental, it's $50. So those are the benefits depending on where you go. Um, now, you do have um also inpatient, like if, if you go to the hospital and they admit you into the hospital, then you have uh $250.
[AGENT][NEUTRAL] And you have a daily hospital confinement of $100 up to 30 days. And then you have intensive care, which is covered $200 up to 15 days of intensive care.
[AGENT][NEUTRAL] And um you have ambulance benefits up to 250. And all this information you can find it under the policy. If, if you go ahead and click on the policy, yeah, I will give you a breakdown.
[CUSTOMER][NEUTRAL] Right, right, right, if I had an office, uh, uh, an office visit, which I did, I had to pay a copay, so I still have $50 on top of the imaging then, right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It may be, yes. I, I cannot guarantee until they review the documents, but it may be that $50 yes. Mhm. Yeah, if you did go to the physician's office within 30 days of that accident, yes, you may qualify for that one, OK? All right. So for your disability, let me go ahead and pull your disability really quick.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let's see.
[CUSTOMER][NEGATIVE] Now this is the confusing one.
[AGENT][NEUTRAL] OK. So let me go ahead and just pull what you send and see if it's enough for us to start a claim.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, with this one I'm just waiting for the doctor to pull out the paperwork.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, so you said 24 pages. Let me just let us in here.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So far I don't see the claim form um.
[AGENT][NEUTRAL] OK, for the disability, you need to submit a claim form. I see you submitted a lot of documents and they look like medical documents.
[CUSTOMER][NEUTRAL] I submitted two claim forms. There's a claim form for um both. I can, I have a number.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um, I just was able to log in, so I don't know which one is which. I can give you what claim number are you looking at? One is they both said.
[CUSTOMER][NEUTRAL] They're under the CO 959726 and there's 2 and they said they're pending.
[AGENT][NEUTRAL] OK, the disability one is the OSC 99517. That is the disability. Now, um, the claim form is a document that consists about 8 pages and I don't.
[CUSTOMER][NEUTRAL] Yeah, oh yeah, that's the one that I said, that's the one I said that my doctors, I'm waiting for that my doctor for that.
[AGENT][NEUTRAL] Oh, OK. So did you fill out your portion and, and so you're just waiting for the doctor to fill out his portion? OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So the portions that I have filled out, should I send them in?
[AGENT][NEUTRAL] Yes, you can send your part and then have the doctor, um, no, you can send it in different, um, if you want to send your part and just we can wait for the doctors to send his part. And um so we're gonna need your part and the employer's part and then, yeah, we need your doctor's part, so those.
[CUSTOMER][NEUTRAL] Or should I wait for all of them?
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yep, I have all of that. I have all of that. I have another.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have another question with that too and that is hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I mean.
[CUSTOMER][NEGATIVE] You know, it's so hard. Uh.
[CUSTOMER][NEUTRAL] OK, here it is pulled it up.
[CUSTOMER][NEUTRAL] Um, it does say on here, um.
[CUSTOMER][NEUTRAL] On section E for me, it says that um.
[CUSTOMER][NEUTRAL] Federal income tax can be withheld, so you can have, that's an option or no, you don't have to, but you, you can.
[AGENT][NEUTRAL] I'm sorry, can you repeat that question again?
[CUSTOMER][NEUTRAL] Section Section E federal income tax withholding.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So there'll be taxes taken out?
[AGENT][NEUTRAL] Um, this, the, that part is your reporting. Reporting is what um you have to report whenever you get paid, um.
[CUSTOMER][NEUTRAL] It says
[AGENT][NEUTRAL] Let me pull the
[CUSTOMER][NEUTRAL] No, it acts on section E, it's the federal income tax withholding.
[AGENT][NEUTRAL] Bear with me.
[AGENT][NEUTRAL] One moment, let me look at the claim together with you. Let me pull an image.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, if we do not have the, the, the federal tax, then what's gonna happen is that you're gonna receive a um a tax form in the end of the year for you to report.
[CUSTOMER][NEUTRAL] Alright, so I need to put that that's the only thing I did not. OK, so I need to put something in that blank, OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, and I'm looking at your benefits, you said that.
[CUSTOMER][NEUTRAL] So I put, I can just put any amount, any amount to be withheld.
[AGENT][NEUTRAL] You can put any amount, that doesn't mean that's gonna be sufficient for whenever you do your taxes. So it really depends on how much you make out of your disability.
[CUSTOMER][NEUTRAL] It's 87,000.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, and that's why I'm saying the disability. I don't think it's only gonna be like $200.
[AGENT][NEUTRAL] Yeah, let me check on that. That's what I'm uh looking at your benefits right now. Um, let me go over the benefits so you have a little bit of understanding on how it's gonna work, if it's payable or how it's gonna pay. OK, and this is not a guarantee of payment, just a verification of coverage. OK, so it looks like based on the information, the eligibility for this plan is that you need to be employed working 20 hours or more per week.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you need to be working 20 hours or more per week to qualify. Um, the monthly disability benefit is 650, not exceeding 60% of your monthly compensation.
[CUSTOMER][NEUTRAL] OK, that's OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] The minimum disability benefit is 10% of your monthly benefit or $100 whichever is greater.
[AGENT][NEUTRAL] And that's just the minimum. Um, the maximum disability period is up to 90 days.
[AGENT][NEUTRAL] And you have a 7 day elimination period, so that means that we're not gonna start to pay until the 8th day.
[CUSTOMER][NEUTRAL] Right, OK, let's go back to the 650 or what? 60%?
[AGENT][NEUTRAL] 60% of your compensation.
[CUSTOMER][NEUTRAL] Is it 650 or 60% of or is it just 650?
[AGENT][NEUTRAL] No, it is 650 or 60%.
[CUSTOMER][NEUTRAL] For 60% of what?
[AGENT][NEUTRAL] Of your monthly compensation.
[CUSTOMER][NEUTRAL] A monthly.
[CUSTOMER][NEUTRAL] And how do we determine that? How, how do
[AGENT][NEUTRAL] Um, OK, you determined that basically.
[CUSTOMER][NEUTRAL] So here's an example. If I just say here's an example, if I make $1200 a week.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right?
[AGENT][NEUTRAL] You get 6:30.
[CUSTOMER][NEUTRAL] I'll get 6:50.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And, and that's if I'm out, even if I'm out for 7 or 10 days, I still get the 650. I don't get less than the 650.
[CUSTOMER][NEUTRAL] So if I'm only out for 10.
[AGENT][NEUTRAL] After the
[AGENT][NEUTRAL] That's gonna be
[CUSTOMER][NEUTRAL] I'm also supposed to be out for 10 days.
[AGENT][NEUTRAL] OK. The 10 days including the elimination period or no?
[CUSTOMER][NEUTRAL] So my last day of work was last Wednesday and I don't go back to work until [PII].
[CUSTOMER][NEUTRAL] That's what my post visit is.
[AGENT][NEUTRAL] OK, so last Wednesday.
[CUSTOMER][NEUTRAL] So [PII].
[CUSTOMER][NEUTRAL] Oh shoot, I can't my hands. OK, 123456789. So that'd be 10 days. I'm out for 10 days, so I don't go back until I'm sorry, the [PII], so 10 days I'm out.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So do you get 6:50 because I'm out for those 10 days or is it prorated?
[AGENT][NEUTRAL] And you have
[AGENT][NEGATIVE] No. Mm mm, no.
[AGENT][NEUTRAL] No, no, no, no. Um, OK. Um, let me go back again and explain. Um, do you have 10 days. That means you have 7 days of elimination period. That means we're not gonna pay for the 1st 7 days. You only have 3 days to collect.
[AGENT][NEUTRAL] And uh what you're gonna collect on those 3 days is what you make on those 3 days.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] You're not gonna get the 650, you're gonna get what you make. Like if the amount is more than 650, you get 650, but if the amount is less than 650, you get that 60%.
[CUSTOMER][NEUTRAL] Can you, I, I, I'm still confused. Can you give me an example? Uh, I'm sorry, I just had.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's OK. So if you make $1200 a month, you're gonna get that 650, OK? Because that is your maximum benefit.
[CUSTOMER][NEUTRAL] 1200 a month.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so if I make $1200 a month.
[AGENT][NEUTRAL] You get the 650. You will get the 650 because that is your maximum benefit. 650 is your maximum benefit monthly.
[CUSTOMER][NEUTRAL] You say what?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So if you make $1200 you get the $650 OK? Now, if you have um like in this case, you only have 3 days and those three days, let's say uh you make $400 for those 3 days.
[AGENT][NEUTRAL] Then you're gonna get that 60% of that 400.
[CUSTOMER][NEUTRAL] I, I just wanna, I'm still OK, so.
[AGENT][NEGATIVE] It's not gonna pay you for the 10 days. It's only gonna pay you after the elimination period.
[CUSTOMER][NEGATIVE] No, no, I know it's not gonna pay me. I know it's not gonna, I know, I know it's not gonna pay me for the 10 days. It's only gonna pay me for a month, that's one time, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, it's gonna pay you for the days that you're off work. If it's just 3 days, it's gonna pay you 3 days. If it's 5 days, it's gonna pay you 5 days. If it's a whole month, it's gonna pay you a whole month.
[CUSTOMER][NEUTRAL] Um, for
[CUSTOMER][NEUTRAL] OK, so I'm gonna be out for 10 days. How much will it pay me for 10 days out?
[AGENT][NEUTRAL] 3 days because you have a 7 day elimination period.
[CUSTOMER][NEUTRAL] So it's gonna take me 3 days and so that's only gonna be.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] What? 60% of my pay?
[AGENT][NEUTRAL] Yes, um, it's.
[CUSTOMER][NEUTRAL] Or
[AGENT][NEGATIVE] We cannot, we cannot really, no, it's not gonna be the 650. We cannot really determine. I cannot tell you, oh, it's gonna pay you $300 because there's no way without looking at all the documentation, but it's not gonna be 650. It's not gonna be 650. That, that's all I can tell you. It's not gonna be $650 for 3 days.
[CUSTOMER][NEUTRAL] Or 650.
[CUSTOMER][NEUTRAL] No, no, no, no, I understand. I'm just trying to get a, I'm just trying to get a, an estimate. I'm just trying to get an estimate.
[CUSTOMER][NEUTRAL] Right it's gonna be less
[CUSTOMER][NEUTRAL] I know it's gonna be less than that. Right, I calculated it's gonna be like $200 and something dollars.
[AGENT][NEUTRAL] Mhm, yes.
[AGENT][NEUTRAL] Maybe, maybe. Yeah, it's gonna be based on what you make on those 3 days.
[CUSTOMER][NEUTRAL] That's what I calculated.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] What I make on those 3 days. So,
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So let's, so let's give it, I, I just, I, I might give an example. So if just say if I make.
[CUSTOMER][NEUTRAL] $20 an hour.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Alright, and so in the day I make $160 a day.
[CUSTOMER][NEUTRAL] So x 3.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, let me, let me, let me just a different number. Hold on I do.
[CUSTOMER][NEUTRAL] 8.
[CUSTOMER][NEUTRAL] Over $40 an hour times 8, that means I make $320 a day.
[CUSTOMER][NEUTRAL] And then times 3 days.
[CUSTOMER][NEUTRAL] $950. So if I made $960 in 3 days.
[CUSTOMER][NEUTRAL] The policy is only gonna pay me 650.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] No more.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEGATIVE] And I have to be out more than 7 days.
[AGENT][NEUTRAL] Yes, because we, we don't pay for the 1st 7 days.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So the 1st 7 days you're not gonna pay, you're only gonna pay for the last 3 days, right?
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Right?
[CUSTOMER][NEUTRAL] Am I right? Is that how you, that's right? So you're only gonna pay for the last 3 days.
[AGENT][POSITIVE] Yes, yes, yes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, yeah, the last 3 days and then there will, it, it, it should be 650 minus the taxes.
[CUSTOMER][NEUTRAL] Am I correct?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Based on, based on the calculation you made, it may be, but um yeah, it could be, it could be less, it could be like in the beginning you said, OK, let's calculate 3 days at $20 per hour. That was $480.
[CUSTOMER][NEUTRAL] If I get taxes with help.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] If you calculate the 3 days for $20 an hour, so basically, um it really it's gonna depend on how much you make per day. Um, so basically whatever is calculated on how much you make per day is gonna be I guess that $650 which is your maximum benefit, um, but that's not, yeah, it is hard to determine this or it's hard to get like a usual amount over the phone. It's really hard to do that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Mhm. Yeah, I just wanna, yeah, and I'm trying to figure out is it even, you know, work, you know, I know I need to rest and, you know, I'm, I'm still having pain.
[AGENT][NEUTRAL] And that's why we cannot guarantee.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] And I just don't want to, and I'm old. I don't wanna freaking cause more.
[CUSTOMER][NEGATIVE] Injury to myself, you know, more harm to myself because of work. Now I know I need to work because of money, but I also need to heal.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] As well.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] And I know if I'll start working, I'm gonna work and I'm gonna, I know I'm gonna use the hand. I know it for a fact.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And I don't want them pins to, I need those pins to be right. I need them to get my bones back aligned.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK. I mean, I have, I'm still confused about the.
[CUSTOMER][NEUTRAL] The 650 and everything but.
[CUSTOMER][NEUTRAL] Like you said, I'm gonna go ahead and submit the two pieces that I have from the employer and.
[CUSTOMER][NEUTRAL] Uh, my and myself that I filled out at least we can get that process started and then wait for the, the, the.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The session.
[CUSTOMER][NEUTRAL] The physician to fill his teeth out. I do have one more question when it comes to that form.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And that is um.
[CUSTOMER][NEUTRAL] Where is that section.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Right let's see what is it.
[CUSTOMER][NEUTRAL] Oh, here's my question. There's a different question.
[CUSTOMER][NEUTRAL] If I start this, I can, I can cancel this process at any time too, right?
[AGENT][NEUTRAL] Mm, what do you mean by cancel the the process?
[CUSTOMER][NEUTRAL] If I start the claim.
[CUSTOMER][NEGATIVE] So if I, you know, I'm, I'm going through the paperwork and I, and then I may decide, you know what, it's not even worth going through all of this, then I can cancel.
[CUSTOMER][NEUTRAL] Cause I, that's why I was, I was trying to call so I can understand.
[CUSTOMER][NEUTRAL] If this is at least going to benefit me some way.
[CUSTOMER][NEUTRAL] Um, I did understand the way we went over the, the group accidental stuff. I get that cause it's straightforward, but this part, when it comes to the disability is what I'm confused about.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] You know,
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Cause you, you know, you just said that after
[CUSTOMER][NEUTRAL] So you said it won't pay until after the what did you say the 7th day or what did you just say?
[AGENT][NEUTRAL] 7, yeah, after the 7 day, yes, so it will pay on the 8th day.
[CUSTOMER][NEGATIVE] After 7 days it's not going to pay.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] So I have to be off work for 7 days for the for the disability consider paying and then when it does, it's gonna pay for 3 days.
[AGENT][NEUTRAL] It's gonna pay after the 7th day, correct.
[CUSTOMER][NEUTRAL] I'm, I'm sorry, it's gonna pay after the 7th day. So after the 7th day, it will send me a check, whatever direct deposit or whatever it's gonna do. I have no idea, and, and it will send me the funds after the 7th day, correct.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] After it's processed, not after the 7 day, but after it's processed. Mhm. Yeah.
[CUSTOMER][NEUTRAL] And it, it, it
[CUSTOMER][NEUTRAL] Right after it's processed, right.
[CUSTOMER][NEUTRAL] Right after this process.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And I have to be out more than 7 days, correct?
[AGENT][NEGATIVE] Yes, because if you're less than 7 days out, then that means you're not gonna get paid anything.
[AGENT][NEUTRAL] And so
[CUSTOMER][NEUTRAL] So it doesn't have to be 10 days, it has to be 7, correct?
[AGENT][NEUTRAL] Um, no, in order to get paid, it has to be more than 7 days. So basically it's more than 7 days. Anything more is payable.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] So I have to be out more than 7 days, so I could be out 8 days.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Correct, and I can still file for the disability, correct?
[AGENT][POSITIVE] And you get paid one day, yes.
[AGENT][NEUTRAL] For one day, correct.
[CUSTOMER][NEUTRAL] Only get it for one day.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Not 3 days like you said before.
[AGENT][NEUTRAL] No. Correct, not 3 days. It depends on the length of time of the disability. If let's make another example. If you are off a whole month, which that's 30 days, 31 days, the 1st 7 days is not gonna be payable. You're only gonna get paid for that 3 weeks that are left.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] So the first week basically it's not gonna be payable. The 1st 7 days is not gonna be payable. So if you are out of work only 6 days, then.
[AGENT][NEGATIVE] There is um basically you don't really need to send a claim because it's not gonna be payable.
[AGENT][NEUTRAL] Now, anything
[AGENT][NEUTRAL] More than 7 days could qualify for some of the benefits. Like in your case, you said it was 10 days. Since you have more than 7 days, you have 10 days, the 1st 7 days is not going to be paid, so you have 3 days that you can qualify for.
[AGENT][NEUTRAL] If you're out more time than just 10 days, let's say you're 20 days, then you have 13 days that you can go ahead and um get benefits for. But the 1st 7 days is not payable.
[AGENT][NEUTRAL] So if you're off 2 days, 3 days, 4 days, 5 days, 6 days, you will not qualify even if you have 7 days, it's not going to qualify for any benefits. It has to be on the 8th day. So that 8 day, 9 days, 10 days, those are the days that are counting. So those 3 days are payable. Like I said before, if you have 10 days off, um, then you have the 1st 7 days or and then the 3 days or if you have 20 days, you have those 13 days that you're gonna get paid in the 1st 7 days you're not.
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] I'm still confused. OK.
[CUSTOMER][NEUTRAL] I'm gonna
[CUSTOMER][POSITIVE] I'm gonna go ahead and uh fill this out and send it in. That was, thank you for taking the time and being patient.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome. No problem. It's OK. Is there anything else I'm gonna help you with today?
[CUSTOMER][POSITIVE] I appreciate it.
[CUSTOMER][POSITIVE] That's it. Thank you.
[AGENT][POSITIVE] Thank you. You're welcome, Ms. [PII]. Thank you for calling ATL. Have a good day and a good week.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thank you bye bye.