AccountId: 011433970860
ContactId: bf45ed2d-5b95-4948-aa95-a1342320bbba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 760039 ms
Total Talk Time (AGENT): 296770 ms
Total Talk Time (CUSTOMER): 200168 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=-1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/bf45ed2d-5b95-4948-aa95-a1342320bbba_20250225T15:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling because I'm still waiting on a claim that I put in almost a month ago.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEGATIVE] It seems like you guys are trying to refuse to pay it, and I understand you're gonna say you're not refusing to pay it, you're trying to get your stuff, but when you're advertising that, you know, your, your policies are to cover paychecks, but you're just sent me a letter saying it'll take up to 90 more days. Um, I don't understand how you could be covering a paycheck loss when.
[CUSTOMER][NEGATIVE] You're taking longer than 90 days for something that isn't even there. So I would like to know how to speed this up because this is gets ridiculous. There's nothing to find. And what you're waiting on now is my DOT physical, which
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] It is basically irrelevant to the whole thing because I wouldn't be able to get the DOT physical unless I went to the doctor to get the problem fixed. Otherwise, they wouldn't have issued me my DOT physical.
[CUSTOMER][NEUTRAL] So you guys are hunting for something that isn't there.
[AGENT][NEUTRAL] OK, so I can take a look at that.
[CUSTOMER][NEUTRAL] So, so how.
[CUSTOMER][NEGATIVE] Yeah, because you guys are waiting on literally a DOT physical. That's all that's there that you guys are waiting on and say, telling me now it's 90 day wait and they wouldn't have given me my physical if I had this problem. They would deny me my physical and then they would have sent me back to a doctor, which you guys would have found that paperwork from my doctor. So we're spinning our wheels here.
[AGENT][NEUTRAL] OK, sure, so give me a moment to take a look at that. Can I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, thank you. And what's your policy number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let
[CUSTOMER][NEUTRAL] 248-2897
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Alright, Mr. [PII], verify your address and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that information and also verify your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, thank you, and you are calling in regards to your claim, um, right?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, let's see what we have here.
[AGENT][NEUTRAL] Bear with me just a moment, just looking through the notes and at what we have on file.
[AGENT][NEUTRAL] All right, Mr. [PII], if you don't mind holding just a moment, I wanna take a deeper look to see if I could um get an update.
[AGENT][NEUTRAL] At this minute. Is that OK?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Good morning, [PII]. I need you to look at a a policy. Let me know what we're waiting for. It's.
[AGENT][NEUTRAL] 248-28997
[AGENT][NEGATIVE] Mr. [PII] is on the phone and he's not a happy camper.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Yup. And he, he got the letter. That's why he's calling cause he's mad about the time. He's saying something about 90 days. Does the letter say 90 days?
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 30. OK, so I'll, yeah, he's
[AGENT][NEUTRAL] Yeah, that's what I figured, but he was like, I'm getting a letter saying 90 days and you guys are just
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, that's what he's fussing about. He's like.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Isn't it the worst?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Let me see if I can get it well you try, OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Exactly. OK.
[AGENT][POSITIVE] All right. I'll let him know. Thank you, [PII]. OK, bye.
[AGENT][NEUTRAL] Hi, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you for holding. I was just um looking at the information and um at this point, we are waiting for those records from a physician and immediate care. And um it's, it's not uh 90 days, it's 30 days. And those records were sent out on, the request was sent out on the [PII].
[CUSTOMER][NEUTRAL] Well, yeah.
[CUSTOMER][NEUTRAL] So, 30 days from the record sent down on the [PII], I went out on disability on the [PII].
[CUSTOMER][NEUTRAL] Which means that
[CUSTOMER][POSITIVE] It's gonna be almost 2 months before I see a payment from you guys, which makes basically makes your policy completely worth of short term disability coverage for when I'm off of work.
[CUSTOMER][NEGATIVE] I'm not understanding how this is actually a good policy to have. I'm still struggling to fail to see this one. Like I said, all you're waiting for is a piece of paperwork that tells you I got a DLT physical.
[CUSTOMER][NEUTRAL] Which if I had a hernia, I wouldn't have been released to get a DOT physical.
[AGENT][NEUTRAL] Understood. And uh ideally, that we received the claim and the claim is processed based on your benefits, but because of the effective date of this policy, it's within that first year, which is the pre-existing period where it adds that extra piece where we have to reques[PII] those medical records.
[CUSTOMER][NEUTRAL] I think he has
[AGENT][NEUTRAL] So, yeah, ideally, this would not be the case when you file for your disability benefits, but because of the effective date of uh for [PII], it's within your preexisting period where we have to do that uh process before the benefits can be paid.
[CUSTOMER][NEGATIVE] Ridiculous.
[CUSTOMER][NEUTRAL] Well, I've sent the thing, I've
[AGENT][NEUTRAL] I, I definitely understand your frustration. We follow up every other day with the physician to get those records. And um at this point, once we receive them, they'll um be processed and moved forward, but it's just waiting for those records. And again, we follow up to get them to get those over to us as soon as possible.
[CUSTOMER][NEUTRAL] I mean, wouldn't my own DLT physical be the record for that?
[AGENT][NEUTRAL] Well, the, based on the policy, the records would be any provider that you've seen um prior to the effective date, so we have to go through the processes to rule out preexisting.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. I'm sorry about that, Mr. [PII]. I definitely understand your frustration, but um we are working to get those records and uh we wanna get those uh benefits paid to you. We just have to get those records back in order to move forward with the process.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] I'm just letting everybody at my work that that I work with that we all got this policy understand that this is what they're gonna go through also because.
[CUSTOMER][NEUTRAL] Basically, this right here is something that we, when we got these policies through your person that was providing them.
[CUSTOMER][NEUTRAL] Um, they made it sound like, you know, as long as we.
[CUSTOMER][NEUTRAL] Put all of our stuff and, you know, and there was no preexisting we're all good, but they didn't say we'd be dragged out over this stuff and there's policies that'll pay better than this, so.
[AGENT][NEUTRAL] Oh sorry about that. But yeah, after [PII], that preexisting would not be a factor. So you submit a claim, we process that claim, but it's just because it's within the first year um of the policy. I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] What was
[CUSTOMER][NEUTRAL] What was the
[CUSTOMER][NEUTRAL] I'm sorry, what was the date of the policy?
[AGENT][NEUTRAL] Um, the effective date is [PII]. So after April of this year, preexisting would not apply to um your claims. So um it's.
[CUSTOMER][NEUTRAL] I got my, I want the physician's assistant on [PII].
[CUSTOMER][NEUTRAL] 2 days after I got in your policy last year.
[AGENT][NEUTRAL] Understood, and that is why there's a pre pre-existing um research ongoing because again, it's within your first year of the policy being active, that's your preexisting period.
[AGENT][NEUTRAL] After that preexisting period, which ends on [PII], that step will no longer apply. We will process the claims um as you submit them, but because you filed the claim within the first year, it is subject to preexisting.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] OK, but we're definitely following up again, uh, sending a message over to the adjuster, um, the last follow up was on yesterday, we'll follow up again tomorrow, but as soon as we receive that information, that claim will be processed, OK?
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] No problem, Mr. [PII]. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, that was it.
[AGENT][POSITIVE] All right. I'm sorry about that inconvenience. Uh, thank you for calling ATL. You have a great day.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] Thanks bye bye.