AccountId: 011433970860
ContactId: c0f02430-1840-4d47-8854-58a51eb7abad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 481760 ms
Total Talk Time (AGENT): 147443 ms
Total Talk Time (CUSTOMER): 234640 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/c0f02430-1840-4d47-8854-58a51eb7abad_20250429T22:12_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good afternoon, um.
[CUSTOMER][NEUTRAL] I was calling to make sure that all the documentation uh needed for my claim was received.
[CUSTOMER][NEUTRAL] Because I, I got, got something from my doctor's office. I got something from work that they had sent everything in. Um, I tried sending my claim, my original claim. I tried sending it via email to um [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And it kept getting rejected it said it wasn't a valid email address.
[CUSTOMER][NEUTRAL] So instead I sent it to care team at [PII] and I received uh an email email back saying that you had received what I sent.
[AGENT][NEUTRAL] OK, do you have your policy number?
[CUSTOMER][POSITIVE] Well, that's where it gets interesting.
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] Could you please not do what the last person in APL did about 15 minutes ago, which was.
[CUSTOMER][NEUTRAL] Ask me to hold and then transfer me straight over to ERB.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] My policy number is.
[CUSTOMER][NEUTRAL] 024.
[CUSTOMER][NEUTRAL] 19152.
[CUSTOMER][NEUTRAL] And when I said it gets interesting is because.
[CUSTOMER][NEUTRAL] I was injured on the job [PII].
[CUSTOMER][NEUTRAL] But I put off going to see the doctor because I thought it was just a, a strain that would heal itself.
[CUSTOMER][NEGATIVE] Turns out it was a torn um lateral meniscus.
[CUSTOMER][NEUTRAL] Um, but I put off seeing the doctor for about
[CUSTOMER][NEUTRAL] 4 months? I didn't go to see him until April.
[AGENT][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Like the end of April.
[AGENT][NEUTRAL] Can you verify your name and your date of birth?
[CUSTOMER][NEUTRAL] Sure, [PII] the clerk, and that would be [PII].
[AGENT][NEUTRAL] And then what is your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then what is your email address?
[CUSTOMER][NEUTRAL] Email address is [PII].
[AGENT][NEUTRAL] OK, thank you. And then lastly, do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, thank you for asking [PII].
[AGENT][NEUTRAL] OK, thank you. And, OK, so I'm so you had an injury in [PII], is that right?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So and in [PII].
[CUSTOMER][NEUTRAL] I had coverage with APL.
[CUSTOMER][NEUTRAL] OK, it wasn't until May apparently.
[CUSTOMER][NEUTRAL] That APL made some changes.
[CUSTOMER][NEUTRAL] But when I first called APL.
[CUSTOMER][NEUTRAL] A month ago
[CUSTOMER][NEUTRAL] You know, I explained.
[CUSTOMER][NEUTRAL] I explained that my injury happened in January.
[CUSTOMER][NEGATIVE] I just put off seeing the doctor, like I said, because I thought it was a strain that would heal, but it didn't get better. It started getting worse.
[CUSTOMER][NEUTRAL] So that's when I went to see the doctor and, you know, he had ordered an MRI.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, all said and done, when I followed up with him at the end of May, he said, yeah, you need surgery to get that fixed. So that's when he put me off work, was at the end of May.
[AGENT][NEUTRAL] Of [PII].
[CUSTOMER][NEUTRAL] But I was told
[CUSTOMER][NEUTRAL] Yes, of [PII], but I was told since the accident happened in January of [PII].
[CUSTOMER][POSITIVE] That my policy was still good, it was in effect.
[AGENT][NEUTRAL] OK, let me pull up your other policy. There is
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, so it looks like we do have, we've received claims and they're currently in processing under this policy.
[CUSTOMER][POSITIVE] Oh great, OK.
[AGENT][NEUTRAL] Because it looks like and, and I'm not sure what the determination has been made yet, but because it looks like your policy number, there was one that was effective, um.
[AGENT][NEUTRAL] [PII], and then
[AGENT][NEUTRAL] Another policy, it's the same policy. It was effective from 51-2024 in terms [PII].
[AGENT][NEUTRAL] And your surgery was in May?
[CUSTOMER][NEUTRAL] Right, and I was told that.
[CUSTOMER][NEUTRAL] Uh, no, my surgery didn't happen until [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I mean, it, it is based on when the services are rendered.
[AGENT][NEUTRAL] Cause that's what short term disability pays out for when services are rendered under the, cause that mean when you're off work.
[AGENT][NEUTRAL] Cause it's a, it's tied to when you're working and then when you're off work.
[CUSTOMER][NEGATIVE] Well, I was put off work like [PII] or [PII].
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] That's when he made a determination that yeah you, I'm not sending you back to work, you need this surgically repaired.
[AGENT][NEUTRAL] And then you did get a statement from your employer as well?
[CUSTOMER][NEUTRAL] Yes, both of those were were faxed over, um, to APL. I received notification from both my doctor's office and my employer on the same day, um, last week on the [PII].
[AGENT][NEUTRAL] OK, yeah, it looks like we've received everything and it's just currently in processing. So typically takes about 7 to 10 working days for us to make a determination on if we'll pay any benefits out.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So, um, at this point, I would probably check back.
[AGENT][NEUTRAL] I would probably check back about next Monday and it should be processed by then.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] From your experience.
[CUSTOMER][NEUTRAL] Do I have a claim?
[AGENT][NEUTRAL] Um, I'm not I'm not in the claims department, so I just simply look at claim status and tell you the status of it and then if what your benefits are. So our claims department, they do close at 5, so you can definitely call back tomorrow and discuss if you had questions, you know, specifically on how the claim would pay or something like that, um, but it, it looks like we have received everything.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's being reviewed by our claims department and like I said, probably about next Monday there should hopefully be a determination on whether it's payable or not.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you that's.
[CUSTOMER][POSITIVE] Miles further than I got with the last phone call, so I appreciate that.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, no problem. Is there anything else I can help with today, [PII]?
[CUSTOMER][NEUTRAL] Alright, I'll
[CUSTOMER][POSITIVE] No thank you you've been a huge help. I'll try calling back next Monday and see what the status is.
[AGENT][POSITIVE] OK, that sounds good. Well, thank you for calling APL and I hope you have a good evening.
[CUSTOMER][POSITIVE] Thank you you too take care.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.