AccountId: 011433970860
ContactId: c48d26b7-ae31-49f4-8750-ed64009d3371
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 842500 ms
Total Talk Time (AGENT): 259213 ms
Total Talk Time (CUSTOMER): 462261 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/c48d26b7-ae31-49f4-8750-ed64009d3371_20250219T13:49_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Morning, [PII]. It's [PII], uh.
[CUSTOMER][NEGATIVE] I would like to speak to one of your supervisors because I am not happy with what is going on here. I filed an accident claim on the [PII] for a broken leg, and the lady I just spoke to a couple of minutes ago was telling me that was never a claim received. However, I received documentation that I needed to use a different form.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] Which I did turned that form in now she's still saying there's nothing received. Somebody's not doing a good job here and I would like to speak to somebody that knows what we're talking about.
[AGENT][NEUTRAL] Alright, and I'll be happy to transfer you to a supervisor. Ms. [PII], do you have your policy number? Let me get that information pulled up.
[CUSTOMER][NEUTRAL] Uh, I do not have the accident policy number. I can give you my husband's social, which is which the accident policy is under.
[AGENT][POSITIVE] Alright, let me get to that screen and let's get this pulled up and see what's going on for you.
[AGENT][NEUTRAL] Bear with me.
[CUSTOMER][NEUTRAL] OK, he has a uh.
[CUSTOMER][NEUTRAL] Yeah, that would be under his accident policy. I'm assuming the lady I just spoke to didn't know what we're talking about, but I need to make sure this has been received and it's being processed.
[AGENT][POSITIVE] All right. Well, we'll be happy to assist you. What is his social so I can pull that policy up.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And that's for [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And Miss [PII], do you.
[CUSTOMER][NEUTRAL] My insurance, my insurance agent [PII], um,
[CUSTOMER][NEGATIVE] He, uh, actually turned that all in the second time also and told me it was received by you guys and now you're telling me again it's not received. I need to know why we're not trying to.
[CUSTOMER][NEUTRAL] Like speak the same language, so to speak.
[AGENT][NEUTRAL] Sure, absolutely, I understand completely and we're gonna see what we can do for you. I do just need to verify your date of birth if you don't mind.
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And are y'all still on [PII]? I'm sure that the representative that you spoke with.
[CUSTOMER][NEUTRAL] Yes, all the same.
[AGENT][NEUTRAL] Verified your information. Yeah.
[CUSTOMER][NEUTRAL] Mhm. Oh, she actually didn't, but yeah.
[AGENT][NEUTRAL] She did not? OK, is it [PII]?
[CUSTOMER][NEUTRAL] No, she's.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what is a good callback number just in case we get disconnected we can get right back to you, Ms. [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Do you know who, who you spoke with, Ms. [PII]?
[CUSTOMER][NEGATIVE] No, no, no, I was way too upset. She asked me what the letters or the documentations that you actually sent me back that I have to use a different form. Initially I turned this claim in with apparently the wrong claim form, but we redid all this. We turned in the correct form. You sent me the forms. [PII] sent me the forms. Uh, it was.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sent to [PII] via mail. He turned it in and confirmed it was received.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] I am looking at your accident policy and we did receive a claim on the [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let me take a look at this and see.
[CUSTOMER][NEGATIVE] That was for a broken fibula.
[CUSTOMER][NEUTRAL] With a couple of X-rays. There was a follow-up orthopedic visit on it and X-ray, the documentation was literally all there. The doctor filled out his form, um.
[CUSTOMER][POSITIVE] Everything was done correctly.
[AGENT][NEUTRAL] Now, let me ask you, when you sent in that new claim form, was it for you or for [PII]?
[CUSTOMER][NEUTRAL] Well, that's the thing, and I'm thinking somebody's confused. There was one file for [PII], he had a splinter in his eye that would have been.
[AGENT][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] The end of the year.
[CUSTOMER][NEUTRAL] So, and this accident on the [PII] has nothing to do with [PII]. This is [PII]'s claim.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Got you, because I see we paid [PII]'s claim for 12/27. That one was processed and paid, so now I'm gonna take a look at your claim.
[CUSTOMER][NEUTRAL] What did you, what did you pay, [PII]? Was that $200?
[AGENT][NEUTRAL] It was, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, yeah, that was received.
[AGENT][NEUTRAL] OK. So,
[AGENT][NEUTRAL] Bear with me just one moment. I'm just gonna check your documents and I know you wanted to speak with the rep um supervisor and I'm checking.
[CUSTOMER][NEGATIVE] Well, I mean, if you, if you can help me, I don't need you to go through the trouble transferring me, but I can't have somebody tell me, I can't, you know, have somebody tell me it's not received, nothing is under this accident policy for [PII] because, uh, trust me, I'm sitting here with a broken foot, with an air cast. It is a broken foot and I did claim that.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right, I'll be happy to help you.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] I know you've got
[CUSTOMER][NEUTRAL] So, you know.
[AGENT][NEGATIVE] Miserable with that broken foot.
[AGENT][NEUTRAL] Bless your heart. Now, that was not in December, right? When, when was that accident? I'm just checking these. What was?
[CUSTOMER][NEUTRAL] The accident happened [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This year, [PII]. And then the, the initial claim would have been turned into you probably a couple of days later, 3 days later, maybe. Not sure. the accident itself happened on the [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I'm just checking everything for you if you don't mind. And I, I appreciate your patience.
[CUSTOMER][POSITIVE] No, that's quite all right. Yeah, I appreciate you doing this, yeah.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII] is actually, he told me this morning via text message to conference him in, but I tried it before and he does not answer the phone. Um, while you're checking this, would you mind me conferencing him in?
[AGENT][NEUTRAL] Not at all. That would be fine.
[CUSTOMER][NEUTRAL] OK, hang on, don't, don't leave, OK?
[AGENT][NEUTRAL] I'm not gonna leave and if we get disconnected, I've got your phone number to call you right back.
[CUSTOMER][POSITIVE] Thank you. So I'm gonna try to keep, get, catch [PII] here. Hang on.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEGATIVE] Yeah, [PII] does not answer. I'm, I'm not sure what's going on there either because I hate when people tell me do this and do this and then we just don't connect. It's not good.
[AGENT][NEUTRAL] Right, right. I'm the same way. I'm like, don't tell me to do that and then don't be there.
[CUSTOMER][NEUTRAL] No, no. At this point, I need to know, has the claim been received? Uh, is there anything else we need? Because I literally did everything I could do to make this claim.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Legally received by you. And I'm not sure what else is going to be needed here. The doctor wrote the paper out and I went through medical records. Everything was documented. I, I had one follow-up with the orthopedic 10 days after the accident.
[CUSTOMER][NEUTRAL] And that was also turned in as a follow-up visit for the accident.
[CUSTOMER][NEUTRAL] Again
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Not sure.
[AGENT][NEUTRAL] Well, I'm just looking at everything now. The last claim documents that we received, and this did come from your agent, from the broker, it has the 12:17 emergency room visit.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Documents on it.
[CUSTOMER][NEGATIVE] No, that is, that is incorrect. He turned in several times.
[CUSTOMER][NEUTRAL] After my accident on the [PII], he literally uploaded that and he confirmed it was uploaded. And the thing is, when after he uploaded the initial paperwork,
[CUSTOMER][NEUTRAL] I got a letter from APL stating that we used the incorrect accident form, so we redid everything with the correct incident form, so you did receive it. I'm not sure where it went.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, I'm just looking at the.
[CUSTOMER][NEUTRAL] Les has two policies. Les has an accident policy, and then he has a, uh, some other policy.
[CUSTOMER][NEGATIVE] Uh, it has been received because you replied with the letter I used the wrong form.
[AGENT][NEUTRAL] Right, so that was on the um.
[AGENT][NEUTRAL] If I'm checking all the policies too just to make sure it didn't accidentally get placed.
[CUSTOMER][NEUTRAL] The one you're referring to on [PII] was for [PII]'s eye. He had an accident where he had a splinter in his eye that was removed and that was a whole different story.
[AGENT][NEUTRAL] Right, and that, and that has already been addressed, of course, um.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm just checking everywhere I can.
[AGENT][NEUTRAL] But the on the last.
[CUSTOMER][NEUTRAL] Because [PII] told me he uploaded that and it was received.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Where would it be? How many more times do we have to send that to you?
[AGENT][NEUTRAL] I, I wish I knew, Ms. [PII], um.
[AGENT][NEUTRAL] and you said he sent it on [PII]?
[CUSTOMER][NEUTRAL] Well, the second was my accident. The initial claim reclaimed a couple of days later, that would have been 3 days later or so, and then you you you replied that we used the incorrect form and we used the correct form and resubmitted everything.
[AGENT][NEUTRAL] That's it, yes, me.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] And now nothing is there.
[CUSTOMER][NEGATIVE] It's totally wrong to do this to us.
[AGENT][NEUTRAL] Well, uh, you know, I, it's just there's nothing that we can do without the document in hand, and I'm wondering, and you, did you say that [PII] uploaded it on your, on the portal or faxed it to us?
[CUSTOMER][NEUTRAL] He would have, yeah, he would have uploaded it on his portal from his side, mhm.
[AGENT][NEUTRAL] Do you know if he got a, did he tell you he got a confirmation or anything?
[CUSTOMER][NEUTRAL] Uh, if you hold just one more second, I'm gonna try again to catch him here. Hang on, please.
[AGENT][POSITIVE] Right, thank you.
[CUSTOMER][NEUTRAL] Yeah, that, uh, he's not answering, so.
[AGENT][NEUTRAL] I wish that
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] I wish he would answer so we can ask him how that was said.
[CUSTOMER][NEUTRAL] Yeah, I would, I wish so too. I'm not exactly sure what's going on there, um.
[AGENT][NEUTRAL] The, but the
[CUSTOMER][NEGATIVE] If you, I'm, I'm not sure what it would have been to. I do not understand the way we are working here. I do not understand.
[AGENT][NEUTRAL] Yeah, and, you know, we can process it. We just need that information. And I did check every policy.
[CUSTOMER][NEUTRAL] Yeah, but how many times how many times do we have to file the claim? That's my question.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Is it under ad did it get put under a different policy? Did it get misplaced? Is it filed under a different insurance policy? Where is it?
[AGENT][NEGATIVE] Well, Ms. [PII], I did check all three policies cause there's a hospital indemnity policy as well. I checked the cancer policy, uh, and the accident policy, and it doesn't look like we ever received it.
[CUSTOMER][NEGATIVE] Right, right, not there.
[AGENT][NEUTRAL] So I'm wondering if there was a computer issue when he uploaded it. I mean, uh, you know, I have no idea what happened. I apologize.
[CUSTOMER][NEUTRAL] Uh, let's see here. I'm on the phone with APL and they want.
[CUSTOMER][NEUTRAL] Conference. Hang on, he's answering me. Uh, he is in a meeting but I'm in, I'm in a meeting too, so he needs to answer his phone. Hang on.
[AGENT][POSITIVE] Wonderful.
[CUSTOMER][NEUTRAL] Hang on, please.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEGATIVE] This is ridiculous.