AccountId: 011433970860
ContactId: d95c053b-4bc1-4be4-ac6c-b2fb8b5f145b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 469679 ms
Total Talk Time (AGENT): 252576 ms
Total Talk Time (CUSTOMER): 104076 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/d95c053b-4bc1-4be4-ac6c-b2fb8b5f145b_20250421T21:55_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], my name is [PII], and I was thinking about putting in a claim.
[AGENT][NEUTRAL] OK. Do you have your policy number, Mr. [PII]?
[CUSTOMER][NEGATIVE] I do not. I don't have it with me.
[AGENT][NEUTRAL] OK. I'll look it up by your name. Hold on one moment.
[AGENT][NEUTRAL] And last name, is that [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, pulling that up. Give me one moment.
[AGENT][NEUTRAL] And what was your first name again? I'm sorry.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is this for short-term disability or?
[CUSTOMER][NEUTRAL] No, uh accident.
[AGENT][NEUTRAL] Accident, OK.
[AGENT][NEUTRAL] Are you trying to upload a claim on the portal or how can I help today?
[CUSTOMER][NEUTRAL] You know, I, I don't know anything about a portal. I was just trying to make a claim for an accident claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Get this pulled up
[CUSTOMER][NEUTRAL] I'll just see what I needed to do.
[AGENT][NEUTRAL] Let me verify just a few pieces of information. Do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And what is your birth date?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then lastly just your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK, so, um, let's see. So we'll need, do you have, have you been to the hospital or ER, um, for an accident?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so,
[AGENT][NEUTRAL] What we'll need is, um, you'll need to fill out a claim form.
[AGENT][NEUTRAL] Uh, do you have access to a laptop or a desktop?
[AGENT][NEUTRAL] Or do you just want to send this by?
[CUSTOMER][NEUTRAL] Uh, yes.
[CUSTOMER][NEUTRAL] Have access
[AGENT][NEUTRAL] OK, um, do you want to get your account set up? I can help walk you through that or I can email you like the information on how to set it up.
[CUSTOMER][NEUTRAL] Uh, you can email it to me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'll get that emailed over.
[CUSTOMER][NEUTRAL] Or something that you can set up on your end.
[AGENT][NEUTRAL] Uh, I can't set it up. You'll have to set it up for yourself, um, because you'll have to create a password.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so I can send you the information on how to set that up. That's usually if, if you don't have any issues with getting that set up, that's typically the easiest way because you can go on to your portal, you can print off your claim form, get that completed, and then you can submit like the itemization from your hospital charges. um, most important thing is, did they give you like an itemized bill or like a discharge summary or?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] They gave me discharge papers, um, but it was.
[CUSTOMER][NEUTRAL] It was ongoing. I had to go get a for X-ray, MRI and stuff like that.
[AGENT][NEUTRAL] OK. Um, so what you'll need to get is we'll, we'll need to show, you'll need to show us information from the hospital that shows like what date you got the X-ray, what date did you go to the ER, um, how much were those charges, and then what diagnosis was the accident. So like, it has to show that, that information.
[AGENT][NEUTRAL] So, um,
[AGENT][NEUTRAL] When you set up your online portal, there's a claim form and it tells you exactly what we need. So you'll have to gather this information from your healthcare providers to get that submitted.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the most important thing is that it shows what dates you were seeing.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] You know, and by what provider or hospital?
[AGENT][NEUTRAL] And then what your diagnosis was.
[CUSTOMER][NEUTRAL] OK, I got
[CUSTOMER][NEUTRAL] I don't think it has the diag well, it does have the diagnosis. They didn't, even if they didn't find anything at the, the ER.
[AGENT][NEUTRAL] Yeah, so they
[CUSTOMER][NEUTRAL] Because the X-ray didn't show.
[AGENT][NEUTRAL] So it should have a diagnosis. So were you in like a car accident or did you fall or?
[CUSTOMER][NEUTRAL] No, I feel.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But the the, the, the X-ray don't show certain, uh.
[CUSTOMER][NEUTRAL] You know, injuries or, you know, so to say.
[AGENT][NEUTRAL] Right. Um, it'll still, it should, if, if it indicates that the diagnosis that was that you fail, that's what we're looking for. They still have to, they still have to show that, you know, why did you need an X-ray.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That makes sense.
[CUSTOMER][NEUTRAL] Yes ma'am. So would the release papers be OK, or would I have to sit and wait for the bill to come?
[AGENT][NEUTRAL] So, it depends. If the release papers do show why you were seen and what services you had and how much it was, then that would be fine.
[AGENT][NEUTRAL] But like I said, it does have to show the diagnosis was that you fail.
[AGENT][NEUTRAL] And then, you know, whatever services they did like an X-ray or, or whatever they did in the hospital.
[AGENT][NEUTRAL] So it depends, depends on if that information you have right now includes that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, what I can do is um let me send you, I'm gonna send you the guide to set up your account, but I'm also gonna send you an accident claim form. So look over that form, it's gonna tell you exactly what we need, what we just discussed, that way you can kind of compare.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] When you're looking at that form to the paperwork that you have, does it have everything that's on that form?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me see.
[AGENT][NEUTRAL] Like I said, it does have to have, you know, specific information so we can make sure it was due to an accident and then, you know, that it's covered under the policy.
[AGENT][NEUTRAL] Which you have several benefits that are covered under here, so.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, so I'm gonna email this over to you, um, Mr. [PII], and then if you have any questions after you read through it, um, and try to match up what you've received so far, um, then give us a call back and we'll be happy to answer any questions.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] No, ma'am, that'll be all.
[AGENT][POSITIVE] OK, well, thank you for calling APL. I hope you have a good evening.
[CUSTOMER][POSITIVE] Alright thank you bye.
[AGENT][POSITIVE] Thank you. Bye.