AccountId: 011433970860
ContactId: da440438-2a9a-4af9-9b84-e9bc43a0b7e8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 783739 ms
Total Talk Time (AGENT): 249606 ms
Total Talk Time (CUSTOMER): 346971 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/da440438-2a9a-4af9-9b84-e9bc43a0b7e8_20250325T22:38_UTC.wav
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[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes ma'am, yes ma'am. My name is [PII].
[CUSTOMER][POSITIVE] And I'm calling it said that you could help assist with a claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have temporary.
[CUSTOMER][NEUTRAL] Disability insurance I've been.
[CUSTOMER][NEUTRAL] Uh, medically separated from my job through the company that I bought insurance from you until I heal up. I am a diabetic and I got my big toe cut off and it's gonna be a while before I can get back. They gave me 6 months to heal up, but I had bought it. I had no idea I was getting my toe cut off, but I got my toe cut off.
[CUSTOMER][NEUTRAL] So I need help.
[AGENT][NEUTRAL] So do you have some claims that you filed, [PII] that you need me to check on? Is that what we're needing?
[CUSTOMER][NEGATIVE] No, it said that in this phone at the beginning prompts it said that you would help me start to file it. I have waited. I called you while I was in the hospital after I told you I was getting it cut off, not you, but one of the representatives that I was getting my toe cut off. Well, now it is cut off and I'm going to see my follow up doc, the surgeon that cut my toe off tomorrow. I.
[CUSTOMER][NEUTRAL] Ask if you would send the emails, but somehow the emails blinked off on the forms I need, but then the prompt said you could help me get it started, so I need to get it started.
[AGENT][NEUTRAL] What's the policy number? Do you by chance have that?
[CUSTOMER][NEUTRAL] I have the card. Is that what you need? on the back policy certification number.
[AGENT][NEUTRAL] Yeah, there should be like a
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] 02597992
[CUSTOMER][NEUTRAL] It's employee and spouse.
[CUSTOMER][NEUTRAL] Uh, there's also a medical ID number.
[AGENT][NEUTRAL] And then if I could just verify please for security your date of birth and address.
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[CUSTOMER][NEUTRAL] And my address is [PII].
[AGENT][POSITIVE] All right, thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So claims can be filed 3 different ways. They can be filed online. We have an online service center. It can be done electronically. They can be sent in the mail or they can be faxed.
[AGENT][NEUTRAL] Do you have a
[CUSTOMER][NEUTRAL] OK, well, the lady that I talked to, the lady that I talked to last week or week and a half before while I was in the hospital.
[CUSTOMER][NEGATIVE] Was was gonna send it to me in the mail which it hasn't got here yet and she sent me forms to get started on when I went back to the doctor that we looked we looked when she sent them and they came through but somehow they didn't they got erased or.
[CUSTOMER][NEUTRAL] Something so I don't have the forms because I guess I can go to the doctor and they I could send it to them email and then they can print it off with their I don't have a printer or anything.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so is your email still the.
[CUSTOMER][NEUTRAL] That that's what I'm assuming I can do.
[AGENT][NEUTRAL] Is your email still the Gmail account?
[CUSTOMER][NEUTRAL] Yeah, [PII], I think it's think on [PII] 60.
[AGENT][POSITIVE] Correct. OK.
[CUSTOMER][NEUTRAL] And I called, I called you on my wife's phone, so if you send them again I can check without hanging up on you because I'm not real high tech right now.
[AGENT][NEUTRAL] OK, so I just sent you the claim forms.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I'm a look hold on.
[CUSTOMER][NEUTRAL] Say even.
[CUSTOMER][NEUTRAL] So is it care team at claim forms?
[AGENT][NEUTRAL] The email would be from the care team, yes, uh huh, and it should say claim forms in the subject line, yep.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, and it says your business is very much appreciated. Click here to extend your expectations, email, and then it has two PDFs.
[AGENT][NEUTRAL] Right, so the PD.
[CUSTOMER][NEUTRAL] Online service.
[AGENT][NEUTRAL] Yeah, the PDFs are the um one is the user guide for the online service center if you want to do it online, and then one would be the claim form that you need.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] So if
[CUSTOMER][NEUTRAL] I'm sure that if I, I download the the regular written form and send it to my doctor, I'm sure that they can get it off of theirs and then print it out for me and then.
[CUSTOMER][NEUTRAL] Can you tell um it said what do I need to do exactly to get it started just fill this form out?
[AGENT][NEUTRAL] Yeah, so the first thing you'll need is just to get the form filled out, um, and then as far as accompanying the form, let me see what's required with it because you'll need some, give me just one second.
[AGENT][NEUTRAL] So you'll need the claim form and then you're gonna need an itemized bill from your provider with any uh diagnosis codes on it also.
[CUSTOMER][NEUTRAL] And that would be from my doctor or from the hospital because I was admitted for 5 days.
[AGENT][NEUTRAL] So you're gonna want an itemized bill from the hospital to claim the hospital stay, but then you'd also want one from the provider to claim any sort of surgery that you had.
[CUSTOMER][NEUTRAL] OK, and then like, like, OK, they let me out, uh, not just last Thursday I was in for 5 days and now since I'm diabetic they're gonna, I don't know if you know what a pick line is to where I can get like outpatient IVs since I'm diabetic and I don't heal up good. I, whenever I finally start doing that, I just need them to give me an itemized bill on that and then I can fax that to you too.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm, exactly, yeah, and that claim form is good for any of those services. So if you get that provider, if they can print it out for you, then I would just see if you can get like an extra copy so you have one on hand. Um, the forms are also located on our website also, but if they can print you out another one that might be useful.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So since you have a short time.
[CUSTOMER][NEUTRAL] I have short term disability, right? Is that correct?
[AGENT][NEUTRAL] Um, let me look and see.
[AGENT][NEUTRAL] Yeah, so you do have a disability policy with us too, which is separate.
[CUSTOMER][NEUTRAL] The lady before.
[AGENT][NEUTRAL] Um, so that's
[CUSTOMER][NEUTRAL] So can you send the claims for those.
[CUSTOMER][NEUTRAL] Are those different claims?
[AGENT][NEUTRAL] Yeah, so that's a different claim form.
[CUSTOMER][NEUTRAL] So she fax that could you email me that too?
[AGENT][NEUTRAL] Let, let me.
[AGENT][NEUTRAL] Yeah, let me send you that one in a separate email so you don't get them confused.
[CUSTOMER][POSITIVE] OK thank you
[CUSTOMER][NEGATIVE] And then after you get all that email, could you give it? I know that it's not a locked in amount, but could you give me some kind of number because she gave it to me in the hospital and I've lost my job, my toe, my insurance, uh, you know, I've lost everything and I was kind of overwhelmed whenever I was getting my toe cut off or a blister, so I don't remember what she said.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, we can, yeah, we can look at this, uh.
[CUSTOMER][POSITIVE] Appreciate it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I tried to not even use it and I went to the Social Security office today, but they don't give you temporary disability through Social Security unless you're off for a whole year and I unless I start losing my foot and then my leg and I don't think that I'll be off that long, you know what I mean so I've tried to go another route.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So there's the claim form for that. Let me
[AGENT][NEUTRAL] Pull your policy certificate and see what it says.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] You're listening.
[CUSTOMER][NEUTRAL] I was just giving it a time to upload so it wouldn't I don't know if it sends a while I have it OK.
[CUSTOMER][NEUTRAL] I did get the other one. It was disability claim form at ATO customer.
[AGENT][POSITIVE] OK, great.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I'm sure if the doctor can't do it like the library or the.
[CUSTOMER][NEGATIVE] Walmart or somewhere could I could yeah Walmart, I mean the library isn't help will help you through that.
[CUSTOMER][NEGATIVE] I just really am not even good with the phone, let alone a computer or a fax machine or any of that.
[AGENT][NEUTRAL] I hear you.
[AGENT][NEUTRAL] OK. So let's see. So it looks like to be eligible for the disability, you have to just, at the time when you were working, you would have had to have worked at least 20 hours or more per week.
[AGENT][NEUTRAL] There is an elimination period of 7 days, so that just means your 1st 7 days out would not be paid.
[AGENT][NEUTRAL] The maximum disability period on the plan is 90 days, so that's the most it's gonna pay is for up to 3 months.
[AGENT][NEUTRAL] The monthly disability.
[CUSTOMER][NEUTRAL] So that's 90 minus 7, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] 90 days minus 7, yeah.
[CUSTOMER][NEGATIVE] So the 7 days have already passed.
[AGENT][NEUTRAL] Yeah, so the monthly disability benefit of 650, it's not to exceed 60% of your monthly compensation.
[AGENT][NEUTRAL] So it looks like the monthly disability amount is 650 but not to exceed 60% of his or her monthly compensation is what it states on your benefits.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, well, I got, I think I got what I need if uh.
[CUSTOMER][NEUTRAL] If uh I have any more questions I'll probably call back tomorrow after I see the doctor and stuff.
[AGENT][NEUTRAL] OK, yeah. Just make sure you take both claim forms with you cause you'll need both filled out by your physician, the disability and the um hospital one, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I appreciate your help thank you very much.
[AGENT][POSITIVE] You're welcome, [PII]. You take care.
[CUSTOMER][POSITIVE] Alright thank you bud.
[AGENT][NEUTRAL] Uh-huh. Bye-bye.