AccountId: 011433970860
ContactId: db5dc382-a7ae-479c-87ae-5868f445a25a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 612900 ms
Total Talk Time (AGENT): 230525 ms
Total Talk Time (CUSTOMER): 172584 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/db5dc382-a7ae-479c-87ae-5868f445a25a_20250423T14:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I was calling about this program I'm in with y'all and how, how did it go?
[CUSTOMER][NEUTRAL] I've been in, I think I've been in over 2 years now, I think, or a year.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK. Do you have your?
[CUSTOMER][NEUTRAL] And that is uh.
[AGENT][NEUTRAL] Number?
[CUSTOMER][NEUTRAL] Say it again.
[AGENT][NEUTRAL] Your policy number or policy certificate number?
[CUSTOMER][NEUTRAL] You know I ain't got no number.
[CUSTOMER][NEUTRAL] Where do I get that from?
[AGENT][NEUTRAL] Uh, do you have a card with us, or?
[CUSTOMER][NEGATIVE] No, they, what happened my job, I got, I got it with the, you know, they had a roll at the job and I got in it, but they, I ain't get no car, no nothing or no paperwork.
[AGENT][NEUTRAL] OK, um, do you have, I, I can look it up by your social, do you have that?
[CUSTOMER][NEUTRAL] Yeah, um, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] And are you checking on, it looks like you have a short-term disability policy, a group accident, and a critical illness. Is there a specific one you're wanting to check on?
[CUSTOMER][NEUTRAL] The one with the um the accident?
[AGENT][NEUTRAL] OK, um, let's see.
[AGENT][NEUTRAL] Let me get that pulled up.
[AGENT][NEUTRAL] OK. I just need a few pieces of information. Um, what is your birth date, Mr. [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And then your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and then you're just wanting to check on what is the plan cover, is that right?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Pulling up your policy.
[CUSTOMER][NEUTRAL] You say the short term.
[AGENT][NEUTRAL] Uh, the one that you had asked about is the group accident. There's also a short-term disability, um, that's if you get, uh, have an illness or injury and need to be off work.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh, I got that too all over it together.
[AGENT][NEUTRAL] Yeah, you've got 3 different policies. The short-term disability for if you ever get need off work for illness or injury, group accident that pays out certain dollar amounts for certain accidents, and then a critical illness, which also pays for certain illnesses.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And my wife [PII], is she on all these policies?
[AGENT][NEUTRAL] Um, looks like she is, she is on your group accident policy.
[AGENT][NEUTRAL] Let me look on the other ones.
[AGENT][NEUTRAL] OK, it looks like she is on your critical illness policy as well.
[AGENT][NEUTRAL] And then let me look on your short term disability.
[AGENT][NEUTRAL] Uh, it's just you on the short-term disability.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then like on your group accident, um, not a guarantee of payment based outline of your policy. So it pays certain dollar amounts if you experience certain types of accidents.
[AGENT][NEUTRAL] So, like, for example,
[CUSTOMER][NEUTRAL] But see what happened, um, what happened, um, I didn't know my wife was in it and then when I um was last year.
[CUSTOMER][NEUTRAL] The date of the [PII] yeah last year we had to enroll again and I asked the um the guy about it.
[CUSTOMER][NEUTRAL] And he said, uh, I said first I asked human resource they told me it was just me in it.
[CUSTOMER][NEUTRAL] So next, so when, when we got to the to come for enroll, I asked the guy myself and he said no, you and your wife are sitting together.
[CUSTOMER][NEUTRAL] So I said, oh, so that I didn't know that because when I called him a resource, but what happened, my wife was in a car accident in August of that year, and so I didn't know that nothing about it till I was in it till last year.
[CUSTOMER][NEUTRAL] So I don't know is it too late or how that was.
[CUSTOMER][NEUTRAL] But anyway, now, what happened since the accident, she just had surgery.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] This Friday, how it, it tore our Rotary Cup.
[CUSTOMER][NEUTRAL] And they had to replace the rotary cup and she just got that done Friday.
[AGENT][NEUTRAL] And was that related to the accident?
[CUSTOMER][NEUTRAL] I think it was related to the accident with the seat belt or something.
[AGENT][NEUTRAL] OK, um, let me see.
[AGENT][NEUTRAL] OK, so let's see what's on your accident.
[AGENT][NEUTRAL] Um, can I place you on a brief hold?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Huh.
[AGENT][NEUTRAL] OK, let's see what
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thanks for holding. OK, so I've got your policy up um there's no timely filing limit, so you, you can still file those claims if they happened last August trying to see though what um the benefit is for.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So last year when she got in the wreck, was, was there anything that happened then like did she break any bones or?
[CUSTOMER][NEUTRAL] To, um,
[CUSTOMER][NEUTRAL] To book her um.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] But she had a cast with her um, something to do with her foot.
[CUSTOMER][NEUTRAL] An arm and a foot.
[CUSTOMER][NEGATIVE] At all.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] One I told I think because they had a little funny shoe on too.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, cause it's got certain benefits for like, for example,
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Accident or like accident related to ankle or wrist pays about 3200.
[AGENT][NEUTRAL] Upper arm pays out 1600, um, forearm pays out $1200 so it pays out different dollar amounts for certain body parts.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] That are injured. Um
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what you would need to do is get, I can send you the accident form to fill out.
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] And then and then it explains what information we'll need um because you'll have to go get like the.
[AGENT][NEUTRAL] Invoices and itemized charges from the hospital where she was seen.
[AGENT][NEUTRAL] Um, that shows, you know, what happened. Like you were seen in the ER, she had broken bones, etc.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, and the X-rays and all that too, and MRI.
[AGENT][NEUTRAL] Yeah, there'll be a list on the form that tells you exactly what we need for your claims. Um, do you have an email address?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Um, yeah.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] The THE twin.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, what I can do is I can send you the claim form and then look through that, um, and then you can gather the information and then get these, um, you know, submitted for a possible reimbursement.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK. OK, I sure would do that then.
[AGENT][NEUTRAL] OK, and then
[CUSTOMER][NEUTRAL] OK, that's all I need to do.
[AGENT][NEUTRAL] Yeah, I'll send that form to you look through that and if you have any questions at all just give us a call back and then we can explain it further and go over it.
[CUSTOMER][POSITIVE] OK then thank you very much. What's your name again?
[AGENT][NEUTRAL] Uh, my name is [PII].
[CUSTOMER][POSITIVE] OK Miss [PII], alright, thank you very much.
[AGENT][POSITIVE] OK, thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.