AccountId: 011433970860
ContactId: dcdb5210-6c56-4055-b21b-c59b6c616254
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 844679 ms
Total Talk Time (AGENT): 395110 ms
Total Talk Time (CUSTOMER): 227578 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/dcdb5210-6c56-4055-b21b-c59b6c616254_20250623T19:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I'm calling to check the status of my claims.
[AGENT][POSITIVE] OK. I'm happy to check on a claim for you, [PII]. Do you have your policy number?
[CUSTOMER][NEUTRAL] Yes, it's two of them. The first one is short term and it's 263.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 6070
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And then if I could just verify, please, your date of birth and address.
[CUSTOMER][NEUTRAL] Uh, date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And then what address should we have on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK. So,
[AGENT][NEUTRAL] On the disability, it looks like there was some information uploaded a couple times. Looks like on the [PII], the [PII], and then the [PII]. Does that sound right?
[CUSTOMER][NEUTRAL] Yeah, because I kept calling and y'all kept saying that it wasn't pushing through so I just wanted to make sure.
[AGENT][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] And it said one was the accident was denied. I saw like on Friday, but I'm not, it was because the doc, they hadn't received the doctor's paperwork about it yet, I'm assuming.
[AGENT][NEUTRAL] I know.
[AGENT][NEUTRAL] Let me take a look.
[AGENT][NEUTRAL] So the disability is still showing in progress. I don't see any request for additional information or anything like that. It's just still in progress. Let me see on the accident.
[AGENT][NEUTRAL] Yeah, so I see an upload on the accident from the [PII] and then we have one from the [PII] and the [PII] also, um, but no decisions have been made on anything. Everything's still in progress. I will let you know that generally they ask for um 5 to 7 days minimum to work claims, and there were a lot of people out of office on [PII], so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Maybe give it an extra day just because we didn't have as many people and we only work Monday through Friday, so I feel like you probably should know something by the end of the week on these.
[CUSTOMER][NEUTRAL] OK, and then have you all received my, I got my banking direct deposit.
[CUSTOMER][NEUTRAL] Faxed as well. Do you have, can you see that?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yeah, let me double check on that for you. One second. Yes, that information is all on file. So any payments, yep, are gonna go uh direct deposit. We have it on both policies.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then once they decide yes or no for whatever they will pay, it takes another 5 to 7 days to get paid, is that correct?
[AGENT][POSITIVE] No, once the claim is processed because you did direct deposit, it should just take a couple of days to hit your account. We'll, we'll process out the payment that day when the claim is processed, so yeah, you won't have to wait that long.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] So maybe sometime next week.
[AGENT][NEUTRAL] Mhm, yeah.
[CUSTOMER][NEUTRAL] Like I'm I'm talking like maybe July like before the [PII] hopefully because I know that's a holiday weekend and y'all aren't gonna be working that.
[AGENT][NEUTRAL] Oh yeah, no, we won't. So yeah, hopefully before that weekend because the only way it would take any longer is if we had to mail you a check, but that's not the the case here. So yeah, once it's processed, you should get payment within a day or two.
[CUSTOMER][NEUTRAL] OK, and uh I will get a text message about it's just.
[CUSTOMER][NEUTRAL] I don't have a hard computer, so I was going to the library to upload because it won't let me upload from my phone.
[AGENT][NEUTRAL] Mm. Mhm, mhm.
[CUSTOMER][NEGATIVE] And I was, I got them the fax, but then y'all are saying y'all didn't get it so then I was concerned, you know.
[AGENT][NEUTRAL] Right. No, I get it.
[CUSTOMER][NEUTRAL] And so I think there was, there was just like a delay and
[CUSTOMER][NEUTRAL] They were, I guess that's why y'all got double entries because on Friday or Thursday, whenever some whatever day I called, they were saying that they didn't get it. So I was like, all right, well, I'm gonna do it first thing in the morning. That's why you got a Friday submission.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right. Yeah.
[CUSTOMER][NEGATIVE] And I can't see like this like I have a hard time logging in because it wants you to.
[CUSTOMER][NEGATIVE] Put your email and then like I'm not getting the email to put like the code. It takes a long time if you do that log in from your phone.
[AGENT][POSITIVE] Oh, yeah, so it does send the verification code now and you have to enter that in. It does sometimes take a minute, but I get it on the phone. It's just like not a great way to like check or, you know, it, it works better off of a desktop. Yeah, you're absolutely right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So the rule of thumb is 5 to 7 business days. We can maybe say that today would be business day 1, maybe.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, well, no, because, I mean, they got some information on Monday, um, it looks like for both of them. So I would say today would be, um, day 4 as far as like having the information. I know that you submitted some extra stuff on Thursday and Friday, but if it was duplicate information, the examiner will just mark it out as a duplicate and move on, you know what I mean? So.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I think that they're, I think the doctor submitted on the, well, yeah, the [PII] is whenever they said that they submit it. OK. So hopefully, I'll, I'll check back in a couple of days if I don't hear anything from you guys, just because I wanna stay on top of it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, no, not a problem. We're happy to help. We're here until [PII] Central time Monday through Friday.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEGATIVE] And also my accident policy, I cannot view it.
[CUSTOMER][NEUTRAL] Online it'll let me download my short term but it won't let me download the accident policy.
[AGENT][NEUTRAL] The actual certificate?
[CUSTOMER][NEGATIVE] Like what, what pays for the accident? I have no clue. Like I can't log in and get those documents.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Yeah, when you log in, it should bring up both policies, like whatever policies you have with us, but what I can do.
[CUSTOMER][NEUTRAL] Right. So it said,
[CUSTOMER][NEGATIVE] And then the last time I tried to get somebody to email it it didn't go through.
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] That's your direct deposit.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah, there's just all kinds of stuff on here. I'm trying to see if I can.
[AGENT][NEUTRAL] Pull up the certificate.
[AGENT][NEUTRAL] It doesn't look like a certificate's been uploaded yet for your policy.
[AGENT][NEUTRAL] Um, what
[CUSTOMER][NEUTRAL] I know, that's why I'm concerned.
[AGENT][NEUTRAL] Yeah, so what I can do is, did they say if they put in a request for one when you spoke to somebody last time?
[CUSTOMER][NEGATIVE] Well, one person said it wasn't in. The second person said that she would email it to me. I never got the email. And then like you're the 3rd person that's saying like, I'm not seeing it either.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, it's just not the certificate.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then also I have one other question. In my disability short term, it says your disability benefit will be 3750, not to exceed 60% of your monthly compensation.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Does that mean that if it's approved it'll be 3750?
[AGENT][NEUTRAL] Right, as long as the 3750 does not exceed 60% of your monthly compensation.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Sounds good.
[AGENT][NEUTRAL] Um, so like the accident policy has like accidental death on it, um, which is a benefit of 6000. It has an ambulance benefit which would pay 250.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] What I can do is put in another request to have it uploaded and then sent off to you. Is there something specific that you want me to check to see if it's listed on here? I can try and scroll through.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Well, I've got like X-ray. I got X-rays of my foot, so I wanna know if that would be covered.
[CUSTOMER][NEUTRAL] For the accident.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Fracture.
[AGENT][NEUTRAL] I wonder if I can.
[AGENT][NEUTRAL] Yeah, it looks like for this group, it's they're just working on uploading them because they're all it looks like new.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I mean, it does list like a fracture, but the way that I'm reading this is not, it's really not clear and concise, I'll be honest with you. Let me see.
[AGENT][NEGATIVE] I don't wanna give you information that's not accurate.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Cause it's very detailed. I mean, it breaks it down to like.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] Dislocations, fractures, elbows.
[CUSTOMER][NEUTRAL] Yeah, like I have a definitely break, so fracture would be considered.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] like an elbows, it's just like.
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Like it goes like down into detail of the actual uh
[AGENT][NEUTRAL] I'm telling you, yeah, I'm telling you it's like toe, forearm, like, yeah, it's very.
[AGENT][NEUTRAL] Let's see, fracture benefits.
[AGENT][NEUTRAL] Shows $50.
[AGENT][NEUTRAL] I wonder if that's like a per day thing. It doesn't really break it down. It just says fracture benefit.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I mean, it's not like a huge deal, but it's just, it would be, I'd be interested on how like just.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Whether I wanna keep it for future, you know, like, does it pay anything towards like the
[AGENT][NEUTRAL] No, I
[AGENT][NEUTRAL] Right, I mean, I feel like it.
[CUSTOMER][NEUTRAL] It's more like the medical expenses aspect of it, some of that is what I was hoping for.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, yeah, so what I'll do, what I can do is just put um another request in. I'll mark this at a higher priority since you've already contacted us multiple times on this and just let them know that we need the policy certificate uploaded and then sent to you um.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Because yeah, it's like, uh they have, I mean, it breaks it down to like fracture if it's one toe or a finger or, you know, so yeah, we definitely need the detailed certificate to get the full scope of benefits here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I will do that and then just make it an urgent request um on that. Do you have any other questions, concerns you can think of, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] OK. Have a good rest of your day. Thanks for calling.
[CUSTOMER][POSITIVE] OK thanks you too.
[AGENT][NEUTRAL] Bye-bye.