AccountId: 011433970860 ContactId: e3ee04ae-646e-45c7-b29e-97326fd606c8 Channel: VOICE LanguageCode: en-US Total Conversation Duration: 1856180 ms Total Talk Time (AGENT): 536593 ms Total Talk Time (CUSTOMER): 598386 ms Interruptions: 6 Overall Sentiment: AGENT=0.3, CUSTOMER=-1 Redaction Types: PII Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/e3ee04ae-646e-45c7-b29e-97326fd606c8_20250528T17:23_UTC.wav -------------------------------------------- [AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you? [CUSTOMER][NEUTRAL] Hey, [PII], it's [PII]. How are you today? [AGENT][NEUTRAL] Fine. How are you? [CUSTOMER][POSITIVE] Oh, I'm all right. I'm ready for Friday, but I'm good. [CUSTOMER][NEUTRAL] I, OK, so let me give you the policy number 1st. 258. [CUSTOMER][NEUTRAL] 1355. [PII]. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] His spouse, [PII] is on the line. [CUSTOMER][NEUTRAL] And her callback number is the one that's up on the screen. [CUSTOMER][POSITIVE] OK, so she's been transferred multiple times. It's she was talking to someone on the care team. The care team transferred her customer service and the customer service transferred her back and I got her. [CUSTOMER][NEUTRAL] But it's regarding this claim for him because it looks like the group submitted it. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] But he was um [CUSTOMER][NEGATIVE] He was killed in a boat explosion at work. [CUSTOMER][NEUTRAL] He said, she said he was on a crew boat that exploded. [CUSTOMER][NEUTRAL] So she doesn't have the death certificate yet because [CUSTOMER][NEUTRAL] She said that they're not gonna get that until the autopsy is completed. [CUSTOMER][NEUTRAL] But the other documentation that we're asking for, hm. [CUSTOMER][NEUTRAL] Um, one of them is a completed claim form. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEGATIVE] The wording on that is terrible by the insurer giving a detailed description. [CUSTOMER][NEUTRAL] Of the accident or diagnosis. [CUSTOMER][NEUTRAL] That's, and then the other one about needing the death certificate and supporting documentation to evidence the date on which the accident occurred. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] She's wanting to know, you know, she's talking about news articles and [CUSTOMER][NEUTRAL] You know what is acceptable supporting documentation. [AGENT][NEUTRAL] OK, so he's deceased? [CUSTOMER][NEUTRAL] Yes. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] She said that he was um worked on a crew boat, part of a crew, and then the boat exploded. [AGENT][NEUTRAL] Mhm. [AGENT][NEUTRAL] OK. And she, she don't have the death certificate yet. [CUSTOMER][POSITIVE] She's real nice. No. No. [CUSTOMER][NEUTRAL] Because they're gonna have, um, she said that's not gonna be available until the autopsy is completed. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] But she's just wanting to verify what they said, you know, what's acceptable for other documentation, and I've never had a call like this, [PII], so. [AGENT][NEUTRAL] OK. Yeah, I'll have to check to verify exactly what other information can be submitted other than a death certificate. [CUSTOMER][NEUTRAL] Yeah. But she's, she's really. [CUSTOMER][NEUTRAL] Right. [CUSTOMER][NEUTRAL] I mean, because it's asking for two things we need we will need the following 1, a death certificate and two supporting documentation. So she's aware of the death certificate, but then like as far as filling out the claim form, and they have, she hasn't even gotten that in the mail. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] And that other remark talks about the enclosed claim form, but she's not received anything, so she's gonna get the claim form from, you know, but can she complete that? [AGENT][NEUTRAL] Is she the bene let me see. Yeah, the yeah, the claim form is on the website. [CUSTOMER][NEUTRAL] Of the website. [CUSTOMER][NEUTRAL] Uh she's covered. I mean, she's, yeah, I mean, I've given her that information. She's covered on this policy. [AGENT][NEUTRAL] Yeah, I see that, but we have to look to see who's actually the beneficiary of the policy. [CUSTOMER][NEUTRAL] Let's see. [CUSTOMER][NEUTRAL] With the. [CUSTOMER][NEUTRAL] Yeah. [AGENT][NEUTRAL] But [AGENT][NEUTRAL] Let's see. Yeah, I can check. You can send it to me. I can check, check, further checking to see what additional information can we use. I know we definitely do need the death certificate, but as far as additional supporting documentation, I can check into it and see what other information. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] Right. [CUSTOMER][NEUTRAL] Yeah, I mean, [CUSTOMER][POSITIVE] OK, thank you, cause, yes, I, I've never, yeah, I've never had a call like this. Poor lady, she's really nice, so. [AGENT][NEUTRAL] And that she's a spouse. [CUSTOMER][NEUTRAL] She is, uh-huh. [AGENT][NEUTRAL] OK. OK. [CUSTOMER][NEUTRAL] She's part two listed on the policy, yes. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] You can send her to me. Mhm. [CUSTOMER][POSITIVE] OK. OK. Thank you so much, [PII]. Have a good afternoon. [AGENT][POSITIVE] You're welcome. You too. [CUSTOMER][NEUTRAL] OK, bye bye. [AGENT][NEUTRAL] Claims department, this is [PII]. [CUSTOMER][NEUTRAL] Yes, ma'am. [CUSTOMER][NEUTRAL] Hi. [AGENT][NEUTRAL] Hi, she said, she transferred you to me and you had some questions regarding the claim for Mr. [PII]. [CUSTOMER][NEUTRAL] Yes ma'am. [AGENT][NEUTRAL] You had a question as as far as what additional information is needed? [CUSTOMER][NEUTRAL] Yes, ma'am. That's, I, I, I need to know what I need to do or what paperwork I, what I need to do to complete this claim. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] OK, let me take a look, give me one moment. [AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold, Ms. [PII], while I take a look at the claim. Give me one moment. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEUTRAL] Hey, [PII], you have a moment? I, I am looking at an accident claim. Let me give you the policy number. [AGENT][NEUTRAL] It's on 258-1355 for [PII]. I have the spouse on the line. I, he's deceased and we were requesting additional information such as the death certificate. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEUTRAL] OK, so I'll have to clarify with her is to see if he passed on the scene. So that's what's OK, because that's why I want to double check because I've seen supporting documentation that's referring to if he was in the hospital in those itemized billing, OK. [AGENT][NEUTRAL] Yeah, OK. OK, so then I'll, I'll let her know we need the, the claim form completed in the death certificate. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] Mhm. [AGENT][NEUTRAL] OK. I think [PII] said she hadn't received the claim form yet, so we might have to resend it to her. [AGENT][NEUTRAL] So, OK, so I'll just clarify. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] Or maybe email it to her. OK, I'll check with her. OK, alright, thanks. [AGENT][NEUTRAL] Mm bye. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEUTRAL] Thank you for holding, Ms. [PII]. So it looks like as far as this claim, the information that we're needing, there is an accident claim form that will need to be completed by you. And also we will need a copy of the death certificate. Was, did he, did he pass on the scene or was he hospitalized? [CUSTOMER][NEUTRAL] Um, [CUSTOMER][NEUTRAL] He [CUSTOMER][NEUTRAL] was in a boat explosion. [CUSTOMER][NEUTRAL] And they, he, he died instantly, but they didn't pronounce him dead until he got to the hospital. [AGENT][NEUTRAL] OK. So there, if he was at the hospital, then we will also need the, the itemized billing from the hospital as well along with the copy of the death certificate and then the accident claim form completed. [CUSTOMER][NEUTRAL] And, and. [CUSTOMER][NEUTRAL] Where do I complete this? [CUSTOMER][NEUTRAL] Claim. [AGENT][NEUTRAL] OK, it looks like they mailed you out a claim form. The claim form is also available on our website, or I can also email it to you. [AGENT][NEUTRAL] I can give you our, our website address. [CUSTOMER][NEUTRAL] I can yeah. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] Alright, email our website address is [PII]. [AGENT][NEUTRAL] And the claim form you'll need to complete this for the accident. [AGENT][NEUTRAL] There will be a section where it says claims and forms, you'll click on that. [CUSTOMER][NEUTRAL] Uh-huh. [AGENT][NEUTRAL] And then you'll select the accident claim form to download that. [AGENT][NEUTRAL] And that's the form that needs to be completed. [CUSTOMER][NEUTRAL] Yes, ma'am. [CUSTOMER][NEUTRAL] Or I can log into the API. [AGENT][NEUTRAL] Yes, you can log into the uh to the online service center. [CUSTOMER][NEGATIVE] Um, I can't. [AGENT][NEUTRAL] If you're wanting to submit the claims online, but yes, that will be the form that you'll need to download to complete and upload that claim form if you're submitting it online. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] OK, so, um, because, uh, that's what I was explaining to them. I did not have, so what supporting documents are you, you talking about because um [AGENT][NEUTRAL] That will be the item since he did go to the hospital, we will need the hospital billing, the itemized hospital billing, and then also the death certificate. [CUSTOMER][NEUTRAL] OK, but again, as I said, he was dead, he was dead upon arrival. [CUSTOMER][NEGATIVE] Um, like he was, he, he died instantly. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] Um, but they did not pronounce him dead until he got to the hospital. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] So, do, do you know that he incurred any charges at the hospital or any services were actually done at the hospital? [CUSTOMER][NEUTRAL] Um, so, like, [CUSTOMER][NEGATIVE] I never received any type of, I never received any type of billing. I am imagining that um that would have been went directly to his company. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Uh, so I don't know. [CUSTOMER][NEUTRAL] Um [CUSTOMER][NEUTRAL] I don't know what like I, I mean I can possibly check with the. [AGENT][NEUTRAL] If you [AGENT][NEUTRAL] You might want to reach out to that. [CUSTOMER][NEUTRAL] To the hospital and find out if there's anything. [AGENT][NEUTRAL] Yes. [CUSTOMER][NEUTRAL] But um again like I said I know because I'm imagining that they would have sent the bills directly to their company. [CUSTOMER][NEUTRAL] Um, [CUSTOMER][NEUTRAL] So I don't know. [CUSTOMER][NEUTRAL] Uh [AGENT][NEUTRAL] So, yes, you might want to verify with the actual hospital where he was sent to to verify if there, if there's any um charges that incurred and submit and request that itemized billing. If not, then we, the, the only information we will need is that claim form and then the death certificate. [CUSTOMER][NEUTRAL] Cause I mean, um. [CUSTOMER][NEUTRAL] Uh, that's why I was asking her, letting her know that there was um. [CUSTOMER][NEUTRAL] Yeah, I mean, it was, it was on the news. I mean, it was a boat explosion. Um, so everything was on the news as far as um [CUSTOMER][NEUTRAL] Then there's news reports that say that it was a crew boat explosion, you know, the crew boat exploded. [CUSTOMER][NEUTRAL] Um, [CUSTOMER][NEUTRAL] And that he was deceased, you know, among the two people that were deceased. [CUSTOMER][NEUTRAL] Um, so I didn't know if that, that, that would be considered supporting document or. [CUSTOMER][NEUTRAL] Because she said something about supporting documentation, I guess as the. [AGENT][NEUTRAL] That, that was in regards to if he, he was, if, if any hospital bills incurred, that will be the supporting documentation. [CUSTOMER][NEUTRAL] OK, so I need to contact the hospital. [AGENT][NEUTRAL] Yes. [CUSTOMER][NEUTRAL] But, but again, so if, if his employer was sent the bill directly. [AGENT][NEUTRAL] Yes [CUSTOMER][NEUTRAL] Do, does, do I still have to send that in? [AGENT][NEUTRAL] We will need the information. We haven't received it. So if they do have that information, we'll still need that information. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] And that's in order just to pay out the death benefit claim? [AGENT][NEUTRAL] Yes, we need all that information to consider the claim. [CUSTOMER][NEUTRAL] OK. Now, [CUSTOMER][NEUTRAL] Oh, what, I don't know if you would know that, uh, uh, cause I, uh, again, I've done spoke to so many people. I don't even know what section you're in. [CUSTOMER][NEUTRAL] Um, [CUSTOMER][NEUTRAL] On the documentation, it says that common carrier. [CUSTOMER][NEUTRAL] It would be doubled. [CUSTOMER][NEUTRAL] Um, [CUSTOMER][NEUTRAL] Um, what, what is that, would that be, because it, I mean like I say, it was on a crew boat. [CUSTOMER][NEUTRAL] Um, is, is that, um, something that. [CUSTOMER][NEUTRAL] Is considered common carrier or what would determine that? [AGENT][NEUTRAL] OK, let me take a look, give me one moment. [AGENT][NEUTRAL] What type of, of boat was it? Cause it, the common car only, it falls within any air, land, or motorized, operated or license license for the transportation of fare paying passengers, including ride sharing programs. Do you know what type of boat it was? [CUSTOMER][NEUTRAL] It was a crew boat that carried uh. [CUSTOMER][NEUTRAL] The workers to another location to work. [AGENT][NEUTRAL] The common carrier does not include any courtesy transportation for which, which a charge is not made. It doesn't cover any cruise ships. It doesn't cover any um [AGENT][NEUTRAL] So that was something with his job that he worked with. [CUSTOMER][NEUTRAL] Yes. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] It was something with the job. [CUSTOMER][NEUTRAL] That was, I mean, I wanna say these boats were rented. [CUSTOMER][NEUTRAL] Well [CUSTOMER][NEUTRAL] To carry them [CUSTOMER][NEUTRAL] From one location to another location. [AGENT][NEUTRAL] OK, let me further check on that for you. Give me one moment, Miss [PII]. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEUTRAL] It's me again. I got another question on the, on the policy. She has a question regarding the common carrier benefit. I'm looking at it and I have it pulled up cause she said since it happened on the boat and it was while he was working, I mean, I read the description of common carrier, but I'm not sure if it falls within these guidelines. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEUTRAL] Right, this is new. [AGENT][NEUTRAL] Yeah, cause it says, yeah, cause she said that it was a boat, you know, while he was working. [AGENT][NEUTRAL] Yeah. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEUTRAL] See, yeah, that's why I asked her, was it, you know, I charged it, you know, she was like, no, it was just a boat with his, with his job is all she could say, all she said. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] Mhm. [AGENT][NEUTRAL] [PII], OK. [AGENT][NEUTRAL] Mhm. [AGENT][NEUTRAL] OK. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEUTRAL] OK, so just let her. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] Mhm. [AGENT][NEUTRAL] Mhm. [AGENT][POSITIVE] OK, OK, alright, I'll let her know thanks. [AGENT][NEUTRAL] She said that they took him to the hospital to declare him dead. Then she said he did die, but they did transport him to the hospital to declare him deceased. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] OK, I'll, I'll clarify to see if it was. [AGENT][NEUTRAL] Mhm. [AGENT][NEUTRAL] Yeah, that's why I told her if she when she said she wasn't sure that they may be sent that to the employer, but I said that she might wanna reach out, she may wanna reach out to where he where he sent him to the hospital to verify if there were any charges that incurred when they sent him. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEUTRAL] OK. [AGENT][POSITIVE] OK, I'll let her know thank you. [AGENT][NEUTRAL] Mm bye. [AGENT][NEUTRAL] Thanks for holding, Ms. [PII]. In order for us to determine if that would fall up under that benefit, we'll need a little more information to check into that a little further. If you do have a copy of that news article, if you can go ahead and submit that to us as well. [CUSTOMER][NEUTRAL] OK [AGENT][NEUTRAL] And do you know if he was transported by ambulance to the hospital or by a medical examiner? [CUSTOMER][NEUTRAL] Yes. [CUSTOMER][NEUTRAL] Um, he was transported by ambulance. [AGENT][NEUTRAL] OK. So then if you, uh, we will also need that billing as well, the ambulance billing. [AGENT][NEUTRAL] As well. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] Cause there are, there are benefits for ambulance. So that billing we need in any hospital if he, if any charges incurred due to that when they sent him to the hospital. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] So the news article, death certificate. [AGENT][NEUTRAL] Ambulance billing or hospital billing? [CUSTOMER][NEUTRAL] In hospital. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] So it is possible that it could fall under that category. [AGENT][NEUTRAL] Possibly, but we just need a little more information to look further to see if it falls within the provisions of the policy. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] Is there anything else I can assist you with today, Ms. [PII]? [CUSTOMER][NEUTRAL] So [CUSTOMER][NEUTRAL] So you, you don't need like, you don't need an obituary and none of that stuff, just the death certificate. [AGENT][NEUTRAL] No, ma'am. [CUSTOMER][NEUTRAL] Death certificate, um, news articles. [AGENT][NEUTRAL] Ambulance and hospital billing. [CUSTOMER][NEUTRAL] Yeah for the billing, OK. [CUSTOMER][NEUTRAL] OK and uh again like I say I'm, I mean. [AGENT][NEUTRAL] And then the claim form, completing the claim form. [CUSTOMER][NEUTRAL] So, I, I, I've seen on his online account like the claim form, it says I have it, it, one claim was it was like it was processed but it, it said um. [CUSTOMER][NEGATIVE] Like I have 180 days to appeal the, the, the thing because they didn't pay out because they didn't have the all the information again, I don't know how long this is gonna take me to get the death certificate, so how long do I actually have to complete this claim? [AGENT][NEUTRAL] 180 days just in regards to if you're wanting to submit an appeal on the claim. [AGENT][NEUTRAL] But there's no deadline for you to submit this additional information to us. That's just only in regards if you're wanting to submit an appeal on the claim. It's 180 days for that. [CUSTOMER][NEUTRAL] Uh, so in other words, it's not saying that they're not paying, they're just saying we requiring documentation. [AGENT][POSITIVE] Correct. [CUSTOMER][NEUTRAL] Correct. And I, I don't, not limited to 180 days to get this paperwork in. [AGENT][NEUTRAL] No, ma'am. That's only in regards if you're wanting to submit an appeal. That's the time frame you'll need to submit an appeal to us. [CUSTOMER][NEUTRAL] But, so, once y'all actually make a decision, say y'all make a decision and you, and y'all don't. [CUSTOMER][NEUTRAL] Um, they don't pay out the doubles as a common carrier, and I wanna appeal that. [CUSTOMER][NEUTRAL] Does that appeal start from the day y'all decide not to pay that or? [AGENT][NEUTRAL] Mm [AGENT][NEUTRAL] Yes, once that that claim is actually processed, it will be from that date. It'll be 180 days from that date. [CUSTOMER][NEUTRAL] Back to the original data found. [CUSTOMER][NEUTRAL] So once [CUSTOMER][NEUTRAL] From the date that the, the claim is actually uh processed. [AGENT][POSITIVE] Correct. [CUSTOMER][NEUTRAL] Correct? OK. [CUSTOMER][NEUTRAL] I, I just wanna make sure cause. [CUSTOMER][NEUTRAL] There's a lot of things that's been, oh, I've been to. [CUSTOMER][POSITIVE] I don't even remember how many people were on the phone for an hour right here trying to get all this statement, but I, I appreciate it so um [CUSTOMER][NEGATIVE] So they said they mailed some stuff, but I never received anything in the mail, um, which I'm gonna go back and double check because somebody may have been checking my mail and it may have gotten lost or or misplaced, but um. [AGENT][NEUTRAL] So have the your address changed? [CUSTOMER][NEUTRAL] So, so [CUSTOMER][NEUTRAL] No, it hasn't. But um so my thing is is I can download the forms online. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Fill them out and then submit them through his online account. [AGENT][NEUTRAL] Yes. [CUSTOMER][NEUTRAL] Is what I need to do like download the claim. So basically I need to download the claim form. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] That they fill out and send in and just sign it. [CUSTOMER][NEUTRAL] And and send it back in because or do I just start with a fresh new claim form. [AGENT][NEUTRAL] So it'll be this, the accident claim form. So you'll complete the claim form, you'll upload that online. [AGENT][NEUTRAL] And it will be a new and then it will be a new claim number assigned to it. Any, any new mail receipt, it would be a different claim number, but it will be in regards to the same claim. It'd be just a different claim number. [CUSTOMER][NEUTRAL] Correct. But uh in [CUSTOMER][NEUTRAL] OK, so just download a blank form, fill it out and upload it on his website. [AGENT][NEUTRAL] Yes, for the accident claim form. [CUSTOMER][NEUTRAL] On the, on his account. [AGENT][NEUTRAL] Yes. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] All right. [AGENT][NEUTRAL] Is there anything else I can help you with today, Ms. [PII]? [CUSTOMER][NEUTRAL] Alright, and I guess if I have any more. [CUSTOMER][NEUTRAL] Uh, no, ma'am. But if I do have to, what department do I need to ask for so I don't have to talk to 10 different people? [AGENT][NEUTRAL] It'd be in the claims department. [CUSTOMER][NEUTRAL] If I have to call back? [AGENT][NEUTRAL] It will be the claims department. [CUSTOMER][NEUTRAL] OK, and I'll probably still end up having to talk to 10 people before I get to the right person, I guess. [CUSTOMER][NEUTRAL] Cause that's what I did today, but OK. [CUSTOMER][POSITIVE] Alright, well thank you so much. [AGENT][POSITIVE] You're welcome. Well, thank you for calling APO. You have a good day. [CUSTOMER][NEUTRAL] You too bye. [AGENT][POSITIVE] Thank you, bye.