AccountId: 011433970860
ContactId: e4a702eb-f8c1-4617-a7d1-4a421924edd7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 344640 ms
Total Talk Time (AGENT): 147427 ms
Total Talk Time (CUSTOMER): 162148 ms
Interruptions: 3
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/e4a702eb-f8c1-4617-a7d1-4a421924edd7_20250310T17:22_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes ma'am. I was just following up on a, a recent, uh, claim that I submitted.
[AGENT][NEUTRAL] Sure, I can check on that claim for you. Uh, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you. Do you have your policy number?
[CUSTOMER][NEUTRAL] Uh, no, ma'am, I do not have it in front of me, sorry.
[AGENT][NEUTRAL] That's OK. Uh, I can start using your social.
[CUSTOMER][NEUTRAL] OK, it's uh [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, I'm just gonna verify some information really quick. Uh, can I get your date of birth, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And can I get your mailing address?
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][POSITIVE] Perfect and last thing I need is the email address we've got on file for you.
[CUSTOMER][NEUTRAL] Um, it should be, oh gosh, I think it's, is it [PII]?
[AGENT][POSITIVE] Yes, OK, thank you so much for verifying that. All right, bear with me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And who was this uh claim for? Was it for you or for one of the dependents?
[CUSTOMER][NEUTRAL] No, it was for my son [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Was that uh 5-19 [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][NEUTRAL] OK, so I am showing that we've received some claim information on [PII]. Does that sound right to you?
[CUSTOMER][NEUTRAL] Yes, that's the information, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So we did receive that and it is uh still currently being processed right now um it can take about 7 to 10 business days for claim information to complete processing, but we did receive it.
[CUSTOMER][NEUTRAL] OK, OK, yes, there was some confusion with my HR, um, because I know that we no longer have, uh, you guys as a vendor for accident, um, you know, um, effective at the beginning of the year, but they told me that if they were, um, there was a surgery that he had done in January, but because of the accident happened prior to [PII], they said we'd have to claim with you guys. So, um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, so any time that um during the time that this policy was active if anything happened, yes, you can still file those claims.
[CUSTOMER][NEUTRAL] OK, even though he didn't have his surgery until January? Is that gonna, I mean, that's where I was confused.
[AGENT][NEUTRAL] This, what did he have any other kinds of that is a bit confusing. Um, so when was the initial accident?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] I can't think of the top of my head, uh, maybe trying to think of July.
[AGENT][NEUTRAL] 00, OK. Um, so did he receive any other treatment, um, prior to this surgery?
[CUSTOMER][NEUTRAL] Well, he, this, this is, this is the 2nd surgery that they have, um, they've had him do. Um, he's already
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, had surgery on it once. And then, um, it, uh, did not, the pin that they put in his finger did not take. And so therapy and everything wasn't working. And so then the physical therapist is like, you, we, you need to have a, a screw put into the, to your hand. And so then he went back to the doctor and the doctor looked at all the PT notes or whatnot. And so then he ended up having surgery again.
[AGENT][NEUTRAL] Oh man.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, for the same injury, um, but in this time, they didn't, they weren't able to get him into the [PII], which was January. So that, this is what this claims about. So, yeah, I was just trying to see um if the insurance, that is a lot, that is a lot, yes.
[AGENT][NEUTRAL] Oh man.
[AGENT][NEUTRAL] Tour guides, that's a lot. Um.
[AGENT][NEUTRAL] Um, OK. So, and that's the information that you just submitted was for that surgery, is that right?
[CUSTOMER][NEUTRAL] Yes, yes, for that surgery, uh huh, because y'all have all the information for, you know, prior like you wanna I'm the one that, uh, accident first initially, you know, all that other stuff. So I was just trying to see if, uh, the benefits would pay anything out because we found ourselves, um, and then like now currently I know this is no longer, I don't know if it's through y'all or whatever, but now he's having to start PT again and so I didn't know if there was any kind of benefit that they would pay out because this has just been ongoing.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Oh man.
[AGENT][NEUTRAL] Yeah, I can tell that's awful um so unfortunately as far as this, uh, the surgery and really any claims, I would be unable to say whether or not yes this will pay without us first getting and processing that claim, um, as I'm not sure what would have been submitted, but, um, I mean what this claim, let's see you sent those.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The [PII], let me see when that was.
[AGENT][NEUTRAL] Oh that was last week. OK, so I would say, um.
[AGENT][POSITIVE] And maybe in the next couple of days, but at the latest Friday I would say um we should have that completely processed and as if we have everything that we need um or if there's information missing we'll be able to let you know you can check the status on our website of course or you're more than welcome to give us a call.
[CUSTOMER][POSITIVE] Yes, yes, OK, all right, that's all I need to know. I appreciate all the information and I definitely will just kinda keep an eye on it. Thank you.
[AGENT][POSITIVE] Of course, absolutely.
[AGENT][POSITIVE] Sounds good. You're welcome. Thank you. Have a great day. Thanks. Bye-bye.
[CUSTOMER][POSITIVE] You have a great day and you too thank you.