AccountId: 011433970860
ContactId: e694afe2-2100-46d4-b75f-988ee7ed74f0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 659559 ms
Total Talk Time (AGENT): 299390 ms
Total Talk Time (CUSTOMER): 206176 ms
Interruptions: 4
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/e694afe2-2100-46d4-b75f-988ee7ed74f0_20250319T16:02_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. Uh, this is [PII] at [PII]'s office, and I wanted to see if you could please um give me some information on a claim and see if it's been set up yet with a, with a claim number.
[AGENT][NEUTRAL] Oh, I can help you with that, Ms. [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] I have his social.
[AGENT][NEUTRAL] All right, let me get to that screen.
[AGENT][NEUTRAL] And what is her social?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And his date of birth is [PII].
[AGENT][NEUTRAL] And what is the insured's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And I apologize. What did you say that date of birth was?
[CUSTOMER][NEUTRAL] Hold on, let me go back.
[AGENT][NEUTRAL] I apologize.
[CUSTOMER][NEUTRAL] It's OK. I just already turned the page 82764.
[AGENT][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] And are you with the employer, the agent's office?
[CUSTOMER][NEUTRAL] We are with the agent [PII] Partners Benefit Group.
[AGENT][POSITIVE] Got you, thank you.
[AGENT][NEGATIVE] Now he has a disability.
[AGENT][NEUTRAL] Claim
[AGENT][NEUTRAL] That has been paid in March.
[AGENT][NEUTRAL] And that was starting.
[CUSTOMER][NEUTRAL] What day in March?
[AGENT][NEUTRAL] Uh, well, starting for February and it was paid on [PII], so he probably has not gotten notification of that from his bank. It was just sent to his bank yesterday.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, so, um, how much was sent?
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] Let's see, bear with me.
[CUSTOMER][NEUTRAL] They do do that very quickly [PII] because Friday they didn't even have it set up.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] We sent him a benefit amount of 62923.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you, do you know what period of time that was for? Does that, does it show that?
[AGENT][NEUTRAL] Yeah, so his uh.
[AGENT][NEUTRAL] Disability time started on [PII], so there was that elimination period, so from 26 to 212, that was not covered for his elimination.
[AGENT][NEUTRAL] And then from [PII] to 41.
[CUSTOMER][NEUTRAL] 2:13 to 41?
[AGENT][NEUTRAL] Yeah, it looks like 213 to 228, so we pay for February.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, what's his monthly benefit?
[CUSTOMER][NEUTRAL] That's not be that much.
[AGENT][NEUTRAL] And I do need to check on one thing on this for you, so.
[AGENT][NEUTRAL] $800.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks
[CUSTOMER][NEUTRAL] But that couldn't be right if it was for.
[AGENT][NEUTRAL] Yeah. Let me, do you mind holding just one moment?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh, you know what, they did deduct his premium too for April.
[CUSTOMER][NEUTRAL] Oh, you
[CUSTOMER][NEUTRAL] But still, that wouldn't make up that much. Yeah.
[AGENT][NEUTRAL] Yeah, let me
[AGENT][NEUTRAL] Let me check on that for just a minute if you don't mind, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Spring.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello.
[AGENT][POSITIVE] OK. So bless you.
[CUSTOMER][NEUTRAL] I'm so sorry. I thought I was gonna get that in before. Yes, I'm just, we have terrible uh pollen here and it's uh
[AGENT][NEUTRAL] Are you OK?
[AGENT][NEUTRAL] 00, yeah, we do too. It's, everything's yellow now.
[CUSTOMER][NEUTRAL] Oh my goodness. Yeah, I'm so sorry, but go on.
[AGENT][POSITIVE] Come from, no, you're fine. I completely understand. And you probably won't need to sneeze after you're off the phone, right?
[CUSTOMER][NEUTRAL] I, I know exactly. I'm just hoping it doesn't come back, but go ahead.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] So if he does, you're fine. You can sneeze in my ear. I won't complain.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] So his return to work date that was issued with the paperwork was on [PII].
[AGENT][NEUTRAL] So first he had the um.
[CUSTOMER][NEUTRAL] Oh, I don't think he's at work.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Why, yeah, he's.
[AGENT][NEUTRAL] According to the paperwork, we have to return to work date of [PII]. Now he can send in an updated physician's form, the physician portion.
[AGENT][POSITIVE] And then we can go back and reconsider for additional benefits.
[CUSTOMER][NEUTRAL] OK. I was trying to see what page that was on and I'm just trying to get my ducks in a row so when I call him, um.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And try to explain because
[CUSTOMER][NEUTRAL] 00, like full time.
[CUSTOMER][NEUTRAL] If you have not returned to work, what is the?
[CUSTOMER][NEUTRAL] Anticipated return date. He did write [PII] on here, [PII].
[CUSTOMER][NEUTRAL] Um, so yeah, so he would probably, what, what do, yeah, he might have thought that at the time. What do you need a whole new thing or what?
[AGENT][NEUTRAL] Just the updated physicians portion, if they can.
[AGENT][NEUTRAL] Go back and redo that physician's portion and the new expected return to work date.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, what is the claim number so I'll know um.
[AGENT][NEUTRAL] And then let me see if we need that.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I wonder why they thought that he was returning to work on [PII] they would have taken out the April premium.
[AGENT][NEUTRAL] In order to pay the be able to pay the claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so a lot of times on the disability policies if they're not current, they'll deduct that premium in order to be able to provide a benefit because without the premium they couldn't provide the benefit. Now I can tell you from 213 to 228.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Because you know that 1st 26 to 212, that was a seven day elimination period, that's not payable. From 213 to 228, they paid 42667, so that wasn't a full month.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And then from [PII].
[AGENT][NEUTRAL] They paid 240 and that would be up to his return to work date listed on the paperwork and then they deducted the premium for April.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's why his payment was not full.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So once we get that updated paperwork then they can go back and provide those benefits.
[CUSTOMER][NEUTRAL] Yes, is there any way you can scan me a copy of that um physician continuing disability claim form?
[AGENT][NEUTRAL] You want me to email it to you?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] Give me just a second, I'll be happy to email that to you.
[AGENT][NEUTRAL] And you know that's on our website as well or if you have the um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Our portal you can go to the claims and form section under the short term disability.
[CUSTOMER][NEUTRAL] OK, I don't think I have the portal, but um.
[CUSTOMER][NEUTRAL] Do I just go to APL's website like if I don't have the portal?
[AGENT][NEUTRAL] Mhm. [PII], and I can tell you exactly where to go.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I mean, I'll be happy to email it to you but it's easier you'll have it right now. um, go, go to the claims and forms section.
[CUSTOMER][NEUTRAL] OK, just tell me real quick.
[CUSTOMER][POSITIVE] Exactly, yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's on page 2 under the short term disability claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And just to be safe, you know, because this is going to be a continuing disability claim, I would have him complete.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Sections A through E and G through H again.
[AGENT][NEUTRAL] The, uh, Mr. [PII].
[CUSTOMER][NEUTRAL] OK, give me that again. A through E A through E.
[AGENT][NEUTRAL] A through E and G through H.
[AGENT][NEGATIVE] Because it's going to be a continuing disability.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And that way we'll have, I mean, I hate for him to send just the physician's form and then him need to fill file that as well so I would go ahead and have him complete that.
[CUSTOMER][NEUTRAL] OK, and the employer doesn't need to do anything just him, right?
[AGENT][NEUTRAL] That's right. Just, just Mr. [PII] and the physician.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And hopefully they'll give us a good return to work date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Right, OK. All right, thank you so much.
[AGENT][POSITIVE] It's been such a pleasure to assist you, Miss [PII]. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] know.
[CUSTOMER][POSITIVE] That's it. I appreciate it.
[AGENT][POSITIVE] And thank you for calling APL. Hope you have a wonderful day.
[CUSTOMER][POSITIVE] thank you
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.