AccountId: 011433970860
ContactId: f6b6339c-4768-44af-bbbf-064819bf56e5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 771150 ms
Total Talk Time (AGENT): 412941 ms
Total Talk Time (CUSTOMER): 300849 ms
Interruptions: 4
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/f6b6339c-4768-44af-bbbf-064819bf56e5_20250312T19:49_UTC.wav
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[AGENT][NEUTRAL] Good afternoon thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good afternoon, [PII]. I have a question. Um,
[CUSTOMER][NEUTRAL] Maybe I should give you my policy number first.
[AGENT][NEUTRAL] Uh, first off, who am I speaking with, please?
[CUSTOMER][NEUTRAL] You're speaking with [PII].
[AGENT][POSITIVE] I'm so sorry. Can you please repeat your full name for me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Last name is [PII] I don't have any on here.
[AGENT][NEUTRAL] OK, Ms. [PII], and what is a good callback number for you please?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And your policy number now please, Ms. [PII]?
[CUSTOMER][NEUTRAL] 01057109
[AGENT][POSITIVE] OK, thank you. And while I'm pulling your policy information up, Miss [PII], how can I help you today?
[CUSTOMER][NEUTRAL] So I'm calling because I'm an FMLA and I um sent in an application to have my um.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] My benefit of, um, what's it called, short term disability paid.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And the amount, the amount that was deposited in the bank, I think it was 1686 08.
[CUSTOMER][NEUTRAL] And I just got the explanation of benefits today, so I'm looking at, they had my premium deduction, which was fine, but my, my total amount is not, um, it's not adding up.
[CUSTOMER][NEUTRAL] But my benefit amount should have been 2400.
[AGENT][NEUTRAL] OK, so you have a question regarding the benefit amount that was most recently paid on your most recent process claim, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, yes, ma'am. Well, I can help you with this. So first off, Ms. [PII], I will need to verify several things with you for security purposes and then also any information provided would be a verification of benefits and not a guarantee of payment. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And then also your home mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the phone number that we should have on file, is that the one that you gave me today, the [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you and the last piece of information to verify would be your email address please.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Now Miss [PII], have you ever set up your profile in our portal in the online service center so that you can have access also to all of your information online?
[CUSTOMER][NEUTRAL] I don't.
[CUSTOMER][NEUTRAL] Uh, I don't know if I did, to be honest with you, cause I've had this forever. Uh, probably not.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can see you have had a OK, so what I'll do is I will also email you, yes, and you've had your policy with us since [PII]. I will send you the user guide in an email and the email will come from [PII] and when you get an opportunity, you know, to set that up, um, that way you can again have access to your information online. You can also upload information to submit to us in your portal as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so just 1 2nd.
[AGENT][NEUTRAL] It shouldn't go to your junk or spam folder, Ms. [PII], I don't think, but if it, you know, if you haven't received that in about, I would say 10 minutes or so, check that to make sure it didn't go there.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so now let me pull this most recently a process claim up. I do see that the benefit was in the amount of 1686.08.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so on this claim.
[AGENT][NEUTRAL] There was a, OK, so this period shows from 31 to 318.
[AGENT][NEUTRAL] There is a benefit of $1440.
[AGENT][NEUTRAL] And then from 2.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Well, I guess I'm going in reverse order because they're not in order, so I'm sorry. $225 to 228, that was $320.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So the first, the, the, go ahead.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] The 218, I'm so sorry, go ahead if you have it, the 218 to 224, that is showing these dates represent your elimination period in which benefits are not allowable until after this period.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] There was the premium.
[AGENT][NEUTRAL] 441.
[AGENT][NEUTRAL] And premium for 31. So this looks like you had your, your disability started on 218. That was the start of your elimination period.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and so then we did pay the $320 beginning $225 to $228.
[AGENT][NEUTRAL] And then for the month of March, from [PII] rather to [PII], that was the $1440.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They're, they're just making that so confusing because I thought they would, since it's the elimination period is one week which starts on the [PII]. Well, the, the elimination, the one week went from 218 to 224. So I thought the monthly premium would be from 224 to 324.
[AGENT][NEUTRAL] From the [PII].
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh.
[AGENT][NEUTRAL] No, it paid you, right. It paid you the.
[CUSTOMER][NEUTRAL] So that's 4 weeks.
[AGENT][NEUTRAL] From $225 to 228, that was the $320. We did pay for those few days.
[AGENT][NEUTRAL] In February, once your elimination period had been satisfied.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the March, from [PII], [PII].
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh, so they're going calendar month, February to March, OK. So, then it's from [PII], which that's what? Two weeks and change?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Roughly, yes, ma'am.
[AGENT][NEUTRAL] 16 days
[CUSTOMER][NEUTRAL] OK. So what
[CUSTOMER][NEUTRAL] So according to this, I mean, that means my, that means I would have been back to work on [PII] according to this, because that's what they paid me up to.
[AGENT][NEUTRAL] That is, yes, ma'am. Was that your return to work date?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, I think on my, on the form that's what he had put 3.
[CUSTOMER][NEUTRAL] About there cause that would have been like my 4 week after surgery. Yeah, but I had some, I had some issues, so my, actually my 4 week appointment which which which was scheduled for the [PII], actually [PII], he pushed it out another week. So I'm gonna be out at least 5 weeks on, on that date, on my next follow up.
[AGENT][NEUTRAL] So let me look at what that.
[CUSTOMER][NEUTRAL] Um, so, so.
[AGENT][NEUTRAL] OK. So if he has extended, so yes, I can see the remark on your, on that paid um date it says this payment completes your claim for this occurrence benefits have been paid to the date you were released to return to work. So if he did not release you to return to work, then yes ma'am, we would have to have, you know, in addition to your claimant statement, the physician would also need to complete.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We would need to receive another completed form with the, you know.
[AGENT][POSITIVE] Notification that you did, that is correct. Yes, ma'am. Uh-huh.
[CUSTOMER][NEUTRAL] Did you return to work date?
[CUSTOMER][NEUTRAL] So would it have to be the same form, the same original form that I submitted earlier?
[AGENT][NEUTRAL] Yes, the original claim form, uh-huh, that had juror section.
[CUSTOMER][NEUTRAL] Mhm. The whole, the entire thing, or just certain pages?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Well, it would be the whole thing because you have to complete your claimant's statement and then there's the physician's statement and your employer's statement.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Yes, ma'am. Mhm. And then again, once you have all that information together, you can upload it. If you set up your portal, you can upload all that directly into the portal or it can be faxed or mailed. We just can't receive it via email due to security.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, so complete another set of forms like when I get released, um.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Yes, ma'am. That said, does that answer some of your questions? I mean, does that clear that up for you?
[CUSTOMER][NEUTRAL] Um, yeah, I guess I had in my head that it was a monthly benefit of $2400 and the originally I was supposed to be out at least a month, um, but that would have been 3 weeks minus, it would have been 4 weeks minus my elimination. So that would have, so basically they paid me for 3 weeks.
[AGENT][POSITIVE] Yes, because your elimination, you do have that elimination period. Mhm. So it, correct, and it did pay you up.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Nomination. OK, so that's, that's why I didn't get my whole 24.
[AGENT][NEUTRAL] Right, cause, mhm.
[CUSTOMER][NEUTRAL] 100.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's, that, that explains it then, because I was saying that's not what my, my monthly benefit is.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure. Yes, ma'am. But your return to work date was before the end of the month, so that's, you know, it did, it paid you to that date that we had.
[CUSTOMER][NEUTRAL] So it's
[CUSTOMER][NEUTRAL] Right, right, he pro he prorated it.
[AGENT][NEUTRAL] Correct, for the number of days that you were off of work.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Right, so being that I'm out another week from
[CUSTOMER][NEUTRAL] The original return to work date, that would make it, make it exactly 4 weeks. And so they would have to pay me for that that the extra week then, that's all you would owe me.
[AGENT][NEUTRAL] Yes, ma'am. If approved, then yes, we would pay you through the next, you know, if it's approved through your next return to work date, that is.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Alright, I'm, I'll look for the email. I haven't seen it yet.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Yeah, I did send it, so you should, again, it's coming from [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I did send it to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I got it.
[AGENT][POSITIVE] OK, well, good.
[CUSTOMER][NEUTRAL] So you said I can fax or mail the, the forms but not email?
[AGENT][NEUTRAL] Or
[AGENT][NEUTRAL] Yes, ma'am. Not email, you can, the most efficient way is to upload them into your portal.
[AGENT][NEUTRAL] Because you will get a confirmation instantly and you will be able to see that they were accepted. The next would be to fax and that would take, you know, you would need to give us about 48 hours to have that processed and put onto your policy information to get in line for review and then obviously the third choice would be to mail it.
[CUSTOMER][NEUTRAL] Uh-huh. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you very much.
[AGENT][POSITIVE] OK. Well, you are certainly very welcome. And is there anything else that I could help you with this afternoon?
[CUSTOMER][POSITIVE] No, ma'am, that's it. You answered all my questions. Thank you so much. [PII], right?
[AGENT][NEUTRAL] Well, you're welcome. Yes, ma'am, it was. Uh-huh. [PII].
[CUSTOMER][POSITIVE] OK. Great. OK. Well, have a good day and thank you for your help.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Absolutely, it was my pleasure. So if that is all I can help you with, Ms. [PII], thank you again for calling APL and I hope you have a very nice rest of your day.
[CUSTOMER][POSITIVE] You as well. Thank you so much.
[AGENT][POSITIVE] Yes, ma'am. You're welcome and thank you too.
[CUSTOMER][NEUTRAL] OK, bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] OK, bye.