AccountId: 011433970860
ContactId: fab3abed-2176-4f4d-bc96-8dbd2d6c7153
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 929520 ms
Total Talk Time (AGENT): 294859 ms
Total Talk Time (CUSTOMER): 350045 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/fab3abed-2176-4f4d-bc96-8dbd2d6c7153_20250609T19:15_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], good afternoon. My name is [PII], and I was, uh, working on a claim with the uh the LinkedIn Financial Company, um, recently they told me I could go back 15 months, and that when I was working through that they realized that I was with a different provider the year before which I checked with our HR department and it was American Public Life, um, so APL, so I was trying to see what the, um, I don't know the time frame is.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] To file a claim. I had an accident last year, [PII]. So, so I was filed a claim for my son right recently, and then going through that process, I realized there was these different on the schedule benefits there's different things I could file a claim for. So that's what triggered me to, to look into that accident from the year before, um, but what is your, I guess, timeline that you could file a claim with EPO, I guess how far back can you go?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well, um, so we don't have like a timely filing limit like most insurance companies are like a deadline that you have to send it in. As long as the policy was active on the date of service, you can file the claim at any time.
[CUSTOMER][NEUTRAL] Oh great, yeah, I'm trying to set up a log in so what I before I did that I wanted to call in to make sure that I wasn't like wasting time, you know, to go through that process and it was too late to file a claim, um, so go ahead.
[AGENT][NEUTRAL] Well, let
[AGENT][NEUTRAL] Let me check, let me pull up your policy. If it's no longer, it depends. If the policy is no longer active, you won't be able to set up the online account, but you can still file a claim, you would just have to mail it or fax it.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] I see. OK, great, yeah, that makes sense.
[AGENT][NEUTRAL] So you want me to check it for you? I can check for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, it it could be helpful thank you.
[AGENT][NEUTRAL] Sure. OK. And do you have like an ID card there or you're working with paperwork or I know what to ask for?
[CUSTOMER][NEUTRAL] Well, I don't
[CUSTOMER][NEUTRAL] Yeah, good question. Um, I know I had the plan last year, but I don't have the information in front of me I can check with HR if you need the plan number or something like that.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] You don't have to do that. Um, I can find the policy with your social if you like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] It's kind of taking its time here. I apologize.
[AGENT][NEUTRAL] Here we go.
[AGENT][NEUTRAL] Accident. OK, I believe I just located it. I'm just waiting for it to come up now.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. Hold on one moment.
[AGENT][NEUTRAL] OK, and [PII], can you verify your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] Yes, date of birth is [PII]. Mailing address is [PII]. It's kind of [PII] in [PII]. Email address [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So it looks like your latest accident policy, uh, let me give you this policy number.
[AGENT][NEUTRAL] It's 121.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] 7687.
[CUSTOMER][NEUTRAL] OK, 12176887.
[AGENT][NEUTRAL] This
[AGENT][NEUTRAL] Mhm. This policy was active from [PII].
[CUSTOMER][POSITIVE] Oh we had a long time with that plan, yeah.
[CUSTOMER][NEUTRAL] OK, great, uh, [PII].
[CUSTOMER][NEUTRAL] Now is there any information I can get um was it and I'm sorry, on the call, remember your first name.
[AGENT][NEUTRAL] Oh, my name is [PII].
[CUSTOMER][NEUTRAL] Well, uh, I know, yeah, and then, um, is there any information you can get to see like how do I go about the, the process of filing the claim, uh, or to make sure the claim is gonna be something that qualifies like a schedule of benefits or things, accidents that I could make sure that I meet their criteria for that.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Yes, um, hold on one second. Let me see if it's, it should still be available. Let me check. 12345678.
[AGENT][NEUTRAL] Yes, so I can email you if you like a copy of your policy certificate, so it has like the breakdown of everything that it will cover and how much it'll pay towards that. And then if you need me to also, you want to do that, OK. And then also on the email, I can um
[CUSTOMER][POSITIVE] It'd be great.
[AGENT][NEUTRAL] Attach the short term, I'm sorry, short term, the accident claim form, so that when you whatever you decide to mail or fax, you'll need that um claim form with it.
[CUSTOMER][POSITIVE] OK great yeah I'll do that um so I can email the information to you right? or.
[AGENT][NEUTRAL] Well, now, I can email it to you, but you can't email the completed documents back because the HIPAA laws we can't email is not really secure.
[CUSTOMER][NEUTRAL] No one.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] OK, just facts. Alright, thank you for that. Yeah, no, that's great to know. That's great to like my son had a, I mean, this, I mean, I said a long time, but I know with the last few years he had a severe like accident to have one of my sons. I'm, I'm assuming my family is under that same plan, right, like myself and, and my kids and wife.
[AGENT][POSITIVE] Mhm, or male. You're welcome.
[AGENT][NEUTRAL] Yes, let me see.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] I can tell you everyone that was on here. Um, so yes, you, um,
[AGENT][NEUTRAL] Mrs. [PII] and then [PII], [PII] and [PII].
[CUSTOMER][NEUTRAL] Great, yeah, we took [PII] to the house. Yeah, like I guess he an accident at the house, he had to go and
[CUSTOMER][NEUTRAL] You know, make sure you get stitches or things like that, right, but it was nothing major, but it's still like I, I didn't, I didn't really think about my accident plan at times until recently because my son, well, my, my youngest son [PII] had a, he's in special needs and he does cracks and so he fell, so I just had to, I don't have accident plan for this. After you pay all these little bills, right, you realize, hey, I have some coverage. So I, I turned his claim in the current company which
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's why I took her they told me, well, you can go back to any accidents, and I realized I had a couple within the last few years, but thank you for that help, and I can, I'll look into that if you can send me that information and I'll follow up for sure.
[AGENT][NEUTRAL] Yes, you're very welcome and the um the breakdown that I'm sending is the same for everybody on the policy. So um if something does apply for the boys, you know, you can definitely or for anybody, you can definitely send in those claims to be processed.
[CUSTOMER][NEUTRAL] Now what would be the only reason they wouldn't like you said I can go back the last couple of years to get my claims filed, but would there be a reason why they wouldn't, um, I guess approve any of those claims other than.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't know just they don't need the qualifications.
[AGENT][NEUTRAL] Either is something not covered or additional information might be needed.
[CUSTOMER][POSITIVE] OK, I yeah, that sounds good.
[AGENT][NEUTRAL] But then if it is the, you're welcome. Um, if it is the additional information, then once you send whatever they're asking for in, they'll just go ahead and continue processing for your decision.
[CUSTOMER][POSITIVE] Well thank you for your help.
[CUSTOMER][NEUTRAL] OK, great. So, I have technically I have that window of [PII] and [PII], right? I'm not gonna go that far. I mean, I just have a couple of things that I have. I know I have accidents that we can deal with within the last few years. So that's as long as I.
[AGENT][NEUTRAL] Oh, well, you
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] You actually had another accident policy before, wait, let me go back. Before the one that started in [PII], you, so technically you've had a policy with us since [PII] and
[AGENT][NEUTRAL] 14 was the first accident policy you had.
[AGENT][NEUTRAL] You want me to put both of the policy numbers in here and then if you have something for both, you'll just know which one of you, OK, I'll put that in the email for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, no, an accident is just like an accident. The way I look at that is something that happens where it happens from one day, like my, my kid broke his hand, right, as an accident at track or not like you're admitted to the hospital now only if you're admitted to the hospital because of an accident that qualifies, right? Like if you're in the hospital because of the, OK.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That makes sense.
[CUSTOMER][NEUTRAL] OK, I was in the hospital, but that was, that's a different. I had COVID back in 21 as severe COVID when it first came out, right? But that was not related to um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, the accident.
[CUSTOMER][NEUTRAL] His accident that was related to COVID.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Um, uh, OK, well thank you so much again for your help. Uh, it's been a big help, um.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEUTRAL] OK, well, I'll look for that email and then, um, we should come from American Public Life sometimes our, our servers they block certain things. Let me see APL.
[AGENT][NEUTRAL] Um, so it's gonna come from care team. Um, I would say to check the spam folder as well. I'm attaching the documents. You know what, is it alright if I place you on a brief hold? I can send it while we're on the phone if you like.
[CUSTOMER][POSITIVE] Yeah, that'd be great thank you.
[AGENT][NEUTRAL] OK, you're welcome. Hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Wait a minute, that's not the right one.
[AGENT][NEUTRAL] 981.
[AGENT][NEUTRAL] And I'm gonna see DAT.
[AGENT][NEUTRAL] And then I'm gonna copy and then I'm gonna, oh, copy and then I'm gonna paste.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Requested information from [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII]
[AGENT][POSITIVE] It was a pleasure speaking with you today.
[AGENT][NEUTRAL] If you attached to this email a copy of your.
[AGENT][NEUTRAL] Accident.
[AGENT][NEUTRAL] Policy certificate and claim form for filing.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Uh oh.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes ma'am, it's that.
[AGENT][POSITIVE] All right, thank you so much for holding. I apologize for the wait. So I just sent the email, um, you should be receiving it shortly.
[CUSTOMER][POSITIVE] Yeah, I think it came in and I thank you. Let me pull up the policy here that yes ma'am, I think so. I think it's downloading here. Let me open up this.
[AGENT][NEUTRAL] You got it? OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] And I saw two documents, yeah, one for the uh.
[CUSTOMER][NEUTRAL] Hold on one second, I think I pulled the wrong one up here.
[CUSTOMER][NEUTRAL] Cim form accident. OK, here's the accident claim form.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect, I can fill it in here. That's great and then then you send me the uh.
[CUSTOMER][NEUTRAL] The American Public Life Insurance Company, yeah, I've seen this. I mean, yeah, I've had this before.
[CUSTOMER][POSITIVE] Um, every year we go through this. Oh well, thank you so much, [PII], this is perfect, so I'll look at the um.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEUTRAL] So here the, you know, go through and give me the different coverages right that we qualify for.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you so much for your help. You have a wonderful day, [PII]. Thank you again.
[AGENT][POSITIVE] You also, Mr. [PII]. Thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye-bye.