AccountId: 011433970860
ContactId: fb1d310e-cdaf-4af2-91d0-731b03f9e860
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1232060 ms
Total Talk Time (AGENT): 391304 ms
Total Talk Time (CUSTOMER): 793735 ms
Interruptions: 7
Overall Sentiment: AGENT=0.4, CUSTOMER=-1.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/fb1d310e-cdaf-4af2-91d0-731b03f9e860_20250624T22:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][POSITIVE] Hey [PII], I have a hot one just to let you know.
[AGENT][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Uh, I have it, yeah, I'm sorry. I have an insured on the phone in regards to his disability claim, and it was denied due to being workers' comp and he just went off on me.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Saying that uh they sold the policy if oh I probably intended to escalation, but I don't know.
[CUSTOMER][NEUTRAL] But um since it was workers' comp, it was denied as an exclusion, but he starts.
[CUSTOMER][NEGATIVE] said that BS gonna call a cop or call cops. He is a cop, uh he's gonna get a lawyer.
[AGENT][NEUTRAL] OK, and what's this gentleman's name?
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And it's how you say it [PII].
[CUSTOMER][NEUTRAL] I don't know. I just say Mr. [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The way you acting over, well, I verified all this other information and it is correct.
[AGENT][NEUTRAL] I was just gonna say he's been verified and what's his callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Got it OK.
[AGENT][NEUTRAL] Alright you can send him on over and he's uh.
[CUSTOMER][NEUTRAL] You know I be like me, sorry.
[CUSTOMER][NEUTRAL] You rock Cathedral.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] I'm just trying to read the notes.
[CUSTOMER][NEUTRAL] Is it
[CUSTOMER][NEUTRAL] Oh, OK, I wanna pay.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] It is hot.
[AGENT][NEUTRAL] OK, you can transfer him. I don't know what to tell him other than uh what the policy states. I can't.
[CUSTOMER][NEUTRAL] It looks like several other people tell them about workers' comp too.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] He verified it was workers' comp. Got it in notes, sir.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh guys, I told him several times. I'm sorry, I'm just looking at notes.
[CUSTOMER][NEUTRAL] You ready, [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] I'm sorry. You have a great one, Ms. [PII].
[AGENT][POSITIVE] You too. Thank you.
[CUSTOMER][NEUTRAL] Alright bye.
[AGENT][NEUTRAL] Bye.
[AGENT][NEUTRAL] Hello, Mr. Mr. [PII].
[AGENT][NEUTRAL] Did I say that right?
[CUSTOMER][NEUTRAL] Speaking.
[AGENT][NEUTRAL] Hi, I hope I didn't mess up your name too badly. My name is [PII]. I'm on the claim support team and I understand that you have a question in regards to your claim denial.
[CUSTOMER][NEUTRAL] Ma'am.
[CUSTOMER][NEUTRAL] No ma'am
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do. The reason is, is I work for a police department.
[AGENT][NEUTRAL] How can I help?
[CUSTOMER][NEUTRAL] The insurance for people to come in so these policies so if you happen to get hurt with short term disability you pay so much a month.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] Didn't say nothing about it get worker's comp that you don't get paid. I paid $40 something dollars every two weeks, so I would get $1500 in case I had to go out every month. Now they're telling me to deny it because I have worker's comp. I still won't get workers' comp every, every two weeks what what I should have gotten from you guys. I, I don't see how y'all gonna deny my claim because uh I got hurt as working as a police officer and I bought disability insurance. I'm paying all my premiums and now y'all gonna deny it.
[CUSTOMER][NEGATIVE] You know, I don't wanna get an attorney, but I will. This is, this is not right. I mean, you got the town of [PII] being mis misled by your insurance agent whoever this is selling insurance, your insurance so police department, you know, and I can't see how y'all gonna tell me I don't get my, my my.
[CUSTOMER][NEGATIVE] I can't work details. I can't do nothing, so I don't get my, my, my, my what I paid them to get, you know, and now y'all denying my claim.
[AGENT][NEUTRAL] Right. Well, I'm, I'm sorry. According to what I'm reading in your policy though, that is, um, that is what's written in the policy. It's not um.
[AGENT][NEUTRAL] If you're receiving, you can't receive both benefits, um, and since you are
[CUSTOMER][NEUTRAL] Well, let me ask you something. I'm number one.
[CUSTOMER][NEGATIVE] Policy from these people, but I pay every every two weeks. I think it's $46 out of my pay being paid to your company. I've never been given an insurance policy. I was showed a price list where certain amount, every, every certain amount of dollar that you had to pay every two weeks of your salary.
[CUSTOMER][NEGATIVE] And I paid it and now they deny it. I, I just, I'm not gonna, I'm not gonna agree to this. I should have been given a policy so if I have to get an attorney involved I'm going to this is, this is not right. I mean, I can't help I got hurt at work, you know, and now, now you tell me you're not gonna pay me $1500 a month. That's, that's, that's, that's, that's not, not gonna cut it.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] And, and you said you, you don't have the policy?
[CUSTOMER][NEGATIVE] No, I was never given a policy. I bought a policy, but I was never furnished the policy. It's through the town of [PII] River, uh, through the town of [PII] River, you know, and I was never furnished the policy. Lady [PII], let's see, Terry Gla[PII] is the one I guess who sold us this the policy and uh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] When, when, uh, [PII] inquired about it because for me to take out this insurance, OK, this is what [PII] sent out was a sheet that says how much you pay is how much you get, you know, and I, I selected, I think the that wait 7 days or something, and I selected $1500 a month and if I'm not mistaken, my premium is almost 4 $47 every two weeks.
[CUSTOMER][NEGATIVE] You know, I was never given a policy. Y'all, y'all telling me you come up with a policy, but I was never furnished the policy, and the police department has never been furnished the policy. So we got a problem here, you know, I just something that I'm not trying to be mean or disrespectful to you, you know, but I bought insurance, I think I'm entitled to being compensated. I said it because I got hurt at work is, it's regardless how I got hurt, I can't work. I'm unable to get any overtime. I'm unable to get details and everything else.
[CUSTOMER][NEGATIVE] You know, I make $50 an hour for details, but I can't work because I got hurt.
[CUSTOMER][NEUTRAL] You know, so now you
[AGENT][NEUTRAL] I understand.
[CUSTOMER][NEGATIVE] Because I'm getting workers' comp, that's that workers' comp don't add up to what I see what I'd be getting from you guys. I could tell you that one.
[AGENT][NEUTRAL] Right, well, under of course in, in the policy definitions and I can um request a copy of your policy be sent to you and my apologies that you were never provided it. You should have been furnished a copy.
[CUSTOMER][NEUTRAL] Well, it's, it's, it's kind of.
[CUSTOMER][NEGATIVE] Right, I think, I think it's kind of late for that. I should have been given a policy. I mean, you guys take my money every month, almost $100 a month to to supply me with this insurance. I was gonna give us policy. All I could go by is what excuse me, is what I was told.
[CUSTOMER][NEUTRAL] You know, about this lady [PII], you familiar with [PII]?
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] You do what you wanna have.
[AGENT][NEUTRAL] I I believe she is um I'm not I'm not um but I'm in again I'm in the claims department so um just let me see if I could take a look here.
[CUSTOMER][NEGATIVE] I'm very unhappy here if I have to hire an attorney, you know, I don't wanna get an attorney involved, but this is, this is ludicrous. I mean, you gotta tell somebody if you get disabled while you're working, it's short term. It's only good for 6 months, and I understood that that's where the policy should be.
[CUSTOMER][NEGATIVE] It should be, well, if you get workers' comp, we're not gonna pay you. That's, that that should have been mentioned to me and it wasn't and I have witnesses who's the, the, the secretary for the police department. She's very unaware of this also.
[CUSTOMER][NEGATIVE] So I'm sure a lot of people gonna be canceling this policy with this company because this is, this is terrible.
[CUSTOMER][NEUTRAL] And I think everyone is being deducted out of the paycheck money should be given a policy personally and like I said, ma'am, I have, I'm being honest, I haven't received a policy from you guys. I know I have it because.
[CUSTOMER][NEGATIVE] When I called last time, spoke to a very nice lady, [PII], OK, which was a supervisor said the first thing they told me is gonna prorate it, so I told her it was gonna be prorated either. I was told for the price I paid, it's 1500 a month.
[CUSTOMER][NEGATIVE] And like I said, that's, that's all I was told, you know, I wasn't told nothing about if you get hurt working and work was comp pays you, we don't, we, you know, that's, that's not a, that's not a, uh.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] That's not a disability that you get, you see what I'm saying?
[CUSTOMER][NEGATIVE] That's like my, my, my opinion, and like I said if I, uh, I guess I'm gonna have to go further with an attorney. I mean this is, this isn't right. I mean we got a whole police department that's got you on insurance and we've been misled and fraudulently misled if that's the case. evidently this lady [PII] must make a percentage on whatever she sells, and now if she's selling something fraudulent because we should be given the policy and we should be told.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Thank
[CUSTOMER][NEUTRAL] And we should have to understand what the policy covers not if you get hurt at work. Well, if I get shot, I don't get it that that's the same thing. I'll get my disability, you see what I'm saying.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Well, it, it does.
[CUSTOMER][NEGATIVE] I, I know it's a very hazard.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Huh?
[AGENT][NEUTRAL] Uh, it does appear though, um, I'm seeing in the notes that there was some communication, um, and that information was conveyed to you that it was, um, worker, if it's a worker's comp, they will deduct, um, there is a, a, um.
[AGENT][NEUTRAL] In the policy language it says your disability would be minus any deductible sources of income as outlined in section 3. Now I realize that you don't have a copy of the policy. However, I'm looking at the notes and I do see where [PII], uh, you spoke with [PII] and she was, um, you know, communicating that information.
[CUSTOMER][NEUTRAL] No, no, no, I did.
[CUSTOMER][NEUTRAL] Oh, that, that stuff was communicated to me. I did speak to [PII] and what happened was I called this lady [PII].
[AGENT][NEUTRAL] To you.
[CUSTOMER][NEUTRAL] Oh no, they're gonna, no, they're gonna prorate it. What do you mean pro rated lady? That's not what I was told. So that's when I called your company and they said, uh, [PII] was very nice. Oh no, Miss [PII], let me look into this policy. I will get back with you. She got back with me and she told me she didn't say nothing about workers' comp. Maybe she added that, but, you know, they got, got the tape recorders completely reporting when I spoke to her.
[CUSTOMER][NEGATIVE] There's nothing, he says, Oh no, Mr. [PII]. I looked into it and you do have where you don't have to wait 7 days and, and no, it's not pro rated because you're paying for the exact $1500 a month. Some of the, some of the parties are prorated, but yours is not because you're paying for $1500 a month. There's no way that I was told about this proration. All the one that told me something about pro rating was this lady, uh, [PII], so they've been pro rated on, uh.
[CUSTOMER][NEUTRAL] The disability a pro rated. I said no, I paid for a certain amount of money. I paid for $1500 a month, not $1000 not $1200 1500 dollars, and that's what the.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] The question that I was told and like I said, even the chief secretary of the police department will verify that because uh she was gonna call uh and speak to [PII], but she could never get in touch with her. She did did call twice and [PII] didn't call her back and I I told her she needs to speak to the secretary because she has an understanding like I do. So I'll call her, but that never did happen. Like I said, I did speak to [PII] that was because they told me I was gonna prorate my money.
[CUSTOMER][NEUTRAL] On the amount of money I make, and that, and, and that's what I told her I said, no, I, that's not what I signed up for. I signed up for $1500 not if I made $1000 or $20,000 on one, I signed up for $15,000 and that's the conversation we had, ma'am, and I said I'm not trying to give you grief and heart of.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I'm being honest and I'm pro for which I'm not desperate for the money, but.
[AGENT][NEUTRAL] Yeah, and then I, I, like I, right, I understand.
[AGENT][NEUTRAL] I, I do see the notation here where [PII] um tried to get in touch with the [PII]. I believe that is who you're speaking of in the um human resources, right?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, so it looks like there was some communication between [PII] and [PII], um.
[CUSTOMER][POSITIVE] Yeah, yes ma'am.
[CUSTOMER][NEUTRAL] And that was
[AGENT][NEUTRAL] And apparently, it looks like Miss uh Miss [PII] did call back and she says that, um, you know, she did indicate that you would be um eligible for that $1500 benefit after the seven-day elimination period. However, um, I'm not certain that she was aware that you were going to be receiving a worker's comp, um, a worker's compensation benefit as well.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] So in the policy though, it does state, it does state that that would be deducted.
[CUSTOMER][NEUTRAL] Right, I'm told
[CUSTOMER][NEUTRAL] Part
[CUSTOMER][NEGATIVE] Uh, I, I, I, like I said, I told her I got her at work, you know, and like I said, I, uh, being a policeman, and anytime you get, you get shot, my, my, my, my, I had to have surgery, my roller coaster chair got tore, you know, in, in, in training. And here it is. Now I'm, I'm coming to this battle where they're telling me, no, no, no.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] And uh like I said, ma'am, I don't have to lie to you. I don't need to lie about getting a policy. I had no clue about this. I would have never spent $50 almost $50 a month for this policy, every 2, I'm sorry, every 2 weeks for this policy, you know, but I felt like it was an insurance if something does happen to me. I have a family I got to support and listen for that little bit of money for workers' comp, workers' comp only pays me 60 66% of my salary.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] So for that little bit of money, I don't pay my bills, you see, I understand what I'm saying? So I said, well, and listen, I'm the type, I'm [PII] old now. I go to work every day. I've worked a long time. I've been a policeman 43 years. I work and I work, but the thing is I, I feel I've been misled and, and they said, uh Ms. [PII]'s told me she did not speak to to [PII]. Maybe [PII] did try to reach out to us and, and left a message, but, you know, but I, when I hang up with her.
[AGENT][NEUTRAL] Yeah, like I said, that's what the notes in[PII] there was some communication. I don't know if they actually spoke. She said she tried to leave a message and then someone uh told her that there was no way to leave a message for her because it was the police department. I mean that's just what the notes say. so I'm not, I'm not privy to that conversation. I can only go by what I'm reading. However, like I said, unfortunately, um, this has been um.
[CUSTOMER][NEUTRAL] Yeah, she's
[AGENT][NEUTRAL] Uh, reviewed a few times and it was also discussed with the risk management carrier um as well and you know we verified the um information because like I said, per your policy it does, you know, we do have to factor in that other um.
[AGENT][NEUTRAL] That other benefit that you're receiving and it, and it is considered a deductible source of income. So I'm sorry if you were given false information, but my only suggestion for, for you, um, and I know this is, you know, probably not what you wanna hear and I do apologize, but you'll have to appeal the decision.
[AGENT][NEUTRAL] Um, because based on what I'm seeing here, that is our only recourse.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] I'm, I'm not.
[CUSTOMER][NEGATIVE] I'm not gonna appeal. I'm gonna give the attorney, and if I have to pay, I'm gonna pay because this I was misled and I was not given a policy that said this, you know, that's, that's on your end. I should have furnished a policy, and I was not. This lady I've never seen this lady carry [PII], you know, I've never seen her. All I know is they take the money of my paycheck.
[CUSTOMER][NEGATIVE] And told me I had a disability insurance and now I'm telling you're telling me no and listen, I don't get my whole, whole salary. I get where it's comp, but it's not my whole salary, so that's why I, I figured at least work is I mean, uh, with this benefit it'll substitute some of my income and now you're telling me no, you know, so I guess it'll be a long battle. I guess if I gotta go hire an attorney. I, I have an attorney. I would turn on police. I'm gonna, I'm gonna call them and
[CUSTOMER][NEUTRAL] I'm gonna explain the circumstances, see if we can file a suit because this is, this isn't, this isn't gonna come up with me, man. I just so think it's fair. You're either gonna refund me all my money I paid y'all and I guess it has to go by the wayside or we go, we guess we have to go to court, you know. I mean, I'm not trying to be disrespectful, but I hope you understand where I'm coming from. I mean, I'm being, I've been misled.
[AGENT][NEUTRAL] Uh, I understand, and I, like I said, I do apologize for that. I'm not certain why you weren't furnished the policy. Um, usually they're mailed out to you to the address on file once the policy becomes, um, you know, active and um.
[CUSTOMER][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] Do you have, you have a record that y'all sent me a policy? No.
[AGENT][NEUTRAL] Well, I, yeah, unfortunately I don't have that information because I'm in the claims department so I can't see, you know, some of the information is not, um, I'm not privy to that information, so to speak, so I'm not cer I can't tell you for certain whether or not um the policy was sent out to you like.
[CUSTOMER][NEUTRAL] You see what I'm saying? you.
[CUSTOMER][NEUTRAL] You just said
[AGENT][NEUTRAL] I said, as a general rule that's usually what happens once the policy is um and has been activated um you know, and it becomes um that once it's effective we do generally send out those copies of the policy so I do apologize if you didn't receive that um.
[CUSTOMER][NEGATIVE] OK, but I, I'm the one that suffered for it, not you guys. I'm, and you know, if you don't tell me that should happen, it should have happened, but it didn't, so I should be refunded every penny I paid you guys since I was misled. I mean this is terrible.
[CUSTOMER][NEUTRAL] You know, and believe me,
[AGENT][NEUTRAL] Well, I, I, I under I understand and like I said, what I would suggest is to go ahead and write an appeal letter and just state that information what you're telling me and that you are appealing the decision based on the fact that you weren't provided the information um regarding, you know, the language and the policy and that um you know, you are um.
[CUSTOMER][NEGATIVE] Y'all gonna lose the whole privilege.
[AGENT][POSITIVE] You know, like I said, that appeal will um will help you to in the long run and hopefully it will, you know, it at least it's one step in the right direction so it's not having to cost you um money by hiring an attorney but like I said, that isn't, you know.
[CUSTOMER][NEUTRAL] Well, I'm not they costing me.
[CUSTOMER][NEGATIVE] It ain't costing me nothing because I'm a member of Patern on the police. I have attorneys, you know, I pay a fee every day for my attorney, you know, then is the time I'm gonna.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, alright, understood.
[CUSTOMER][NEGATIVE] I think I've been misled. Listen, tell the chief and believe me, I don't wanna lose all the business at Pearl River. I could tell you that one.
[AGENT][NEUTRAL] Alright.
[CUSTOMER][NEGATIVE] You know, over this woman [PII] because I was not furnished the policy and I was told what I would get and I didn't and I didn't, I'm not getting it because I got hurt hurt at work and I'm only being partially compensated for work, not the whole percentage, you see what I'm saying, because I get 66% from work.
[CUSTOMER][NEUTRAL] Yeah, I mean, this is, this is product. So, OK, uh.
[CUSTOMER][NEUTRAL] I'll, I'll have my attorneys get in touch with you.
[AGENT][NEUTRAL] Alright, and I will put the notes in your file that we spoke and what we spoke about, um, is there any other questions I can answer for you at this time, Mr. [PII]?
[CUSTOMER][NEUTRAL] No, ma'am, there's not and I'm sure you guys are here for my attorney. Thank you.
[AGENT][POSITIVE] Alright, I hope you have a nice evening. Thank you so much for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye-bye.