AccountId: 011433970860
ContactId: fccabb4a-9b05-4853-8831-07915cbac0e6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1200000 ms
Total Talk Time (AGENT): 201272 ms
Total Talk Time (CUSTOMER): 351796 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=-2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/fccabb4a-9b05-4853-8831-07915cbac0e6_20250108T19:38_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] Yes ma'am, I, uh, the one that I talked to you about my, my wife, uh, benefits. I'm trying to claim her benefit. Her name is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And her social security is [PII].
[CUSTOMER][NEUTRAL] And I was supposed to send you some paperwork of it and some other paperwork from the hospitals uh and uh I wonder if they got there or not. Can you check?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Oh, I can check for you. I sure can. And um may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] My, uh, my name is [PII] and my phone number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK so [PII] uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that.
[CUSTOMER][NEUTRAL] And I sent them out on the, I'll send the paper out the paperwork out on the [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Here we go, and I am showing that the claim was um received on [PII]. Um, it is still in processing. It usually takes about 7 to 15 business days, but yes, sir, it did come in on the [PII].
[CUSTOMER][NEUTRAL] OK, let me ask you something.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I don't, I don't know who's the claim of it or what, but I am her husband and I got all her, I'll send you all her information. Y'all should have a marriage license, or, or, uh, her death certificate and everything, you know, I send it all out and y'all should have everything.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] They tell me that uh uh if I am married, I still can't claim it. I don't uh I can claim it, but I gotta go to court. Do I gotta go to court to claim it or or get a paper to claim it or should could it go in my name?
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] Cause she's passed away on me. It's been a year and I've been trying to do this.
[AGENT][NEUTRAL] Wait a minute. So you're saying, I, I, I want to make sure I understand what you're saying, so.
[AGENT][NEUTRAL] Someone here advised you that you'd have to go to court to make claims on her policy?
[CUSTOMER][NEGATIVE] No, just some of these other ones, you know, wanted to get, and, and, and, and, but they said that they would, they would send a check on her name, not on my name on [PII]. It won't take, it won't come on.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEGATIVE] It won't, it won't come on my name.
[CUSTOMER][NEUTRAL] And the two of them come in my name. The other one, it didn't come, but it come on her name, you know, the like the school she had school and uh and uh and another two more insurance she had, uh, it come in my name, but I wonder if it would come in my name because you know whenever it cause she's no longer exists no more she passed away.
[AGENT][NEUTRAL] Right, OK.
[AGENT][NEUTRAL] You know what, let me, um,
[AGENT][NEUTRAL] Let me ask claims that, um, do you mind if I place you on just a brief hold? I just want to give you, give you some clarity because and I'm not, that's a good question.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Um, hold on one moment, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. I just wanted to check back with you. I'm speaking with uh my supervisor to try to get a clear answer for you, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] What?
[AGENT][NEUTRAL] What?
[AGENT][NEUTRAL] I claim.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] I don't have time for this. The insured is on the phone.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][POSITIVE] Good afternoon. Thanks for calling AP. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey, [PII], this is [PII] on the care team. Um, can you look at this policy with me?
[CUSTOMER][NEUTRAL] OK, what's the policy number?
[AGENT][NEUTRAL] Um, it's 207-721-6.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So the insured has passed away. The husband um spoke with us since all, you know, death certificate, everything in there, but he asked me, so would the claims check be in his name or hers, but I didn't know how to answer that because he's not anywhere but the notes. How does that work?
[CUSTOMER][NEUTRAL] Uh, let me.
[CUSTOMER][NEUTRAL] See.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] So it looks like.
[CUSTOMER][NEUTRAL] The claim is being worked on, uh.
[AGENT][NEUTRAL] It's like a whole like 500 and something pages.
[CUSTOMER][NEUTRAL] Yeah, [PII] has been working on this since yesterday. So normally the way it goes is um.
[CUSTOMER][NEUTRAL] Once we, as long as he sent them the beneficiary information, all that information in here.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] They are, um, I believe they, I believe it will go in his name or whoever the beneficiary name is, but like I said I can't say I mean because I mean if he's
[AGENT][NEUTRAL] Disney. OK.
[CUSTOMER][NEUTRAL] I said if we have our paperwork then like I said they probably go in his name um because they, what they'll probably do is end up adding him.
[CUSTOMER][NEUTRAL] To the policy, be able to send it out um to him.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But like I said, we can't really say end until we go through the, the claim, yes.
[AGENT][POSITIVE] All righty.
[AGENT][NEUTRAL] Process everything.
[AGENT][POSITIVE] OK. Well, thank you very much. I appreciate you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Alright bye bye.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. So, um, as long as we receive the beneficiary um beneficiary information, everything that you sent us really, um, the claim would go to you, um, or the next of kin, whoever is listed in that paperwork, but more than likely it would be you.
[CUSTOMER][NEUTRAL] Because you know I'm, because you know my wife, me and my wife been together 46 years, you know, and, uh, so you know, and then everybody wanted her, uh, a marriage license and all that so I, I, I gave it to them, you know, whatever they wanted, but some that's why I actually some insurances want me to go higher I guess and uh.
[CUSTOMER][NEGATIVE] A lawyer, I said what for? I mean one wanted me to do one wanted me to do it and they would the other one put send me a paper and I just signed my name and everything and send it in there and, uh, and, and one was wanted me to do that and there's only 500 but they sending her her name. It was only 500. That's it, and it cost me more money just to hire a lawyer, you know.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right, then, so what, what you would be getting out?
[CUSTOMER][NEGATIVE] You're right, I wouldn't, then they won't tell me nothing, you know what, you know, how much is it? You know, they wouldn't tell me, and I said that's crazy. It was only 500 bucks.
[CUSTOMER][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] So that's why I asked that question. OK, so, uh, so how many days you think I know about that check or whatever her, her, her balance, whatever.
[AGENT][NEUTRAL] Um, so it takes about 7 to 15 business days to process the claim. Um, I actually called claims to get the, um, this further information there, she's been working on it, um, since she said the last 2 days. So she's just going through all the papers, um, to process the claim, and then we usually say 15 business days at the most.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, do you, uh, are y'all gonna send me a paper where I can send it, uh, sign all my information, or how do y'all do that, or just send me a check through the mail?
[AGENT][NEUTRAL] Oh no, once we, once um she goes through all the paperwork and we see that you're the next of kin, um, or either if it's listed as next of kin or beneficiary, it would just go to um you, you don't have to like sign anything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, no, I'm the only one, I'm, I don't know if she's got my daughter on there or not or my granddaughter, but I'm the only one claiming it, you know, so I'm, I'll live with her. I got it from her school, you know, I've been claiming it, uh, nobody had claimed it, only me. I've been, I'm the only one, you know, my daughter and nobody else don't claim nothing, so I've been claiming, you know what I mean.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right, I do.
[CUSTOMER][NEUTRAL] So that's the reason I'm doing it because she's my wife, not your person. Mostly everything I got is I put it for my kids when I go, you know what I mean.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Yeah, I sure do.
[CUSTOMER][NEUTRAL] So I, you know, I'm, you know, you know, mostly everything she got it in her, in my bank, but on her name. Well, it's together with ours, you know, it's separate.
[CUSTOMER][NEUTRAL] But it's OK, so, so it'd be about 15 days.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][POSITIVE] Excuse me. OK, sounds good.
[AGENT][NEUTRAL] All right. Well, was there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So, do I need, I need to call you back or, or, or what, what, how do we do that?
[AGENT][NEUTRAL] Oh, no, sir. Once the claim is um finished processing, you'll receive an explanation of benefits in the um in the mail and then it'll most likely if it's a payment, I'll have the check attached, if it's a denial, it will let you know why, but you'll definitely receive notification in the mail.
[CUSTOMER][POSITIVE] OK, sounds good alright appreciate it.
[AGENT][POSITIVE] All right. Well, thank you so much for calling APO Mr. [PII]. I hope you have a great day and, and happy New Year.
[CUSTOMER][POSITIVE] OK you too thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.