AccountId: 011433970860
ContactId: 0fed7cc3-e1e3-409b-9d60-ff4cdd9f979f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 258839 ms
Total Talk Time (AGENT): 171238 ms
Total Talk Time (CUSTOMER): 110303 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/0fed7cc3-e1e3-409b-9d60-ff4cdd9f979f_20250225T20:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. You're speaking with [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] over on the care team. How are you?
[AGENT][POSITIVE] I'm doing good. How are you doing?
[CUSTOMER][NEUTRAL] I'm doing well thank you so I have a question for you regarding a cancer policy. Um, I've not actually run into this before, so for the policy there's no waiting period, but there is a pre
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] Oh sure it's um 2558412.
[AGENT][NEUTRAL] OK, I got it. And this is for Ms. [PII], OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, so her first policy, uh, started in [PII], and I guess her husband was diagnosed with cancer beginning at [PII], so obviously before this policy was active, um, and I see that's 12 months for the pre-existing. So after that initial 12 months from the policy being active, so that would have been [PII], correct?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] So when, when did the policy lapse? This is a takeover, so they don't have to worry about Pri. If you go to the PINAM screen, anytime you see a Y, that means it's a takeover. Preexisting don't don't affect this policy.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh, I didn't know that. Oh, I just pulled up the actual policy.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yeah, and I don't know why you got the new policy or the old policy.
[CUSTOMER][NEUTRAL] The new one.
[AGENT][NEUTRAL] OK, I guess some people that wouldn't be a takeover. So you would have to, anytime you, you question it about whether it's preexisting and they already had a policy before, always check the PINAM screen. If you see a Y in there where it says takeover, TO means takeover, and then PWPS mean waiver of uh uh Prix.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That is very good to know. I appreciate I've never heard that but thank you. That is very good to know. OK, so I guess her question and mine as well um is so from that period when can they start? What's the date that they can file claims going back to?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] They can go back to if it's something that they need to file on the old policy, tell her to put the information and put the old policy number on there. If it's something new after [PII], send that information for the new policy. Anything after [PII], she can.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You know, filed on that policy. Anything before that that was covered on the old policy, just tell them to separate the two so they can know one party for the new policy and one party for the old policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So just after that initial 12 months, right?
[AGENT][NEUTRAL] Well, no takeover, so it's just starting from [PII], whatever, whatever her old policy was, whatever the effective date was. See if he already been diagnosed with cancer in pre-X must have been already ruled out if it's still related to his cancer that he had in [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right, right, so the first policy was.
[AGENT][NEUTRAL] What's the what's the old policy number? What's the old policy?
[CUSTOMER][NEUTRAL] It's uh 223-1232. And so that one's effective date is [PII]. She said he was formally diagnosed uh January of that year.
[AGENT][NEUTRAL] [PII]. 0 yeah, so that, that would have been pre-X. So they looked like they must have never filed the claim. She ain't never filed the claim. So she have to go back from [PII].
[CUSTOMER][NEUTRAL] Right. [PII]. Yes, ma'am.
[CUSTOMER][NEUTRAL] Got it. OK, that's.
[AGENT][NEUTRAL] The present, but now, now one of [PII], this policy lapsed. Did you see that you have another policy?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, so she, she has another one in between there, so she's had it since [PII], yes.
[AGENT][NEUTRAL] What
[AGENT][NEUTRAL] OK. What's the, what's the other policy number?
[CUSTOMER][NEUTRAL] It's 243-040490.
[AGENT][NEUTRAL] OK, #2.
[AGENT][NEUTRAL] OK, so she ain't that, so now one of [PII]. So yeah, so she was, she was after sending the original pathology report?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Cause she never filed a claim, the original pathology report, the itemized itemized surgery bills, any, any bills, uh, hospital bill, any bills she wants us to review. Anything that's before [PII] or [PII] we go on this policy. Any claims after [PII] we go on a new policy.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] OK, I really appreciate you clearing that up. Thank you so much for your help, [PII]. I will let her know.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, you're welcome. Bye bye bye.
[CUSTOMER][POSITIVE] All right thank you bye bye.