AccountId: 011433970860
ContactId: 1966b599-df2b-4ead-8fb9-1114a27ea05a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 810659 ms
Total Talk Time (AGENT): 249736 ms
Total Talk Time (CUSTOMER): 219242 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/1966b599-df2b-4ead-8fb9-1114a27ea05a_20250429T14:28_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], um, one second, I'm sorry.
[CUSTOMER][NEUTRAL] OK, yes. Um, I'm actually handling this call for my mom. She just had to step out of her office, um, but, uh, we're calling, she's calling to make a claim for the, um, I think it's the hospital, uh, Aend them, um.
[CUSTOMER][NEUTRAL] The district, uh, she had that insurance in [PII], um, do you need her like birthday or uh the policy number?
[AGENT][NEUTRAL] Um, well, 1st may I have your name and then a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK, um it's [PII]
[CUSTOMER][NEUTRAL] And then the uh the phone number is [PII].
[AGENT][NEUTRAL] Thank you for that. And then, um, yes, may I have the policy number if you have it?
[CUSTOMER][NEUTRAL] OK, let me
[CUSTOMER][NEUTRAL] Oh, actually,
[CUSTOMER][NEUTRAL] Yeah, we're not, yeah, we're, uh, yeah, we don't have the we don't have the policy number because we're, we're not with you all anymore. Um, could you do it by, well, she's here, never mind. She ain't, I do apologize for that. Uh, yes, um, I.
[AGENT][NEUTRAL] Oh, it's OK.
[CUSTOMER][NEUTRAL] OK, oh, the policy number is 17588.
[CUSTOMER][NEUTRAL] Oh, can I go to discount.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] It's an old policy. Um, the policy has, uh, we're no longer with the company. um, it's through my, uh, district that I work, but that was the policy number at that time.
[AGENT][NEUTRAL] That may be the group number. What's the, is it, what's the name of the school district?
[CUSTOMER][NEUTRAL] Beaumont Independent School District.
[AGENT][NEUTRAL] OK, yeah, this is it. That's the group number. Hold on one second. I'm just waiting for the policies to populate here. No, you're OK. And then, um, may I have your first and last name?
[CUSTOMER][NEGATIVE] Oh sorry.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And that's [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Oh, OK
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] oh hold on.
[AGENT][NEUTRAL] OK, here we go.
[AGENT][NEUTRAL] OK, and then I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] OK, my date of birth is [PII]. Um, my email address on file is [PII].
[AGENT][NEUTRAL] Thank you for that. And the mailing address that would be on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And so I see you had, are you trying to file for the hospital indemnity policy or which uh policy?
[CUSTOMER][NEUTRAL] Actually, it's, so it would be the hospital indemnity cause they said both was with you all and then there was a wellness clause for stroke as well.
[AGENT][NEUTRAL] Mhm. So you need the, the hospital indemnity and the cancer policy, OK?
[AGENT][NEUTRAL] And what's the date of service because that determines which policy you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That we use, OK, so, um, the first, and it's not for me, it was for my husband that's covered under that, uh, policy. Um, the first one was [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And, and he was like, I'm sorry, go ahead.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] No, no, go ahead.
[CUSTOMER][NEUTRAL] OK, and the second one claim would have been uh [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] The, sorry, I'm thinking at the same time, the only policy that was active during these two dates of service is your very first cancer policy. It was active from [PII], and then [PII] is when you enrolled in the hospital indemnity policy, so it wasn't active on those first, on those dates of service, but the first cancer policy was.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, um, to file a claim, you can either fax it or you can mail it to us. Um, let me give you that policy number.
[CUSTOMER][NEUTRAL] Hold on just a minute.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Cause, OK, hold on, let me look at something.
[CUSTOMER][NEUTRAL] OK. So do you send the, the documents that I am needing?
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] To submit to you all.
[AGENT][NEUTRAL] So let me give you the policy number.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then I'm gonna, um, we can go over how to file a claim because it's gonna ask you for that policy number on the claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so your policy number was 176.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 9493.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you're going to need
[AGENT][NEUTRAL] Well, now, hold on, because that changes things. What were you wanting to file for the hospital indemnity?
[AGENT][NEUTRAL] Like a hospital stay?
[CUSTOMER][NEUTRAL] Yeah, yeah, he was in the hospital for a week.
[AGENT][NEUTRAL] Let me pull up this
[CUSTOMER][NEUTRAL] He was diagnosed, he had a stroke.
[CUSTOMER][NEUTRAL] We brought him to the emergency room.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] Were you still speaking, Ms. [PII], because the phone went out. All I heard was you took him to the emergency room.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] That's it, uh, we took him to the emergency room and that's when he said that when they determined he had had a stroke.
[AGENT][NEUTRAL] OK. So let me pull up this.
[CUSTOMER][NEUTRAL] And they needed
[AGENT][NEUTRAL] Policy.
[AGENT][NEUTRAL] And Mrs. [PII], do you mind if I place you on just a brief hold? I'm just looking through the benefits on this, on that very first policy you had.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] See if he doesn't care at any time.
[AGENT][NEUTRAL] Let's see what else is on here.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] That's intensive care writer, oh my lord.
[AGENT][NEUTRAL] I don't even see the heart attack and stroke on here.
[AGENT][NEUTRAL] Wait, wait, wait, wait, wait.
[AGENT][NEUTRAL] Well, Miss [PII].
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] But not really.
[AGENT][NEUTRAL] Because the diagnosis prevented, well, that could be considered. I would.
[AGENT][POSITIVE] Yeah, it is OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, so we can tell her about that.
[AGENT][NEUTRAL] OK, wasn't there another one?
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Still the same thing.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Hello, Mrs. [PII].
[CUSTOMER][NEUTRAL] When
[CUSTOMER][NEUTRAL] Yes, she's here
[AGENT][NEUTRAL] All right, thank you so much for holding. I apologize for that wait. So, I was going through the policy um to try to see what, what could possibly be used. So,
[CUSTOMER][NEUTRAL] No, it's OK.
[AGENT][NEUTRAL] Was he in intensive care at any time?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK. So the only benefit that would be able to be used possibly is the diagnostic testing benefit. Um, you said there was like a wellness test?
[CUSTOMER][NEUTRAL] So, it doesn't cover under the stroke?
[CUSTOMER][NEUTRAL] Part
[AGENT][NEUTRAL] Right, that's, so there is no stroke part.
[AGENT][NEUTRAL] The only two
[CUSTOMER][NEUTRAL] OK, so this is. OK, go ahead. I'm missing. I'm sorry.
[AGENT][NEUTRAL] It's OK. The only two like additions that you added was the intensive, um, I'm sorry, internal cancer if there was ever a positive diagnosis, and then the hospital intensive care, which is why I was asking, was he ever in intensive care because we could have maybe used that.
[CUSTOMER][NEUTRAL] Yeah, no, he wasn't in ICU, and I, and the reason why is because of course our plan isn't with you all right now anymore and my new plan has that covered, so that's why they told me to contact you all. So, OK, so we did.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yeah, it didn't have that part on it so it just had ICU and cancer. OK, no, I understand, thank you.
[AGENT][POSITIVE] You're welcome, Mrs. [PII]. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that's it. Thank you.
[AGENT][POSITIVE] Alright, you're welcome thanks for calling APL. Have a good day bye bye.
[CUSTOMER][NEUTRAL] Uh-huh, bye bye.
[CUSTOMER][NEUTRAL] Yes it is.
[CUSTOMER][NEUTRAL] OK, let me see what's going on.