AccountId: 011433970860
ContactId: 2b7943f3-ba4e-44a6-8f5c-ab1606c58988
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1058469 ms
Total Talk Time (AGENT): 461227 ms
Total Talk Time (CUSTOMER): 347286 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/2b7943f3-ba4e-44a6-8f5c-ab1606c58988_20250328T15:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII]. Um, I'm confused about something. First of all, I need to, to file a claim for my cancer insurance.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And, and secondly, um,
[CUSTOMER][NEUTRAL] And it started back in [PII]. I'm, I was just waiting until the did finish up the breast reconstruction and all that, and that's why I haven't done it before now.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then they're gonna have to, they're gonna have to do one, we do one of the breasts that it looks like because it's, it moved on me or something. Anyway, the other thing I wanna know is, I got this, I got this check.
[CUSTOMER][NEGATIVE] It said refund of premium received on expired policy. They said something about I turned [PII] and so it expired. I didn't think I had anything besides the cancer.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Policy.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, uh, I'm confused about that. I also, I guess I need another card because I don't have one.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And is there anything else I need besides the form?
[CUSTOMER][NEUTRAL] I'm not really sure what I need, I'll be honest with you.
[AGENT][POSITIVE] OK, no worries.
[CUSTOMER][NEUTRAL] I thought the state police took care, I thought, state police took care of this until I did not know that once my husband retired, then they didn't handle it anymore and I'm thinking, OK, so.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] You know, it's, it was just a mess.
[AGENT][NEUTRAL] OK. Um, do you
[CUSTOMER][NEGATIVE] And then he died of cancer and I never did file for on him because I was so upset. But anyway, go ahead.
[AGENT][NEUTRAL] Oh, no, that's totally fine. I was just gonna say, do you have your policy number?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, let's take a look.
[CUSTOMER][NEUTRAL] That's why I need the card.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And your last name you said is it [PII]?
[CUSTOMER][NEUTRAL] No, [PII], [PII], like sitting down.
[AGENT][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. And then [PII], if I can get your date of birth and address, please?
[CUSTOMER][NEUTRAL] OK, uh, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And it could be one of 2, um, [PII] is my
[CUSTOMER][NEUTRAL] Fiscal address my post office box is [PII].
[AGENT][POSITIVE] Thank you, yeah, it looks like we have your PO box on here, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um let's see.
[AGENT][NEUTRAL] OK. So was the check that you got for $10.40?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So, it looks like you guys had an intensive care policy, um, that was started way back in [PII], um, and it looks like that was the one that expired where you got the premium for that. So that was the that was the policy that was for.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][MIXED] Like I said, you know, uh, he did things and I just didn't know it. So, because he took care of all the bills and so when he died, I didn't, you know, I didn't have a clue. I just thought I was paying for a cancer premium. I did not, not know I was paying for everything else. So that's a good thing, I guess.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, OK, let's see.
[AGENT][NEUTRAL] If
[AGENT][NEUTRAL] So as far as filing a claim goes um you can file claims there are a couple different ways you can do it um you can submit it in the mail you can fax it to us or you can do it online um I'm gonna check and see.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so for this particular policy if you wanted to do it online there's never been any sort of account set up or anything like that so if you wanted to do the claims online you would just need to create a username and password online which I could help you do that if you want to do that or like I said you can fax them or put them in the mail.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] I still, like I said, I still have this other thing I have to go through.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, yeah, I'll just go ahead and
[CUSTOMER][NEGATIVE] And fix me up an account.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You want to do it online then?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Well, even if, if I don't.
[AGENT][NEUTRAL] Or I mean if it's easy if it's easier for you, [PII], I mean I can mail you the claim form and everything so you have it to fill it out if that's easier than the online stuff.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, I, I can do it online.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, so I'll just go in and create a user number and a password number and go from there.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, I can do that.
[AGENT][NEUTRAL] OK, we do need to get.
[CUSTOMER][POSITIVE] And then if I get, then if I get stuck I can always call you back.
[AGENT][NEUTRAL] Oh yeah, absolutely. We do need to add um an email to your policy because you don't have an email and you'll need an email for an online account.
[CUSTOMER][NEUTRAL] Oh, OK. Now, I'll tell you this, I never look at my email.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] If somebody emails me, I always say, you have to call me and tell me it's there or I will never see it because
[AGENT][NEUTRAL] OK
[CUSTOMER][NEGATIVE] I swear these people like, you know, like 500 a day and I'm thinking I can't keep up with this, but I don't have time to go in there and delete either. So, so that's why I say if you, if you want to get in contact with me, you're gonna have to call me and tell me it's there. But it's [PII].
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, yeah, when you go to, let me give you the web address where you're our web our website.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So our web address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so when you get there to the website you're gonna see on the far right hand side there's an option to it says sign in.
[AGENT][NEUTRAL] And when you click that it'll take you to a secure site then to log in you're gonna click on new user.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once you click new user, it's going to ask you um.
[CUSTOMER][NEUTRAL] The name and password.
[AGENT][NEUTRAL] Well, it's gonna ask you which best describes you. You're gonna click the top one it says I'm an individual with an APL insurance policy, and then you click next. When you click next then it asks for your name, social, zip code, email, and date of birth, so that's why we need the email on file.
[CUSTOMER][NEUTRAL] OK. Then social.
[CUSTOMER][NEUTRAL] What else?
[AGENT][NEUTRAL] Uh, name, social, zip code?
[CUSTOMER][NEUTRAL] And I gotta make sure I do the [PII].
[AGENT][NEUTRAL] Yes, do the [PII].
[CUSTOMER][NEUTRAL] Because I'll put new [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, cause I'll put in [PII] and no and I said what is this?
[AGENT][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] It'll say it can't find you, yeah.
[CUSTOMER][NEUTRAL] I'll say, who is this person?
[CUSTOMER][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] And then anything else?
[AGENT][NEUTRAL] Um, no, and then once you click next again, then it should ask you to um create the username and password and then you should be all logged in. Um, once you get in there, there's a big green button that says upload files that's where you will upload all of your claim documents pretty pretty easy um to to see that and uh the claim forms are located there as well.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Well, thank you so much. I've got to go see this other plastic surgeon because my, my plastic surgeon, he, um,
[CUSTOMER][NEGATIVE] He went to the VA and one side, this is a, one side has never healed.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] And the other side that is drooping down and I'm thinking, really, so I may have to have it, I may have to have them redone and I, and we all pay for that because of that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me see if there's any sort of
[AGENT][NEUTRAL] Let me pull this policy here. Give me just a second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEGATIVE] You know, I was thinking I probably could just get more fluid, put it in one, but it's going up underneath my arm and I'm thinking that's not gonna work.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] So it does have on the benefits page, um, it says inpatient surgical expense and then
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It does give an option for a 2nd and 3rd, like if you were to get another opinion, which might be something that would apply maybe to your situation, it sounds like.
[AGENT][NEUTRAL] Um, so it does list that on the benefits page, um, it does.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Have it looks like the daily hospital that it would looks like pay benefits towards also. So if you're in the hospital, it has a benefit for that.
[AGENT][NEUTRAL] So it does look like something that is listed on your schedule of benefits. So it definitely
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, well, I think if I remember correctly, this was done outpatient.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And that's a good thing.
[AGENT][NEUTRAL] Yeah, yeah, I hear that.
[CUSTOMER][NEUTRAL] Cause they can go in there and take care of it, and I go home.
[AGENT][NEUTRAL] Right?
[CUSTOMER][NEUTRAL] I, I don't want to stay in the hospital if I don't have to.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Um, oh gosh.
[AGENT][POSITIVE] So yeah, it gives all of these.
[AGENT][NEUTRAL] So, yeah, I mean, for the breast, it looks like it lists like simple mastectomy at $800 for maximum payment.
[AGENT][NEUTRAL] Um, it has radical mastectomy listed, and the max payment for that is 1520.
[CUSTOMER][NEUTRAL] Well, that's not much, is it?
[AGENT][NEUTRAL] Yeah, so.
[AGENT][NEUTRAL] It may be who view in this particular instance because the outpatient surgical expense, let's see.
[AGENT][NEUTRAL] So if as a result of internal cancer, an insured person is advised by a physician uh to have another surgical option or surgical operation.
[AGENT][NEUTRAL] Um, a second surgical opinion, we will pay a benefit for. We will pay the actual charge, it says, but not to exceed $200 made by a second opinion, made by a second physician for examining and advising this insured person.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, because it's not um oncologist that's sending me over there.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] They do like
[CUSTOMER][NEUTRAL] Oh, OK dokey.
[AGENT][NEUTRAL] Yeah, so, um,
[AGENT][NEUTRAL] I would say
[CUSTOMER][NEUTRAL] I can just send it all in what they pay, they pay.
[AGENT][POSITIVE] Exactly, exactly. That's what I tell people sometimes. I'm like, when in doubt, just submit it all and you know, if it's not paid, it's not paid, but at least you, you know, submitted everything you had and and got the most, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Right, right. OK, well, I will do that then. Um.
[CUSTOMER][NEUTRAL] I was gonna ask you, do they?
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEGATIVE] This time they didn't do, thank goodness they didn't do chemo and radiation. First time I had to go through all that. This time I didn't.
[AGENT][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] But yeah, I mean, if you, if you're gonna go.
[CUSTOMER][NEUTRAL] Yeah, that I have to go by.
[AGENT][NEUTRAL] If you're gonna go back and submit um previous stuff, I mean, you can definitely submit any old chemo or radiation if you wanted to also.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][POSITIVE] Alrighty well I appreciate it so much.
[AGENT][POSITIVE] You're welcome. I hope you have a nice rest.
[CUSTOMER][NEUTRAL] And if you, and if
[CUSTOMER][NEUTRAL] And if you'll send me um a um card.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][POSITIVE] I would appreciate it.
[AGENT][POSITIVE] Oh, yes, absolutely. So is the PO box OK?
[CUSTOMER][NEUTRAL] Yes, that's fine.
[AGENT][POSITIVE] OK, and then did you want to take down the policy number just to have it? I'm happy to give that to you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. The policy number is 85302.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh thank goodness it's not one of those 12 numbers things.
[AGENT][NEGATIVE] No, it's very short.
[CUSTOMER][NEUTRAL] Yeah, 853-02. I can do that.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] All right. Is there anything else?
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] Your
[CUSTOMER][NEUTRAL] No, that should do it.
[AGENT][POSITIVE] All right. You're welcome. Have
[CUSTOMER][NEUTRAL] And I'll cash his check now.
[AGENT][POSITIVE] All right, have a good day.
[CUSTOMER][POSITIVE] You too. You have a blessed day and hopefully it'll be very quiet for you today since it's Friday, so you can go home.
[AGENT][POSITIVE] All right, I know, right? I know, I appreciate it.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] All right. Bye.