AccountId: 011433970860
ContactId: 2e85b2f5-974b-4334-9afe-d1dd6d66a615
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 449079 ms
Total Talk Time (AGENT): 172692 ms
Total Talk Time (CUSTOMER): 174301 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/2e85b2f5-974b-4334-9afe-d1dd6d66a615_20250328T13:31_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] Yes ma'am and I hope so uh I've got a policy in front of me and I'm just trying to figure out what actually this policy covers, um, I.
[CUSTOMER][NEUTRAL] This is my mom's policy. She's [PII] old and she's in a nursing home and uh you don't have cancer right now but she's got another disease. Can, can you give me just a brief overview of what this policy covers if I give you a policy number?
[AGENT][NEUTRAL] Um, yes, I may be able to, depending on who's on the policy, but yes, I can definitely look for you. May I have your name?
[CUSTOMER][NEUTRAL] My name is [PII], but I can give you the insured's name.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Um, her name and then the um policy number as well.
[CUSTOMER][NEUTRAL] Yeah, her name is [PII]. [PII], policy number 01.
[CUSTOMER][NEUTRAL] 076396
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And Mr. [PII], what's a good contact number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] OK, so here's the thing. OK, so she doesn't have anyone.
[AGENT][NEUTRAL] Wait a minute.
[AGENT][NEUTRAL] You said the policy number is 1076396?
[CUSTOMER][NEUTRAL] It's 01.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 076396
[AGENT][NEUTRAL] The reason I'm asking is because it's a different member.
[AGENT][NEUTRAL] Name.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEGATIVE] It's not [PII] at all.
[CUSTOMER][NEUTRAL] So let me go over it so it's not one it's 01076396.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm. Correct. The 0 in front doesn't matter. Um, it, it's fine, but as far as the policy number though, it's bringing up like someone with a completely different, like it's not [PII] at all. Um, I can look at the name though.
[CUSTOMER][NEUTRAL] Oh it
[CUSTOMER][NEUTRAL] OK, well, can, can you, can you, can you
[CUSTOMER][NEUTRAL] Yes, I do a query for a name.
[CUSTOMER][NEUTRAL] I know she's been paying uh something for 26 years maybe I mean I got the policy in front of me but maybe she got it somewhere else.
[AGENT][NEUTRAL] And it says
[CUSTOMER][NEUTRAL] supposed to be effected since February.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] It says American Public Life?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. And last name is [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is [PII] um together or?
[AGENT][NEUTRAL] It's and the middle name.
[CUSTOMER][NEUTRAL] Now [PII], well, the middle name is [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I think I found it. Hold on one second.
[AGENT][NEUTRAL] I found it. Hold on one moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Problem is, she doesn't have anybody on the policy. How can I get around this? Hold on one second, let me think.
[CUSTOMER][NEUTRAL] Well, I, I don't need to get any specifics. I just want to know what kind of policy this is. That's not really getting into her business, I guess. Uh, I mean, I can, she's, she's an hour and a half away in a, in a nursing home right now.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] I understand. Um, technically, all I can say is it's a cancer policy, but you already know that in terms of like the coverage and things, I can't go into detail because she doesn't have anybody on the policy, but what we can do.
[CUSTOMER][NEUTRAL] OK, but it's a, it's a treatment policy. It's no life insurance involved, and she has a, uh, a term she's, she's been diagnosed with a terminal illness, and I've read through this policy.
[AGENT][NEUTRAL] Right, right, right.
[CUSTOMER][NEUTRAL] I'm gonna go ahead and tell you what it says here idiopathic pulmonary fibrosis with intestinal lung disease, chronic hypoxia respiratory failure needs oxygen stuff. I don't, I mean, you got all kinds of stuff listed in your policy here, but that one don't look like a man, but the, the, the who makes that determination whether that disease is covered or not.
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Um, that will be the claims examiner. So once we receive all the documents, anything that you think can qualify, go ahead and send it in. Once we receive the documents, um, the claims examiner will go ahead and process and if we can apply the benefit, we definitely will.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, so I have a claim form in here, a green form.
[CUSTOMER][NEUTRAL] Uh, let me see what the date it says 1007.
[CUSTOMER][NEUTRAL] Is that the recent claim form?
[AGENT][NEUTRAL] October
[CUSTOMER][NEUTRAL] Is that the date of the
[AGENT][NEUTRAL] Of [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No, I will go on our website, [PII].
[AGENT][NEUTRAL] [PII],
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And um as soon as the page populates to the top right corner, you'll see claims and forms and you're just looking for the cancer claim form. It's in alphabetical order.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, just from your experience, is it, uh, what do you, what type of documentation do you is it just a form you fill out or do you have to send in a bunch of stuff?
[AGENT][NEUTRAL] Um, so you'll have to fill out the um cancer claim form and then depending on what you're um filing for, like if you're trying to prove a diagnosis, you'll need the pathology report, the itemized bill, um, I, I would send the itemized bill with any claim you send, um, because they're gonna ask for that. And then if she has like a, like a primary insurance, their explanation of benefits.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But depending on what you're filing for, that first page of the claim form has a list of instructions and it'll tell you what what's needed for whatever you're filing for.
[CUSTOMER][POSITIVE] Yes ma'am. All right. OK, thank you, ma'am.
[AGENT][POSITIVE] You're very welcome, Mr. [PII]. I wish I could give you more information. Was there anything else I can help with?
[CUSTOMER][POSITIVE] No, I, I'm, I'm, I appreciate your help and all you live over there in [PII]?
[AGENT][NEUTRAL] No, I'm actually in [PII].
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] Well, I, I saw, I saw where the company was from or whatever, so we, we, my wife used to live over that area, but I appreciate your help, man.
[AGENT][POSITIVE] You're very welcome, Mr. [PII], and thanks for calling APL. I hope you all have a great weekend.
[CUSTOMER][POSITIVE] Thank you man bye bye.
[AGENT][NEUTRAL] Bye bye.