AccountId: 011433970860
ContactId: 31352fa5-17be-4588-a5c1-27096c729359
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 962849 ms
Total Talk Time (AGENT): 422989 ms
Total Talk Time (CUSTOMER): 248862 ms
Interruptions: 5
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/31352fa5-17be-4588-a5c1-27096c729359_20250106T21:30_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII], and I am a teacher at Hallsville ISD in [PII].
[CUSTOMER][NEUTRAL] And I need to file a uh.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Claim on my uh deceased spouse, um, that died of a massive coronary in November.
[AGENT][POSITIVE] Oh, I'm very sorry for your loss.
[CUSTOMER][POSITIVE] Well, thank you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's been a tough holiday season.
[AGENT][POSITIVE] Yes, ma'am. I know that it has been my, my deepest condolences.
[CUSTOMER][POSITIVE] Well, thank you.
[AGENT][NEUTRAL] OK, so you're needing to find out about filing a claim for your husband? OK. So, yes, ma'am, I can help you with that. And Ms. [PII], what is your callback number?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, thank you. And your policy number, please?
[CUSTOMER][NEUTRAL] It's 254-927-8.
[AGENT][NEUTRAL] OK, thank you. One moment while I get your information pulled up.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so first off, any information, Ms. [PII] that I provide for you today will be a verification of benefits and not a guarantee of payment. And as I stated before, I will have to verify several things with you first for security. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And go ahead and verify your husband's name and date of birth for me, please.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then also your home mailing address, please.
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. The phone number that we have for you is the same as the one that you gave me, so that is your best contact number. Is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] Oh, OK, thank you. And then the last piece of information to verify is gonna be your email address?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I guess I probably, you probably have my work email address so it is [PII].
[AGENT][NEUTRAL] This appears to be, oh, actually, it appears to be personal.
[CUSTOMER][NEUTRAL] OK. [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is that the one you have?
[AGENT][NEUTRAL] Uh-huh, and what's the rest of that email?
[CUSTOMER][NEUTRAL] Oh, OK. [PII].
[AGENT][NEUTRAL] OK, thank you very much. OK. And so when did Mr. [PII] pass away?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And so you're needing to file, I do see that your policy, we have been notified and changed the coverage effective [PII].
[CUSTOMER][NEUTRAL] Very
[AGENT][NEUTRAL] Two individuals, so we had received that notification. OK, so you're needing.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is this a cancer claim that you're filing for him, Ms. [PII]? What type of
[CUSTOMER][NEUTRAL] No, it's a heart policy claim. Uh-huh.
[AGENT][NEUTRAL] Uh, let's
[AGENT][NEUTRAL] So give me a moment to get your policy information just because I can see that this is a cancer policy.
[CUSTOMER][NEGATIVE] Right. And then I found I printed something that also said heart as well. So I thought, well, I try to do this online and it just shows me cancer.
[AGENT][NEUTRAL] Yes, ma'am, that's the only policy that I can pull up for you with APL is this cancer policy. So let me see.
[AGENT][NEUTRAL] If there are any benefits.
[AGENT][NEUTRAL] On here.
[CUSTOMER][NEUTRAL] My insurance lady assured me that it was cancer and heart. I said, OK.
[AGENT][NEUTRAL] So give me just a moment to look through your policy information.
[AGENT][NEUTRAL] For you, OK?
[CUSTOMER][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on this policy, you do have a benefit, a first occurrence benefit.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For the heart attack or stroke, that benefit amount, and as I stated to you before, any information I provide for you, Ms. [PII] would be a verification of benefits and not a guarantee of payment.
[AGENT][NEUTRAL] But that benefit amount on this policy is $7500.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] Give me a moment. I'm still looking at a few other things, but you do have that benefit on this plan.
[CUSTOMER][POSITIVE] Thank you, Lord. I need every dime I can get at this point.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Let me see what the benefit waiting period is on this policy because this policy went into effect originally [PII].
[AGENT][NEUTRAL] So just one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But I've had
[CUSTOMER][NEUTRAL] This policy
[CUSTOMER][NEUTRAL] For a couple of years, I think, or more.
[AGENT][NEUTRAL] Um, the only policy.
[CUSTOMER][NEUTRAL] It just, I think
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] I share this sorry.
[CUSTOMER][NEUTRAL] It's different from everyone else.
[CUSTOMER][NEUTRAL] Because we, we don't.
[CUSTOMER][NEUTRAL] Everything starts over for us [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Which is the beginning of the [PII].
[AGENT][NEUTRAL] Correct. Yes, ma'am. Mhm. Most, I do know most of the school districts are that way.
[AGENT][NEUTRAL] Now, with American Public Life though, I show that your, this is the first policy you've had with us.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] With our company.
[CUSTOMER][NEUTRAL] Is this not
[CUSTOMER][NEUTRAL] OK, so is this not Aflac?
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] You, I'm with American Public Life.
[CUSTOMER][NEUTRAL] OK, I thought this was Aflac.
[CUSTOMER][NEUTRAL] Alrighty. I guess I have 3 policies.
[AGENT][NEUTRAL] No, OK.
[AGENT][NEUTRAL] Oh, well, hopefully, that's good. I'm trying to look here to see what the limitation may be on this.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] For that first occurrence benefit. So give me just one, that's still what I'm looking for.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] I'm still trying to locate the waiting period on this, the benefit waiting period.
[CUSTOMER][NEUTRAL] OK, that's fine. I'm in no hurry.
[AGENT][POSITIVE] Thank you for your patience.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So this waiting period on this plan that you have.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Miss [PII], um, I'm sorry, Miss [PII].
[AGENT][NEUTRAL] is 120 days.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] From the effective date.
[AGENT][NEUTRAL] So that
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] His event occurred within that time period, I mean within the waiting period.
[AGENT][NEUTRAL] It states I can read the policy language to you. I can see you're set up in the portal for the online service center so you do have a copy of this information.
[AGENT][NEUTRAL] In the, in the portal, um, but the waiting period reads as follows. The policy under which this certificate is issued contains a waiting period during which no benefits will be paid. If any covered person has a specified disease diagnosed before the end of the waiting period.
[AGENT][NEUTRAL] Immediately following the cover person's effective date, coverage for that person will apply only to loss that is incurred after 120 days from the covered person's effective date.
[AGENT][NEUTRAL] The waiting period is shown on the certificate schedule.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So it's, you said the wording there was diagnosed?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, which means.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Yes, if it has an event occur prior to the 120 days of the policy becoming effective.
[CUSTOMER][NEUTRAL] He
[CUSTOMER][NEUTRAL] OK. Well, I'm gonna have to call [PII] on this because I, I swear I thought she told me this was Aflac.
[CUSTOMER][NEUTRAL] And I don't.
[CUSTOMER][NEGATIVE] Because I don't even remember signing up uh like I said, I thought this APL was Aflac, so I don't even remember signing up for this.
[AGENT][NEUTRAL] Mhm, OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, so.
[CUSTOMER][NEUTRAL] Since his event was only 6, 72 days, I guess.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So there will be no payment on this policy.
[AGENT][NEUTRAL] That is, yes, ma'am. That is correct because it falls within that window.
[CUSTOMER][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] OK, well, I will call um our insurance person tomorrow because I'm sure she's probably already left and find out.
[CUSTOMER][NEGATIVE] What in the world is going on with this? Because I don't, I don't know. I, I, yeah.
[AGENT][NEUTRAL] Yes, ma'am. And see, and I, unfortunately, yes, ma'am, and I'm so sorry that I can't, you know, I just don't have any information on the Aflac, any, any of that, um, with that being a completely separate entity. But you can, uh, look, like I said, since you are set up on the portal, if you pull up your
[CUSTOMER][POSITIVE] But I appreciate.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Policy certificate in there. It gives a waiting period. Um, if you search the entire document.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's page 17 of 36. That's not the page number, but it's the total.
[CUSTOMER][NEUTRAL] At this time.
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] OK, well, all I'm getting.
[AGENT][NEUTRAL] The document, let me see if I can get what I'm getting. Uh, the document itself is a total of 36 pages. So if you search the document, it would be page 17 of that total 36, but it's, it explains what the waiting period is, and that goes on over to page 18 as well.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, I'm OK, um.
[CUSTOMER][NEUTRAL] I'm in the portal but I'm not seeing I'm seeing my policy number and I'm seeing.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, you should be able to click on that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You should see a little PD it should say downloading. There should be a PDF.
[AGENT][NEUTRAL] Icon
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And if you click on that, it should say downloading and that's your policy certificate.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][POSITIVE] OK. All right. I've got it. Thank you so much.
[AGENT][NEUTRAL] OK. All right. Well, you're welcome, Ms. [PII]. And is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] I don't think so, thank you.
[AGENT][POSITIVE] OK. Well, you're welcome and thank you for calling APL. I hope you have a nice evening.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Bye bye.