AccountId: 011433970860
ContactId: 340c52f9-5595-407e-966b-4795a4bc758d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 675039 ms
Total Talk Time (AGENT): 299390 ms
Total Talk Time (CUSTOMER): 152084 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/340c52f9-5595-407e-966b-4795a4bc758d_20250403T16:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII].
[CUSTOMER][NEUTRAL] My name is [PII] and.
[AGENT][NEUTRAL] Hi
[CUSTOMER][NEGATIVE] I got a text message saying that my claim had been updated but I cannot figure out how to log into the website.
[AGENT][NEUTRAL] OK, Ms. [PII], I can help you with the online service center. Can you please give me your callback number, ma'am, just in case the call gets dropped, I'll be able to call you back.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you. And what is your policy number?
[CUSTOMER][NEUTRAL] Oh, I don't know
[AGENT][NEUTRAL] That's OK. I can look it up with your social.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome, um, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Are you still there?
[CUSTOMER][NEUTRAL] Yes, can you hear me?
[AGENT][NEUTRAL] Oh, yes, I can hear you now. OK, and that social was [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] [PII] my gosh, I'm sorry, that's my telephone number. I've lost my mind.
[CUSTOMER][NEUTRAL] Let me try again, um [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] For me?
[AGENT][NEUTRAL] [PII]. OK, so that was [PII] and what was the middle digits, the two middle digits?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] No, I'm sorry, it's [PII] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 317, yes.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] 461-473-167
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, alright, I've got it.
[AGENT][NEUTRAL] Let me look you up
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK, Ms. [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is uh your address, a phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] OK, um, I would think it would be [PII]. Um, phone number [PII]. Um, email, uh, it could be two different emails. I'm not sure which one you have, um, either [PII] or [PII].
[AGENT][NEUTRAL] Right, I've got the [PII].
[AGENT][NEUTRAL] OK, let me look real quick um.
[AGENT][NEUTRAL] OK, so you have one active policy with us. Let me give you that policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 253-1996.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And at this time, I'm not showing that any claims have been filed on this policy.
[AGENT][NEUTRAL] And this is a a cancer policy.
[AGENT][NEUTRAL] Did you hear me say that it was a cancer policy?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, so I don't have the heart attack policy with y'all.
[AGENT][NEUTRAL] Let me look and see if you had one,
[AGENT][NEUTRAL] No, ma'am. I don't see a heart attack and stroke policy with us.
[AGENT][NEUTRAL] Um, just, and I'm looking, I'm gonna look real quick at your benefits to see if you have a rider on here for heart attack and stroke.
[CUSTOMER][NEUTRAL] OK
[AGENT][POSITIVE] No, ma'am, you do not wait, yes you do.
[AGENT][NEUTRAL] You do have a heart attack and stroke rider with this cancer policy.
[CUSTOMER][NEUTRAL] OK, that's what I thought. And I did submit paperwork and I got stuff that said my claim. I've got a claim number.
[AGENT][NEUTRAL] OK, what is the claim number?
[CUSTOMER][NEGATIVE] But I'm unable to log in so I don't know.
[CUSTOMER][NEUTRAL] I don't know what my login information is um.
[AGENT][NEUTRAL] Was the claim for yourself?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It says um no, it's for my husband, um 357-455-5.
[AGENT][NEUTRAL] OK, are you there?
[AGENT][NEUTRAL] I'm sorry, the phone acted a little crazy there for a minute. I apologize. And the claim is for [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, and the claim number you had again please, ma'am?
[CUSTOMER][NEUTRAL] 35 74555
[AGENT][NEUTRAL] OK, let me look that up. I see it right here.
[AGENT][NEUTRAL] For him
[AGENT][NEUTRAL] OK. You've got a couple of comments that's on um this claim. Let me read them to you. It's kind of lengthy. Um, it says that, um,
[AGENT][NEUTRAL] The critical illness writer attached to your policy provides a lump sum benefit for a heart attack, which is defined as an acute myocardial infarction resulting in the sudden death of a heart muscle resulting from a blockage of the of one or more coronary arteries. The definition of heart attack does not include congestive heart failure.
[AGENT][NEUTRAL] Oh, this is a big word. Authors.
[AGENT][NEUTRAL] Atherscolic or any other dysfunction of the cardiovascular system, um, heart disease, angina, including unstable angina or coronary disease. According to the records on file, this, the condition diagnosed was not that of a heart attack as defined by the policy.
[AGENT][NEUTRAL] Yes, so the way that the
[CUSTOMER][NEUTRAL] He had a massive, he had a massive heart attack and his
[CUSTOMER][NEGATIVE] Um, artery ripped all the way from the top of his heart all the way down into his legs.
[AGENT][NEUTRAL] Oh, gosh.
[AGENT][NEUTRAL] OK, well, you do have the option to appeal the um.
[CUSTOMER][NEUTRAL] And he had open heart surgery and all of that and had a stroke after.
[AGENT][NEUTRAL] Yeah. OK.
[AGENT][POSITIVE] Oh goodness. Gosh. I'm so sorry you went through all of that. Um, you can appeal the claim.
[CUSTOMER][NEUTRAL] It's been
[AGENT][NEUTRAL] Um, you have 180 days from the date the claim was initially processed and the claim was processed on.
[AGENT][NEUTRAL] Let me tell you
[AGENT][NEUTRAL] And you just need to send a letter why you would like to appeal the claim.
[CUSTOMER][NEUTRAL] OK, can you tell me how to get into the system?
[AGENT][NEUTRAL] Did you
[AGENT][POSITIVE] Yes ma'am, let me look real quick, sure.
[CUSTOMER][NEUTRAL] Like
[AGENT][POSITIVE] And I'll pull you up real fast.
[AGENT][NEUTRAL] OK, so let me pull you in real fast.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And we verified all your information, so, um,
[AGENT][NEUTRAL] Your username is [PII].
[AGENT][NEUTRAL] Is it letting you in with
[CUSTOMER][NEUTRAL] OK, so that
[CUSTOMER][NEUTRAL] Like the capital letter [PII]?
[AGENT][NEUTRAL] All lowercase.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII] is not spelled out.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That works. OK. All right. Thank you.
[AGENT][POSITIVE] Oh, good, good deal.
[AGENT][POSITIVE] All right. I'm glad that you're in there.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're very welcome. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] So I'll write the letter and upload it. Is that how it works?
[AGENT][NEUTRAL] Yes ma'am, you write the letter and um just state that this is a letter of appeal for for the claim number 357455-5.
[AGENT][NEUTRAL] And the reason why you're appeal appealing the claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then it'll go under review.
[CUSTOMER][NEUTRAL] Any suggestions? Any suggestions that would help? Any suggestions that would help?
[AGENT][NEUTRAL] Ma'am.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] If you have uh.
[AGENT][NEUTRAL] Any notes, doctor's notes or anything like that?
[AGENT][NEUTRAL] And even this uh operation notes if you can say claim that would be a good backup.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] That'll be it. Thank you much.
[AGENT][POSITIVE] OK, well, you have a blessed day and thanks for calling APL.
[CUSTOMER][POSITIVE] All right you too bye.
[AGENT][NEUTRAL] Bye-bye.