AccountId: 011433970860
ContactId: 3500ba14-8991-4861-b8a3-d5df7b96c39e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 758109 ms
Total Talk Time (AGENT): 455209 ms
Total Talk Time (CUSTOMER): 227217 ms
Interruptions: 5
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/3500ba14-8991-4861-b8a3-d5df7b96c39e_20250131T22:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, um, I need to see if I can get a copy of my policy.
[AGENT][NEUTRAL] Yeah, I can look at getting a copy of your policy um let's see, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] All right, thank you. Do you have your policy number?
[CUSTOMER][NEGATIVE] I don't have it, not with me.
[AGENT][NEUTRAL] That's OK, uh, OK, I can start choosing your social.
[CUSTOMER][NEUTRAL] OK [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] Um, I'm gonna read that back to you, [PII]. I don't know that I heard that correctly. Um, that was [PII], 0, I'm sorry, yeah, [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, um, I am not finding you in our system.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] See
[CUSTOMER][NEUTRAL] It should be. Did y'all buy out American uh ages?
[CUSTOMER][NEUTRAL] It was a cancer policy.
[AGENT][NEUTRAL] OK, um, you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] I'll be the INS.
[AGENT][NEUTRAL] Let me try that.
[CUSTOMER][NEUTRAL] My agent gave me um your number so.
[AGENT][NEUTRAL] OK, let's see. I did find a [PII]. Um, what was your date of birth, please, [PII]?
[CUSTOMER][NEUTRAL] [PII] and also I need a copy of [PII] as well.
[AGENT][NEUTRAL] OK, I do believe I found it. I think it's because it is in [PII]'s name and not yours. OK, no, no, that's perfectly fine. It's all right. We were able to find it. That's OK. Alright, uh, just gonna verify let's see.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, I didn't realize his name was first.
[CUSTOMER][POSITIVE] That that's all right. That's all matter.
[AGENT][NEUTRAL] Hold on just a moment.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, um, and if you would, [PII], can you verify your uh mailing address please?
[CUSTOMER][NEUTRAL] Well, I, my, uh.
[CUSTOMER][NEUTRAL] It's been years ago we've had it for years and I have a new mailing address.
[AGENT][NEUTRAL] OK, um, I have one that's in Little Rock if that helps if you're able to verify that.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Yes, that's when we got it.
[CUSTOMER][NEUTRAL] [PII], I believe.
[AGENT][POSITIVE] Perfect, yes ma'am thank you for verifying that. OK, and I can get that changed for you. What is the current address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm sorry, that was [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that matches.
[CUSTOMER][NEUTRAL] And the zip is [PII]?
[AGENT][NEUTRAL] OK, matches like uh what you start a fire with?
[CUSTOMER][NEUTRAL] No, [PII]
[AGENT][NEUTRAL] Oh, I see. OK.
[AGENT][NEUTRAL] That's still [PII]. Alright, thank you.
[AGENT][NEUTRAL] All right, I will get that changed. Let me get your policy pulled up here. Bear with me just a moment. OK.
[AGENT][NEUTRAL] So for this policy [PII], and I do appreciate you verifying all that information um as this is a bit of an older policy I'm gonna have to uh request to have it um would you prefer having it mailed to you like a paper copy?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Yes, or you can email it either way. I mean I can print it, that's not a problem.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Sure, alright, so I do have to request to have this, uh, put in our system. I've got some older files that might compile it, but it's not gonna look very pretty so um I will submit that request to have it sent to you. We can do both if you'd like I can have a paper copy sent to you and um a copy emailed uh let me get.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That'll be great.
[AGENT][NEUTRAL] OK, I do not have an email address for y'all um what is an email that you'd like that sent to [PII]?
[CUSTOMER][NEUTRAL] OK, well, can you tell me what it covers?
[AGENT][NEUTRAL] Um, let me take a look.
[AGENT][NEUTRAL] I'm not sure that I'll be able to go in depth um as again I'm not able to see the policy right now um but.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, chemo radiation, daily hospital benefit, and of course based uh cancer coverage. I think.
[AGENT][NEUTRAL] That's going to be the extent. It is, uh, typically, that's most anything to do with uh regarding cancer and treatment for cancer.
[CUSTOMER][NEUTRAL] OK. Does it, will it pay for surgery or um?
[CUSTOMER][NEUTRAL] Hospital stay?
[AGENT][NEUTRAL] There is a hospital stay benefit, yes. Um, it does depend on the surgery. Was there, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Are one of y'all positively diagnosed with cancer?
[CUSTOMER][NEUTRAL] Um, I'm just kind of doing a precaution kind of thing.
[AGENT][NEUTRAL] Oh, sure, sure. OK. So one of the things that I think there's a lot of confusion on with these kinds of policies is the initial biopsy. If that resulted in uh negative, like it was not cancer, uh, then that would not be covered. However, if there was a biopsy performed and it was deemed positive for cancer, then it would be.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Alrighty I will get that submitted for you um and hopefully I apologize I can't answer more at the moment, um.
[CUSTOMER][NEUTRAL] No, that's OK. So when should I expect that?
[AGENT][POSITIVE] But I will definitely try to get something as soon as you can. Sorry?
[CUSTOMER][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] Yeah, yeah, I'll
[CUSTOMER][NEUTRAL] Could I expect the email?
[AGENT][NEUTRAL] Um, I'm not quite sure. It really depends on how soon they're able to get it in. They can't say it it excuse me, it can take up to a month at times, but I don't imagine with that's usually in the middle. It's the end of this month, so hopefully not too long. You might get a paper copy before you get an email.
[CUSTOMER][NEUTRAL] OK, so if I needed to know what the benefits were or something, I could call. Is there something I can somewhere I can call or look to see what it will cover?
[AGENT][NEUTRAL] At this present time until I can get I can look there's some back files if you had, was there something uh specific that you were wanting to check was covered?
[CUSTOMER][NEUTRAL] Well, I just had a biopsy and I'm waiting on test, test, uh, results. So I need to know if they call me next week. I need to know um what I can do as far as going forward with it.
[AGENT][NEUTRAL] You did.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Sure, OK, give me just a moment let me see what I can find um I do apologize I can't do much at the moment.
[CUSTOMER][NEUTRAL] I mean, do I let them file? do I file myself after something is done?
[AGENT][NEUTRAL] Oh, you, I see, sure, typically with these kinds of policies you would file it, um, I would ask if they're willing to file for you um that's just less of a headache for you, but most of the time providers wouldn't, they would only do for like you know your major medical um.
[AGENT][NEUTRAL] But all we would really need is, of course, if it was um positive, we would need that initial pathology report with the diagnosis of cancer. uh and then any itemized statements that they have for your treatment or whatever procedure.
[CUSTOMER][NEUTRAL] So I would have to request those from them?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And then you can send that to us and we would be able to get those claims filed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] The only benefits that I'm able to see at the moment, I do apologize, are the uh chemotherapy and radiation treatment um that is 7.
[CUSTOMER][NEUTRAL] What percentage does it pay for chemo and radiation?
[AGENT][NEUTRAL] So it's not a percentage um it's a you get a set dollar amount allowance essentially per 12 month period.
[AGENT][NEUTRAL] And that period would start from when you first receive that treatment. So for example if your first one was uh [PII], that would be when that 12 month period starts and then that dollar amount would reset from that point, uh, and that amount is $7500 so it would pay it all until it reaches that amount and that amount is exhausted.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, then there's also a daily hospital expense. So if you were hospitalized for days on end, um, it is $140 per day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For the hospital, those are the only benefits I'm able to see at this present time, um, so I, I do apologize but I will try to get that policy up and running as quickly as we can so we can get that information to you.
[CUSTOMER][NEUTRAL] OK, let me ask you this, um.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I went through a grant to get like um the Pap smear not Pap smear done um.
[CUSTOMER][NEUTRAL] And so would this be totally separate?
[AGENT][NEUTRAL] For a, uh, you said for a mammogram? I'm sorry.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Some of our cancer policies do offer wellness benefits um for these older policies I'm not quite sure, but typically it would be one per calendar year that they would pay a benefit of, you know, so many.
[AGENT][NEUTRAL] So much um per
[AGENT][NEUTRAL] Diagnosis or diagnostic preventative diagnostic test is what they call it. So that would be a mammogram, a colonoscopy, Pap smear. You could select one of those per calendar year. I'm not 100% that this policy offers that. So until we can get your policy, I don't wanna say yes or no. I'm so sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so how long will it, I mean, I mean, I'm thinking I need to know something next week.
[AGENT][POSITIVE] OK, I will do my best to get this done as quickly as we can for you.
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] I'm just trying to figure out if they call and um.
[CUSTOMER][NEUTRAL] Trying to figure out what we can do for treatment or whatever. Do I mention I have this policy? I can't tell them what it pays and what it don't.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] You can.
[AGENT][NEUTRAL] You can, um, I would first ask typically again with these kinds of policies the insured, so you would be the one to file those claims, um, and it's.
[AGENT][NEUTRAL] There's no timely filing limit. It's not like you have to get it to us within a specific time frame um obviously you know you want your money but there's no rush is what I'm saying so I.
[CUSTOMER][NEGATIVE] So this is kind of a policy to where it's just kind of an independent policy. It doesn't, it's not gonna get me in the hospital. It's not really gonna.
[CUSTOMER][NEUTRAL] Get them to hold something it's just, you know, like a benefit for me to file to get money from.
[AGENT][POSITIVE] Absolutely. It's just uh uh for a bit of relief for if you know, any sort of cancer treatment um to help with bills. It is very um uh it would be considered supplemental.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Supplement. OK, so it's not like the um
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, like regular insurance where you turn it in and they file and all this, this is totally separate, correct? OK, OK.
[AGENT][POSITIVE] Right, right, absolutely.
[AGENT][POSITIVE] That is correct. And I think, let me see.
[CUSTOMER][NEUTRAL] And I'm sure I have the policy at home.
[CUSTOMER][NEUTRAL] Put up somewhere safe. I just couldn't put my fingers on it, so, um.
[AGENT][POSITIVE] That's OK. That is OK. I've, I lose track of just about every important document. I mean my goodness so but that's, we will definitely be able to get it recovered for you um I apologize it's just, you know, I don't have it right now but we will definitely get it to you as quickly as we can.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, thank you so much.
[AGENT][NEUTRAL] Yes, did you have any other questions for me?
[CUSTOMER][NEUTRAL] No, ma'am, that should do it.
[AGENT][POSITIVE] All right well thanks for giving us a call. I sure hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you for all your help. I appreciate it.
[AGENT][POSITIVE] Yes ma'am have a great weekend.
[CUSTOMER][POSITIVE] All righty. You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.