AccountId: 011433970860
ContactId: 3757107f-fee5-4076-84dd-f1f840e25f2e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 940119 ms
Total Talk Time (AGENT): 288504 ms
Total Talk Time (CUSTOMER): 404257 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/3757107f-fee5-4076-84dd-f1f840e25f2e_20250224T15:43_UTC.wav
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[AGENT][NEUTRAL] This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. Yes, I, I hope so. I called, um, a few weeks ago before I went to the hospital to get a copy of or a claim form for my uh hospital uh stay.
[CUSTOMER][NEUTRAL] Uh, policy number.
[CUSTOMER][NEUTRAL] Do you need the policy number?
[AGENT][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] 01.
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] 64342.
[AGENT][NEUTRAL] And what is the, what's your first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] And uh could I get a, OK, could I get a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] obvious
[CUSTOMER][NEUTRAL] It's a big one and then the.
[CUSTOMER][POSITIVE] Exactly
[CUSTOMER][NEUTRAL] I think a lot of people.
[AGENT][NEUTRAL] You gave me
[AGENT][NEUTRAL] Policy number 01764342.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Is this policy in your name?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, spell your last name, [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], OK, give me one second.
[AGENT][NEUTRAL] And what type of policy is it that you have?
[CUSTOMER][NEUTRAL] It's an intensive care uh policy.
[AGENT][NEUTRAL] OK, and what state do you reside?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And [PII] verify your date of birth and your complete mailing address for me?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, you had given me that earlier and what's your email address?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that information.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] OK [PII], thanks for holding. So you said this call is in regards to uh an a critical ill.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Or
[CUSTOMER][NEUTRAL] Uh, uh.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Have you submitted the
[CUSTOMER][NEUTRAL] A critical
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, I haven't, no, I haven't submitted and that's why I'm calling. I called to get, I called to get a, uh, uh, a claim form, but I, I don't have one on this policy, the claims form.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] OK. Would you like for me to email you a copy of the critical illness claim form?
[CUSTOMER][NEUTRAL] Uh, yes, ma'am, email it to me. I'll mail it to me what you want.
[AGENT][NEUTRAL] Is the email address that you verified OK to mail it to you?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] All right, so I just emailed you over the claim form.
[AGENT][NEUTRAL] And then on page one of the claim form it gives you detailed instructions as to.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What documents are required depending on what benefit you're claiming.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it'll tell you the specific documents that we need for review and then it will also show you how to complete uh the claim form.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, this is not to cancel so that this is uh.
[AGENT][NEUTRAL] This is critical illness.
[CUSTOMER][NEGATIVE] OK, like they sent me the cancer form and that that wasn't what I needed.
[AGENT][NEUTRAL] Oh, you received the cancer form before?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] They said it a couple of weeks ago when I called in.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And she sent me, and she sent me the cancer form, but that wasn't what I needed. I needed, I need, I need the critical care for intensive care and coronary care policy, so.
[AGENT][POSITIVE] Right, exactly.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] So is that what is that what you're sending me now?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] I've already sent it, yes, that is the form that I sent to you.
[CUSTOMER][NEUTRAL] OK, so, so all I got to do is just look at and read it and fill it out.
[CUSTOMER][NEUTRAL] If the cancer has a place where you can fill it out, fill it out and send it back to you. I have a doctor sign to. Is it requiring a doctor's signature?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] No, it'll require you the statement of insured. There's a section for you to complete.
[AGENT][NEUTRAL] Um, and then there is um an attending physician statement to complete, but it depends on, uh, what benefit are you claiming, do you know?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, intensive care cause I was in intensive care in hospitals.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so for that benefit, it does require that the uh attending physician statement is fully completed.
[CUSTOMER][NEUTRAL] OK. I go to the doc I attend, I go to the doctor tomorrow. So I will.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I will try to have him.
[CUSTOMER][NEUTRAL] Can you, uh, make a copy of this off of my phone? Can I?
[AGENT][NEUTRAL] You can, you can.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] This is more, this is more than a notion, um.
[CUSTOMER][POSITIVE] More than not for an old person to do, boy. I've had this, I've had this policy for 20 years and goodness gracious. Anyway.
[CUSTOMER][NEUTRAL] Anyway, I, I, I'll see if I can get someone to come make a copy of, of my phone. I don't see it though. I don't, I don't see it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I'm gonna hold the line just a few seconds just to make sure that you do get it. It's coming from [PII].
[CUSTOMER][NEUTRAL] Oh, OK, I see. OK, I see, I see [PII], yes.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] You see it?
[AGENT][NEUTRAL] OK, and make sure that you see the attachment and that you are able to.
[AGENT][NEUTRAL] Open the attachment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, critical illness claim form. OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and so all I have to do is have this form filled out. It's a section.
[AGENT][NEUTRAL] You know, the statement of insured, you'll, you'll complete that section and then there's an attending physician statement, you're.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Of course your physician will complete that part and then
[AGENT][NEUTRAL] I think that there is an authorization like if we needed to request medical records. Um, it's uh something for you to read, but at the bottom, it does require your signature, uh, your print your name, date, and, you know, if we needed to request, you're giving us permission to request medical records from your healthcare providers if needed.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I'm just looking at all this.
[CUSTOMER][NEUTRAL] All of this information, uh, the policy signature require relationship or person.
[CUSTOMER][NEUTRAL] All of that comes with, comes back to you.
[AGENT][NEUTRAL] Mhm. And so when you complete the, uh, statement of insured, you can fax that back to us and then your physician's office, they can send it to us themselves.
[CUSTOMER][NEUTRAL] OK, I see the instructions for the location.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, that's a lot of paperwork.
[AGENT][NEUTRAL] Yeah, it is.
[CUSTOMER][POSITIVE] A lot of people were, oh my goodness, oh my goodness.
[CUSTOMER][NEUTRAL] This is all for this form of um critical illness training from all of this.
[AGENT][NEUTRAL] Yeah, so that's what I was saying depending on what benefit you are submitting a claim for it'll specifically tell you what documents are required so um I believe that first one, let me go back to the form.
[AGENT][NEUTRAL] It says so the insured would complete the statement of insured which would be sections A through F as applicable to your claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It says that the following benefits require supporting documentation.
[AGENT][NEUTRAL] Um, the indicated documentation must accompany the completed statement of insured.
[AGENT][NEUTRAL] When filing a claim, so if you're filing for the critical illness benefit, um, it says provide medical records.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And the attending physician statement.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, and so if you, um.
[AGENT][NEUTRAL] Let's see what else
[CUSTOMER][NEUTRAL] OK, I will get
[CUSTOMER][NEGATIVE] I'm gonna have to get this all this cause I can't see it on, it's so small on the.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Yeah, on your phone.
[CUSTOMER][NEGATIVE] Uh oh I don't care about that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I maybe have to get my computer.
[CUSTOMER][NEUTRAL] Bring it up
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Critical in this claim.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, transplant. I didn't have a transplant on the idea.
[AGENT][NEUTRAL] You did?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, I, I have vascular disease and put a stent in.
[CUSTOMER][NEUTRAL] That's not transplanted.
[AGENT][NEUTRAL] Mm, it's not.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, now going to. OK.
[CUSTOMER][NEUTRAL] I just have to copy this off of the uh telephone onto something and then.
[AGENT][NEUTRAL] Yeah, they, yeah, they can print it from your phone to a printer.
[CUSTOMER][POSITIVE] Alright, alright, so finish. OK then, I thank you. I appreciate it. You just have to get.
[AGENT][POSITIVE] Oh, you're welcome.
[CUSTOMER][NEUTRAL] I'll just just copy off the phone and have it printed and then fill it out.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Thank you. Bye bye.
[AGENT][NEUTRAL] All right, Ms. Do you have any other questions?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Not at this moment. What, what is your name?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] That's right, you've seen it.
[CUSTOMER][NEUTRAL] It's to me over the phone. OK, tell me, uh, I'm gonna try to get this back to you as soon as I can. Uh, how long is it take for them to, uh,
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Process.
[CUSTOMER][NEUTRAL] How, let me, let me, let, let me ask you this. This has been
[CUSTOMER][NEUTRAL] This procedure was done 2 years ago.
[CUSTOMER][NEUTRAL] Can I still claim, can I still claim that too?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You can. There's no timely filing limit.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, alright.
[CUSTOMER][NEUTRAL] OK. Well, OK then that, that's all the questions that I have right now. Let me just have somebody to copy this off of the computer, off my phone onto the computer so I can get it printed out.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I get it back to you, OK?
[AGENT][NEUTRAL] OK. All right.
[CUSTOMER][POSITIVE] Oh, thank you, [PII]. Thank you, [PII].
[AGENT][POSITIVE] You're welcome. You're welcome and thanks for calling APLL. Have a good day.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] If I call back again, would I get you?
[AGENT][NEUTRAL] Um, our calls come through a queue, so anyone and, and you may get me or someone else, uh, we document our calls and so th[PII] would be able to assist if you want to speak with me, you can just ask to speak with me if you like.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh, OK, alright then.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you ma'am. Have a good day. Have a best day.
[AGENT][NEUTRAL] Are you
[AGENT][NEUTRAL] You too, [PII].
[CUSTOMER][NEUTRAL] And I
[CUSTOMER][POSITIVE] Hopefully talk to you later.
[AGENT][POSITIVE] OK. All right, [PII], thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, it's insurance.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Any other questions, Ms. [PII]? I think we're still connected.
[CUSTOMER][NEUTRAL] No, no, I walked away from the phone.
[CUSTOMER][NEUTRAL] Uh, that's all I hear. OK. All right, bye-bye.
[AGENT][POSITIVE] All right. Have a good day.
[CUSTOMER][NEUTRAL] I just