AccountId: 011433970860
ContactId: 3d44d667-8161-469a-bd7b-e158f9c0ce40
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 678479 ms
Total Talk Time (AGENT): 439628 ms
Total Talk Time (CUSTOMER): 248111 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/3d44d667-8161-469a-bd7b-e158f9c0ce40_20250128T16:31_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Yes, my name is [PII], and I think I have insurance with you all because I know I was just looking on my check stub and I seen that it was coming out. Could you tell me what do I have with you all please?
[AGENT][POSITIVE] Yeah, I'd love to look that up for you today, and Ms. [PII], do you mind real quick if I snag a quick callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] We did my number come up on there?
[AGENT][NEUTRAL] Is it the [PII], is that a good number?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] Perfect awesome and then.
[AGENT][NEUTRAL] I can, I can search for a policy with us using your social if you'd like, ma'am.
[CUSTOMER][NEUTRAL] OK, uh, [PII].
[AGENT][NEUTRAL] All right, [PII], I believe I found you. Would you be able to verify some information with me?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Awesome, would you be able to verify your, your date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Wonderful and then if you could also go ahead and verify for me please just your mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Wonderful. Thank you so much. I appreciate that. So I do see with us it looks like you have one policy, and it is a uh critical illness policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, what do they insist of, you know what? I didn't even know I had that. I know I've just looked at my uh my text and it was coming out, so.
[AGENT][NEUTRAL] Yeah, let me pull it up, so.
[CUSTOMER][NEUTRAL] OK, let me check and see, OK.
[AGENT][NEUTRAL] I will, I do want to let you know any benefit information I give you over the phone today or um coverage information is always just a verification of coverage and never guarantee a payment.
[AGENT][NEUTRAL] And all right, so what this policy is, is it has one benefit that you can get on a reoccurring basis. That's gonna be your health screening and mammogram um benefit. It looks like your
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Your for those wellness benefits either one of them um can get you up to $50 a year. So if you go in regularly for like um a mammogram or a health screening um like just a wellness screening, you can submit that and get a $50 benefit and then it has a list of, oh, I'm sorry.
[CUSTOMER][NEUTRAL] How
[CUSTOMER][NEUTRAL] What I'm sorry, uh, when, when I submit that, how much is that? Well, I know the mammogram is what, $50?
[AGENT][NEUTRAL] Yep, um, either a health screening or a mammogram, whichever one you, um, you wanna make use of, they're both $50 and you can do either one once a year.
[CUSTOMER][NEGATIVE] OK, now, like how many years can I go back and submit this because I'm just realizing that I have this I could have been using this.
[AGENT][NEUTRAL] Yes, so it looks like your policy started with us [PII]. So if you have any routine health, physicals, a wellness test or anything like that in the last couple of months of [PII], um, submit that you can submit anything for [PII] as well.
[CUSTOMER][NEUTRAL] OK, OK, and, uh, [PII] also?
[AGENT][NEUTRAL] [PII] you're current and active so if you've done anything in [PII] absolutely and then I'm looking on this the mammogram portion of it's every two years, but you can always um you I mean if you're going just even your wellness check at your doctor where you go in and they're like, hey, good to see you and then you leave um that can have benefits on it. So just a routine physical exam from your doctor would count on the alternating years of your mammograms.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, now I've seen on here I've seen a form or something like this do uh uh doctor have to sign it or I can just put the date on there that I went there or what?
[AGENT][NEUTRAL] For the wellness benefit all you have to do is um like let us know what date you went what screening or exam you had done and the location and the like the location and the phone number and that's it like you don't have to submit any paperwork.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, OK, let me see. OK, what do I do? Just call you all?
[AGENT][NEUTRAL] So we have a form I can send you, but you can also um if you feel.
[CUSTOMER][NEUTRAL] I have a, I printed, I printed the, uh, the wellness, uh, claim form out. I clean, I printed that and I also have the, uh, critical form that I had filled out. I mean that, uh, I have that.
[AGENT][NEUTRAL] Oh,
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] So that wellness one you can just fill it out and if you want you can fax it to us or you can mail it to us.
[CUSTOMER][NEUTRAL] OK, what is your, OK, your fax is [PII]?
[AGENT][NEUTRAL] Yep.
[AGENT][NEUTRAL] You betcha.
[CUSTOMER][NEUTRAL] OK, OK, OK, alright, now let me see, do I get a clear understanding that I know about the mammogram you said like this every 2 years, right? So if I went.
[AGENT][NEUTRAL] For the mammogram in particular, every two years, but on the years that are off sending, so say you had a mammogram in [PII], in [PII], you can just use your routine wellness check with your doctor, and then in [PII] the mammogram would be eligible again.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, OK, I got you, OK.
[AGENT][NEUTRAL] And then do you want me to tell you about the um the covered conditions on your critical illness if you get diagnosed with one of these conditions, they have that lump sum payout.
[CUSTOMER][NEUTRAL] OK. I think I've seen something on here like uh like if I uh if I went to like to the doctor or something like for an eye exam or something like that, is that covered under that?
[AGENT][NEUTRAL] I don't think so, no, um, but it does have.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see if there's anything for eyes. It's um.
[AGENT][NEUTRAL] It's gonna cover you like if you have complete loss of sight, um, you could have like benefits payable or if you get like
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Loss of speech or complete loss of hearing or a heart attack or invasive cancer. So it just has a list of like, I mean, I wanna say a handful, but it's
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Almost 20, maybe 16, 12.
[AGENT][NEUTRAL] 78911 1213 14.
[AGENT][NEUTRAL] 21 different um diagnoses uh that are considered critical illness. And if you're diagnosed with one of those conditions, um, it, it's a, it looks like a lump sum payment on this benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, OK, let me see if I get this correctly now before I hang up now with the uh with the mammogram that if I went in [PII] and had a mammogram.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. OK, so I couldn't submit one for 24, right?
[AGENT][NEUTRAL] Nope, but you could submit another well.
[CUSTOMER][MIXED] OK, but but wellness, but I can't do a wellness.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, you could do a different wellness so like um what it does is it lets you alternate so it has the health screening and the mammogram both listed um you can only claim one of them per year, whether it's the health screening or the mammogram, and it seems like the mammogram you can only do every other year. So on the years that you can't claim the mammogram, you can still claim that other health screening. And with that one, it lists those benefits as a wellness test.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, which could be like a Pap smear. Um, it could be your blood tests that you do when you get like routine blood work done at your doctor. It could be just a routine physical exam or any additional medically accepted screening test received as an outpatient. So, um, it, it seems pretty open as far as that. So if you are in an offsetting year where you can't use your mammogram, it seems like you have a plethora of other options to still redeem that benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me tell you this right here. OK, I could, OK, I have it for the mammogram and also, uh, just say for instance I couldn't use, uh, I'm gonna go use the mammogram for [PII]. OK, for [PII] I can do the weather check or could, uh, for [PII], right?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and then like if I have a blood drawn, which I have that blown when I go uh go to the doctor, so I can use that for one of them.
[AGENT][POSITIVE] Yes you can you can only do one for calendar year whether it's a health screening or a mammogram so you can just pick and you can alternate them out or if you never wanted to put in a mammogram and every year you put in a different health screening, um, you're gonna be eligible that way too.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Um, and I think they have it spent like that, so if you're a gentleman, um, and you might not have a mammogram, you can still get benefits, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Um, whatever you want to submit for [PII], just make sure your date of service was after [PII] because that's when your policy started with us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] After September, after September the what baby?
[AGENT][NEUTRAL] [PII] is when you started with us.
[CUSTOMER][NEUTRAL] OK, OK, OK.
[CUSTOMER][POSITIVE] All right, I think I got it.
[AGENT][POSITIVE] Perfect, is there anything else I can do to answer some questions for you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, ma'am, I think that's it. Did, uh, did I ever get a, uh, a policy or anything on that? Do I need a policy or anything on that?
[AGENT][NEUTRAL] So I have um.
[AGENT][NEUTRAL] Some policy documents. I can, if you, if you need them, if you don't have them, I can email them to you and they'll just tell you about all your benefits. Would you like that?
[CUSTOMER][NEUTRAL] OK, it
[CUSTOMER][POSITIVE] Yes ma'am, yes ma'am.
[AGENT][NEUTRAL] OK perfect let me go um and would you just verify your email address for me so I know they go to the right place.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Perfect. Alright, I do have that listed and I will go ahead. The subject line is just gonna say APL policy cert, which is short for certificate, and um I'll get that sent out to you. Have you ever used our online service center, Ms. [PII]? Is that something you'd be interested in getting information on?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No ma'am.
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] Um, OK, if you, if
[CUSTOMER][NEUTRAL] I'm not sure if I know how to do it.
[AGENT][NEUTRAL] That's OK. um, if you ever want to, you can like upload all your claims through the service center, change your payment information.
[AGENT][POSITIVE] Um, it's just kind of an online portal so you can access all your information, um, but they also allow you to do the wellness claim form on there really simple and easy without filling out that paper, um, and so if you want I can email you out a guide and that way if it's something you're just bored one day and you wanna try to tackle it, um, you'd have a step by step guide on how to set it up and then how to use all the functions in it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, you can do that yes ma'am.
[AGENT][POSITIVE] Perfect. I'll include that in that policy certificate I sent you so it'll just be right there in that one email, OK?
[CUSTOMER][POSITIVE] OK all right thank you.
[AGENT][POSITIVE] Hey, it's my pleasure and is there anything else I can do to take care of you, my friend?
[CUSTOMER][POSITIVE] No ma'am, I think that's it I appreciate you so much.
[AGENT][POSITIVE] Hey, it's my pleasure thank you so much for calling APL and I just hope you have a fabulous day.
[CUSTOMER][POSITIVE] Thank you. Have a good one. Yes, ma'am. Bye-bye.
[AGENT][POSITIVE] My pleasure thank you.