AccountId: 011433970860
ContactId: 4b0c3636-a4e8-4559-ad13-0e7d103cb2af
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1075829 ms
Total Talk Time (AGENT): 469384 ms
Total Talk Time (CUSTOMER): 429696 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/4b0c3636-a4e8-4559-ad13-0e7d103cb2af_20250505T13:08_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, uh, yes, ma'am. I'm [PII].
[CUSTOMER][NEUTRAL] Do you need my policy number?
[AGENT][NEUTRAL] Um, yes, ma'am, and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK, uh, contact number is [PII].
[CUSTOMER][NEUTRAL] And my policy number is 72.
[CUSTOMER][NEUTRAL] 668 8
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And I have you here and I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][NEUTRAL] And then just your email.
[CUSTOMER][NEUTRAL] Uh, it may have changed since this, um, [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. It's changed since I've had this. I don't know if I've updated it or not.
[AGENT][NEUTRAL] Um, yes, this is the same your, so your name [PII].
[AGENT][NEUTRAL] That's what's on here.
[CUSTOMER][NEUTRAL] Uh, no, no, no, no, no, it's, oh, OK, no, ma'am, it's, it's the [PII]
[AGENT][NEUTRAL] Let me change it.
[CUSTOMER][NEUTRAL] Yes ma'am please if that one's no longer good.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's uh [PII], OK, I'm sorry, [PII]
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I've updated the email address for you, and then how may I help you today?
[CUSTOMER][NEUTRAL] OK, well, I was hoping I'd never have to use my.
[CUSTOMER][NEUTRAL] Cancer policy?
[CUSTOMER][NEUTRAL] But um I have been um diagnosed with breast cancer and I just kinda need somebody to help me what I need to do to file, you know, a few little claims.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Or what plans are available or whatever I guess I just like I said I was hoping I'd never have to use this.
[AGENT][POSITIVE] Well, I'm glad that you have it. I know you don't, you know, we, we never want to have to use it, but I'm glad you have it here just in case. So you just really want to know how the policy works.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Yeah I guess so, yes, ma'am. I guess that would be definitely a start.
[AGENT][NEUTRAL] OK, hold on one moment, let me pull your policy um benefits.
[CUSTOMER][NEUTRAL] I mean, I've tried reading but I.
[CUSTOMER][NEUTRAL] I didn't understand some of it.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] That's what we're here for. Hold on one moment, it's coming up now.
[CUSTOMER][NEUTRAL] Yes ma'am, and I will be going to [PII]. I have my first appointment that.
[CUSTOMER][NEUTRAL] [PII] or [PII].
[CUSTOMER][NEUTRAL] That whole week for um.
[CUSTOMER][NEUTRAL] You know, test and
[CUSTOMER][NEUTRAL] Um, talking to them about different things and treatment and da da da da da what you're gonna do.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So let me see. So,
[AGENT][NEUTRAL] Your policy covers um
[AGENT][NEUTRAL] If you ever have to be confined to a hospital, um, it'll pay up to $200 a day for the 1st 30 days and then $400 a day after the 30 days. Um, you do have drug and medicine coverage, um, surgical coverage. Um, if they, if they do give an opinion or, you know, suggest that surgery is needed, you do have a 2nd and 3rd opinion.
[AGENT][NEUTRAL] Um, benefit. So that, uh, $300 per diagnosis of cancer for the second opinion and then an additional $300 for the third opinion if uh.
[AGENT][NEUTRAL] If a third opinion is, is required. Um, you do have the anesthesia benefit, um,
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Hair prosthesis, blood plasma, um, and platelets benefit for your labs, um, radiation therapy, chemotherapy, or immunotherapy, the policy will pay up to $15,000 towards those um therapies per year.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Then you have like the um ambulance, you have transportation. So if you from your home to the treatment facilities, if it's 50 miles or more, um, you can file for transportation, it will pay up to 50 cents per mile. Um, the max one trip will pay out is $1500 and um the policy will pay up to 12 round trips per year. There's also lodging.
[AGENT][NEUTRAL] Um, and that's for you and a family member as well. Um, like if someone was, if you needed this and someone was to go with you, they do have coverage too that they can file for, um, for a family member.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And what and how much is that now for uh.
[AGENT][NEUTRAL] For the family member?
[CUSTOMER][NEUTRAL] For a hotel, how much?
[CUSTOMER][NEUTRAL] For my, well, I mean, well, will it take like if I'm, I'm going there for my first appointment, you know, that whole week I'll be doing an appoint um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Testing, talking about the treatments and the options and whatnot. Now, does it cover anything like that or I have to actually be in treat, treat in the hospital or treatment or something?
[AGENT][NEUTRAL] Yes, for the transportation and the lodging you, um, it has to be for treatment.
[CUSTOMER][NEGATIVE] Oh, OK. Well, that's a bummer.
[CUSTOMER][NEUTRAL] So that's a long ways. OK. I'm going to [PII].
[CUSTOMER][NEUTRAL] And I'm in [PII].
[CUSTOMER][NEUTRAL] So I have to be in treatment, you mean like chemo or, or radio, I'm not sure what defines treatment.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So for like you would need, so from your house to the center that you receive chemotherapy or radiation therapy, like it has to be
[AGENT][NEUTRAL] Some type of treatment that you're receiving at that location for the mileage to go into effect.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, OK, good grief, that's OK, all right.
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Um, hold on one moment. I'm going back to the benefits.
[AGENT][NEUTRAL] Um, so then you have like your home healthcare if it's ever needed, um, diagnostic and prevention, um.
[AGENT][NEUTRAL] If there's any follow-up tests that were required after a cancer screening, the policy will pay up to $60 per year for the follow-up testing.
[AGENT][NEUTRAL] Um, if any physical or speech therapy is needed, you have coverage for that and then also medical imaging. Um, the policy will pay up to $200 per image with a max of 2 per calendar year.
[CUSTOMER][NEUTRAL] And these are after, after the cancer treatments.
[AGENT][NEUTRAL] The like the imaging.
[CUSTOMER][NEUTRAL] I said I've had one at
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] Let me see if it specifies on one moment.
[CUSTOMER][NEUTRAL] I mean I thought I thought there was something there that.
[CUSTOMER][NEUTRAL] Uh, the, um, when you get an abnormal.
[CUSTOMER][NEUTRAL] Test
[CUSTOMER][NEUTRAL] I thought you I thought that was something first before you even.
[CUSTOMER][NEUTRAL] I mean when you find out I thought there was something in there for that.
[AGENT][NEUTRAL] Let me double check and see if you have a first occurrence, um,
[AGENT][NEUTRAL] But the medical imaging on this policy is limited to MRI, CT scan, CAT scan, or PET scan when performed due to cancer or treatment of cancer.
[AGENT][NEUTRAL] So it's after the diagnosis for the imaging.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] And let me, I did not see one, but let me double check for, um, it sounds like what you're describing is like a first occurrence benefit. So if there's like a positive diagnosis, the policy will pay like a lump sum.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Uh, well, our
[CUSTOMER][NEUTRAL] Or something, I mean not necessarily a.
[CUSTOMER][NEUTRAL] I don't know what I don't, I see, I don't, I don't know a thing about, I don't even know what I had.
[AGENT][NEUTRAL] Hm let me see.
[AGENT][NEUTRAL] Oh no, it's OK. I'm, I'm looking through it. Um, hold on.
[AGENT][NEUTRAL] Yeah, I'm now for this policy, I'm not showing the first occurrence or like it.
[AGENT][NEUTRAL] For us, it's called the first occurrence benefit. If there is a positive diagnosis, it would pay something towards, you know, we have an amount that it would pay to you.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] All right, did you need a copy of your um policy certificate?
[CUSTOMER][NEUTRAL] Um, I don't, I don't, yeah, um.
[CUSTOMER][NEUTRAL] I probably have it somewhere, but it's, I've had this thing for no telling how long.
[AGENT][NEUTRAL] Since [PII].
[CUSTOMER][NEUTRAL] Uh, I don't even know when I got it.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] a long time.
[AGENT][NEUTRAL] Yes, it's a very long time.
[CUSTOMER][NEUTRAL] Oh yeah, [PII].
[AGENT][NEUTRAL] Well, I can um email you a copy if you like.
[CUSTOMER][MIXED] Uh, I, I guess that'll be fine, but I'm just a little disappointed, but I was kinda hoping it would help me with my mileage going to [PII], um.
[CUSTOMER][NEUTRAL] You know, uh, I mean, I know I'm gonna have to go back and it'll help then. Um, now that you say it has to be treatment, I understand, but for surgery too though, right?
[AGENT][NEUTRAL] For the mileage, let me see.
[CUSTOMER][NEUTRAL] That it, it will.
[AGENT][NEUTRAL] You're saying does it cover like if you were to go for a surgery versus like a treatment?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] Yes, surgery as well.
[CUSTOMER][NEUTRAL] OK, and search, OK, because I know I'll probably have to go back. Well, actually, I'm hoping I get there and they say, oh, it's gone.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] All right, well, this is not really what I, I mean I like I said, I was never wanting to use it.
[CUSTOMER][MIXED] But I knew it would be there when I guess I just, I guess I just thought it was more to it to have been paying this long. I guess I didn't understand it when I got it. That's my fault. It just doesn't seem like it pays a lot, but, uh, but it will come in handy when I do have to go back. I was hoping it would help with this trip because we're going to be there a week doing all tests and everything. Um.
[CUSTOMER][NEUTRAL] And talking to the uh surgeon and the oncology or whatever you call them.
[CUSTOMER][NEUTRAL] Uh, so,
[AGENT][NEGATIVE] Yeah, I wish I had better news for you. I'm sorry.
[CUSTOMER][NEUTRAL] Oh well, just send it to me I guess.
[CUSTOMER][NEUTRAL] Yes, ma'am. Let's say now, uh, the De didn't answer, I don't think about the lodging. Now that is when I'm in the hospital, right? Or what, what's the, now what was the deal with that?
[CUSTOMER][NEUTRAL] Um, the lodging.
[AGENT][NEUTRAL] With lodging?
[CUSTOMER][NEUTRAL] With a lot, you know, uh, yeah, the hotels and stuff.
[AGENT][NEUTRAL] So you have
[AGENT][NEUTRAL] So you have um the same lodging and transportation benefit you have for yourself, you have it for a family member also for um and it doesn't have, it's just one adult family member, um, but like it can be if you need lodging or if you're in the hospital and they need lodging or, you know, or you both need lodging as long as it, it just has to be in relation to treatment or surgery being received.
[CUSTOMER][NEUTRAL] OK. And how much does that pay a night?
[AGENT][NEUTRAL] Um, hold on one second.
[AGENT][NEUTRAL] It's $60 per day, up to 90 days per calendar year.
[CUSTOMER][NEUTRAL] $60. The places are $300 apiece a night.
[AGENT][POSITIVE] Wow
[CUSTOMER][NEGATIVE] That's crazy, isn't it, but this must not updated that it must not update any to the current.
[CUSTOMER][NEUTRAL] A comedy.
[AGENT][NEUTRAL] Oh, right. I don't, I don't know about that.
[CUSTOMER][NEGATIVE] Oh my gosh, that is horrible.
[CUSTOMER][NEGATIVE] You can't, you can't find a place for that.
[CUSTOMER][NEUTRAL] OK, all right. Just send it to me please, ma'am, and.
[CUSTOMER][NEUTRAL] I'll see what I'm gonna do.
[AGENT][NEUTRAL] I sure will send it to your email, um, and Ms. [PII], was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, well, uh, well, I guess so when I get ready to file.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, my second time going over there for the surgery. Now, just, I guess it's.
[CUSTOMER][NEUTRAL] Just pull it up and it'll kind of tell me what I need or what will I need for that receipts or.
[CUSTOMER][NEUTRAL] Or just the mileage or how do, how do you, how do we do?
[AGENT][NEUTRAL] So the easiest thing to do would be to, when you go to the facility and they ask you for your insurance information, just give them this um policy number and our phone number, let them know that you have an additional cancer policy.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The.
[AGENT][NEUTRAL] And they would uh give us a call and verify the benefits and then they'll go ahead and bill your other insurances and then they will automatically bill us um or you can file the claims on your own, um, it's up to you.
[CUSTOMER][NEUTRAL] OK, so,
[CUSTOMER][NEUTRAL] OK, well, I mean if they were, I'm talking about like transportation. I mean they don't do that, do they?
[CUSTOMER][NEUTRAL] On lodging?
[AGENT][NEUTRAL] Well, I mean, so to file, so how you get paid for it is filing the claim, so they could file the claim and on their letterhead, you know, on their bill or whatever documents they're sending, it shows the, the facility, the address.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][POSITIVE] Oh, OK, and you have my address I understand. OK, and you already have my address so you know where I'm coming from and then then I'll just do the mileage or whatever. Oh, that'd be wonderful.
[AGENT][NEUTRAL] Right. Mhm.
[CUSTOMER][POSITIVE] OK. Yeah, one positive thing out of the whole thing. How about that?
[AGENT][NEUTRAL] Oh my
[AGENT][POSITIVE] So that would definitely take some off of you. So that's the one less thing you'll have to do.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, OK, now what policy should I have gotten to have that?
[CUSTOMER][NEUTRAL] That first occurrence or something, cause I mean, I work at a school and they come once a year to talk to us about this and I want to be able to tell other people that don't be get, getting this because it doesn't seem like it's that.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] That good
[CUSTOMER][NEUTRAL] You know, so what policy should they have gotten or should I have gotten, I guess, or something so I can tell somebody to be careful when they do, if they do decide on this particular.
[CUSTOMER][NEGATIVE] Um, insurance that they, they need to be aware that some of the stuff's not, it's, it's just not that good. So what do I need to tell people?
[AGENT][NEUTRAL] Well, it depends.
[AGENT][NEUTRAL] So it depends, it depends because your policy, you've had this policy since [PII], so I don't even know if they're offering this type of policy anymore. Um, so we need to see what policies are out, you know, that your job is offering to be elected from now and then if they offer the first occurrence benefit, most of our policies do offer them now, so I don't.
[AGENT][NEUTRAL] I mean, it could be a thing of now if you can, when open enrollment comes, see if you can upgrade your policy. Um, I mean, there's, there's a lot of different options.
[CUSTOMER][NEUTRAL] Well now it's kind of late for all that.
[CUSTOMER][NEUTRAL] Yeah, kind of late for all that. Um, OK, I just want to know what to tell people because I don't want them to, to be like me thinking that they're gonna have some help if they have to use it and they're not really getting that much help. So I was just curious what to tell them.
[AGENT][NEUTRAL] Yeah, it's
[AGENT][NEUTRAL] Yes, ma'am. It, it definitely depends on what what they have.
[CUSTOMER][POSITIVE] Right, OK. Alrighty then, well thank you so much. You have helped me a lot.
[AGENT][POSITIVE] You're welcome, Ms. [PII]. Well, thank you so much for calling APL. Was there anything else I can help with?
[CUSTOMER][POSITIVE] Oh no, ma'am. That, that's uh that's OK. Thank you.
[AGENT][POSITIVE] All right. Well, I hope you have a good day. You're welcome.
[CUSTOMER][NEUTRAL] Yes ma'am bye bye.
[AGENT][NEUTRAL] Bye bye.