AccountId: 011433970860
ContactId: 4ddcd77d-5452-4fd7-89f7-eae96c0adf77
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 356570 ms
Total Talk Time (AGENT): 140851 ms
Total Talk Time (CUSTOMER): 156773 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/4ddcd77d-5452-4fd7-89f7-eae96c0adf77_20250512T21:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][NEUTRAL] Hey Ms. [PII], it's [PII]. How are you doing today?
[AGENT][POSITIVE] Doing well, [PII], thank you. How are you?
[CUSTOMER][NEUTRAL] I feel like I need a nap, but.
[AGENT][NEUTRAL] Yep, Monday.
[CUSTOMER][NEUTRAL] It is, um, but I have an insured sister on the phone. Apparently, she had sent an email today, um, and looks like [PII] put a note in the system. Her brother had passed away in April from a heart attack. And [PII] sent her, or she was sent the claim form along with, um, tell her we need medical records. But she is saying that he died at home from a heart attack and
[CUSTOMER][NEUTRAL] As far as records she can see for him, uh, it's only for.
[CUSTOMER][NEUTRAL] A clinic, so she didn't, she wasn't, she said she wasn't sure what information we would need to file a claim for heart attack.
[AGENT][NEUTRAL] OK, so that's like a critical illness policy, right? You're saying?
[CUSTOMER][NEUTRAL] Even though and it states she said it's.
[CUSTOMER][NEUTRAL] Um, well, he has a cancer policy, but, um, let me see. She said he had a heart attack rider, but let me double check.
[AGENT][NEUTRAL] What's the
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And he, well, he does have a critical illness rider.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The policy number 21583887.
[AGENT][NEUTRAL] For [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so she's questioning whether what she can send or?
[CUSTOMER][NEUTRAL] Right, she's want to know what information she can send but she said that she um well no it looks like [PII] put that the death certificate was received and she sent the customer service, um.
[CUSTOMER][NEUTRAL] And it's, and I was wondering because it states on the death certificate he died of a heart attack, what other information would we need?
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Let me pull up that claim form, just bear with me for just a moment.
[AGENT][NEUTRAL] So it's a critical illness and not uh.
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] Because even though it's a rider, it's still going to require that critical illness claim form.
[CUSTOMER][NEUTRAL] So he
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So if she can't get the medical records, then I would assume that we would need a completed attending physician statement. And since he was, he passed away at home, that would then fall to, I believe, the medical examiner or she would have to get maybe his primary care doctor or somebody to provide us that information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] But with she would need the, the cancer claim form. She would need to clear the Lord words or critical illness form, correct?
[AGENT][NEUTRAL] Right, because even though it's a cancer policy, if she's wanting to file that claim under the critical illness writer, it would then fall to the critical illness because the cancer claim form is gonna be specific to that cancer, you know, information, whereas the critical illness is, is the benefit that we're needing. So then it does, it does state on the critical illness benefit that needing to provide medical records and the completed attending physician statement.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Exactly, right.
[AGENT][NEUTRAL] Um, and the critical illness benefit may include the first time diagnosis, additional or reoccurrence, um.
[AGENT][NEUTRAL] So yeah, like I said, if he passed away at home, then she would either need to get with the medical examiner's office to complete that or like I said, uh, um,
[AGENT][NEUTRAL] Maybe possibly a PCP.
[CUSTOMER][NEUTRAL] You attendant physician.
[AGENT][NEUTRAL] Yeah, that attending physician form uh huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome. Well, I can definitely tell her that and send her the correct form. I'm assuming at least you just send her a cancer claim form. It's from the way it sounds, but OK.
[AGENT][NEUTRAL] Yeah, you can just kind of double check with her and see what form she received, but yeah, I would think that um we would definitely need that critical illness claim form if that's the benefit that we are looking at.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome sauce. Thank you, madam. I appreciate you.
[AGENT][NEUTRAL] You're welcome. Did you have any other questions?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] All right. Thank you. Have a great day.
[AGENT][NEUTRAL] OK. You too, not too much longer, right?
[CUSTOMER][NEUTRAL] Not too much longer. And I was supposed to go to the gym tonight, but I think I might just take a uh take a nap.
[AGENT][NEUTRAL] I hear that.
[CUSTOMER][NEUTRAL] Really don't, he don't need to go to bed anytime soon. Uh, they're almost out of school, so it's not like he has homework or anything, you know.
[AGENT][NEUTRAL] Yeah, yeah. It's getting to be that time of year.
[CUSTOMER][POSITIVE] Yeah, and I gotta finish registering uh him for next year. Yay, it's gonna be fine.
[CUSTOMER][POSITIVE] Can't wait for middle school.
[AGENT][POSITIVE] Yeah. Good luck with that, hon.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] I know. I appreciate you. Have a great one.
[AGENT][POSITIVE] You too thank you [PII].
[CUSTOMER][POSITIVE] Bye. You're welcome.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Bye bye.