AccountId: 011433970860
ContactId: 54fe0b4b-5bc1-4bb4-acb7-49d5fd31d882
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 492700 ms
Total Talk Time (AGENT): 225453 ms
Total Talk Time (CUSTOMER): 178456 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/54fe0b4b-5bc1-4bb4-acb7-49d5fd31d882_20250116T22:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, hi [PII]. I, I've got a question for you. I, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I, I've got a cancer claim because I have renal cancer. But I also have um colorectal cancer. Now, do I get an initial claim for each of those?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] When you say a claim,
[CUSTOMER][NEUTRAL] There're two separate cancers.
[AGENT][NEUTRAL] When you say a claim, uh, do you mean the benefit that's like a first time occurrence?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The lump sum benefit is that what you mean?
[CUSTOMER][NEUTRAL] Right, yeah, the first time occurrence.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yeah, let me take a look. Um, let me get your policy pulled up, we'll see. Uh, I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] [PII], yeah.
[CUSTOMER][POSITIVE] And I can get you my policy number, yeah.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, um, first, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] 7138767888
[AGENT][NEUTRAL] OK, thank you, and then yes, I'll go ahead and take that policy number.
[CUSTOMER][NEUTRAL] Uh, it's 253-224-4.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] And by the way, I want to upload uh my my my thing for the month of December and they would only take one at a time. They wouldn't take them all. I had to, I had to do them one at a time.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, sometimes there's a file limit or a uh size limit for the online portal, but that's OK. I do, OK, yeah, we can look at that, um, I'm gonna verify some information really quick, [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect, last thing I need is the email address that we've got on file for you.
[CUSTOMER][NEUTRAL] I think, I think it's my work. It's
[AGENT][NEUTRAL] It looks like it's through an organization yeah it does look like it's through an employer.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][POSITIVE] Perfect.org, yes ma'am. OK, thank you for verifying that.
[AGENT][NEUTRAL] Alright, bear with me just a moment. Let me get the policy pulled up here, but I do see where we've received several pieces of claim information today, um, so that it is currently in line for processing.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right. No, but my question was, um, uh, the, the cancer policy, OK? First time occurrence. Is it first time occurrence cancer anywhere in your body or is it like, I've got two different types of cancer that it hasn't metastasized or anything. So, my question is,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Have you received the initial lump sum?
[CUSTOMER][NEUTRAL] My question is, is the
[CUSTOMER][NEUTRAL] I have.
[AGENT][NEUTRAL] Yeah, OK, so I believe, and I'm going to get it pulled up just to make sure, um, cause you know, they're all different, you never know um but from what I understand is the first occurrence is going to be, that's it, that's extended so just the first time you are diagnosed with any kind of cancer.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Excuse me, OK.
[CUSTOMER][NEUTRAL] OK. Yeah, cause my husband's cancer policy pays out for each cancer.
[AGENT][NEUTRAL] I see, OK, so again I will verify that let me.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Internal cancer first occurrence.
[AGENT][NEUTRAL] Alright, bear with me just a moment, OK?
[CUSTOMER][NEUTRAL] No, no, it's no problem. It was like I said, it was just a question.
[AGENT][POSITIVE] Right, yes, but I wanna make sure that I get the correct answer for you.
[CUSTOMER][POSITIVE] Yeah, I appreciate that.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] OK, yes. So it does explicitly say only one first occurrence benefit for internal cancer is payable per covered person per lifetime. Um, so that is for the cancer. Now, you also, just so that you are aware, you do have a, a first occurrence benefit for a heart attack or stroke as well, and that is a separate benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[AGENT][POSITIVE] OK, just so that you are aware if you'd like [PII], I can send you a copy of this policy, um, it is very easy to read, um, it's not just a bunch of jargon, uh, but it does go through all of that kind of finer details.
[CUSTOMER][NEUTRAL] Right, right, right.
[CUSTOMER][NEUTRAL] OK. Um, no, I think that, I, I, I've got a copy on my phone.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, OK.
[CUSTOMER][POSITIVE] OK. I, I, I appreciate it. um.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so I'm just sending my uh my oncology reports to you. That is the appropriate thing to do, right? I mean.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I just do it once a month.
[AGENT][POSITIVE] Yeah, that's perfectly fine.
[CUSTOMER][POSITIVE] OK. All right, awesome, um.
[AGENT][POSITIVE] Yeah, whenever is convenient for you.
[CUSTOMER][NEGATIVE] Right. OK. So, I know right now I'm getting, I'm getting for my nausea medicine.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because that's part of the claim too.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, but I think, have I maxed out my chemo?
[AGENT][NEUTRAL] Oh, let's take a look.
[AGENT][NEUTRAL] Oh, let me see how it.
[AGENT][NEUTRAL] Let me see the rate because I don't think this is on a.
[CUSTOMER][NEUTRAL] It's 15, it's 15,000.
[AGENT][NEUTRAL] Right, I don't think this is a most of the time they're not per calendar year. I think they're.
[AGENT][NEUTRAL] From the time that you begin.
[CUSTOMER][NEUTRAL] Yeah, no, no, they're not calendar year.
[CUSTOMER][NEUTRAL] Right, right, right. Uh, it is, it goes from September to September.
[AGENT][NEUTRAL] OK, so let me
[AGENT][NEUTRAL] September. OK. All right, let's take, hm, let's see.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I think I probably maxed it out.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I do see I just looked for the year yeah that's just for [PII] though OK I think what I'll have to do is look at.
[AGENT][NEUTRAL] Each claim
[AGENT][NEUTRAL] Because it only lets me.
[CUSTOMER][NEUTRAL] That's all right. But you know what? I, I put the key I mean the chemo's in this one too, so when you guys um process it all, um, there'll be an explanation.
[AGENT][NEUTRAL] Look at
[AGENT][NEUTRAL] Oh yeah, we'll definitely be able to see then um but I think it resets I know it resets yearly, but I know it's from the first time you got treatment, so the first time you actually got radiation or chemo, um.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So I'm gonna see when that was because I just put in last it lets me do like a calendar year so as for [PII] I see the chemo benefit was 14 we paid $14,346 but that doesn't necessarily mean you know that could reset really soon.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, yeah, then I guess I just have like another $600 on that because it's $15,000.
[CUSTOMER][NEUTRAL] That was for the for the [PII] correct?
[AGENT][NEUTRAL] That's for all of [PII], yes.
[CUSTOMER][NEUTRAL] Right, right, OK, yeah, so that's.
[AGENT][NEUTRAL] OK, yeah, I do see the policy's effective date was September. You're right. OK, sorry.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So we're, we're looking at like another $600 or something.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Yeah, OK, all right, thank you very much I appreciate your help.
[AGENT][NEUTRAL] Of course, yeah, was there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that was it. Thank you.
[AGENT][POSITIVE] OK, yeah, thanks for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.