AccountId: 011433970860
ContactId: 55efcb5d-36a0-4004-8def-071ea6324a25
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 502079 ms
Total Talk Time (AGENT): 270605 ms
Total Talk Time (CUSTOMER): 169629 ms
Interruptions: 1
Overall Sentiment: AGENT=2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/55efcb5d-36a0-4004-8def-071ea6324a25_20250103T15:10_UTC.wav
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[AGENT][NEUTRAL] Hi, thanks for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hey [PII], um, I have one of the hospital indemnity policies to my employer, and I don't have like my policy number or anything like that, but I needed to see if I was filing a claim.
[AGENT][POSITIVE] OK, yeah, absolutely. Um, I can help look up that policy for you with your social.
[CUSTOMER][NEUTRAL] OK, let me know when you're ready.
[AGENT][POSITIVE] All right, and I am ready for you, my friend.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] And your first and last name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Ms. [PII], could you verify for me your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Wonderful, thank you so much and.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm just gonna verify a little bit. I cannot talk today. I'm so sorry, a little more information with you if you could verify for me your mailing address.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Wonderful and then just the email and phone number on file if you can please.
[CUSTOMER][NEUTRAL] Um, [PII] and it's [PII].
[AGENT][NEUTRAL] Alright and it looks like the email I have might be a professional one.
[CUSTOMER][NEUTRAL] OK, it's either um we just got a new email, so it's either gonna be [PII] or it's gonna be [PII].
[AGENT][POSITIVE] OK, perfect. It was that 2nd 1, and then thank you so much, Ms. [PII]. So.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I am
[AGENT][NEUTRAL] Looking at this policy, it looks like.
[AGENT][POSITIVE] Let me see, I'm so sorry.
[AGENT][NEUTRAL] Alright, it looks like the policy is no longer active, so the only way we'd be able to take a claim would be from mail or fax, and I can give you the mailing address or the.
[CUSTOMER][NEUTRAL] OK, wait, I just, I just have, I wait, I just have a question like this policy apparently like this policy was active in [PII] and that's when the hospitalization occurred on [PII] and then now it looks like we have a different provider, like a different carrier. I think now we have an Allstate policy.
[AGENT][NEUTRAL] Yes, so, um, you, you're still welcome to file claims as long as you were covered during the time or the incident, the date of service you were in the hospital, so absolutely you still have coverage. I just can't have you create an online portal to submit claims, but you can still submit them through your through fax or through email with us, and we'll still process them.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, well, yeah, I can have my mom's back here. OK, let me get the fax number from you.
[AGENT][POSITIVE] No worries there.
[AGENT][NEUTRAL] You bet you so let me pull that up and.
[AGENT][NEUTRAL] I'm sorry, it's one of those numbers that once I see it, I'm like, oh, I have it memorized, um, but then if I'm not looking at it, I panic and I don't remember it anymore. Um, it is 877.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] 3659423
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then I can give you your policy number as well, my friend.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, whenever you're ready.
[AGENT][NEUTRAL] 02552188
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] 9
[CUSTOMER][NEUTRAL] 02552188. OK and then um OK, now let me just ask you a couple questions about the policy because I've never received any like paper correspondence regarding the policy, like a copy of it or anything.
[AGENT][NEUTRAL] You betcha.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Do you know if it like covers, I was only in the hospital for like one night. Uh, you know, I was admitted one day and they placed me in ICU straight from the emergency room because I was on an insulin drip. And then from the ICU I went home. Um, do you have like the sea schedule for the policy that shows like, OK, you received this if your claim is covered, you know, for this treatment or procedure.
[AGENT][NEUTRAL] Yeah, so I can definitely talk you over through some of the benefits on that. I do wanna let you know that any benefit information I give you over the phone is just um a verification of the coverage and it's never a guarantee of payment.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So it looks like you have a hospital admission benefits on here of.
[AGENT][NEUTRAL] Hold on, I wanna make sure I'm reading the right line. Hospital admission benefit of $2500 so that's for being admitted to the hospital. And then,
[AGENT][NEUTRAL] It looks like you have a hospital confinement benefit.
[AGENT][NEUTRAL] Of $200 and that is typically daily.
[AGENT][NEUTRAL] And then,
[AGENT][NEUTRAL] Let's see, you said you're in the ICU, so then you do have an intensive care unit benefit amount, and what that might do is that might just um override the hospital confinement and that's a $400 benefit.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] It looks like it covers for up to 10 days.
[AGENT][NEUTRAL] In the ICU.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] $5 and what's like, OK, so when I submit the claim, like what do I need to send?
[AGENT][POSITIVE] Yes absolutely so I can email you if you want a claim form, and we have uh those claim forms will tell you like everything that's required and needed um when you're submitting the claim let me pull it up because I'd rather just read straight off of it and not give you any wrong information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So for the hospital indemnity plan, um, when you submit it, you're gonna want to submit an itemized bill with your diagnosis code from the hospital along with the claim form that I'll email your way.
[CUSTOMER][NEUTRAL] OK, and can you send that to my personal email?
[AGENT][POSITIVE] Yes, I absolutely can. Um, what is going to be a great email address to use, my friend?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's gonna be my first name, [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alright, perfect, one second please.
[AGENT][NEUTRAL] All right, [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] All right, I'm gonna have that coming your way. It's gonna say HI claim form in the subject line for you and it's gonna come from care team at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um, OK, let me ask you this. Like I know obviously I'm gonna have to get the itemized bill from the hospital. Is there a certain amount of time that I have to file a claim because I don't know how long it's gonna take, you know, I should to generate a bill.
[AGENT][POSITIVE] No worries, absolutely so we actually at our company we do not have a timely filing limit so even if you submitted this in a year from now you're still gonna be fine as long as your date of service was for the coverage period.
[CUSTOMER][NEUTRAL] Did you
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, I just wanna check because I know some of you have like 30 days to file a claim and you know.
[AGENT][POSITIVE] Mhm. Absolutely. That's a great question.
[CUSTOMER][NEUTRAL] I don't always work because.
[CUSTOMER][POSITIVE] OK great thank you so much for your help I appreciate it and you have a good day.
[AGENT][POSITIVE] Yeah my pleasure and that email should be coming your way now if there's anything else you need help with just reach on out to us and we'll do our best to take care of you, OK?
[CUSTOMER][POSITIVE] OK great I appreciate it so much thank you.
[AGENT][POSITIVE] My pleasure, [PII], thank you.
[CUSTOMER][NEUTRAL] OK.