AccountId: 011433970860
ContactId: 5aee8612-a085-45d9-b83c-fceec19c0a7d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1189650 ms
Total Talk Time (AGENT): 418038 ms
Total Talk Time (CUSTOMER): 376655 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/5aee8612-a085-45d9-b83c-fceec19c0a7d_20250521T21:13_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. I'm calling about a policy that I have that's really old and I just realized I had it.
[AGENT][NEUTRAL] OK. Uh, do you have the policy?
[CUSTOMER][NEUTRAL] No, far as the cancer, yes, uh.
[CUSTOMER][NEUTRAL] What is that?
[CUSTOMER][NEUTRAL] 5871887
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Can I verify your first and last name and your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, Ms. [PII], and can you verify your address for me?
[CUSTOMER][NEUTRAL] Um, you should, you originally you had a PO box and I, I don't have that. My physical address is [PII]. Um, the post office changed it to [PII].
[CUSTOMER][NEUTRAL] The coastline.
[CUSTOMER][NEUTRAL] A road in me, um, so you, it's all the same.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, that's what we have. Um, and then can you verify your email address for me, please?
[CUSTOMER][NEGATIVE] Oh God, I don't know what you would have. I, I tried to get that changed to the [PII]. I don't know what you have.
[AGENT][NEUTRAL] That's what we have, OK, um, and then you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you so much. And how can I help you today?
[CUSTOMER][NEUTRAL] Uh, I don't know how to make these claims, um.
[CUSTOMER][NEUTRAL] Is there something you can do online and my kids can help me?
[AGENT][NEUTRAL] Yeah, absolutely. Um, I can send you an instructional guide. Um, it has to be done from a laptop or desktop, um, and it'll tell you how to log in, create your account, um, or we can walk through it now if you'd like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I can do that. Here's the thing while I'm trying to log into it, can I ask you some questions until I get on the page and I can go.
[AGENT][POSITIVE] Yeah, absolutely
[AGENT][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I just learned about another policy I had and.
[CUSTOMER][NEUTRAL] They have a time frame when I could have.
[CUSTOMER][NEUTRAL] Actually filed a claim and um
[CUSTOMER][NEGATIVE] Even though that I can write a letter because I'm outside of their 15 month window, there's something like that applied, I had cancer in [PII].
[AGENT][NEUTRAL] No, there's no time limit on this policy. You can file anytime.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] I'm a retired school teacher. Do you have, is it possible that I have, the only reason I knew about the other one is because the lady called me. Do, do you see anything else in your system other than this for me?
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Uh, looks like this is the only one we have.
[CUSTOMER][NEUTRAL] OK, um, what's the site that I need to go to?
[AGENT][NEUTRAL] At secured.
[AGENT][NEUTRAL] [PII]. So secured. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] I don't know why the computer is going so far.
[CUSTOMER][NEUTRAL] And um I can say this, um, I have one breast removed.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I mean, yeah, mastectomy had one breast removed. They removed all the cancer. I didn't have chemo. I actually had um
[CUSTOMER][NEUTRAL] Radiation.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, um, I don't know.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Secured that I am public.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] 99.
[CUSTOMER][POSITIVE] Oh it is secure.
[AGENT][NEUTRAL] Yeah, it'll be secured with a D at the end, secured. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm on here new user.
[AGENT][POSITIVE] OK, yeah, new user and then you're gonna do.
[CUSTOMER][NEUTRAL] Would that be it for me when I go?
[AGENT][NEUTRAL] new user and then I'm an individual with an APL insurance policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Um, you should see a box that'll have last name. You'll need to enter your full Social Security number, no dashes.
[AGENT][NEUTRAL] And zip code
[AGENT][NEUTRAL] The email you provided, um, which was the
[AGENT][NEUTRAL] The [PII].
[AGENT][NEUTRAL] And then your date of birth.
[CUSTOMER][NEUTRAL] The user was found.
[CUSTOMER][NEUTRAL] You said no lashes, right?
[AGENT][NEUTRAL] Yes, let me, uh
[CUSTOMER][NEUTRAL] Or you could put the member number.
[AGENT][NEUTRAL] Uh, no, it's your, it's your.
[CUSTOMER][NEUTRAL] Oh, was that the policy number? No.
[AGENT][NEUTRAL] Your social security number, yeah.
[CUSTOMER][NEUTRAL] Social.
[CUSTOMER][NEUTRAL] No dashes. I I like coming up.
[AGENT][NEUTRAL] No dashes.
[CUSTOMER][NEUTRAL] So I know.
[AGENT][NEUTRAL] OK, I see, yeah, I don't see.
[CUSTOMER][NEUTRAL] Let me see.
[AGENT][NEUTRAL] You in here either, so it might be because the policy is quite old. Let me
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] It's telling me to call a customer.
[AGENT][NEUTRAL] Oh, actually, I see you did create, you have an account.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] How long did I
[AGENT][NEUTRAL] Yeah, you've got an account. Um, here's your username if you want to take that down, you'll if you don't remember your password you can reset it.
[AGENT][NEUTRAL] So I've got.
[CUSTOMER][NEUTRAL] I have an idea because I use a lot of. What is it, is it [PII] or?
[AGENT][NEUTRAL] Uh, [PII], yeah. Uh, [PII] and then lowercase [PII].
[CUSTOMER][POSITIVE] Or something like that, I amusement.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I want.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, let me see one more thing.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, I'm try I have to.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, OK, so you said you had radiation, is that right?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I had like 30 rounds on it, but um 6 weeks, 5 times a week.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So that benefit is 7500 in a 12 month period. Um, so you just wanna um get any bills that you'd receive that so that will show, you know, the dates of service you had radiation, um, your diagnosis.
[AGENT][NEUTRAL] And then you can submit those for reimbursement.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Yeah, because I don't show you've submitted anything ever on the policy. So, um, we've got that, the 7500.
[AGENT][NEUTRAL] There is, let's see.
[AGENT][NEUTRAL] Uh, were you, did you stay inpatient in the hospital at all, or?
[CUSTOMER][NEUTRAL] Just overnight for the surgery.
[AGENT][NEUTRAL] Just overnight, OK.
[CUSTOMER][NEUTRAL] After the surgery.
[AGENT][NEUTRAL] Um,
[AGENT][POSITIVE] There is a benefit for the surgery.
[AGENT][NEUTRAL] Uh, it looks like, let's see.
[AGENT][NEUTRAL] Um, that's under the schedule, it's a dollar amount for the surgery.
[AGENT][NEUTRAL] Uh, it shows 5:40.
[AGENT][NEUTRAL] Um, so
[CUSTOMER][NEUTRAL] 140 what?
[AGENT][NEUTRAL] Uh, $540. Um, well, if, if it was simple mastectomy, it's $400 and then radical is $540 but that's, that's a benefit.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then let me see if there's anything else that we can submit.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Right now, that's what I'm showing, um, you could submit for. So the 7500 for the radiation, like I said, just get an itemization from the hospital that did the radiation that shows, you know, that it clearly states it was for radiation, what dates you had it, what the charges were, and then your diagnosis.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Now, I know my, I had another doctor um because of my health issues, she wouldn't, she didn't recommend um radiate uh chemo, but she gave me some pills that were like a hormone pill.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Does that have anything to do with anything? Cause I didn't get any paperwork from her. I didn't reach out cause I didn't think that was significant.
[CUSTOMER][NEUTRAL] I don't know if that matters.
[AGENT][NEUTRAL] Um, well, so the radiation, uh, therapy and chemotherapy benefit is under that entirety of the 7500.
[AGENT][NEUTRAL] There is a drugs administered with um chemical substances in and out of the hospital that would pay $25.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, but if it was like, if it was specifically a chemo drug, then it would fall under that chemo benefit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't know if it was considered one. It's not let me reset my password so it doesn't appear to be a reset option set up on your account.
[CUSTOMER][NEUTRAL] Um, so I can't get in there to do that. So does this mean I have to do this by mail or something?
[AGENT][NEUTRAL] No, you should be able to reset it. Hold on one moment.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Maybe, maybe I can.
[CUSTOMER][NEUTRAL] Sometimes I say
[CUSTOMER][NEUTRAL] I for sure.
[CUSTOMER][NEGATIVE] You said this party wanted it didn't.
[AGENT][NEUTRAL] Uh, SST Fisher. I have [PII], so capital S and then lowercase [PII] 41.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] That might be why.
[CUSTOMER][NEGATIVE] I couldn't get in.
[AGENT][NEUTRAL] Yeah, so I, if you try that, it should give you the option to click on primary email, primary phone or mobile phone to reset for your verification.
[CUSTOMER][NEUTRAL] Oh, I thought that.
[AGENT][NEUTRAL] You can have it sent to your email or your phone.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did they give you the option?
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] It did 805127.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] That didn't work either, did it?
[AGENT][NEUTRAL] Did it say it was sending you a verification?
[CUSTOMER][POSITIVE] Oh goodness.
[CUSTOMER][NEUTRAL] Yeah, I did that.
[CUSTOMER][NEUTRAL] Trying to reset the password, I moved up a step.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, here we go.
[AGENT][NEUTRAL] I, I know there's specific criteria for the password, so.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] OK, now I'm in there so I can upload docs.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Yes, you can upload your documents for the radiation, the surgery, um, and then you can also look at your policy certificate and see what's covered.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] But reading over your certificate, based on what you've told me is, um, that would be what would, you would be able to get reimbursed for at this point.
[AGENT][NEUTRAL] Um, there is anesthesia too, so be sure to submit for anesthesia cause that's gonna cover, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you do a breast prosthesis?
[CUSTOMER][NEUTRAL] A brace what? I'm sorry.
[AGENT][NEUTRAL] Uh, breast prosthesis. Did you get like a breast prosthesis brawl or anything like that?
[CUSTOMER][NEUTRAL] No, no, I just opted to just have her removed and that was it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um.
[CUSTOMER][NEGATIVE] There's a plane passing by, so I had a hard time hearing.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, yeah, it looks like they.
[CUSTOMER][NEUTRAL] And what's a wellness plan that's just going to the doctor every year?
[AGENT][NEUTRAL] Yes, like for your routine, um, you know, mammograms, any kind of routine physical.
[CUSTOMER][NEUTRAL] What does that one pay?
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Mm let me see.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] I'm trying to find the benefit. Hold on.
[CUSTOMER][NEUTRAL] It's weird.
[CUSTOMER][NEUTRAL] So this is, oh, I had this on me and my husband.
[CUSTOMER][NEUTRAL] OK. I'm trying to see.
[CUSTOMER][NEUTRAL] Um, on my policy.
[CUSTOMER][NEUTRAL] I change.
[CUSTOMER][NEGATIVE] It doesn't show.
[CUSTOMER][NEGATIVE] Like I'm not doing so well and if in the midst of this before it got processed.
[CUSTOMER][NEUTRAL] Um, did I have a beneficiary?
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] I would think it would be my husband, but I don't, I have my original policy which is very old and it does not tell me.
[CUSTOMER][NEUTRAL] have our names as being in both insured.
[CUSTOMER][NEUTRAL] Which my husband has passed on. He, um, passed 2 years ago.
[AGENT][NEUTRAL] OK, and
[CUSTOMER][NEUTRAL] That first few years ago. I don't, it says answering disease, but
[CUSTOMER][NEGATIVE] I don't know what kind of disease, uh he did have in just a heart failure.
[CUSTOMER][NEUTRAL] And we both.
[CUSTOMER][NEUTRAL] He has the, um, he had dementia.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, you'll want, so we.
[CUSTOMER][NEUTRAL] And then they say
[AGENT][NEUTRAL] We still have him on the policy, so do you have by chance a copy of his death certificate so we can get him canceled?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] I knew somewhere, honey.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] Does it really even matter at this point?
[AGENT][NEUTRAL] Well, I believe it, I, I, I don't think your policy is very expensive, but I believe it would change the premium potentially.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] I it could affect the premium, um, that's the reason I ask, um.
[CUSTOMER][NEUTRAL] I said we had a cancer and specified disease and then there was an intensive coronary care.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEGATIVE] Well, know that I still have that, uh, but I mean, I canceled so much stuff. I don't know.
[AGENT][NEUTRAL] Yeah, I understand.
[CUSTOMER][NEUTRAL] I'm sure I can't. I could have canceled it, could have canceled that at some point. Well, I'll just upload the, go ahead.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, I was trying to make sure that I didn't see.
[AGENT][NEUTRAL] Anything for the
[AGENT][NEUTRAL] This appears just to be the cancer policy.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and do you see anything about the beneficiary?
[AGENT][NEUTRAL] I don't see
[AGENT][NEUTRAL] I do not see anything about a beneficiary.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Usually it would be whoever, you know, whoever has, whoever's part of your estate, like if that's your, um, you know, potentially child or whoever you've assigned as next of kin, that's typically who would get.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Potentially any payment, um, but I'm not seeing anything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it looks like it's not much for me to do, but just upload docs and wait, right?
[AGENT][NEUTRAL] Yes, yeah. If you'll upload what you've received, um, or go back on your hospital records, main thing there is, uh, most important is to look for documents that contain, you know, that clearly shows that it was for radiation, what the diagnosis was, so that we can see that it's cancer, um, and then the bill charges and the dates.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][POSITIVE] Sounds good.
[AGENT][NEUTRAL] OK. Well, is there anything else I can help with today, Ms. [PII]?
[CUSTOMER][POSITIVE] That's it, thank you so much.
[AGENT][POSITIVE] OK, well, thank you for calling APL and I hope you have a good evening.
[CUSTOMER][POSITIVE] You too. Thank you. Bye-bye.