AccountId: 011433970860
ContactId: 5de29b85-f6d9-4860-aca8-0b2cc47ad624
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 540909 ms
Total Talk Time (AGENT): 218133 ms
Total Talk Time (CUSTOMER): 250251 ms
Interruptions: 5
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/5de29b85-f6d9-4860-aca8-0b2cc47ad624_20250401T13:20_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] So I
[CUSTOMER][NEUTRAL] Yes, hi, my name is [PII], and I was calling because I had sent in claims for my husband for um his cancer and um I had sent it in with uh the pathology report because that's what it said to do and then they, I guess they didn't approve it yet because then they sent me a physician statement that needed to be filled out.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I uploaded it, but I don't know if it'll tie to that claim. I mean, I don't know what else to, how to make it or what do I, is there anything else I need to do?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, so when you um submit some, anytime you submit something to the online service center on your end, it's going to look like as if like a new claim has been submitted. You're going to get a new confirmation number and everything, but when we get it on our end, we'll see that that's the additional information for such and such claim and they'll just go ahead and process, continue processing.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So it's OK, you did, you did it right. It's just as long as you got the confirmation number, you know it went through. It just shows like that on the online service center.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Yeah, like I can see it. I see it online where it's uploaded, but like you said, it don't have a claim, it's not tied to a claim number or anything, so.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm, OK, alright.
[AGENT][NEUTRAL] So you don't have to worry about as long as you get the um confirmation number, you're OK, but um yeah, anytime you submit something, it'll show like that, but that's how you know you did it right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, so do it still take the same amount like do the the time start over for processing or?
[AGENT][NEUTRAL] No, not with a
[CUSTOMER][NEUTRAL] Cause it's been a while.
[AGENT][NEUTRAL] I understand, um, not with the additional information. Um, it's, it's usually a turnaround time, it's usually 7 to 15 business days if there's no delays from the day that we receive it. Um, but for continued information or additional information, they just continue processing, it doesn't, uh, like start over.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh OK, OK.
[CUSTOMER][POSITIVE] Alright, well thank you so much.
[AGENT][NEUTRAL] You're very welcome. Did you need me to look up anything on your policy or had any other questions about your policy?
[CUSTOMER][NEUTRAL] Um, I don't think so. Um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, I, yeah, maybe you can on the uh on the critical illness one like.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm not sure if it's because I have one and he, this is his, like on my my job one that I have on him.
[CUSTOMER][NEUTRAL] It, he, it pays him like a certain amount a month or whatever. So I don't know if this policy is like that also.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, let me take a look.
[CUSTOMER][NEUTRAL] Because I didn't even realize we had.
[CUSTOMER][NEUTRAL] We, I didn't even realize we had the um wellness thing, so I had to go back and file that from [PII].
[AGENT][NEUTRAL] Oh, OK. For the wellness benefits. OK.
[CUSTOMER][NEUTRAL] For me and him, for the wellness checks.
[CUSTOMER][NEUTRAL] Yeah, cause I didn't even realize that.
[CUSTOMER][NEUTRAL] I signed him up for it, his stuff, but I forgot what it was all about.
[AGENT][NEUTRAL] But that's OK. I can definitely look into the policy for you. Um, may I have a good contact number in case we're disconnected and then um the policy number?
[CUSTOMER][NEUTRAL] OK, it's um [PII].
[CUSTOMER][NEUTRAL] Alright, and the policy number for the critical illness is um 1415882.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] And uh yeah and the cancel policy is a rider on that one I think mm.
[AGENT][NEUTRAL] Oh, go ahead.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] I can't keep all this stuff together.
[AGENT][NEUTRAL] Oh, it's OK. I'm gonna look at it for you. Let me see, critical illness.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Additional
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I just need you to verify. Hold on one moment. The screens are coming up now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I just need you to verify since you're on the policy as well, your date of birth and the mailing address on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[CUSTOMER][NEUTRAL] And the address is [PII].
[CUSTOMER][NEGATIVE] Stop it, so.
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. So let me see if it'll pay him monthly.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And um Mrs. [PII], do you mind if I place you on just a brief hold? I'm just looking through the policy and the benefits.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 2500
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, Mrs. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Alright, thank you so much for holding. So no, it's not like a monthly payout. Um, there is a $250,000 maximum on um covered expenses for the year, um, but once you, as you file the claims, um, depending on what it is, um, for the cancer, it can either be paid at 100% or 25%, um, up to that $250,000.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So now, the, um, so the other question is, like, is this like a first diagnosis type thing or if he's diagnosed with the cancer, does it pay the face, the $10,000 face value? I mean, I don't know how that works. Like my job did pay that. OK, so.
[AGENT][NEUTRAL] Wait, say that one more time.
[CUSTOMER][NEUTRAL] since he's diagnosed with the cancer, does it pay the $10,000 face value?
[AGENT][NEUTRAL] The
[CUSTOMER][NEUTRAL] Is it like a, for diagnosis?
[AGENT][NEUTRAL] So there is a, let me see if this policy has it, so there is like a first occurrence benefit that does pay like a lump sum of like $10,000 or it's, you know, it's a dollar amount, but that's not.
[CUSTOMER][NEUTRAL] Then
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me see what this business. Hold on one second.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] With.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Yeah, this isn't like a first occurrence. Um, if there is a diagnosis, um, the policy will pay like 50% of the, um,
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Baba baba.
[AGENT][NEUTRAL] The benefit amount. So,
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] It depends. It's not, this, this policy doesn't have like a lump sum, but it does pay towards if there is a diagnosis. It's just a percentage, so I don't know what, like I can't say it'll be, you know, like 10,000 or because it's a, it's a percentage. I'm not sure.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEUTRAL] Right, if it's 100% or 25%.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][POSITIVE] All right. Well, thank you so much. I'll just wait and see what they decide.
[AGENT][POSITIVE] You're very welcome. Well, was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] Alrighty. Well, thank you so much for calling [PII]. I hope you have a great day.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye bye.