AccountId: 011433970860
ContactId: 659aa833-c0e8-4ef9-be13-9cea70ea209e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1613900 ms
Total Talk Time (AGENT): 552836 ms
Total Talk Time (CUSTOMER): 386528 ms
Interruptions: 6
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/659aa833-c0e8-4ef9-be13-9cea70ea209e_20250508T13:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Uh, my husband's name is [PII]. Um, he has a cancer policy on both of us, but, um, he spoke with someone, and I'm not exactly sure when, um, because he has been battling lung cancer.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um they spoke about a waiver of premium.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I remember he, um he, he pulled up a form, but somehow or another, it got wet, so he threw it away. But anyway, uh, he's been in and out of the hospital now for 8 weeks and um so I'm trying to get this, um,
[AGENT][NEGATIVE] Oh sorry.
[CUSTOMER][NEUTRAL] Do whatever I need to do to get a waiver of premium.
[AGENT][POSITIVE] Yes, ma'am. Yeah, absolutely. I'm happy to take a look at that with you. Do you by chance have the
[CUSTOMER][NEGATIVE] Taken care of.
[AGENT][NEUTRAL] Uh, policy number, [PII].
[CUSTOMER][NEUTRAL] I do. It is 9, A as in apple, J as in [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 291
[CUSTOMER][NEUTRAL] 438.
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Give me just a moment, let me pull this up here.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] I'm just pulling up the policy itself, [PII], to see what it says for the waiver on here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh ta da.
[AGENT][NEUTRAL] I'm just scrolling through this, you know, there are quite a few pages, so I just need to get to the section I need to get to here.
[CUSTOMER][NEUTRAL] Sure
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] OK, well, I'm actually, let me see if I can see it too, um.
[AGENT][POSITIVE] Alright, so it looks like we will waive premium of any premium.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I read it, day before yesterday, but do you think I could find it now?
[AGENT][POSITIVE] So it does, it does have a waiver. It says we'll waive payment of premium becoming of this policy for totally disabled as a result of cancer.
[AGENT][NEUTRAL] We can waive premium becoming due for a total of up to 5 years if you are continuously and totally disabled, but it's not, you know, so it does have a waiver on it. I just need to figure out what we need to do to get that started for you guys, [PII]. So, um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] If you don't mind, can I place you on just a brief hold and check with uh the claims department see if they know? OK, thank you so much.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Yes, that would be great. Thank you.
[AGENT][NEUTRAL] One
[AGENT][NEUTRAL] OK. Uh, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Just.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] They
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] A rafts, so.
[AGENT][NEUTRAL] Um
[AGENT][NEGATIVE] I feel I need to do something if I can't pay the price.
[AGENT][NEGATIVE] Doesn't make any sense to me.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you so much for patiently waiting, [PII]. I apologize for the long hold, um.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] That's OK, thank you.
[AGENT][NEUTRAL] Do you guys have any upcoming claims or any claims that are gonna be filed, um, or anything like that?
[CUSTOMER][NEUTRAL] Well, probably I don't know honestly how to go about doing that and um
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] How, how does
[CUSTOMER][NEUTRAL] I don't even know how to
[CUSTOMER][NEUTRAL] Ask, how do I go about doing that and what will it cover. Um, you know, we have health insurance, we have Medicare, and we have Blue Cross Blue Shield. So what, what will the cancer policy cover?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] And how does that work?
[AGENT][NEUTRAL] Yeah, so, um,
[AGENT][NEUTRAL] You can still file claims on this, even though you have um the Medicare and the Blue Cross Blue Shield. Um, this would cover
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] I it down has like intensive care on it. Let me see where there's the benefits are listed.
[AGENT][NEUTRAL] Um, because they were telling me that once you file a claim, since there's a waiver of premium on the policy, that claims would notify the billing team.
[AGENT][NEUTRAL] And that they placed the um waiver on the policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, so.
[CUSTOMER][NEUTRAL] So we would need to file a claim then.
[AGENT][POSITIVE] Sounds like it.
[CUSTOMER][NEUTRAL] Before they would um waive the premium.
[AGENT][NEUTRAL] Yeah, let's see.
[AGENT][NEUTRAL] I'm just making sure I asked, I said if you're not filing a claim and there's nothing else really to do at this time. I just wanna make sure I understand cause
[AGENT][NEUTRAL] I, you know, I did, I did tell him. I see that you're on bank draft, um.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] So the plan itself looks like it would have like a daily hospital benefit if he's been in the hospital. Um, it has benefits for like chemo and radiation therapy.
[AGENT][POSITIVE] And then it also has an intensive care writer, so what that means is if you were in intensive care or anything, it has benefits on it for that also.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right. Well, he has been in the hospital. He's been in and out of the hospital since his last, well, gosh.
[CUSTOMER][NEUTRAL] He, he was in the hospital after each round of chemo. He has had 4 rounds of chemo, and he's had 32, um radiation treatments.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, he has basically been in the hospital though since the last round of chemo. In and out of the hospital, he went to rehab.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] He was in rehab for, I think, 3.5 weeks. He went back into the hospital a week before last, um, with a UTI and pneumonia.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um, so,
[CUSTOMER][NEGATIVE] You tell me what I need to do and I will do my best to. This is all just sort of suddenly falling. I mean, he's always taking care of everything. And now all of a sudden this is falling in my lap and it has just been overwhelming.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] OK, so, um, I did get confirmation, [PII], it looks like that we have to have a claim in house in order to put the waiver of the premium on.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So there's, you can't do that until we have a claim. So,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, alright, so then what we need to do is, do you have access to email?
[CUSTOMER][POSITIVE] Oh yes mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the email on here, let me just verify.
[AGENT][NEUTRAL] Is [PII]. Is that still a good email?
[CUSTOMER][NEUTRAL] Yes, but, yes, that's his. Can, can you change it to me?
[AGENT][NEUTRAL] We
[AGENT][POSITIVE] We can change. Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, I can send
[CUSTOMER][NEUTRAL] OK. All right, my email is.
[CUSTOMER][NEUTRAL] Um, all lower case.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so what I'm gonna send you via email is a claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because you'll need a claim form to get started here.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] [PII].
[AGENT][NEUTRAL] And page one of the information I'm sending.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Is um just gonna be instructions. So like when you're filing the claim, what's needed with it, go ahead.
[CUSTOMER][NEUTRAL] Uh-huh. Wait a minute, hold on.
[CUSTOMER][NEUTRAL] Hold on, let me get away from my dog. My yard guy is here. He can see him. Um, I'm sorry. Say that again. Page one, what now?
[AGENT][NEUTRAL] No, you're fine.
[AGENT][NEUTRAL] You're told, yeah.
[AGENT][NEUTRAL] Um, so page one is just gonna be instructions. It's gonna let you know, um.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Depending on what you're filing a claim for. So it'll tell you like if you're filing a claim for radiation or chemo, it'll say we need an itemized bill from the provider and then the explanation of benefits from your other insurance.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, all right. How would I go about getting the explanation of benefits?
[AGENT][NEUTRAL] So it'll
[AGENT][NEUTRAL] So you should be able to.
[CUSTOMER][NEUTRAL] You mean from Medicare and Blue Cross?
[AGENT][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] So you should be able to contact them directly and they should be able to either, um, a lot of these, you know, a lot of insurances have online where you can access it online, but they should also be able to either physically mail it to you, email it to you, whatever, for that date of service.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Um, so yeah, um, they should be able to get that to you and just let them know that you are.
[AGENT][NEUTRAL] Filing a claim under a cancer policy and that's why you need it and they'll total, they should probably then be like, oh, I know exactly what, you know, you're looking for. So,
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, so I am emailing you the claim form with the instructions.
[CUSTOMER][POSITIVE] All right, perfect.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Um, nothing to do on the waiver of premium until that's started.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And then I can you think of any other questions, [PII]?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, OK. Well.
[CUSTOMER][NEUTRAL] How would y'all go about paying?
[CUSTOMER][NEUTRAL] Since our insurance is paying, would y'all pay the provider directly because
[CUSTOMER][POSITIVE] I think, I'm not totally sure, but I think things have been pretty well taken care of with both our um Medicare and Blue Cross.
[CUSTOMER][NEUTRAL] So what happens with payment from y'all?
[CUSTOMER][NEUTRAL] How does that work?
[CUSTOMER][NEUTRAL] Did I lose you?
[AGENT][NEUTRAL] I'm sorry, um, there's no, I was gonna say there's there's no banking information on file, so, um, it would just be sent out in a check to the insured because you're the one filing the claims, so the payment goes to the insured. If the provider was if the provider was filing the claims on your behalf, then we would be sending payment to the provider.
[CUSTOMER][POSITIVE] Definitely.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] Gotcha. OK. All right. That's, that's understandable. I'm, I'm a little brain dead. I'm sorry. I'm, I'm actually just, as I said before, I am totally overwhelmed with all of this and
[AGENT][NEUTRAL] No, don't apologize.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] My husband had mentioned something about this several weeks ago that I needed to look into that, but of course, other things, you know, took priority. I didn't get to it. So, um, I finally, it, it was at the bottom of the stack and I got to the bottom of the stack and I'm like, uh oh, I need to do something about this. So, OK. All right. So you're gonna email me the information then for me to um file a claim.
[AGENT][NEUTRAL] Right, right.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Yeah, no.
[AGENT][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] And, um, and I'll get that done. Tell me your name again, [PII]?
[AGENT][NEUTRAL] Uh-huh, my name is [PII], and on that sheet, [PII], when you, so as far as getting the claim back to us, um, you can get the claim back to us 3 different ways. You can put it in the US postal mail, you can fax it, or there's an online system. If it's easier for you just to put it in the mail, like you can definitely do that. Do you want instructions for online? Is that something that would even interest you or?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, possibly.
[AGENT][NEUTRAL] OK, I'll send it to you just so you have it um if you decide you wanna do it online, but on that form is the mailing address and the fax number too if you decide you wanna get it back to us that way.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. I have a neighbor next door neighbor who works in insurance with doctor's offices and everything. So I may not be able to do it, but boy, she can do it.
[AGENT][NEUTRAL] Oh, there you go, there you go.
[AGENT][NEUTRAL] There you go. I was gonna.
[CUSTOMER][POSITIVE] She has been an absolute lifesaver.
[AGENT][POSITIVE] I was gonna say if you have anybody that can help you and everything like, yeah, that's amazing so definitely utilize all the help that you can get.
[CUSTOMER][NEUTRAL] Yes. She told me, she said, you call, you find out what we need to do, and we'll get it done. I said, OK.
[AGENT][NEUTRAL] Yeah, yeah, yeah, yeah, yeah, especially with these types of policies because it can definitely like you said, it's overwhelming, it's a lot of information so I totally can can get where you're coming from. So, OK, I'm sending you a second email now and that's gonna be the the user guide for online so you guys can set up a profile online if you want to, OK?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that's great. That's great.
[AGENT][POSITIVE] All right. And then if you run into any problems, please feel free to call us. We're always happy to help if, if you run into any roadblocks, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I get to you directly or do I have to just speak with whoever?
[AGENT][NEUTRAL] Um, yeah, I mean when you call the 800 number you just get kind of any one of us in customer care, so but I'm gonna notate that we spoke today, [PII] and what we talked about and everything so if you call back they can see that you know what you called and what the reason was for so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that's great. [PII], thank you so much. You have been
[AGENT][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] a big help. You really have. I appreciate everything and I will get this going just as soon as I can.
[AGENT][NEGATIVE] Oh, no.
[AGENT][POSITIVE] Yeah, not a problem.
[AGENT][POSITIVE] Yeah, no, not a problem. Whenever you have some time, just like I said, get, go ahead and get started and um we are here to help, OK?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] OK. [PII], thank you. You have a wonderful week, rest of the week and weekend.
[AGENT][POSITIVE] You too, B+, [PII].
[CUSTOMER][POSITIVE] Thank you. You as well. Bye-bye.
[AGENT][NEUTRAL] Mhm. Bye-bye.