AccountId: 011433970860
ContactId: 65d71d63-b6b5-4052-8150-435240cd295a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1368839 ms
Total Talk Time (AGENT): 346487 ms
Total Talk Time (CUSTOMER): 435612 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=-1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/65d71d63-b6b5-4052-8150-435240cd295a_20250224T21:40_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, uh, this is [PII] over here in [PII].
[CUSTOMER][NEUTRAL] I received a policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I don't know if this is an upgrade or what it is, but I need somebody to tell me what, uh, why I got it. I got, yeah.
[AGENT][NEUTRAL] Why you have it? OK.
[AGENT][POSITIVE] Well, I'll be more than happy to look into it for you and see um why you received the policy. And Mr. [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's, uh, what was your name ma'am?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] All right, yeah, [PII]. I think I've talked to you before, it's been a while, right.
[AGENT][NEUTRAL] You may have, um, and, and may I have your policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, I got a, uh, let's see here it's uh 00.
[AGENT][NEUTRAL] It may say policies, you see it? OK.
[CUSTOMER][NEUTRAL] Uh yeah, your policy number is 00508584.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And I believe I have you here. I just need you to verify your date of birth.
[AGENT][NEUTRAL] Your mailing and email address.
[CUSTOMER][NEUTRAL] Yeah, 9
[CUSTOMER][NEUTRAL] [PII] and uh [PII].
[AGENT][POSITIVE] Thank you and your mailing address?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[CUSTOMER][NEUTRAL] Uh, [PII] like cotton [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So it looks like this is your um cancer policy, but it's not new. Um, you've had it since [PII].
[CUSTOMER][NEUTRAL] Mhm. I just got a new car. Yeah, they just sent me.
[AGENT][NEUTRAL] You might have, yeah, it's just a new copy.
[CUSTOMER][NEUTRAL] OK, I didn't know what, what maybe they increased the benefits or something.
[AGENT][NEUTRAL] Uh, I'm not sure. Let me see if there's anything in the notes because I'm not showing any changes or anything. Hold on one second. Oh, we received the email, oh wait a minute, that's old, that's back in June. Hold on one second.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'm hoping this isn't the the that you just received the one from a request in June, but that's the last contact I see about it. There was a request for a policy er um certificate to be mailed to the home.
[CUSTOMER][NEUTRAL] it because you did get the one in June. I got the one in June, uh, and, uh, but now I have an intensive care policy.
[AGENT][NEUTRAL] Let me look at that.
[CUSTOMER][NEUTRAL] And uh,
[CUSTOMER][NEUTRAL] that maybe I got.
[AGENT][NEUTRAL] And yeah, intensive care is no longer active. That's just a new, that's just a new copy of the policy, but there's been no changes. The premium is still $21.75.
[CUSTOMER][NEUTRAL] And uh so it, uh, now it says it pays $140 a day on a hospital expense. Is that for cancer only or?
[AGENT][NEUTRAL] Um, let me pull up your, your, um, policy certificate. Hold on one moment.
[AGENT][NEUTRAL] Oh yeah, I see one was printed on [PII], that's what it is.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Um, and then 104.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] Hold on one moment, I'm just waiting for all the pages to pop up here.
[AGENT][NEUTRAL] And just for the call, all the information provided is a verification of benefits, not a guarantee of payment. So you said 104 for a hospital stay. On what page do you see that? I'm trying to
[CUSTOMER][NEUTRAL] Um, it's on page 3.
[CUSTOMER][POSITIVE] It's got uh benefit description.
[CUSTOMER][NEUTRAL] Uh, it's got.
[AGENT][NEUTRAL] Oh, here it is.
[CUSTOMER][NEUTRAL] Chemotherapy and radiation for 12 months is $7500.
[CUSTOMER][NEUTRAL] Daily hospital expense, 140.
[AGENT][NEUTRAL] Yes, sir, that that daily hospital expense is in relation to uh cancer treatment.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, uh, that pays on, uh, blood.
[CUSTOMER][NEUTRAL] Does it, uh, I don't take, uh, blood transfusions, but does it pay on, uh, something like Epo or minor blood fractions?
[AGENT][NEUTRAL] Um, blood fractions.
[AGENT][NEUTRAL] Would that be under like platelets and plasma and blood or it's a treatment?
[CUSTOMER][NEUTRAL] Yeah, it's a, it's a minor blood fraction. They, you know, they take a it's like a shot they usually give it to you before you have surgery.
[CUSTOMER][NEUTRAL] Uh, Epo is one of them, and, uh.
[CUSTOMER][NEUTRAL] They, they use that, uh, for people that
[CUSTOMER][NEUTRAL] Uh, either don't want to have the risk of, uh, a blood transfusion because of side effects or, uh, maybe because of religious convictions of, uh, you know, the body abstain from blood.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] And uh.
[AGENT][NEUTRAL] So I don't see like a particular benefit specified with that on there, but I would still say if you have it to go ahead and file the claim, if it, if it's denied, you know, for non-coverage, then it will just be a denial, but if it is something covered, then yes, it, um, you know, you could use that benefit, but I don't see anything specifically with that wording, so I don't want to say no and it's under something else.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Cause you know, cause the blood transfusion is like a transplant anyway, you know, you, there's a lot of danger in uh taking a blood transfusion too, uh, but uh I just wonder about that because uh I've been having a lot of health problems. I just want to make sure, uh, you know, and uh I itmissions uh dreaded diseases.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh, I just wondered on that, uh,
[CUSTOMER][NEGATIVE] You know, I don't know if that's of any value anymore. It's got to pay so much on dreaded disease. Do you know anything about that?
[AGENT][NEUTRAL] And I was gonna look and see, hold on one second, what the, because there's a specification for dreaded disease. Let me see.
[AGENT][NEUTRAL] I think it's an alphabetical order. Hold on one moment.
[AGENT][NEUTRAL] This is more so like a picture.
[AGENT][NEGATIVE] And Mr. [PII], do you mind if I place you on just a brief hold while I look up the dreaded disease because it, it makes me use each or go to each page and then it has to load.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] It has to be a quicker way.
[AGENT][NEUTRAL] because I've, I've, but you can't search so.
[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] Hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes, uh huh.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. On your policy certificate, it should be on page 7. It says um it lists.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I'm looking.
[AGENT][NEUTRAL] You see like the different um specified uh diseases, it lists them down there.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Like if I get rabies.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] Or like smallpox or
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Or, or polio or TB, tetanus, osteomyllitus, meningitis, diphtheria, smallpox, terramea, scarlet fever, sickle cell anemia.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Uh, I think it's about, uh, one chance and 25 million, you know, that.
[CUSTOMER][NEGATIVE] That's a worthless benefit, uh.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEGATIVE] The way to get that off of your policy, maybe get a little bit more benefit on something else. It's kind of outdated.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Um, I'm not sure, but I can definitely, let me see, are you with, uh, no, you're not with the group. So I can.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] But were you, did you get this policy through your employer?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then you just poured it like it.
[CUSTOMER][NEUTRAL] Uh, I got it. Um, I got it when I was an agent. I wrote it on myself, but, uh, you know, back when I was young.
[CUSTOMER][NEGATIVE] Somebody did a switcheroo agent came through and stole all my customers and
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] What?
[CUSTOMER][NEUTRAL] For policies. Oh yeah, I told the people about it, yeah.
[CUSTOMER][NEUTRAL] Sure is.
[AGENT][NEUTRAL] Well, the reason I was asking was because the
[AGENT][NEUTRAL] The policies and the benefits, they come from the employer, but since this is an old policy, I didn't want to redirect you to the, the employer, but the, the benefits and the premium don't change once you switch it over. So the um benefits most likely cannot be changed either, because it just goes from the employer to you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, so, uh, maybe, well.
[CUSTOMER][NEUTRAL] I don't want to get any of these diseases anyway, you know, so.
[AGENT][NEGATIVE] At all.
[CUSTOMER][NEUTRAL] Uh, multiple sclerosis, yeah, uh, I don't think I got, I don't have sickle cell, sickle cell anemia or polio or rabies unless I get bit by a dog or something.
[AGENT][NEUTRAL] Mm mm.
[CUSTOMER][NEGATIVE] Scarlet fever, man, this is outdated.
[CUSTOMER][NEUTRAL] I didn't know if y'all ever update these policies.
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] I can check with customer service and see if that's an option. I don't think it is, but I can check and see.
[CUSTOMER][NEUTRAL] Now, I've had a, I've had a couple of claims on skin cancer, you know, so that's probably, uh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, I mean, it's not a big thing, but I didn't know.
[CUSTOMER][NEGATIVE] And uh I hate that I lost the intensive care. Like, I didn't know it, but they, when I turned [PII], they, they canceled it, you know.
[CUSTOMER][NEGATIVE] Well no
[AGENT][NEUTRAL] Oh, yes, I think intensive care has an age limit on it.
[CUSTOMER][POSITIVE] Yeah, I really need it though.
[CUSTOMER][NEUTRAL] That time you need it, so yeah, I didn't know if they had any upgrades or uh, uh, I don't think I'm gonna get scarlet fever, you know.
[AGENT][NEUTRAL] That's true.
[AGENT][POSITIVE] Well, I can definitely ask. I mean, I don't mind asking if you want me to look into it for you.
[CUSTOMER][NEUTRAL] I just
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And uh I was wondering if they, they have an intensive care policy, you know, that you can get that, uh.
[CUSTOMER][NEUTRAL] Uh, well, maybe it's not. I don't know.
[AGENT][NEUTRAL] Let me check with, um, let me check with customer service and see, so you do want to see if you can also reinstate the intensive care, oh, but it has a limit.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yeah, I had a limit, you know, and, uh, yeah, I, I had a one for for an old, an old guy, you know.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] But I can definitely check with customer service about the benefit changes. I don't believe you can, but I can see if it's an option for sure.
[CUSTOMER][NEGATIVE] But if I could trade this uh sick cell anemia and smallpox and uh polio thing, I, you know, I'd rather have a little more cancer cover.
[AGENT][NEUTRAL] Sure, I can check for you. Um, do you mind if I place you on just a brief hold while I reach out to customer service?
[CUSTOMER][NEUTRAL] OK, yeah, sure.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Per
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII]. How are you doing?
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey, [PII], can you hear me?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey [PII], it's [PII] on the care team. How are you doing?
[CUSTOMER][POSITIVE] Doing good. How are you?
[AGENT][NEUTRAL] I'm doing good. Um, I just have a quick question. If the insured, um, any policy with us, but this one is a cancer policy, they can't change the benefits on it, right? Like he's mode of payment 3. OK, I just want to make sure, that's all.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] No, they cannot.
[CUSTOMER][NEUTRAL] Oh, wait, wait. He's a mode of payment? No, he can't change the benefits.
[AGENT][POSITIVE] OK, I just want to make sure. Thank you.
[CUSTOMER][POSITIVE] You're welcome. Bye-bye.
[AGENT][NEUTRAL] Alright bye bye.
[AGENT][NEUTRAL] Hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes, uh huh.
[AGENT][NEUTRAL] OK, so unfortunately, no, sir, the benefits can't be changed on the policy.
[CUSTOMER][NEUTRAL] Yes, I.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, so.
[CUSTOMER][POSITIVE] If I get TB or rabies, I'll give you all a call.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, no, uh, I just wondered, you know, usually these companies update their policies, you know, this is old. This is.
[CUSTOMER][NEUTRAL] This come out in [PII], probably.
[CUSTOMER][NEGATIVE] Oh man, you need, you need the new generation working there. You got too many old people.
[CUSTOMER][POSITIVE] Alrighty, thank you.
[AGENT][POSITIVE] Oh my goodness. All right, you're welcome. Well, thanks for calling [PII]. I hope you have a good day.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Alright, have a blessed day. Bye.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm