AccountId: 011433970860
ContactId: 660563b4-2f41-4d2e-8b81-56fd161bafcb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 722309 ms
Total Talk Time (AGENT): 398247 ms
Total Talk Time (CUSTOMER): 184809 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/660563b4-2f41-4d2e-8b81-56fd161bafcb_20250109T22:06_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Pardon me? What did you say?
[AGENT][NEUTRAL] This is [PII] with ATL. How may I assist you?
[CUSTOMER][NEUTRAL] Um, I was calling about a policy that I have with y'all.
[CUSTOMER][NEGATIVE] But I've, I've been canceling some policies today and I.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't remember if I canceled this one or not, so I that's what I'm double checking on.
[AGENT][NEUTRAL] OK, sure, I can assist you with that information. Um, do you have the policy number by any chance?
[CUSTOMER][NEUTRAL] Yes, 017.
[CUSTOMER][NEUTRAL] 8388889
[AGENT][POSITIVE] OK, thank you. And let me have a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have your name and date of birth for security?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you and I need the mailing address and email address for verification.
[CUSTOMER][NEUTRAL] OK, it's [PII] and the email is is that [PII].
[AGENT][NEUTRAL] Thank you. OK. OK, so this is your cancer policy and it's still active.
[CUSTOMER][NEUTRAL] OK, um, does it show that I called earlier?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, let me check. Mhm.
[AGENT][NEUTRAL] OK, so it says that you call for information.
[AGENT][NEUTRAL] Any documentation verify to claim.
[AGENT][NEUTRAL] Uh, it's just saying that you call for information on the policy. It doesn't say that you needed to cancel the policy.
[CUSTOMER][NEUTRAL] Well, I'm trying, I'm trying to figure out because um.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] So it's automatically drafting, is this correct? the 83.
[CUSTOMER][NEUTRAL] What is it? 8370 a month?
[AGENT][NEUTRAL] OK, let me double check.
[CUSTOMER][NEUTRAL] I think it is.
[AGENT][NEUTRAL] Let's see. Um, it is 8370, correct, yes. Mhm.
[AGENT][NEUTRAL] Yes, in this address.
[CUSTOMER][NEUTRAL] OK, I'm just, I'm just wondering, I mean, I don't know.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] So how, how does this.
[AGENT][NEUTRAL] So you're
[CUSTOMER][NEUTRAL] Go go ahead.
[AGENT][NEUTRAL] OK, so you don't know if you wanna keep it or not, is that what you're trying to determine?
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] Mhm, um, do you have the information of the benefits or do you need like a booklet of your information so you can take a decision?
[CUSTOMER][NEUTRAL] Um, well, I have some, but it's dated [PII], so I don't, I haven't gotten anything that's updated since [PII].
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah, it's gonna be the same thing. It's gonna be the same benefits. It hasn't changed since [PII].
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So it's gonna continue to draft 8370 every month.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] So like what, uh, I mean, does it, does it pay 100% on on things when it's used or no just different.
[AGENT][NEUTRAL] OK, let me go over your benefits really quick, OK? Um, one moment, let me just pull the certificate, OK, one moment.
[CUSTOMER][NEUTRAL] Amount.
[CUSTOMER][NEUTRAL] OK, so
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Gonna be one more minute. I'm waiting on the documents.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK. All right. And this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. All right. So this one has cancer benefits and intensive care benefits and it also has a critical illness benefit. Um, so for like in
[CUSTOMER][NEUTRAL] It has cancer. What was the second one you said?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Cancer in intensive care.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] And critical illness.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So for the critical illness, you have internal cancer or heart attack and stroke, um, those are paid at $10,000.
[AGENT][NEUTRAL] That is the maximum benefit if you have either internal cancer or a heart attack and stroke.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] For the cancer part, let's see what you have. OK, so you have several benefits. Um, you have like hospitalization benefits which we um pay $400 per confinement day. So it's $400 per day up to 30 days and $800 per day after, after the 30 days, then we pay $800.
[AGENT][NEUTRAL] Um, you also have drugs and medicine benefit per confinement, so it's every time you're hospitalized. Um, so if you're hospitalized for one day, you have $400 per confinement and this is for drugs and medicine.
[AGENT][NEUTRAL] And if you're hospitalized more than one day, it's gonna be the same benefit because it's per confinement. So, um, it depends on how many times you're confined during the year. Um, for outpatient, you also have drugs and medicine benefit which should be covered $50 per prescription up to $200 per month.
[AGENT][NEUTRAL] For cover person?
[AGENT][NEUTRAL] You also have benefits for surgery. The surgery benefit is 5000 per uh per surgery, I'm sorry, Per surgery is 5000.
[AGENT][NEUTRAL] Um, you also have 2nd and 3rd surgical opinion.
[AGENT][NEUTRAL] Which is $300 per diagnosis of cancer, an additional $300 is if a third um opinion is required.
[AGENT][NEUTRAL] Um, you also have, um, outpatient hospital or ambulatory surgical center benefits. So if you have like a surgery in an outpatient facility, um, we pay $800 per day surgeries perfo[PII].
[CUSTOMER][NEUTRAL] Well, am I supposed
[AGENT][NEUTRAL] Um, the
[AGENT][NEUTRAL] Mhm. Go ahead.
[CUSTOMER][NEUTRAL] Uh, a card for this? I don't have any kind of card, an ID card or.
[AGENT][NEUTRAL] No, mhm.
[AGENT][NEUTRAL] No, you don't get an ID card on this one because you don't have to present this one to the doctors, you submit your own claims on this one because we've seen your reimbursement.
[CUSTOMER][NEUTRAL] Oh OK, so how if, if I had to use this, then how do I get the claim forms just online from y'all's website or what?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm, yes, the claim forms are on our website. If, if you by any chance you need to use it and you don't have a way of getting it online, you can always call us and we can send it by mail or fax.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Mhm. But you have a lot of benefits for this one, including transportation mileage uh for chemotherapy. Um, you do have a radiation chemotherapy benefit up to 25,000 for 12 months. So you have a lot of benefits on this one.
[CUSTOMER][NEUTRAL] OK, then.
[CUSTOMER][NEUTRAL] OK, maybe I'll just keep it so I didn't, I didn't cancel it earlier, correct?
[AGENT][NEGATIVE] No, you did not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, maybe I'll just hold on to it for.
[CUSTOMER][NEUTRAL] For a while.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. All right.
[CUSTOMER][NEUTRAL] I just, I, I
[CUSTOMER][NEUTRAL] I'm trying to I've ended up with too many policies.
[AGENT][NEUTRAL] Mmm.
[CUSTOMER][NEUTRAL] And so that's why I'm trying to.
[CUSTOMER][POSITIVE] See what I really need and what I really don't need, you know, but this one.
[AGENT][NEUTRAL] I understand.
[CUSTOMER][NEGATIVE] I mean, heart disease and cancer run in my family, so.
[AGENT][NEUTRAL] Um.
[CUSTOMER][POSITIVE] This one is probably more beneficial anyway.
[AGENT][NEUTRAL] OK. And I see that you haven't used this policy in the past, and you have a benefit for a um prevention benefit of $90 per year.
[AGENT][NEUTRAL] Um, that you can submit claims for if I see you have not submitted any claims, and you can get that $90 every year for a prevention benefit, which is like if you do a mammogram, a pap smear, um, those you can send in and we can send you $90 for, um, each year for a test.
[AGENT][NEUTRAL] If you want to take advantage of that one, it looks like you had had the policy since [PII], I believe. Let me check again to make sure. Um, yeah, [PII]. So if you had any tests done like after [PII], like a mammogram, Pap smear, um, breast ultrasound, anything like that, you can submit that claim for the $90 for [PII], [PII], [PII], [PII], 23, and 24.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] In this coming year.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] You can get some money back.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let's see, I'm trying to think.
[CUSTOMER][NEUTRAL] I, um,
[CUSTOMER][NEUTRAL] I have, um, I've had thermography.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Test done. And as a matter of fact, I'm gonna be going to my gynecologist appointment in the next, next month, so.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I'll be able to
[CUSTOMER][NEUTRAL] Send a claim then
[AGENT][NEUTRAL] Yes, yes. Whenever you, you have a, a test, a wellness test, um, to detect cancer, any type of cancer, you can submit that claim for reimbursement, um, and again, that's just one test per year, but we do pay $90 for each test each year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, that sounds good.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] All right, and you can find the claim form again through our website at [PII] and it's gonna say wellness claim. So you just fill it out, um, you don't have to send any additional information you just fill it out, sign it and send it back to us.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][POSITIVE] OK perfect thank you.
[AGENT][NEUTRAL] You're welcome, Ms. [PII]. Is there anything else I'm gonna help you with today?
[CUSTOMER][POSITIVE] No, that's all I appreciate your help.
[AGENT][POSITIVE] You're welcome, Ms. [PII]. Thank you for calling APL. Have a good afternoon.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.