AccountId: 011433970860
ContactId: 6f76ae8c-6205-40f7-aa76-53f89f773885
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 719289 ms
Total Talk Time (AGENT): 413578 ms
Total Talk Time (CUSTOMER): 214967 ms
Interruptions: 3
Overall Sentiment: AGENT=1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/25/6f76ae8c-6205-40f7-aa76-53f89f773885_20250625T17:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, uh, I'm calling in regards to policy number 00131493.
[AGENT][NEUTRAL] OK. And, uh, what was your name, please?
[CUSTOMER][NEUTRAL] My name is [PII]. Um, I'm the son of the insured.
[AGENT][POSITIVE] OK, what can we help you with today?
[CUSTOMER][NEUTRAL] Uh, yes, I do like, do we need to, it's a cancer policy.
[CUSTOMER][NEUTRAL] Um, we would like to report her death, but I don't know, we haven't started on any claims on it yet. Uh, can we get claim forms and what do we need to do to start that process?
[AGENT][POSITIVE] Sure, definitely, yeah, OK, so I can uh email you if that's easier uh copies of the claim form, uh you can also get them on our website or whatever is easier for you.
[AGENT][NEUTRAL] And then as far as reporting her death we would just need a copy of the death certificate and you could just email that to us. I can give you that information whenever you're ready.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well, sure, let me, let me, I got a couple of que let me run through that and I'll come back to that, uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Before it gets up I'm, I'm, this just happened, so I'm not real clear right now. I apologize, uh.
[AGENT][NEUTRAL] Oh, sure. No, you're fine.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Um, what is the, she, she found out like.
[CUSTOMER][NEUTRAL] I don't know, roughly, it was late April for sure that she had cancer.
[CUSTOMER][NEUTRAL] And there was a lot of different things that happened, you know, before the treatments and stuff like that. So I know her policy is a cancer and I, I know it probably.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The coverage pertains to different actions or treatments and things that were done. So do does this stuff that you're sending me allow me to start that process of rounding that up for you to submit all that or is there?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Absolutely, to be able to file claims.
[AGENT][POSITIVE] Definitely, so I will say just to make things, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] Is there a
[CUSTOMER][NEUTRAL] No, no, go ahead. Yeah, I'm sorry, uh, yeah, go ahead.
[AGENT][NEUTRAL] You're no, you're OK. No, it's fine it's trust me it's very confusing and I can't imagine how overwhelming um so just for the sake of simplicity so that you are aware, um, first thing we would need before any other claim information can be processed would be that original pathology report. So if she had a biopsy, um, whatever it was that first determined that positive diagnosis of cancer, uh, we need that first and foremost.
[CUSTOMER][NEUTRAL] OK. You know, because she had scans done and, you know, before that and they're.
[CUSTOMER][NEUTRAL] didn't know for sure. I was suspicious of some things and then finally, she had a fall that brought her to the hospital and then it was there where they were finally able to actually get
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Pathology, so we don't need to go all the way back we just need to go back to the first actual pathology identification of cancer in, is that correct?
[AGENT][POSITIVE] Correct, yes sir, that is correct and now um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] It was in multiple places, so real confusing, yeah.
[AGENT][NEUTRAL] No, you're fine. Yes, that's what I like to tell people just straight away that's the starting point is that original pathology report, that first diagnosis of, you know, finding a positive cancer. Um, [PII], I'm so sorry. Before we go any further, can I go ahead and get a good callback number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Absolutely, um, my number is [PII].
[AGENT][POSITIVE] OK, I appreciate that thank you.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] And her phone, do you need her phone as well. I'm on her phone. I do that because it makes it easier because your caller IDs or some companies that, yeah, yeah.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] No, no, that's perfectly fine. It's just because, you know, of course Internet, you never know if there's a disconnect just so I can reach you. I can call you back just in case, um, OK, so yes, uh, that pathology report it's going to be first, um, and now did she receive any other kinds of, I know you said this was just in April correct?
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] Correct, yes.
[AGENT][NEUTRAL] OK. Did she receive any kind of like uh chemo or radiation or immunotherapy?
[CUSTOMER][NEUTRAL] Of
[CUSTOMER][NEUTRAL] She did, she received radiation.
[AGENT][NEUTRAL] She did? OK, so for any kind of treatment that she received of course after that initial uh diagnosis, um, across the board we would need those itemized statements.
[AGENT][NEUTRAL] That show diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] OK, that, uh, would that EOB work for that?
[AGENT][NEUTRAL] And then the
[AGENT][NEUTRAL] Um, it really depends on what information is shown, um, the way that they work, it's all very different, um, what I would do just for the sake of, you know, so you're not having to wait if you know we get it and it turns out it's not what we need, I would simply contact the provider uh facility wherever it was that she received treatment and just ask for that information, the itemized statement that showed those diagnosis and procedure codes just for good measure.
[CUSTOMER][NEUTRAL] OK, OK, we'll do that.
[AGENT][NEUTRAL] The only thing that we would need in addition to that, again, that's going to be any kind of treatment she received or anything regarding her cancer treatment, um would be for the, um, if she had chemo or radiation, we would need the explanation of benefits from the, uh, her primary insurance for, just for the chemo or radiation in addition to that out of my statement. Um, but we won't need it for anything else.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Which is Medicare, yeah.
[AGENT][NEUTRAL] Sure, yeah, just essentially showing what they contributed to that treatment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, the other two things I had was, could you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mail us a copy of the policy like what's.
[CUSTOMER][NEUTRAL] I've got some older stuff here. I'm not for sure.
[CUSTOMER][NEUTRAL] I've got one with a
[CUSTOMER][NEUTRAL] Policy number 37237. Does that sound right?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I do so this is quite an older policy um I've got that and so there are um.
[AGENT][NEUTRAL] Technically two policy numbers associated with this. It's the same policy, um, the old policy number I've got as um AD 9948, but the one that you gave me is the, you know, current policy number um, either way it's perfectly fine. I can definitely send you a copy of the policy and if you'd like I can also, uh, email it to you um so that you've got it quicker, whatever you prefer.
[CUSTOMER][NEUTRAL] Yeah, you could.
[CUSTOMER][POSITIVE] You, oh, that would be great. That would be awesome that way I know I'm getting for sure yeah and.
[AGENT][NEUTRAL] OK, I'll go ahead and do that.
[AGENT][NEUTRAL] For sure, yes, definitely, um, OK, and so let's see.
[AGENT][NEUTRAL] Let's see, give me just a moment and now as far as filing the claims with us you've got of course several different options. I will say that as this policy is still active you could create um a.
[AGENT][NEUTRAL] Uh, log in on our website, our online portal, uh, and file claims that way, um, it typically going to be the quickest and easiest way to get claim information to us. Uh, do you have access to a desktop or a laptop computer?
[CUSTOMER][POSITIVE] Oh yeah absolutely yeah.
[AGENT][POSITIVE] Awesome awesome OK yeah the reason I ask is our website doesn't really have support for mobile devices um so it does work better on a desktop or a laptop.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, um, let's see, and of course that's where you can also upload that pathology report and anything like that as well uh those claim forms will be on the website, but I can also go ahead and just email you a claim form along with this policy if you prefer.
[CUSTOMER][POSITIVE] OK, yes, you could, uh, that way I just make sure I'm getting what I need.
[AGENT][POSITIVE] Definitely.
[AGENT][NEUTRAL] OK. Give me just a moment.
[CUSTOMER][NEUTRAL] And the emails per email of record [PII].
[AGENT][NEUTRAL] I've got [PII] is that correct?
[CUSTOMER][NEUTRAL] Is that what you have?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] That's correct. I'm sorry, I forgot about the [PII].
[AGENT][NEUTRAL] OK, no, no, no, that's fine. I would like to verify. OK, is that the email you'd like me to go ahead and send this information to?
[CUSTOMER][NEUTRAL] Yeah, that's fine you can just send it there, yeah.
[AGENT][NEUTRAL] OK, OK, sure, I'll go ahead and send all of that, um, um, did you have any other questions for me? I know that was quite a bit.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Did this have a?
[CUSTOMER][NEUTRAL] Did this policy have a death benefit?
[AGENT][NEUTRAL] Um, you know, I'm trying to get that policy pulled up right now. Typically there's not a benefit for death per se, um, but let me just so that I can see exactly what.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] She did have. Bear with me just a moment.
[AGENT][NEUTRAL] It's a little bit tricky as this policy uh was originally from uh [PII], so it's been around for a minute. So give me just a moment, it's a different than our more more current policies, so bear with me.
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] OK, so it's for cancer and specified disease.
[AGENT][NEGATIVE] OK. So now, I don't see a benefit for that. Um, it is strictly uh cancer and specified disease. Now,
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Let's see, there's a daily hospital confinement benefit.
[AGENT][NEUTRAL] Outpatient benefits for surgery, therapy, X-ray, or chemo, ambulance.
[CUSTOMER][NEUTRAL] She had nearly all of that.
[CUSTOMER][NEUTRAL] Yeah yeah.
[AGENT][NEUTRAL] OK, OK, well I would say you know even if you know you're looking through the policy because again as especially as this is an older one, it's, it seems quite vague so I would just go ahead and send everything that you can um yeah I always say there's better to have too much information than not enough um you know worst case scenario we say that's we can't pay a benefit or you know best case we'll be able to pay it more than you expected so.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Ok, well, good. Well, thank you for.
[AGENT][POSITIVE] Alrighty well I will go ahead and send that information, yes.
[AGENT][NEUTRAL] I know, I know, I know it's very confusing. Did you have any other questions for me at the moment?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What's the address of your website.
[AGENT][NEUTRAL] Uh, yes, so that and I can go ahead and include that link in the email as well, um, but that is, uh, it's the word secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, well thank you very much I appreciate your help.
[AGENT][POSITIVE] Alright, you are very welcome. Let us know if you have any other questions. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Alright you too thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.