AccountId: 011433970860
ContactId: 74999a19-bdcf-457e-84f8-f9c0c35a1331
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 812859 ms
Total Talk Time (AGENT): 412674 ms
Total Talk Time (CUSTOMER): 230458 ms
Interruptions: 4
Overall Sentiment: AGENT=0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/74999a19-bdcf-457e-84f8-f9c0c35a1331_20250613T12:00_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, good morning, [PII]. I wanted to see if you might be able to help me with a syn or claim.
[AGENT][POSITIVE] Yeah, absolutely. Happy to check a claim. Do we have their policy number?
[CUSTOMER][NEUTRAL] Uh, let me see here, maybe.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Maybe not.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Would it work with maybe a social security number?
[AGENT][NEUTRAL] Yeah, we can check by social or name if you wanna give me social.
[CUSTOMER][NEUTRAL] Sure. [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, thank you. Let me just take a look here, one moment.
[AGENT][NEUTRAL] What is the first and last name on the policy?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then I just need [PII]'s date of birth, please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Was the claim under [PII]?
[CUSTOMER][NEUTRAL] Well, um, no, it was, so this is a, it's a cancer policy.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I'm sorry, sir. Were you waiting on?
[AGENT][NEUTRAL] Yeah, so I've got a, so are you checking on a, are you checking on a claim or what are we checking on? I'm sorry.
[CUSTOMER][NEUTRAL] Something for me or
[CUSTOMER][NEUTRAL] Oh, you found it? OK.
[CUSTOMER][NEGATIVE] No, she, she, she actually passed away uh from cancer.
[AGENT][NEUTRAL] Oh, I'm sorry. OK. So just kind of what we need to do to report that and everything?
[CUSTOMER][POSITIVE] Yeah, I don't know the process. I'm, I'm her grandson.
[AGENT][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Yeah, absolutely. Sorry, I kind of misunderstood you there. All right. Let's see.
[CUSTOMER][NEUTRAL] I I wasn't clear, sorry.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So, we are gonna need, um, we have what we call
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] There's like a loss of life form, but I don't know if you need that for this cancer policy.
[AGENT][NEUTRAL] We just need to.
[AGENT][NEUTRAL] Get a death certificate. Let me double check.
[CUSTOMER][NEUTRAL] I've, I've got the death certificate.
[AGENT][NEUTRAL] Yeah, I think we may just need that.
[CUSTOMER][NEUTRAL] It was the, and it was.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] I think, um, I think the beneficiary, I mean, I mean, she, my this, my grandmother's had this for a long, long time, and uh I think my grandfather was actually listed as a beneficiary, and he passed away 20 years ago.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, so it was just her and white listed on it. They actually didn't have any sort of like beneficiary or anything listed on that so um.
[AGENT][NEUTRAL] They will need something as far as showing um are you like the executor is that kind of how that's work? OK, so yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, I, and I've got a copy of the will is that something that would be needed.
[AGENT][NEUTRAL] OK, yeah, they'll need that just showing where to send, you know, any sort of payment to, um.
[AGENT][NEUTRAL] I was looking to see also if I could find any benefit information for you. This is an old policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I, yeah, I, I, I have no idea how long she had it. I just, I mean, I know, I could.
[AGENT][NEUTRAL] She had it since [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I, I remember it a few years ago, so.
[AGENT][NEUTRAL] Yeah, it's been a minute. OK.
[AGENT][NEUTRAL] Um, so what I can do actually, what is your first name? I'm sorry.
[CUSTOMER][NEUTRAL] Sure, it's [PII]
[AGENT][NEUTRAL] [PII], if you want, what I can do is I know so we're gonna need the death certificate.
[AGENT][NEUTRAL] Um, you're also gonna need to send.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Anything like you said that you have showing you're the executor and then it's going to be a claim form as well if you want I can email you all this information and then.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] As far as getting the information back to us, you can mail it, you can fax it whatever is easiest for you and that information is also on the form, our mailing address and fax number.
[CUSTOMER][NEUTRAL] OK, is it just mail or fax or can you email it?
[AGENT][NEGATIVE] Yeah, it's just mail or fax unfortunately email is not secure enough so we just don't accept documents that way.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, if I mailed it, can I, is it something that I can just check back later and see if make sure you guys got it, or, or I don't know if you would know the pro the, you know, business process it takes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So yeah, usually once they get the information it takes about 1010 business days for a claim to be processed, but yeah, you can definitely always call and check.
[CUSTOMER][NEUTRAL] Uh, best estimate.
[CUSTOMER][NEUTRAL] Oh, OK. Not like 6 months or, OK, so.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK. I, well, I just sometimes you never know. I, so I figured if I sent it, then I check back in a week or two just to make sure it got to get lost in the mail, and that way I'm not waiting for, and then that I know that it, you know, after a couple of weeks, if I don't hear anything, I should check back and
[AGENT][NEUTRAL] No.
[AGENT][POSITIVE] That's fair. That's fair.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, no, absolutely. And then if we need anything additional or, you know, anything like that, um, you could of course then submit that at that time, but yeah, no, it should only take at most maybe 10 business days, 2 weeks.
[CUSTOMER][NEUTRAL] OK. Now, [PII], uh, the, the, the, the documents that they, the, the forms that need to be filled out, that can be done by the executor, or does that have like, so the, the will lists, the uh like the, the, the heirs is, there's like 3, my brother or there's my brother, my sister and I, and then my my uncle. So as long as the executor signs.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The is that good enough or do you need like everybody that's listed?
[CUSTOMER][NEUTRAL] In the estate
[AGENT][NEUTRAL] Yeah, no, that would be good enough. You don't need everybody listed on the estate. Um, it does, let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, yeah, you don't need everybody. I was just double checking. You don't need everybody on there to sign it. That would be just fine for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, what's a good email for you, [PII]?
[CUSTOMER][NEUTRAL] Uh, it's my name, [PII], [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I'm sorry, I'm sorry. uh [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII] OK.
[CUSTOMER][NEUTRAL] Got it early but not early enough to be just [PII] you know so.
[AGENT][NEUTRAL] Alright, so what I will do is email you all these instructions as far as what needs to be sent and um the forms and all that so you can print them out or you can download them whatever easiest for you and then you have it in your email to reference as well um do you have any other questions or concerns?
[CUSTOMER][NEUTRAL] Not really. What did you find that? I don't even know what the benefits are. I haven't, there's so much paperwork I gotta go through that. I found this stuff, but.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Yeah, this.
[AGENT][NEUTRAL] Some of these older ones. I'm just trying to see if I could even find some of these older ones, the certificates aren't.
[AGENT][NEUTRAL] Um, loaded, so I was looking to see.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] So it looks like it's pretty much benefits for if she was in the hospital and then any sort of chemo and radiation.
[AGENT][NEUTRAL] I don't show that there was any sort of like lump sum benefit or anything like that. I don't believe. Let me see that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so it paid up to 7500 for any chemo or radiation.
[AGENT][NEUTRAL] And then it looks like any hospitalization, it paid up to 7500 on that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so I don't know, uh, like she had, she did have those, um, uh, bills, so I guess that we now it's been, it's been over the last year, um.
[AGENT][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Will I need to go back and try to come up with those bills or how does that work?
[AGENT][NEUTRAL] Yeah, so if you're for any of the chemo or radiation, yeah, they will need some itemized bills from her providers so that, you know, I don't know how much of a feed that might be for you guys or any hospitalization.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Because I don't believe.
[AGENT][NEUTRAL] Yeah, I mean, she wasn't filing on it. There was nothing.
[CUSTOMER][NEUTRAL] Yeah, I don't think she, she, I'm sure she completely forgot about it.
[AGENT][NEUTRAL] Yeah, there was nothing ever filed against it, um.
[AGENT][NEUTRAL] So when I send you this claim form, page one is just like instructions on what you need with the claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The I know the radiation chemotherapy that does require itemized bill from the provider.
[AGENT][NEUTRAL] Um, there was never any sort of even diagnosis sent to us, so.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But she didn't have any.
[AGENT][NEUTRAL] I'm sorry, my brain's kinda thinking out loud here.
[CUSTOMER][POSITIVE] That's all right.
[AGENT][NEUTRAL] Um, and then any primary insurance that she had, uh, we would need explanation of benefits from that carrier just showing what they paid.
[CUSTOMER][NEUTRAL] It would have been Medi Medicaid, I don't remember which ones which the Medicaid or Medicare, what's the older person's Medicare, I think it's Medicare, Medicare.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I think it's me, yeah, the Medicare, Medicare, yeah.
[AGENT][NEUTRAL] So, yeah, what they covered on any of that hospitalization, surgery, or chemotherapy.
[AGENT][NEUTRAL] Um, so those would be the things needed, the explanation of benefits, itemized bill, and then the claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so last question if um now if, if once that's sent in and if claims are processed and there's a payment, does that payment get sent to.
[CUSTOMER][NEUTRAL] Is it made out to the estate? I don't know how that how that works.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, usually it's made out to the estate, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah and so that's who would then be um paid out to so yeah that's why we would need any sort of documentation uh just since she didn't have any beneficiaries listed as far as who that can go to.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Thank you very much.
[AGENT][NEUTRAL] You're very welcome, [PII]. I'm sending you that email now, so just be on the lookout for that and then if you have any other concerns or questions, please feel free to call, OK?
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][POSITIVE] You're welcome. Have a good day.