AccountId: 011433970860
ContactId: 7883d962-3611-430f-8de5-68f71c100b57
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1158869 ms
Total Talk Time (AGENT): 501382 ms
Total Talk Time (CUSTOMER): 305892 ms
Interruptions: 3
Overall Sentiment: AGENT=0.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/7883d962-3611-430f-8de5-68f71c100b57_20250528T17:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I had just called and I got cut off. It was a bad connection or something. Uh my name is [PII], and I have a policy with you. My, it's a family policy.
[CUSTOMER][NEUTRAL] And I was wondering if you could tell me if, uh, I have a question about
[CUSTOMER][NEUTRAL] My husband is going to be having a pacemaker put in and an ablation later on. I was wondering if he has coverage on this.
[AGENT][POSITIVE] OK, I can help you with that. [PII]. Can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] And what's your policy number?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I don't know, I can't find it on here anywhere.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] They got a number down here. It's called 36,520. I don't know if that's it or not.
[AGENT][NEUTRAL] Um, that looks like a group number.
[AGENT][NEUTRAL] Do you have your, your husband is the policy holder, correct?
[CUSTOMER][NEUTRAL] No, I am.
[AGENT][NEUTRAL] Oh you are? OK um I can look it up by your social.
[CUSTOMER][NEUTRAL] And he's a
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII] and when you get that, tell me what the policy number is, please.
[AGENT][NEUTRAL] OK. I have 435-404-449.
[CUSTOMER][NEUTRAL] Just a minute. Oh, I'm, I'm, I'm sorry. Oh, sorry, um, my pen was ready. Go ahead.
[AGENT][NEUTRAL] Um, no, I, I think I need to, it looks like your social is missing a number, so can you start over again for me please?
[CUSTOMER][NEUTRAL] Start over please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEGATIVE] Jeez, no, I forgot it. Jeez.
[AGENT][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEGATIVE] That ain't right [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] One, I think it is. I got.
[AGENT][NEUTRAL] OK let me look it up by your last name. That might be a little bit easier for us. uh, can you spell your last name for me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, give me just a moment while I look that up for you, [PII].
[AGENT][NEUTRAL] And your first name is spelled [PII], correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, give me just a moment.
[CUSTOMER][NEUTRAL] Give me the number when you have it.
[AGENT][NEUTRAL] OK, give me just a moment while I look it up.
[CUSTOMER][NEGATIVE] I think you have my social security number wrong too.
[AGENT][NEUTRAL] Yeah, I was missing a number but I think I pulled you up. Can you verify your date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And uh what's your husband's date of birth since we're gonna be looking it up for him?
[CUSTOMER][NEUTRAL] Uh, it is, um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, give me the policy number if you could too, so I can write this down.
[AGENT][NEUTRAL] OK, I just need you to verify your mailing address and phone number and then I can give you that policy number.
[CUSTOMER][NEUTRAL] Well, my mailing address now is [PII]. You have that number? Cause on the policy, it's my old number. OK. Good, cause the, the, the, that's the, the PO box is not mine anymore. I'm, I don't live there anymore.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, we have that one.
[AGENT][NEUTRAL] And is the phone number the one that you're calling from?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And were you wanting the, you're wanting it for your heart attack, um, and stroke policy, correct? Cause you had a few with us. OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So you got your your pen and paper ready?
[CUSTOMER][NEUTRAL] Do I still have those?
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Do I, yeah, do I still have those?
[CUSTOMER][NEUTRAL] Other policies
[AGENT][NEUTRAL] Let me see what all policies you have with us. It looks like currently you only have that policy with us, um, the heart attack and stroke. OK, yeah.
[CUSTOMER][NEUTRAL] OK. That's what I thought.
[CUSTOMER][NEUTRAL] Yeah, you have the number there?
[AGENT][NEUTRAL] Yes ma'am. It's 7, it's 70.
[CUSTOMER][NEUTRAL] Before we get started.
[AGENT][NEUTRAL] 032.
[CUSTOMER][NEUTRAL] 70032.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Not, not 27, just 70032.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEGATIVE] Yes, my, OK, we have the cancer and uh not cancer. No, we have, yeah. No, we have the heart and stroke. Yes. Uh.
[AGENT][NEUTRAL] A heart attack?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My husband had a mini, mini heart attack.
[CUSTOMER][NEUTRAL] Uh, a few months ago, and I did, I had didn't even think about this policy at that time. And number one, would that be covered?
[AGENT][NEUTRAL] Uh, let me check, uh, it should be, uh, for the heart attack because you've had this policy since [PII] and it is still active. We don't have timely filing limits, so as long as the accident or the procedure happen during your active policy period, um, you can file a claim whenever. So yeah, you can file that claim.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I know you said it was a while ago.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah. OK. Um, now, he's going to be having a pacemaker pudding because he has Afib real bad. Uh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is that, is that covered by any uh
[CUSTOMER][NEUTRAL] Any kind of procedure with you guys?
[AGENT][NEUTRAL] Um, let me check.
[AGENT][NEUTRAL] It's an older policy, so I have, it's, it's been scanned in, so I have to go page by page, so give me just a moment. There's only 9 pages so it won't take long. Give me just a second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, if you could also email me that, so I, I don't have the original policy anymore.
[AGENT][NEUTRAL] OK, so do you have an online service account with us?
[CUSTOMER][NEUTRAL] Uh, you can just use my email for it. I don't know if I do or not. I don't think so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, if you'd like, I can send you a help guide on how to get started with that, and you'll use the email that we have on file and once you, uh, get an online portal account with us, you can see all of your documents, um, any sort of policy or ID card you have will be in there and you can even file a claim through, uh, that portal account. Would you like me to send you one?
[CUSTOMER][NEUTRAL] Well, I can try it. I'm [PII] old, so sometimes these things are a little difficult.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's why I was suggesting the guide, um, it should it really whenever you go to the email or to the website it's secured. [PII] and it will be in the email that I send you, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you'll go to that you'll click new user and the only thing that you need really is your last name, the phone number that we have or I'm sorry, your last name, your uh zip code, your social security number and um you'll use the email address that we have on file and do you, uh, is there an email that you prefer? We have one but I wanna make sure that's the one that you want.
[CUSTOMER][NEUTRAL] Yeah, it's it's [PII].
[AGENT][NEUTRAL] OK, you'll use that email um to sign on and you should be able to uh to access all of your documents from there too.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I will send you that um when we get done with our call today so you can expect it and uh maybe maybe by the end of the hour um do check your spam just in case, but let me go ahead and look up that benefit for you still um.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Yes, I do.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm showing a daily hospital benefit.
[AGENT][NEUTRAL] The medical expense benefit, but let me see if it covers the pacemaker.
[CUSTOMER][NEUTRAL] Yeah, cause it's, it's, it's gonna be, he goes in in the morning, you know, and then they release him that day on both procedures.
[CUSTOMER][NEUTRAL] Unless there's complications, I guess, you know, I don't know.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, and all the benefits I'm gonna give you today are just a verification of benefits and not a guarantee of payment?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it looks like we will pay the benefits shown, um, that I'm gonna give you in just a moment, uh.
[AGENT][NEUTRAL] If the heart attack or stroke is diagnosed?
[AGENT][NEUTRAL] We will need that um while the policy is in force which it sounds like um what based off of what you said that it was.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] It does, uh.
[CUSTOMER][NEUTRAL] So you
[AGENT][NEUTRAL] It does say that we won't pay benefits uh if you're treated for any disease or sickness other than a heart attack or stroke.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So I think as long as it's within the, uh, because he had the stroke, let me double check. The page keeps changing on me, so give me just a moment.
[AGENT][NEUTRAL] OK, let me see. Uh, you have a daily hospital benefit of up to $100 per day, uh, for the hospital confinement for a heart attack or stroke.
[AGENT][NEUTRAL] There will be a reduction in benefits after age [PII], which I didn't see if he was there yet.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, yes, he is. He's [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He's a little bit over.
[AGENT][NEUTRAL] I didn't check his age.
[AGENT][NEUTRAL] So it will be slightly different um, I, I don't have that and we'll you'll need to go to uh I'll need to transfer you for that if you want the exact amount, um, but let me see.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, that's fine.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think it's 50%, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am, 50%.
[AGENT][NEUTRAL] I was not showing anything as a pacemaker being um an exemption from this.
[AGENT][NEGATIVE] I don't think it pays because I don't see anything for durable medical equipment or a pacemaker um outlined specifically.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How about ablation? That's where they go into the vein and
[CUSTOMER][NEUTRAL] Do some work on the heart.
[AGENT][NEUTRAL] Let me look.
[AGENT][NEUTRAL] Because it looks like the only thing I'm seeing for this policy.
[AGENT][NEUTRAL] Is that daily hospital benefit and then a convalescent income benefit is all I'm seeing for this particular policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I is that meaning in the hospital or in the home or what?
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] I'm checking to see what, how they have that defined cause it could be different.
[AGENT][NEUTRAL] It looks like it's after you've used up the daily hospital benefit.
[AGENT][NEUTRAL] They pay a daily income of $75 per day. Again, that is um.
[AGENT][NEUTRAL] A reduction in benefit after age [PII].
[AGENT][NEUTRAL] So it looks like it's just after the daily hospital has been um
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] Exhausted.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] I would still file the claim through us, but if you have a major medical, I would, um,
[CUSTOMER][POSITIVE] All righty.
[AGENT][NEUTRAL] I would file the claim through them as well.
[AGENT][NEUTRAL] But this one is just showing that it's the, it's the hospital. It looks like it does hospital benefits and not necessarily the, the pacemaker or surgeries.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, that's too bad
[CUSTOMER][NEUTRAL] So, OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] There's a blood clot in the lungs?
[CUSTOMER][NEUTRAL] Count.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] It looks like that they have heart attack as including
[AGENT][NEUTRAL] Uh, coronary thrombosis or occlusion, but it doesn't give anything a little more specific than that. Let me check.
[CUSTOMER][NEUTRAL] I don't know what those two are. What are they?
[AGENT][NEUTRAL] I know. That's why I was going to look at, look at it real quick. Um, it would need the diagnose it would have the that diagnosis on his
[AGENT][NEUTRAL] Um, papers, but let me see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because we'll need the, we'll need the diagnosis from the, the physician or the doctor anyways. Um.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me check real quick.
[AGENT][NEUTRAL] So the coronary thrombosis would be a blood clot um in the vessels and arteries.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And they cover that.
[AGENT][NEUTRAL] Uh, that, that is in their definition of heart attack.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I would still file for um when you when you said he had a heart attack a few years back, you can still file for that as well um because your policy was active.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Yeah, it was, it was like the last year, it was like that last year.
[AGENT][POSITIVE] Oh yeah, you, you were covered um during that time.
[CUSTOMER][NEUTRAL] Yeah, OK, OK.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] But they don't pay anything on the uh doctor bills or anything like that.
[AGENT][NEUTRAL] Um, your policy looks like it's just, um, uh, the daily benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So not surgeries or anything like that, yeah.
[CUSTOMER][POSITIVE] All righty.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] Is there anything else I can help you with, [PII]? Oh, go ahead.
[CUSTOMER][NEUTRAL] If I
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, if, if I can't get it downloaded, uh, is there any way that you can mail me a copy?
[AGENT][NEUTRAL] Yes, ma'am. Um, I can go ahead. I should be able to, OK.
[CUSTOMER][NEUTRAL] That might be the easiest.
[CUSTOMER][NEUTRAL] That might be the easiest if you could do that.
[AGENT][POSITIVE] Give me just a moment. We'll do that over the phone so that I can make sure that we got everything um correct on here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] If that's all right with you.
[CUSTOMER][NEUTRAL] Yes, that's fine.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, give me just a moment and the address that you have on file, that [PII], right.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, expect that in the mail in just a little bit. Um, I would give it a few days.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and is there anything else I can help you with?
[CUSTOMER][POSITIVE] Yeah, that'd be perfect.
[CUSTOMER][NEUTRAL] Oh, I just wanna make sure you got the address. [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes ma'am, that's the one that we have on file.
[CUSTOMER][POSITIVE] OK. OK, perfect. I just wanna make sure you had the right one. OK, thank you for your help.
[AGENT][POSITIVE] Alright, thank you so much for calling ATL Edna. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you you too bye.
[AGENT][NEUTRAL] Bye bye.