AccountId: 011433970860
ContactId: 83247416-56aa-4ef0-8152-9f0c026ec0cb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 471890 ms
Total Talk Time (AGENT): 219498 ms
Total Talk Time (CUSTOMER): 161486 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/26/83247416-56aa-4ef0-8152-9f0c026ec0cb_20250626T13:15_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I was wondering about our policy, um.
[CUSTOMER][NEUTRAL] If we are policy number is.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, let's see.
[CUSTOMER][NEUTRAL] 724-419
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] May I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK. Do you mind repeating that number one more time?
[CUSTOMER][NEUTRAL] Um, that's on my card. It's the insured. You need, it's the policy is under family and then I have a group number also.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] So do you need the insured or the group number?
[AGENT][NEUTRAL] The insurance.
[CUSTOMER][NEUTRAL] 724-419
[AGENT][NEUTRAL] OK. Thank you, Miss [PII]. And may I have your date of birth and address for verification?
[CUSTOMER][NEUTRAL] Uh, I'm, this is for, I'm asking about my husband, but this is his wife. Do you need my husband's name or mine, birthday and everything?
[AGENT][NEUTRAL] Your information, you're the caller.
[CUSTOMER][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And the address on file?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you. And how may I assist you today?
[CUSTOMER][NEUTRAL] Um, I was wondering if we have any coverage with this for, um, rehab.
[AGENT][NEUTRAL] OK, let me check.
[CUSTOMER][NEUTRAL] My husband had a stroke and he's in rehab.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, bear with me just a second. Let me go ahead and pull the documents of the policy, the benefit documents.
[AGENT][NEUTRAL] And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The.
[AGENT][NEGATIVE] OK, this one doesn't have coverage for rehab.
[CUSTOMER][NEUTRAL] OK, how about assisted living?
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Nothing like that either.
[AGENT][NEUTRAL] No. No.
[CUSTOMER][NEUTRAL] OK. OK, can you give me the um amount for the life insurance coverage? What is this policy? How much is the life insurance policy?
[AGENT][NEUTRAL] Um, let me check if we have a life policy, OK, this one is just the hospital indemnity. One moment.
[AGENT][NEUTRAL] I don't see a life insurance on this one. this one is just a medical.
[AGENT][NEUTRAL] Medical limited policy.
[CUSTOMER][NEUTRAL] So what does this
[CUSTOMER][NEUTRAL] So what does the medical cover?
[AGENT][NEUTRAL] OK. All right. So for this one, and this is a limited hospital indemnity, and this one will cover like for a confinement if you're in the hospital and you are hospitalized, uh, we cover a daily hospital benefit of $500.
[AGENT][NEUTRAL] And that's a one time benefit.
[AGENT][POSITIVE] You also get intensive care, which is a daily benefit of 1000.
[AGENT][NEUTRAL] Um, let's see, you have an emergency accident rider.
[AGENT][NEUTRAL] Which allows $300 per accident.
[AGENT][NEUTRAL] You have the wellness and diagnostic testing, which you have the diagnostic testing, which is like um
[AGENT][NEUTRAL] CT scan, MRI, or colonoscopy is covered at $250 and that's per year. A wellness exams is covered at $75 per test up to the maximum of $250. So that $250 is a combined benefit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Um, you also have benefits.
[CUSTOMER][NEUTRAL] Cause he was in, he was
[AGENT][NEUTRAL] OK. Yes.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Benefits for what?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, you also have the annual first occurrence hospital rider. Uh, so the first time that he's hospitalized, you have 1500. That's one time.
[AGENT][NEUTRAL] And then you have outpatient.
[CUSTOMER][NEUTRAL] That they would cover.
[AGENT][NEUTRAL] Yes, mhm. Yeah, that's um the first uh occurrence is gonna be like the first time he's admitted to the hospital. It's the same thing.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, um, and you also have benefits for sickness, and that is if you go to an office, regular office or PCP or um specialist. This one covers $50 per visit, maximum of 5 visits per year.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][POSITIVE] Um, you also have benefits for surgeries.
[AGENT][NEUTRAL] For the surgery, you have, um, let's see.
[AGENT][NEUTRAL] OK, that's 10,000.
[AGENT][NEUTRAL] And that's per year?
[AGENT][NEUTRAL] And 25% of the benefit amount will go towards the anesthesia.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, you also have, yeah.
[CUSTOMER][NEUTRAL] OK. So, well, he was, yeah, go ahead.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. You also benefits for the facility if you have that surgery. So we do cover the facility of $500 and that's twice per year.
[CUSTOMER][NEUTRAL] Also have like
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] So when we, I gave the
[CUSTOMER][NEUTRAL] Hospital my uh card.
[CUSTOMER][NEGATIVE] Uh, he was in the hospital for 3 weeks and then we got, um, papers back that said that uh no coverage, no coverage. I think the only one we got coverage on was $50 for one.
[CUSTOMER][NEGATIVE] So, um, but he was in the hospital for 3 weeks cause he had a stroke.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'm trying to think here what we got here. Oh yeah, this was like um.
[CUSTOMER][NEUTRAL] Uh high health physicians outpatient sickness benefit was $50 and that's the only thing that was covered.
[CUSTOMER][NEUTRAL] As far, so far.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, it looks like we recently sent out a payment and the claim for [PII] was recently processed on the [PII].
[AGENT][NEUTRAL] So you should be expecting a check.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][POSITIVE] OK. OK. I was just checking on everything and just, yeah, I don't, insurance is mind boggling to me, but, you know, so, OK, I appreciate your help.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] I think that's it. Thank you.
[AGENT][POSITIVE] OK. You're welcome. Thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][POSITIVE] You're welcome. Thank you. Bye-bye.