AccountId: 011433970860
ContactId: 921de867-7f5d-472e-8b9c-7497823289dc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1350819 ms
Total Talk Time (AGENT): 449207 ms
Total Talk Time (CUSTOMER): 731961 ms
Interruptions: 5
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/921de867-7f5d-472e-8b9c-7497823289dc_20250123T21:49_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII] with the care team. How are you doing today?
[AGENT][POSITIVE] Great. How are you doing?
[CUSTOMER][POSITIVE] I'm doing wonderful. I need some help with um an intensive care coronary care policy. Am I in the right spot?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, perfect. I'm looking at policy number 60419 for a Miss [PII].
[AGENT][NEUTRAL] OK, I got it pulled up.
[CUSTOMER][NEUTRAL] OK, um, so she has the policy with us. I can't find this policy certificate at OnBase. I can see the back file application and correspondence, but she said that.
[CUSTOMER][NEUTRAL] We dropped her husband um because he hit 75, we refunded his premium, but she said that on her policy document it shows that the limits and exclusions that his benefits dropped to 50% at age [PII], not that he would be dropped off the policy, and she's wanting some more information, but I just unfortunately I'm not sure how to help her without being able to see the policy document. I wondered if maybe you knew something I didn't know.
[AGENT][NEUTRAL] Um, no, cause I don't see it either. Um.
[AGENT][NEUTRAL] Do we send a request? Let me, um.
[AGENT][NEUTRAL] I guess I may have to take her information and um.
[AGENT][NEUTRAL] I'm not sure how to handle this because there's no policy out there and I think I have to wait to see the policy. And so I guess we will have to just call her back once we get it, but um you can send her through. I'll reach out to my supervisor and find out um.
[AGENT][NEGATIVE] How is this supposed to go? I'm not sure if this is a hub request or not.
[CUSTOMER][POSITIVE] OK, absolutely, and I'm so sorry because I should have just notated it as soon as you said it because I know I'm scatter brains, but what was your name again?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Thank you [PII]. I'm, I'm really bad at that. I'm so sorry. um, I will transfer her to you and I'll introduce you when we join, OK?
[AGENT][NEUTRAL] That's OK.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][POSITIVE] My pleasure.
[CUSTOMER][NEUTRAL] Hi Ms. [PII], are you still there with me? Yes ma'am, yes ma'am. Hey there, so I have Miss [PII] on the line. Um, she does have a little more experience with these policies, and I'm gonna let her take on over the call, um, and that way she can do her best to help you out, OK?
[CUSTOMER][POSITIVE] That will work. Thank you so much. It was a pleasure talking to you Ms. [PII]. You take care. OK. Uh huh.
[AGENT][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Hey, yes, this is [PII] in the claims department. I understand you have some questions concerning um your spouse um on the policy.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um, I was telling her I got, uh, I got the letter and gave me like a $10 something, uh, benefit, uh, refund saying that my husband would no longer be um on the intensive care coronary care policy which he did turn [PII] in.
[CUSTOMER][NEUTRAL] Uh, and I mean he has passed that and.
[CUSTOMER][NEUTRAL] I told her on on my card that I have that was given to us when we took this out years ago and down here it says all I see slash benefits reduced by 50% at 875.
[CUSTOMER][NEUTRAL] I was fixing to file all this letter and then I really was gonna call and ask really what all that had to do with that, you know, as far as what are what's the cost now and is that the only thing that reduced and all but I, I've got to look in this because I use this yearly for the cancer screening and I'm pretty.
[CUSTOMER][NEUTRAL] Up on, you know, keeping up with my book work and I was gonna file this, but I did see this on here.
[CUSTOMER][NEGATIVE] It was like a pamphlet, it wasn't like in the the.
[CUSTOMER][NEUTRAL] It was the pamphlet that that uh that we, you know, had when we took it out.
[AGENT][NEUTRAL] OK. Just give me one.
[CUSTOMER][POSITIVE] And we've had it for a long time.
[AGENT][NEUTRAL] Yes, OK, just give me one moment.
[CUSTOMER][NEUTRAL] It was listed under and I was telling her that it was the very last minute of limitations and exclusions part of the hospital intensive care coronary care unit policy on that card.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So actually I mean it.
[CUSTOMER][NEUTRAL] Let's see, they.
[CUSTOMER][NEUTRAL] So he's [PII] so see that really would that refund wouldn't have been valid anyway because he was, he's been, he's gonna be [PII] in May.
[CUSTOMER][NEUTRAL] And I think it looked at the policy date though.
[CUSTOMER][NEUTRAL] That's what I figured too is that [PII] was a policy date that we took it out. I looked that up.
[AGENT][NEUTRAL] OK, so page one says this policy may be renewed until the policy anniversary following the [PII] birthday.
[CUSTOMER][NEUTRAL] Yeah, uh.
[CUSTOMER][NEGATIVE] I don't know, it might, that might be a new policy coming out there, but I, I haven't ever received a new policy in the mail with anything. I've got everything right here from.
[AGENT][NEUTRAL] No, this is the policy.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Just for the intensive care, right?
[AGENT][NEUTRAL] Yeah, this is the intensive care policy and that's the policy that you're calling about, right?
[CUSTOMER][NEUTRAL] Yes, yes, it's just I've got a letter telling me that he wouldn't be on there anymore and then I saw this on here saying that.
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] It and this is in that block with that that says the benefits reduced by 50% at 875.
[CUSTOMER][NEGATIVE] It didn't say it was no longer effective. It said, you know, reduced by 50%.
[AGENT][NEUTRAL] I'm looking at the header of the policy, the first page, and it does state that, you know, after um
[AGENT][NEUTRAL] 75, but I don't see anything with 50%. Um, is that something, uh something that you have signed or?
[AGENT][NEUTRAL] That you can send us in.
[CUSTOMER][NEUTRAL] Well, it's on a card that, that was the selling product. This is the card that was the selling product that I have things written all over it and this is where I made the decisions like on the chemotherapy plan, like the little block what we decided on that, the daily hospital expense benefit, but what we decided on that and that was all.
[CUSTOMER][NEUTRAL] Um, in this, it's like it was like the selling pamphlet is what it was is what was given to us, you know, as a little brochure type thing and that is, that is what's on the back, on the back side that was the hospital intensive care part of it. Now, um, I mean it's got all kind of things that have to do here that have to do with cancer, you know, it's all stuff. I just, I just caught my eye when I went to look at it.
[AGENT][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] So, is it saying that intensive care, um, or is it the cancer that reduces by 50%? Cause that sounds like something that will, the lump sum benefit under the cancer reduces.
[CUSTOMER][NEUTRAL] Um, I don't know. I mean, as far as the policy.
[CUSTOMER][NEUTRAL] Well, it's in the R.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Oh, the cancer, I haven't seen anything or anything reduces with cancer.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I mean that I don't, I don't think it's that um.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I don't know. I mean, I'm looking at right here um.
[CUSTOMER][NEUTRAL] It's on it's, it's in the same block as hospital intensive care coronary care unit policy.
[CUSTOMER][NEUTRAL] It's got a little, you know.
[CUSTOMER][NEUTRAL] I don't know it tells you the daily benefit, tells you double benefits, whatever, um.
[CUSTOMER][NEUTRAL] And then right uh that's kind of like under limitations and exclusions.
[CUSTOMER][NEUTRAL] Now you probably not gonna have it because this is this is probably back in [PII].
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That you know we took this out.
[CUSTOMER][NEUTRAL] I mean you may not have the same thing um where would it be on the policy itself?
[AGENT][NEUTRAL] I'm looking in the policy and what I see, um, you know, it, the you know, it does.
[CUSTOMER][NEUTRAL] I mean, I have that.
[CUSTOMER][NEUTRAL] What page are you on that that has to do with uh.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] It's the first page.
[CUSTOMER][NEUTRAL] That part.
[AGENT][NEUTRAL] Um, that has our American Public Life Insurance guarantee renewable to age [PII].
[AGENT][NEUTRAL] And then it has um.
[CUSTOMER][NEUTRAL] See we probably don't have anything updated, um, cancer uh disease.
[AGENT][NEUTRAL] This is, um,
[AGENT][NEUTRAL] Yeah, this is, um, you would have, this is something you would have received um because this is um prior to [PII]. So this is the policy for that um prior to your [PII] because this was so.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Let's see benefit provisions. While this policy is enforced, we will pay the daily indemnity showing the policy.
[CUSTOMER][NEUTRAL] I'm looking
[AGENT][NEUTRAL] If you are confined, we will begin paying.
[AGENT][NEUTRAL] In a hospital intensive care unit as a result of a sickness or injury and if you are confined before the policy anniversary following your [PII] birthday. So,
[AGENT][NEGATIVE] After the [PII], they're not gonna pay anymore.
[CUSTOMER][NEUTRAL] Yeah, well, I mean, I
[AGENT][NEUTRAL] That's under the benefit, that's under your benefit provisions.
[CUSTOMER][NEUTRAL] Yeah, I'm, yeah, I'm trying to find I've got the policy itself here and I'm trying to find benefit provision.
[AGENT][NEUTRAL] It's on
[AGENT][NEUTRAL] 85.
[CUSTOMER][NEUTRAL] 10 is what I have. So hold on.
[AGENT][NEUTRAL] From what I see is page 5, and it says benefits provisions.
[CUSTOMER][POSITIVE] OK, I see that and then the first part is like the wellness benefit that I do all the time.
[CUSTOMER][NEUTRAL] Or that is then I see first occurrence.
[CUSTOMER][NEUTRAL] Uh, data hospital expense benefit.
[CUSTOMER][NEUTRAL] Chemotherapy, radiation, drugs, blood plasma, private duty and, and patient surgical.
[CUSTOMER][NEUTRAL] But that goes to the schedule operations. I, I don't see the hospital intensive care coronary part.
[AGENT][NEUTRAL] That, what, what you, OK, so what you, I'm not sure, like each policy has its own so it sounds like you, what you're reading off is the cancer policy.
[AGENT][NEUTRAL] When it comes down to, OK, but see.
[CUSTOMER][NEGATIVE] It is cancer.
[AGENT][NEUTRAL] You have two separate policies.
[CUSTOMER][NEUTRAL] But it, but, but that's a hospital intensive care coronary care unit policy is what I'm looking at.
[AGENT][NEUTRAL] Yeah, that's, that's the
[CUSTOMER][NEUTRAL] That's what that letter.
[AGENT][NEUTRAL] That's the policy that I'm looking at as well.
[CUSTOMER][NEUTRAL] That's wha[PII] I'm talking about.
[CUSTOMER][NEUTRAL] I mean, I guess it's like a router.
[CUSTOMER][NEUTRAL] Yeah, I'm looking at the intensive care coordinated care policy and and and that's what that little statement is made.
[AGENT][NEUTRAL] Yeah. Under the benefit provisions, under your intensive care, coronary care policy, it does state that they will pay up to the policy anniversary following your [PII] birthday.
[CUSTOMER][NEUTRAL] Alright, now where is that part that you're looking at that? uh.
[AGENT][NEUTRAL] Um, it's under benefit provisions. I'm not sure how your policy looks, um, but on this policy, there is 20 let's see how many pages.
[CUSTOMER][NEUTRAL] I've got all kinds of.
[AGENT][NEUTRAL] So there's 7 pages.
[AGENT][NEUTRAL] Just for the intensive care coordinary care policy, there are 7 pages.
[CUSTOMER][NEUTRAL] And I'm not finding that um.
[CUSTOMER][NEUTRAL] See.
[AGENT][NEUTRAL] I would actually just need to have this policy mailed to you.
[CUSTOMER][NEUTRAL] Yeah, you do, um.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And I, I can compare it to what, what I'm looking at um.
[CUSTOMER][NEUTRAL] Uh, I'm not even finding.
[CUSTOMER][NEUTRAL] I'm still looking for where you were talking.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] A benefit provisions part 2 it's considered under part 2.
[CUSTOMER][NEUTRAL] Is that what you're saying?
[AGENT][NEUTRAL] And the, um, no, it just says benefit provisions.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Alright, this is part 2 of the cancer and specified disease policy.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] That's where it started out with a wellness expense benefit.
[CUSTOMER][NEGATIVE] That's not what you're looking at.
[AGENT][NEGATIVE] Well, see, that wouldn't be, no, because that is not intensive care coordinary care. That doesn't have anything to do with that.
[CUSTOMER][NEUTRAL] OK, well I don't.
[CUSTOMER][NEUTRAL] OK, I don't see.
[CUSTOMER][NEUTRAL] First in, in the binder that I have just that you know that we have. I don't see anything. I already looked because before I called you. I didn't see anything about the coronary part which I know that's a rider um.
[CUSTOMER][NEUTRAL] Let's see I second.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] I know I'm probably in a headache, but I, I did go through all my insurances yearly and file and throw away and clean out and.
[CUSTOMER][NEUTRAL] I see the specified diseases, I see the general agreement.
[CUSTOMER][NEUTRAL] Uh, begins renewable plans provision.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] But I don't see any part.
[CUSTOMER][NEUTRAL] In here that even specifies just to that coronary part and I wouldn't probably know that if I had never even called you because it's not in here.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, I see, you know, where what we took out for the chemo and radiation and all that on the very last page.
[CUSTOMER][NEUTRAL] But I don't see anything for just coronary except for that card that I just told you that I just saw it on.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, cancer assessed by the policy.
[CUSTOMER][NEUTRAL] And I see, you know, where we took it out. Let's see.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEGATIVE] Well yeah you just need to send me because that's that's not what I'm seeing.
[CUSTOMER][NEUTRAL] Here's another little folder let's see.
[AGENT][NEUTRAL] OK. I would um have a copy of your intensive care, coronary care policy mailed to the address that we have on file.
[CUSTOMER][NEUTRAL] But I tell you this, just that, but I mean since there's anything else might change, send me I guess send me a copy of the.
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] The whole policy I guess I mean I don't know I don't know if this.
[AGENT][NEUTRAL] So you need a
[AGENT][NEUTRAL] So, OK, so,
[CUSTOMER][NEGATIVE] I'm looking at one. I mean, I'm looking at every and I assume it's still in effect. Everything's good, but I mean since I'm looking at that and I mean I've got the first page and all this got like I was telling her this letter here that I have is not even the same policy number of that my policy number and why I don't know that she she started.
[AGENT][NEUTRAL] You have 2, you have 2 separate policies. You have 2 separate policies.
[CUSTOMER][NEUTRAL] My husband and I
[CUSTOMER][NEGATIVE] Yes, but this, this policy number was foreign. It ain't even nothing I used.
[CUSTOMER][NEUTRAL] Uh, and she said well I don't know what I have, so I gave her what I have. She, I mean you found our thing, so that's not me doesn't matter but.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I'm just saying you have two separate policies. You have a policy number and it's not a rider. It's not a cancer policy rider. You have two separate policies. You have an intensive care policy with one policy number, and you have a cancer policy with another policy number.
[CUSTOMER][NEUTRAL] OK, then that's what that number was. OK, that's why when she pulled it up because I, I do the annual screenings and I gave her the policy number off of what I had that I use, you know, that I feel when I fill it out or do that was the number I got. So this, this policy number here then it was 980 something is just the intensive care coronary care policy.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Number I didn't realize it was two different numbers so but I don't have that for some reason, but I do have it on the back of this card and I'm reading it where it says benefits reduced by 50% at age [PII].
[CUSTOMER][NEUTRAL] I would have never called but that's what I'm seeing so anyway, send me what you have and, and then tell me.
[CUSTOMER][NEUTRAL] I'll see just had something right here.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] This this said that it was in November and I got the check for $10 and something, so.
[CUSTOMER][NEUTRAL] What are the new amounts for that now? What is the new amount for him? Well, I guess he's not on there if he said if you're saying it's done away with him then, right? He's not even on that part no more.
[AGENT][NEUTRAL] OK, so if you wanna talk, discuss premiums, I will have to get you back to customer service cause I can only assist you with claims. Now, what I do see is your intensive care, coronary care is $7 and your cancer is $80.91. That's what I see on this end.
[CUSTOMER][NEUTRAL] OK, well,
[CUSTOMER][NEUTRAL] $7.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] That's for me, that's for both. The cancer is for both of us, right? Family, yes.
[AGENT][NEUTRAL] Yes, and then.
[CUSTOMER][NEUTRAL] I think it's a family plan, yeah.
[AGENT][NEUTRAL] And then the intensive care.
[CUSTOMER][NEUTRAL] So now the $7 is just for.
[CUSTOMER][NEUTRAL] Yeah, I think that read that in that letter it said your new premium will be $70 for [PII].
[AGENT][NEUTRAL] $7.
[CUSTOMER][NEUTRAL] Yes, yes, I, I, I've read that on that letter, yes.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] But what I was too is I got the letter for the $10. I don't even know what I mean the check. I don't even know what that was for or when because if this ended in November.
[CUSTOMER][NEUTRAL] It said it
[CUSTOMER][NEUTRAL] He, he turned [PII] a year ago.
[CUSTOMER][NEUTRAL] Not just last year, year before last year.
[AGENT][NEUTRAL] OK. All right. So you, OK, so I can get you back to those are questions that you would need to ask customer service cause I'm not, I'm, I'm, I'm not too sure about the premiums and how that was applied. So, um just one moment, please.
[CUSTOMER][NEUTRAL] So where's all those funds that that?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Well, do send me that copy of that though, please.
[AGENT][POSITIVE] Yeah. Yes, I sure will. Yes, ma'am. I'll send you a copy of your cancer policy as well as your intention.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Yeah, and I want a hard copy through the mail, not email, but a hard copy through the mail because I just file.
[AGENT][NEUTRAL] Oh, no, ma'am. We can't, we can't, yeah, we can't send anything by email.
[AGENT][NEUTRAL] So it would have to be by the mail. OK. um, [PII], just give me one moment, please. Thank you.
[CUSTOMER][POSITIVE] OK good thank you.
[CUSTOMER][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] These people are crazy.
[AGENT][NEUTRAL] I'm sorry, we're crazy. We'll get you some help. One moment.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] [PII], this is [PII] in the Can you. I have, um, [PII]. Can you hear me?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, I can.
[AGENT][NEUTRAL] Um, I have [PII] on policy 60419.
[CUSTOMER][NEUTRAL] OK, give me just a 2nd April, let me pull that up real quick, OK?
[CUSTOMER][NEUTRAL] One second, 60419?
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII], OK. Yes, ma'am. I got it pulled up.
[AGENT][NEUTRAL] All right. So she was, she was transferred to us from the care team um about her policy. Um, they, she was, they took her husband off because he turned [PII], um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] The care team couldn't assist about um.
[AGENT][NEUTRAL] Why, why that is. So she transferred her here, um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Looked up a policy, um, I'm gonna mail her out a policy, but she wanted to know about the check. Why is it just for $10? I can't assist her with any premiums or the checks or why she received what she received, OK? Um.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, I can help her. What's her callback number?
[AGENT][NEUTRAL] Um, they didn't give me a callback number, but I'm assuming it's the [PII], the one that is showing up, yes.
[CUSTOMER][NEUTRAL] I see it.
[CUSTOMER][POSITIVE] OK, I got it right, and she's been verified everything correct?
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Um, she was transferred from the care team, so I'm assuming so. Thank you.
[CUSTOMER][NEUTRAL] Of course. Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, thank you so much. Have a good day, [PII]. OK, bye.
[AGENT][POSITIVE] Mhm. You're welcome. You too. Bye bye.