AccountId: 011433970860 ContactId: a1f5f888-c8e3-4852-b954-af38a07603a6 Channel: VOICE LanguageCode: en-US Total Conversation Duration: 1461560 ms Total Talk Time (AGENT): 650341 ms Total Talk Time (CUSTOMER): 544318 ms Interruptions: 2 Overall Sentiment: AGENT=0.4, CUSTOMER=0.5 Redaction Types: PII Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/10/a1f5f888-c8e3-4852-b954-af38a07603a6_20250110T16:48_UTC.wav -------------------------------------------- [AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you? [CUSTOMER][NEUTRAL] Yes, this is [PII], and my mother is [PII] who has two policies with you all, and she passed away and I was just trying to see what these policies were because I just received the uh statement where they are due. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] Um, and Ms. [PII], can I have a callback number for you in case we get disconnected and I can call you back? [CUSTOMER][NEUTRAL] It's [PII]. [CUSTOMER][NEUTRAL] [PII] [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] And can you provide me one of the policy certificate numbers, Miss [PII]? [CUSTOMER][NEUTRAL] Yes, yes, the first, I'll give you the first one because the other one is just one number up. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] 88828. [AGENT][NEUTRAL] I'm sorry, you cut out a little bit 8? [CUSTOMER][NEUTRAL] Yeah, it's like your phone is not, I've got a little bit of a feedback on it. [AGENT][NEUTRAL] Oh my apologies. [AGENT][NEUTRAL] Um, [CUSTOMER][NEUTRAL] 8 [AGENT][NEUTRAL] Uh-huh. [CUSTOMER][NEUTRAL] 882 8 [AGENT][POSITIVE] OK, thank you. [AGENT][NEUTRAL] And can I have you verify uh date of birth for Mrs. [PII]? [CUSTOMER][NEUTRAL] [PII]. [CUSTOMER][NEUTRAL] Yes, because she was [PII], [PII]. [AGENT][NEUTRAL] Yeah I have a different date of birth. What's the mailing address? [CUSTOMER][NEUTRAL] [PII]. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] [PII]. It would've been [PII], not [PII], cause she was [PII]. I'm sorry. [AGENT][NEUTRAL] That's OK. [CUSTOMER][NEUTRAL] I was trying to make her [PII] instead of [PII] to [PII] would have been. [AGENT][NEUTRAL] Yeah [CUSTOMER][NEUTRAL] But she passed away in [PII], so that would be [PII]. [AGENT][NEUTRAL] OK [AGENT][NEUTRAL] And do you um are you the um. [AGENT][NEUTRAL] Executor or? [CUSTOMER][POSITIVE] Yeah, I'm gonna say yes because it's gonna be me and my son working on it together. We were her power of attorneys and I took care of everything. [AGENT][NEUTRAL] OK, so because you're not. [CUSTOMER][POSITIVE] I'm signing, uh, so far I've signed everything, so yeah. [AGENT][NEUTRAL] Yeah, OK, because you're not on the policy, I have to have some sort of authorization for you to to provide you that information. So if you could, um, I do you have access to a fax machine or I can give you our mailing address if you would like to mail that information to us along with the death certificate so at least we can get the policy canceled and then if there's any um premium due back. [CUSTOMER][NEUTRAL] Well, uh, well, is it? [CUSTOMER][NEUTRAL] Uh, the reason why I'm asking, is it a cancer hospitalization? Can you tell me that? Because if it's a hospitalization, [CUSTOMER][NEGATIVE] She was hospitalized for a heart attack and a broken hip all within 6 weeks of time. [AGENT][NEUTRAL] OK [CUSTOMER][NEGATIVE] With her her policy would be in effect because [PII] is when she broke her hip and was in the hospital. And then on [PII], she went into cardiac arrest and had a heart attack. [CUSTOMER][NEUTRAL] And was in the hospital for several days. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] So what we would [CUSTOMER][NEUTRAL] So I mean there it. [AGENT][NEUTRAL] Yeah, go ahead. [CUSTOMER][NEUTRAL] I mean, if it is like a hospitalization or something like that, then we would need to file a claim. [AGENT][NEUTRAL] Yes. [AGENT][NEUTRAL] Um, you, you would be, you would, um. [AGENT][NEUTRAL] Just give me one moment. [CUSTOMER][NEUTRAL] So I know she had a cancer policy, but it was with a different company. [AGENT][NEUTRAL] Uh huh [CUSTOMER][NEUTRAL] OK, this is not due until. [CUSTOMER][NEUTRAL] The [PII], so yeah, she passed away the [PII], so. [AGENT][POSITIVE] I'm sorry to hear that. Sorry for your loss. [CUSTOMER][POSITIVE] Thank you. [CUSTOMER][NEUTRAL] He had [PII] good [PII]. That's all I can say. [AGENT][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] I can say that not many [PII] are only taking a blood pressure pill. [AGENT][NEUTRAL] Right [CUSTOMER][NEUTRAL] Yeah. [AGENT][NEUTRAL] OK, it does look like there's some hospital uh benefits on the policy. So, uh, again what I would. [CUSTOMER][NEUTRAL] Now, are you looking, looking at both policies cause she's got 2. [AGENT][NEUTRAL] Yes, mhm. [AGENT][NEUTRAL] So my suggestion again would be to um. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] Go ahead and send that information into us and then to file the claim what you would need to obtain is uh what we call that proof of loss. So if she was hospitalized, we would need those uh itemized bill, an itemized bill from the hospital, um or you can possibly obtain a form called a UBO4. [AGENT][NEUTRAL] And that's like a universal billing form and that is what's used to uh uh the hospitals and doctor's offices used to bill insurance companies so that form again is called a U like umbrella B like boy, 04. [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] OK, I wrote that down. [AGENT][NEUTRAL] Now, yeah, now that would be in lieu of otherwise it would be a detailed itemized billing um from the facility that just provides us the diagnosis and procedure codes and um but if that UBO4 is able to be obtained, usually they have a copy in the file if there's a primary insurance and since this is like a supplemental coverage, they should be able to provide you a copy of that UBO4. So then the other thing we would need again is that death certificate um. [CUSTOMER][NEUTRAL] The [AGENT][NEUTRAL] And then any information that would provide us um that you know uh who the beneficiary uh would be. [CUSTOMER][NEUTRAL] OK, so you need the death certificate? [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] And what my name? I mean, well, we'll just to make it easier we'll just say I'm the beneficiary. [AGENT][NEUTRAL] OK, so we would need some sort of document, yeah, some sort of documentation that verifies that uh you would be the um beneficiary or the. [CUSTOMER][NEUTRAL] Because I, I, our daughter. [AGENT][NEUTRAL] Um, do you have any kind of legal document that provides that information? [CUSTOMER][NEUTRAL] I have power of attorney. I mean, I have a power of attorney where she signed it before she. [CUSTOMER][NEUTRAL] You know, passed away, me and my son were her pair of attorneys. So would that work? [AGENT][NEUTRAL] Um, that would probably be, um. [AGENT][NEUTRAL] Just uh bear with me for just a moment. I'm gonna place you on a brief hold and I'm gonna I I'm in the claims department so I'm gonna place you on a brief hold and get someone from customer service because I do believe that once the party is deceased and the power of attorney um is no longer valid, but if you had that prior to um like I said, and are you named on the death certificate as like the informant? [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Right. [CUSTOMER][NEUTRAL] Oh, I have it. [CUSTOMER][NEUTRAL] Do what? [AGENT][NEUTRAL] Are you on the death certificate as well as the informant? [CUSTOMER][NEUTRAL] Uh, well, she was at the nursing home, so I'm not sure. Let me look. [AGENT][NEUTRAL] OK, while you obtain that document, yeah, can I place you on a brief hold and uh and I'm gonna check. [CUSTOMER][NEUTRAL] Because she was [CUSTOMER][NEUTRAL] Yeah, I look for the other. [AGENT][NEUTRAL] Yeah. [AGENT][NEUTRAL] Just give me one moment, OK? [CUSTOMER][NEUTRAL] OK. [AGENT][POSITIVE] Thank you. [CUSTOMER][NEGATIVE] You are on hold. [AGENT][NEGATIVE] And I don't know why do I always get this fucking call. [AGENT][NEGATIVE] Why isn't customer service answering these calls? [CUSTOMER][NEUTRAL] Sing. [AGENT][NEUTRAL] It's not like [CUSTOMER][NEUTRAL] Hello this is [PII] in the customer service department. How may I help you? [AGENT][NEUTRAL] Hi [PII], this is [PII] in claims. [CUSTOMER][NEUTRAL] Yes, ma'am. [AGENT][NEUTRAL] Hi uh how are you? [CUSTOMER][POSITIVE] I'm good. How are you? [AGENT][NEUTRAL] Good, I have a customer on the line and she is calling in to report that her mother is deceased and she was trying to obtain some information. I don't show her as listed as um. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] Um, authorization or anything now she does say that she has, I advised her to go ahead and send us in the death certificate, um, and then possibly, um, some sort of legal document that shows that she is the um a state uh executor. Um, she does say she has a power of attorney, but I believe that once the party's deceased, the power of attorney is is void. [CUSTOMER][NEUTRAL] Right. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] It's oh, yeah. [CUSTOMER][NEUTRAL] Right. [AGENT][NEUTRAL] So is there something else she can send into us? [CUSTOMER][NEUTRAL] Well, actually, because she is sending the death certificate and has notified the if we can speak to her, but what is she wanting to know? [AGENT][NEUTRAL] Well, she wanted to know what type of policy this was and that if she could file a claim, apparently the um the insured had a fall, um and broke her hip, I believe she said, and then she was hospitalized and then had cardiac arrest, um, but she did pass away on [PII]. [CUSTOMER][NEUTRAL] OK, so like you can tell her what type of policy it is and how to file the claim but like we can't give her. [CUSTOMER][NEUTRAL] We can't give her any details. [AGENT][POSITIVE] Like benefits and stuff like that. [CUSTOMER][NEUTRAL] Yeah, yeah, until we get that death certificate, but we can. [CUSTOMER][NEUTRAL] That's kind of generic as long as it stays on the border of generic and not specific you're, you're OK since she notified us of that. Um, if you'll give me the policy number, what I'll also do, um, in customer service, when we get a notification, we let them know what we need, but we also follow up in 30 days. If they don't send us the death certificate, we send a letter requesting it. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] OK, so the policy number, she actually has two and I'm a little bit confused as to why um it's an older policy it's 88828. [CUSTOMER][NEUTRAL] OK, what is it? [CUSTOMER][NEUTRAL] Mhm. [AGENT][NEUTRAL] And 29. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] And of course since it's so old, I don't have a policy certificate so I'm actually I see the hospital benefit on here I'm not even certain what type of policy it is. [CUSTOMER][NEUTRAL] Alright, give me that policy number again. [AGENT][NEUTRAL] I'm sorry, 88828? [CUSTOMER][NEUTRAL] So it's 382 8. [AGENT][NEUTRAL] Yeah, 888-28 and 88829. [CUSTOMER][NEGATIVE] OK, so the CP one's a cancer. [CUSTOMER][NEUTRAL] She has 2 cancer policies. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] That's what I thought they were both cancer, but I wasn't sure. [CUSTOMER][NEUTRAL] How did she end up with too? [AGENT][NEUTRAL] That's what I was a little bit confused about because they look to be the same and it looks like in the correspondence that at one point she was sent a letter that canceled and then they reinstated it. [CUSTOMER][NEGATIVE] Let me see what type of cancer. Hang on. It's moving slow. [CUSTOMER][NEUTRAL] It's always when you need it to do something fast, it just wants to hit on you. [AGENT][NEUTRAL] Right, of course, yeah, I had that problem a few calls ago. [AGENT][NEGATIVE] I had to end up calling the provider back because I couldn't get. [AGENT][NEGATIVE] Couldn't get it to open. [CUSTOMER][NEUTRAL] Let's see. [CUSTOMER][NEUTRAL] I know this is a cancer policy, but I can't remember. [CUSTOMER][NEGATIVE] It's the system's moving slowly entirely. [CUSTOMER][NEUTRAL] Now what I can also do to stop them from drafting. [CUSTOMER][NEGATIVE] I can put a temporary lapse on it, but she won't. [CUSTOMER][NEUTRAL] She won't be officially lapsed until the death certificate comes in. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] OK. It is a cancer policy and I was thinking that my benefit. [CUSTOMER][NEUTRAL] Screen would tell me which one it is. Hang on just a second, let me try. [CUSTOMER][NEUTRAL] It's a cancer-specified disease policy. [AGENT][NEUTRAL] OK [CUSTOMER][NEUTRAL] Um, [CUSTOMER][NEUTRAL] Do you want me to talk to her and tell her that we could temporary cancel it or? [CUSTOMER][NEUTRAL] And the last 18. [AGENT][NEUTRAL] Um, [AGENT][NEUTRAL] I could, I guess I can just relay the information if that's OK. I mean, I don't need to transfer it's up to you. I can transfer her though if you'd like. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] No, she's wanting to file claims. Like I said, you can tell her about that and just let her know that um [CUSTOMER][NEUTRAL] We'll follow up with her if we don't get the death certificate. [AGENT][NEUTRAL] OK, and then I'll just tell her that we placed a temporary uh uh stop on the um premium until we get the death certificate, correct? [CUSTOMER][NEUTRAL] Right, and I thought she was on draft, but she's not on draft. It looks like she's paying annually. [AGENT][NEUTRAL] OK [CUSTOMER][POSITIVE] And that's probably why she was able to get two policies because they're so low in benefits. [AGENT][NEUTRAL] Uh, OK. [CUSTOMER][NEUTRAL] I just noticed that her annual premium is 2940. [AGENT][NEUTRAL] Yeah, I saw that OK and then yeah that's what happened is she, she didn't even realize she had these policies she got the bill in the mail which prompted her to call us. [CUSTOMER][NEUTRAL] Um [CUSTOMER][NEUTRAL] Right, OK, I'll go ahead and still set it up though to where we'll follow up if we don't get the death certificate and I've officially, well, not officially, but it's not gonna bill anymore after this. It's in a L status. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] OK [CUSTOMER][POSITIVE] Alright, well let me know if you need anything else and I hope you have a good day. [AGENT][POSITIVE] You too [PII] thank you so much for your help. I hope you have a great day and a great weekend. [CUSTOMER][POSITIVE] You're welcome, thank you. [CUSTOMER][POSITIVE] You too man, thanks again bye. [AGENT][POSITIVE] Thanks. Bye. [AGENT][NEUTRAL] OK, Ms. [PII]. [CUSTOMER][NEUTRAL] Yeah yeah. [AGENT][NEUTRAL] Yeah, I'm, I'm sorry about that. OK, so I spoke with um our cus our customer service team so um it, it does appear, excuse me, that one policy is the cancer policy and then there's an additional policy for the um can uh cancer and specified disease. So, um what you'll wanna do, like I said is um. [CUSTOMER][NEUTRAL] That [CUSTOMER][NEUTRAL] Hm [AGENT][NEUTRAL] They did tell me they placed a temporary uh stop on the premium so um now what that means is that usually if you're on a draft it would stop the draft, but it appears that she pays uh annually so she sent us a check and I believe so um it. [CUSTOMER][POSITIVE] Right, that's probably right. [AGENT][NEUTRAL] Yeah, so at this point we're gonna place a temporary stop on that for the billing, so, um, but what we do need like I said is that death certificate and then um. [CUSTOMER][NEUTRAL] And I did check the death certificate and I am listed as the informant. [AGENT][NEUTRAL] OK, I would go ahead and and include any kind of uh. [AGENT][NEUTRAL] Legal information you have as far as you know uh that beneficiary and then um like I said you'll wanna obtain that billing information from the facilities uh where she was treated at and like I said it's either that uh detailed itemized bill with procedure and diagnosis or like I said if they're able to provide you that UBO4 form, that should be all that's needed that will give us the uh patient information, the dates of uh confinement. [CUSTOMER][NEUTRAL] Mm [CUSTOMER][NEUTRAL] OK [AGENT][NEUTRAL] And then uh that diagnosis code. [CUSTOMER][NEUTRAL] Did I [CUSTOMER][NEUTRAL] Did I do that for both of her stays? [AGENT][POSITIVE] I would, yes. [CUSTOMER][NEUTRAL] The November the [AGENT][NEUTRAL] Yeah. [CUSTOMER][NEUTRAL] OK, because she was, actually, she was in two different hospitals on the last time, so I will have to get one from [PII] City. [CUSTOMER][NEUTRAL] Because she had, when she had a heart attack, she was taken to Greenville Community and then switched transferred to Johnson City Medical on the next day. [AGENT][NEUTRAL] OK [AGENT][NEUTRAL] Yeah, so if you're able to obtain that uh billing information that like I said you can just send that information and um. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] And now if you wanna go ahead and send the death certificate and the legal information ahead of time you can I can provide you a secure fax number or you can mail it to us. [CUSTOMER][NEUTRAL] OK, if you don't mind, let me do a secure fax number because I feel like that is safer because I've mailed documents before different places and they said, you know what I saying? I just feel safer with. [AGENT][NEUTRAL] Yeah. [AGENT][POSITIVE] Absolutely. [CUSTOMER][NEUTRAL] OK, where can I fax it to? [AGENT][NEUTRAL] You're gonna fax it to [PII]. [AGENT][NEUTRAL] [PII]. [AGENT][NEUTRAL] 94 [AGENT][NEUTRAL] 23. [CUSTOMER][NEUTRAL] And anybody's attention? [AGENT][NEUTRAL] Um, once they see what the documents are, excuse me, they'll be, um, filed to the um to the departments that, uh, the departments that, uh, received those documents. Now as far as the billing information you can send that to the claims attention claims. [AGENT][NEUTRAL] Um, otherwise I would just address that attention customer service on the um. [AGENT][NEUTRAL] And the other documents. Yes, mhm. [CUSTOMER][NEUTRAL] The death and power of it. [CUSTOMER][NEUTRAL] I'm writing this down and writing it so I can see, read it. [AGENT][NEUTRAL] OK [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEGATIVE] I had I had another question there just um and it just went blank. [CUSTOMER][NEUTRAL] OK, so I need to send. [CUSTOMER][NEUTRAL] It's something with that. I need to get all of the hospital, the UBO4 from both hospitals. [CUSTOMER][NEUTRAL] And both, both visits. [CUSTOMER][NEUTRAL] Death cert go ahead and send the death certificate and the power of attorney to customer service. [AGENT][NEUTRAL] Yes. [CUSTOMER][NEUTRAL] And and send the UBO4 to claims. [AGENT][NEUTRAL] Attention claims and it's the same fax number [PII]. [CUSTOMER][NEUTRAL] OK, now this might take me a little while to get the information together since one town, my hospitals are in two different towns. Does that make sense? [AGENT][POSITIVE] Yes, absolutely, and I'll go ahead and put notes on both of the policies that you know we spoke and what is um needed and that um you you don't have to worry about if it takes a little bit of time there is no filing limit, um, you know, there's no there's no date like you have to get a claim filed by just so you're aware of that. [CUSTOMER][POSITIVE] Oh, OK, good. I didn't know if I needed to do it within a certain amount of time, but since I put that on temporary hold, that's good. [AGENT][POSITIVE] Yes, mhm, and of course because the policy was active during that um during those dates there's nothing to worry about with that. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Oh, I know what I was gonna ask you. She was in the nursing home too. She was there for rehab. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] So do we need anything from them, but. [CUSTOMER][NEUTRAL] Or anything. [AGENT][NEUTRAL] Um, [AGENT][NEUTRAL] Let's see. [AGENT][NEUTRAL] I believe it would just be the hospital information um but you can certainly send that in as well if um the nursing home wants to provide you that information because I'm certain they probably sent a claim to her major medical insurance as well. [CUSTOMER][POSITIVE] Oh yes, I'm sure they did. Because I mean, I think, yeah, cause she had the major medical. So, OK, I will, I just throw one in there with the nursing home as well because it can't hurt. [AGENT][NEUTRAL] Yeah. [AGENT][NEUTRAL] Right and like I said they'll acknowledge it and um if there's anything payable for that uh stay um that would be you know uh determined at the time we receive that information. [CUSTOMER][NEUTRAL] Right, OK, because, yes, because I've not received a statement from them or anything, and I asked them if there was a balance, and my, my answer was I don't know until I close out the month. [AGENT][NEUTRAL] Oh, OK. [CUSTOMER][NEUTRAL] And I'm like, [CUSTOMER][NEUTRAL] OK, you can't go ahead and process that. [AGENT][NEUTRAL] Right. [CUSTOMER][NEUTRAL] You would think you would, you would think you would want to, you know? [AGENT][NEUTRAL] Yes. [CUSTOMER][NEUTRAL] That [CUSTOMER][NEUTRAL] I, you know, that's the reason why I'm not in that business. I'm in a different method. [AGENT][NEUTRAL] Uh yeah, well, some and sometimes, um, just so you're aware, uh, sometimes those facilities do outsource their billing so they may not have that information. So in other words, even though they're one facility they may have another out out, uh, you know, another uh company that does their billing for them and they probably may not have that information. [CUSTOMER][NEUTRAL] Right [CUSTOMER][NEUTRAL] Well, uh, they, they are a corporate, they are part of corporate, so I figured corporate when it does because all the payments and everything has to go through corporate and posted through there, so. [AGENT][NEUTRAL] Yeah. [AGENT][NEUTRAL] Yeah. Mm. So yeah, that could take a little bit of time. [CUSTOMER][NEUTRAL] So [CUSTOMER][POSITIVE] Yes, it can. So, but I appreciate you and who am I speaking with? [AGENT][NEUTRAL] My name is [PII] Last initial is [PII] like love. [CUSTOMER][POSITIVE] OK, I appreciate that. [AGENT][POSITIVE] You're so welcome and again I'm so sorry for your loss. [CUSTOMER][NEUTRAL] Very [CUSTOMER][POSITIVE] Well, thank you very much and I appreciate you. [AGENT][POSITIVE] OK, thank you for calling APL and I hope you have a great rest of your day. [CUSTOMER][POSITIVE] OK, you too, take care. [AGENT][NEUTRAL] Did you, did you have any other questions, Miss [PII]? [CUSTOMER][NEUTRAL] Uh-huh. [CUSTOMER][NEUTRAL] Do what? [AGENT][NEUTRAL] Yeah, do you have any other questions? [CUSTOMER][POSITIVE] Uh, no, I don't, hon. Thank you very much. [AGENT][POSITIVE] You're welcome, thank you again have a great day. [CUSTOMER][POSITIVE] Uh-huh. Thank you. Take care. Bye. [AGENT][NEUTRAL] Bye bye. [AGENT][NEUTRAL] You too bye bye.