AccountId: 011433970860
ContactId: a534280e-0fce-44ab-9839-e9dea672ed27
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 827489 ms
Total Talk Time (AGENT): 444254 ms
Total Talk Time (CUSTOMER): 264142 ms
Interruptions: 6
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/a534280e-0fce-44ab-9839-e9dea672ed27_20250501T20:40_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, I have a question over the benefits, um, for I have, um, I'm the primary holder and, um, and I have a family, um, packet. So, um, I just need to, I guess, get information as to how to file a claim. Uh, my husband was diagnosed with prostate cancer. So we've been, um,
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, I can say it, um, been through some, uh, procedures, I guess. So I just wanted to know what the benefits are and how to file a claim.
[AGENT][NEUTRAL] OK. So you're the primary policy holder and your husband has been diagnosed with cancer, so you're wanting to find out how to go about filing a claim with us and get some benefit information?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am, I can help you with those things. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, Ms. [PII], what is a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] It would be [PII].
[AGENT][POSITIVE] Thank you and your policy number please.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEGATIVE] I don't have it with me.
[CUSTOMER][NEUTRAL] I'm, I'm actually in the hospital.
[AGENT][NEUTRAL] OK. All right, what is your full social security number, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. Give me a moment please to locate your information.
[CUSTOMER][POSITIVE] Yes, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] No, that in the information of my policy.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so first off, Miss [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. I will need to verify several things with you first for security purposes. So first off, if you could please verify your date of birth and then your husband's name and his date of birth.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mine is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then my husband's name is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And your home mailing address, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we have, yes ma'am, it actually shows as horizon, OK, and the phone number that we have for you is the same as the one that you gave me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Or Horizon City.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you and then the last piece of information to verify is your email it's on file and this does appear to probably be your work email.
[CUSTOMER][NEUTRAL] OK, so then it's [PII].
[AGENT][POSITIVE] OK, thank you very much.
[AGENT][NEUTRAL] So first off, um, Ms. [PII], have you ever set up your profile yet in our portal called the online service center?
[CUSTOMER][NEUTRAL] No, never had to.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Start it up.
[AGENT][NEUTRAL] OK, alright, so I actually have a user guide that I will email to you, Miss [PII], that gives you the instructions for setting up your profile. It also explains how you can upload your claims information directly into the portal for review.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] And that uh email that I will send to you when we get off of our call, it's gonna come from [PII].
[AGENT][NEUTRAL] I will include.
[CUSTOMER][NEUTRAL] OK, um, you were like breaking up. Can you repeat that?
[AGENT][NEUTRAL] It's gonna come from [PII].
[CUSTOMER][NEUTRAL] Care thing?
[AGENT][NEUTRAL] I will
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 13, OK.
[AGENT][NEUTRAL] [PII] [PII]. I will, yes ma'am, that's who the email is gonna come from.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I will put APL in the subject line for you and in addition to the user guide Ms. [PII], I'll go ahead and attach the cancer claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For you because that has all of the instructions on page one for what other documentation, you know, in addition to the claim form that you will need to submit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So as far as benefit information on this policy, there is an internal cancer first occurrence benefit.
[AGENT][NEUTRAL] That is a benefit amount of $10,000.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] There are and once you've set up your profile in the portal, Ms. [PII], you will be able to see all of this information because there is a copy of your policy certificate in there.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] With all of your benefits listed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, um, so let me look.
[AGENT][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] And, and so this, this amount of money is uh to be used for treatments and stuff like that?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, that is the, that is an intern, what, it's called an internal cancer first occurrence benefit.
[AGENT][NEUTRAL] So we will have to have, uh, there's no point in you trying to write all this down because again this claim form has all of the document, I mean, the instructions for what you need to submit for this benefit. Now, if he has, yes, ma'am, there's really no need because that first page has everything on it. Now, he is, is he going to undergo radiation, chemotherapy or immunotherapy?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, because I was writing this down. Thank you for telling me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What if he, he, he, um, well, he got surgery.
[CUSTOMER][NEUTRAL] Um, they gave him two options, whether it would be chemo or surgery, um, because what he's got, he's got prostate cancer. So the doctor suggested, uh, for him, well, didn't suggest it just gave him the differences if he was to get chemo, then if it comes back, he would not be able to get chemo again. So, but if he gets the surgery and it comes back, then he can have chemo. And so it's a second.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] How do you say, um, so I don't know, it, it it doesn't have the the option you're giving me doesn't, doesn't, surgery is not in there. Does, does it cover even though with surgery?
[AGENT][NEUTRAL] Now, we do not, under this specific policy, there are not benefits for surgery.
[AGENT][NEUTRAL] But uh, for the first occurrence benefit of internal cancer, the pathology report confirming the diagnosis of cancer is one of the documents that's required, but that is stated on the form.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, should he end up having to have, you know, some type of radiation or that you're saying he probably won't, this policy does have additional benefits for that, but not for surgery.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] And again, once you have created your profile in the online service center you will have access to your policy information that gives you the benefit amounts on this policy and it also gives you definitions.
[AGENT][NEUTRAL] Of what each of the, the benefits mean.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK good I need some explaining.
[AGENT][NEUTRAL] Mhm. Yes, ma'am. I understand. And I can read it to you from your, you know, from the policy, but again, you will have access to that. And then if you have any further questions, you could call us, you know, back.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, yeah, OK, I'll I'll uh I'll start the uh the, the portal.
[CUSTOMER][NEUTRAL] And, and, and with what, with this portal, can I, for example, because I mean like say I have cancer, um, that same portal can hold both my husband's information and my information or do I have to do a separate portal for myself?
[AGENT][NEUTRAL] Yes ma'am, because, no, no, because you're the insured you will set up the portal and you will be able to see each of your dependents. So this user guy is also gonna explain this but like when you're filing a claim for your husband, you will select him as the claimant.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I have another question.
[AGENT][NEUTRAL] So, you know, you will.
[AGENT][NEUTRAL] Mhm. Sure.
[CUSTOMER][NEUTRAL] I, I, I also have my 3 daughters. Is there an age limit for them?
[CUSTOMER][NEUTRAL] Like they'll, they're covered up until a certain age.
[AGENT][NEUTRAL] Uh, let's see.
[CUSTOMER][NEUTRAL] Because one's [PII], one's [PII], the other one's [PII].
[AGENT][NEUTRAL] I believe that one of them has already turned, I mean, let's see. Give me just a moment to go back to your dependents. [PII] is not on this policy anymore.
[CUSTOMER][NEUTRAL] Yeah, is it over?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And I believe that the max age is [PII], but let me double check that.
[CUSTOMER][NEUTRAL] OK, cause she's.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, so they did the same thing with the with the dentist.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm, let's see. Um,
[AGENT][NEUTRAL] Let me look.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am. And this is also in your policy under eligible dependents. And yes, ma'am, it does state who is under [PII] of age.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Unless they, you know, had a disability.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That would
[CUSTOMER][NEGATIVE] OK, no, they're not. Well, they do, they just don't listen to me. No, not really, no, they don't.
[AGENT][NEUTRAL] You know,
[AGENT][NEUTRAL] Oh, so you have normal children, I mean.
[AGENT][POSITIVE] I totally understand.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, I have grown children now too, so I, I can relate, but no, ma'am, and, and all joking, you know, all that aside, it is [PII] unless they did have a medical condition that
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, you know, prevented them.
[AGENT][NEUTRAL] If they were handicapped, they, if they had a disability that was medically diagnosed and documented.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, well, no, they don't. OK then, so, um, so I guess I'll, uh.
[AGENT][NEUTRAL] So the, your other two daughters have a little bit longer on here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well hopefully uh they don't, but I was just wondering.
[AGENT][NEUTRAL] Yes, ma'am. It would be after, if they would come off um after.
[AGENT][NEUTRAL] Once I turned [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK then, well thank you so much. I'll uh I'll I'll start working on that portal.
[AGENT][NEUTRAL] So, OK. Well, you're welcome, so.
[AGENT][NEUTRAL] OK, yes ma'am. Well, give me just a few minutes if you don't see it in your inbox shortly, um, you might wanna check your junk or spam folder. It's possible that it could go there most of the time it doesn't. It will come to your inbox, but again it's gonna come from [PII] [PII] and I will put APL in your subject line for you.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Sounds good. Thank you so much.
[AGENT][POSITIVE] Alright, well, you're very welcome. So is there anything else I can answer for you or help you with this afternoon?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] No, that was all. Thank you.
[AGENT][POSITIVE] OK, well, you're very welcome, Ms. [PII], and again, thank you for calling APL. I hope you do have a nice evening.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] Thank you too, bye bye.
[CUSTOMER][NEUTRAL] Bye bye.