AccountId: 011433970860
ContactId: a854fcfa-e263-4bec-ac23-0862d417e2d0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 509320 ms
Total Talk Time (AGENT): 245168 ms
Total Talk Time (CUSTOMER): 158287 ms
Interruptions: 8
Overall Sentiment: AGENT=1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/a854fcfa-e263-4bec-ac23-0862d417e2d0_20250605T15:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, ma'am. Um, my name is [PII], and I am trying to figure out what kind of coverage I have through y'all.
[AGENT][NEUTRAL] OK, sure I can get those policies pulled up and we'll take a look. um can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] OK, thank you. Do you have uh one of those policy numbers?
[CUSTOMER][NEUTRAL] Um, I have a group number.
[CUSTOMER][NEUTRAL] I don't know if that's the same thing.
[AGENT][NEUTRAL] Um, no, uh, are you looking at your card?
[CUSTOMER][NEUTRAL] I don't have a card.
[AGENT][POSITIVE] Oh OK got you no worries, that's OK.
[CUSTOMER][NEUTRAL] So, um, my
[CUSTOMER][NEUTRAL] The city that I work for, um, provided this and I think we signed up for it in like [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I hadn't looked at it since, so I don't, I don't have any information for you except for my personal.
[AGENT][POSITIVE] Sure. OK. That's all right.
[AGENT][POSITIVE] No worries um I can start using your social.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] All right, I believe I found you just gonna verify some information really quick, um, and what was your date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then uh can I get your mailing address?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Perfect, uh, last thing I need is the email address we have on file for you. Looks like it's a Yahoo account.
[CUSTOMER][NEUTRAL] Um, it would be [PII].
[AGENT][NEUTRAL] Awesome. OK, thank you so much for verifying all of that. All right, well, I did find looks like you um did have an accident policy with us that terminated [PII]. You do have one policy active that is a cancer policy, um, that's been effective since [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so the cancer policy is the one that I'm calling about.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, is my, is it a spouse coverage or is it a family?
[AGENT][NEUTRAL] Let's see, uh, spouse, it looks like the only covered members of you and [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Well, that's why I'm calling. Um, so we've been doing the pre-screening with her for um breast cancer and they found some spots that they want to biopsy. Um, no diagnosis, but they, they're, and so we're trying to figure out how to pay for the biopsy and stuff and didn't know what, what my policy covers.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Absolutely, uh, give me just a moment, let me see if, let me get that pulled up real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, bear with me just a moment. It's thinking about it.
[AGENT][NEUTRAL] Alright, there we are, and I'm also uh if you don't have it, um, I can definitely send you a copy of this policy as well, uh, so you have it for your record, um, yes, it does go through in depth what is and is not covered, dollar amounts, frequencies, things like that, um, let's take a look here if I can just give you kind of a brief.
[CUSTOMER][POSITIVE] Absolutely that would be great.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] A view
[AGENT][NEUTRAL] So I do know, yes, OK. So first thing, of course, would be you do have the first occurrence benefit. Um, so that, of course, is once we have that pathology report, um, from the biopsy, if it, you know, turns out that it is a positive diagnosis of cancer, uh, you would send that information to us, uh, straight away, and then we'd be able to give you that first occurrence benefit. Um, let me take a look at that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that benefit amount is $5000.
[AGENT][NEUTRAL] And then from there, you have coverage for uh radiation, chemo, immunotherapy, uh hormone therapy, and then experimental treatment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that seems to be the extent of the benefits for this policy.
[CUSTOMER][NEUTRAL] OK, is there, um,
[CUSTOMER][NEUTRAL] You said the, the max um sorry you you said the initial.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] The lump sum benefit?
[CUSTOMER][NEUTRAL] Initial lump sum benefit, OK, and that was $5000 so is that um up to $5000 or is that like it's automatically $5000?
[AGENT][NEUTRAL] Yes sir.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] No, no, that's simply, uh, automatically $5000. Yes, that's going to be, you know, for any positive diagnosis of cancer, uh, that first occurrence, that's that $5000.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty, would you like me to email this policy to you in?
[CUSTOMER][NEUTRAL] And then uh how much was the treatment?
[CUSTOMER][POSITIVE] Absolutely if you don't mind.
[AGENT][NEUTRAL] OK, sure, just to this uh Yahoo account that we have.
[CUSTOMER][POSITIVE] Yes ma'am, that would be great. Um, does, does that also have my card number or whatever the policy number will all that be on there?
[AGENT][POSITIVE] OK alrighty I'll go ahead and send that, yes.
[AGENT][NEUTRAL] I can give you that policy number, yes, so cards are not offered for this kind of policy, um, but I can definitely give you that policy number whenever you're ready.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh yes ma'am, go ahead.
[AGENT][NEUTRAL] OK, that is 01.
[AGENT][NEUTRAL] 17.
[AGENT][NEUTRAL] 71
[AGENT][NEUTRAL] 21
[CUSTOMER][NEUTRAL] 01177121
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, also, um, how do I go about filing.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Documents and starting a claim when when it if it comes to that.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Right, so you do have a few different options for filing claims. uh, do you have access to a desktop or a laptop computer?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Awesome OK so uh the reason I ask is our online portal is going to be the quickest and easiest way to get claim information to us. um, however, it doesn't really have much support for mobile devices so it would have to be on a desktop or a laptop um you would create an account with all of the information that we had previously uh verified including this email address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and then from there you can upload, uh, claim information. It gets to us almost immediately, uh, and then from there it can take about 7 to 10 business days for that claim information to process.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] All right, well, um, I think that's all the questions I have.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] I absolutely appreciate you taking the time to explain to me.
[AGENT][POSITIVE] Yeah, no problem.
[AGENT][NEUTRAL] Absolutely, um, and of course you know once you get the policy if you have any other questions definitely give us a call back. It can, it can certainly be confusing.
[CUSTOMER][POSITIVE] And you have a wonderful day, yes ma'am.
[CUSTOMER][POSITIVE] OK, all right, I appreciate it.
[AGENT][POSITIVE] Alright definitely I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You do the same, ma'am bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.