AccountId: 011433970860
ContactId: af11f083-dc10-4331-bea7-e761b8395440
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 835770 ms
Total Talk Time (AGENT): 212275 ms
Total Talk Time (CUSTOMER): 285381 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/af11f083-dc10-4331-bea7-e761b8395440_20250624T13:43_UTC.wav
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[AGENT][NEUTRAL] Morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh, yes, I'm following up on a, um, a policy that my mother um had with you guys. Um, she passed away about 18 months ago, and I believe, uh, you know, I believe I've handled everything, but the more stuff I go through, the more stuff I find.
[CUSTOMER][NEUTRAL] And I just wanna make sure that everything with this policy, it's either, you know, not effective any longer or it's been paid or you know whatever, can you help me with that?
[AGENT][NEUTRAL] Mhm. Sure. May I have your name?
[CUSTOMER][NEUTRAL] Uh my name is [PII]
[AGENT][NEUTRAL] Thank you, Mr. [PII]. Um, may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Do you have a policy number?
[CUSTOMER][NEUTRAL] I do, it's A 0046428.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] What's the name?
[CUSTOMER][NEUTRAL] I was under [PII].
[AGENT][NEUTRAL] Any other last names?
[CUSTOMER][NEUTRAL] Uh, she, I mean, she had, it was under [PII] at so well her last married name is [PII].
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] OK, this policy is terminated, Miss [PII] since [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], was that because she had turned [PII] or what was the.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I mean she, she
[CUSTOMER][NEUTRAL] I mean, I guess [PII], she passed away in [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So when you say um
[CUSTOMER][NEUTRAL] Was it paid or what was the?
[AGENT][NEUTRAL] No, that's when they canceled the policy. It looks like we received the death certificate you sent in.
[CUSTOMER][NEUTRAL] OK, so all the benefits for this policy have been paid.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] This was a cancer policy, not a life policy, mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Correct, yes, it was a cancer policy, but she died of cancer and um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] All the, all the things that I read in the policy.
[CUSTOMER][NEUTRAL] She actually, you know, had, she had cancer, she had hospital stays, um, she had, you know, all the stuff that it seems to me this policy covers. So was there, was there any payment from this policy?
[AGENT][NEUTRAL] OK, um, we did have a lot of payments that came out of the policy. Now, um, after, um, I'm not sure, I don't see anything submitted after that we were notified about her passing, so I'm not sure if you submitted any claims um to us to see if we have any, basically, let's see.
[CUSTOMER][NEUTRAL] I, I guess that's my, that's my issue here. I mean she had, she had lots of stuff and there's, there's all these different policies some of them have changed names, some of them been canceled, some of them, you know, and so I don't know who's who and whatever so can you tell me when the last payment was made on the policy?
[AGENT][NEUTRAL] From the
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Was back in um [PII] on [PII].
[CUSTOMER][NEUTRAL] OK, and what was, what was that for?
[AGENT][NEUTRAL] OK, one moment. Let me go to the to the documents and everything. One moment.
[AGENT][NEUTRAL] Let me go ahead and pull the documents. One moment, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding and being patient for me. OK, so the last thing that I see here that we paid for was for chemotherapy. Um, so basically the last payment for chemo was for date of service [PII].
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Um, I mean, what I see in the policy.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hold on, I'm writing this down, um, is.
[CUSTOMER][NEUTRAL] That you guys have a, a first occurrence payment which I'm sure I mean she had cancer many multiple times so I'm assuming that was paid. You, you have a um a payment for each type of cancer. um I'm assuming that was also paid because she had this particular type of cancer um for uh a, a pretty long time.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So the question I have is.
[CUSTOMER][NEUTRAL] You guys have a, a daily hospital benefit.
[CUSTOMER][NEUTRAL] Um, 60 days and then greater than 60 days.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, she was in the hospital for quite a while. I'd be shocked if it wasn't around 60 days.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] After [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Is that something that is eligible for payment or what am I what what qualification am I missing that that would not be something y'all would pay?
[AGENT][NEUTRAL] Um, more than likely it is, but we cannot determine anything over the phone. So the best thing is to send in the documents. Um, if you can get to the hospital, go to the hospital, get them to give you an itemized bill with all the days that she was in the hospital, hospitalized, then um you can send it to us and we can look into it.
[CUSTOMER][NEUTRAL] OK, an itemized bill from the hospital.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, um, and where do I send that?
[AGENT][NEUTRAL] OK, you can send that by mail or fax.
[AGENT][NEUTRAL] And um which one would you like or would you like both of them? I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] I don't have the address.
[CUSTOMER][NEUTRAL] You don't have an email address?
[AGENT][NEUTRAL] We don't do claims by email.
[CUSTOMER][NEUTRAL] OK, um, I, yeah, I guess give me both. I don't.
[AGENT][NEUTRAL] OK.
[CUSTOMER][MIXED] Neither one is great, but I'll give me both.
[AGENT][NEUTRAL] OK, the mailing address is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] City, [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The fax number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the best form that they can give you in the hospital just in case if you can ask for a UBO4 form that will have all the information we need.
[CUSTOMER][NEUTRAL] UVO4.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I will see what I can do. Thank you so much. Is there, so let me.
[AGENT][POSITIVE] You're welcome. Is there any, yeah.
[CUSTOMER][NEUTRAL] Yeah, is there anything else, um.
[CUSTOMER][NEUTRAL] Uh, there's this um.
[CUSTOMER][NEUTRAL] Let me see what else I saw in here. I'm sorry, um.
[CUSTOMER][NEUTRAL] I mean she was transported by ambulance. Um, I see there's, I mean, there's a benefit for that. I mean, um.
[CUSTOMER][NEUTRAL] I'm not exactly sure how to go about getting all of that information um.
[AGENT][NEUTRAL] Yeah, all that needs to be submitted by itemized bills, so, um, in order for you to claim anything you need to get in contact with the place of service and get an itemized bill, um, so that's why you're gonna send in and you can go ahead and send in any itemized bills and.
[AGENT][NEUTRAL] Let you know if we have paid on it before or not or if it's payable or not you can just go ahead and submit it um there is a claim form um that also needs to be sent in with all the documents and the claim form you can find it through our website at [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm, um, so you can send it together with the, um, documents, but for everything it's gonna be itemized bills.
[CUSTOMER][NEUTRAL] OK, uh, right, I will, is there a, uh, like any time limit on this? Um, I know the policy is not in anymore, but, uh, it was when all this occurred there's no statute of limitations or whatever on it.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] No.
[CUSTOMER][POSITIVE] OK, OK then, thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] I think I'm good thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling APO. Have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.