AccountId: 011433970860
ContactId: b1df40b1-ba1b-4a03-9f5b-97f658e31a23
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 269489 ms
Total Talk Time (AGENT): 140504 ms
Total Talk Time (CUSTOMER): 101354 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/b1df40b1-ba1b-4a03-9f5b-97f658e31a23_20250106T14:25_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, we have, uh, uh, the insurance, and I wanted to know if what was our limit?
[CUSTOMER][NEUTRAL] Oh, if there is a limit.
[AGENT][POSITIVE] It would be my pleasure to assist you. Do you have your policy number available?
[CUSTOMER][NEUTRAL] Yes, 02464243.
[AGENT][NEUTRAL] And what is your name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] All right, thank you, Ms. [PII]. Now, these policies are calendar year policies, meaning that the benefit renews every January.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Let's see, I'm getting that policy pulled up. Have you, have y'all created an online account on our website?
[CUSTOMER][NEUTRAL] Well, I'm looking at my, uh, my family's one.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I'll be more like.
[AGENT][NEUTRAL] So I see that you do have an active online account. If you were on that portal, if you click on your policy number, it will actually download your policy certificate.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, OK, hold on, uh, OK, I guess.
[AGENT][NEUTRAL] And I'm checking, yeah.
[CUSTOMER][NEUTRAL] Any objections?
[AGENT][NEUTRAL] And if you download it, you'll be able to view the benefits.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] What's covered in your calendar year max.
[CUSTOMER][NEUTRAL] Yeah, I was
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Limitations and exclusions claims.
[AGENT][NEUTRAL] Keep going. There's a page called a, a certificate schedule.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] And it will show you the.
[AGENT][POSITIVE] Maximum benefits payable.
[CUSTOMER][NEUTRAL] She
[AGENT][NEUTRAL] So for your inpatient and all benefits given over the phone is verification of coverage, you know what I'm.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Ah, I see. OK, inpatient, so.
[AGENT][NEUTRAL] Yeah, and can
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And for calendar maximum 5 per calendar for all covered purse, so it's 5000 per person.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's for inpatient and outpatient.
[CUSTOMER][NEUTRAL] OK, each individually, so if it'll be 10 for both.
[AGENT][NEUTRAL] Right, so, so if you, it's 5000 per person per calendar year.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's the maximum we can pay for one person, and the maximum per family is 15,000, which is.
[AGENT][NEUTRAL] Uh, for all covered persons combined.
[CUSTOMER][NEUTRAL] So then it really wouldn't be like if each person would use a 5000 it really wouldn't be 5000 per person.
[AGENT][NEUTRAL] Right, because you have more than 3 people.
[CUSTOMER][NEUTRAL] Right. OK.
[AGENT][NEUTRAL] But say um you go into a hospital and there's only a $2000 deductible.
[AGENT][NEUTRAL] I used
[AGENT][NEUTRAL] On that inpatient hospital stay that we pay, well, then you still have 3000 even for another member, or if you go to the hospital again.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] You know, we could do that.
[AGENT][NEUTRAL] On that, on that
[AGENT][NEUTRAL] Insured
[AGENT][NEUTRAL] We could pay additional benefits if it's not maxed out.
[CUSTOMER][NEUTRAL] Right, right. OK.
[CUSTOMER][POSITIVE] All righty.
[AGENT][NEUTRAL] And while I put you on the phone, can, can I verify your mailing address and call back number?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] And your phone number?
[CUSTOMER][NEUTRAL] And call back [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, perfect. And then what is, can we verify your email?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] That's it. Thank you so much.
[AGENT][POSITIVE] It's been such a pleasure to assist you, Miss [PII]. Thank you for calling APL, and I hope you have a lovely day and I hope you and your family have a great new year.
[CUSTOMER][POSITIVE] Oh, thank you. You too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.