AccountId: 011433970860
ContactId: b7fc2545-3321-4e29-9c69-a2296bee39e1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 536419 ms
Total Talk Time (AGENT): 132289 ms
Total Talk Time (CUSTOMER): 201007 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/b7fc2545-3321-4e29-9c69-a2296bee39e1_20250602T16:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. I just had a question in regards to my policy. Do you need that policy number?
[AGENT][NEUTRAL] Um, let me go ahead and get your name and a callback number in case we get disconnected.
[CUSTOMER][NEUTRAL] OK. Uh my name is [PII]. It's [PII] and the last name [PII] [PII]
[AGENT][NEUTRAL] OK, and a good callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] Uh, the policy number is 16254.
[CUSTOMER][NEUTRAL] I'm sorry, 1624545 not not 54.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a moment to look that up.
[AGENT][NEUTRAL] OK. Um, are you looking at your ID card?
[CUSTOMER][NEUTRAL] Um, I am looking at, uh, the printed, um, packet that came in the mail.
[AGENT][NEUTRAL] OK, because I think that's a group number. [PII], is it OK if I look you up by your social?
[CUSTOMER][NEUTRAL] Yes, absolutely. Uh, that's uh [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Right. Give me just a moment.
[AGENT][NEUTRAL] And can I get you to verify your date of birth, please?
[CUSTOMER][NEUTRAL] Uh yes, it is [PII].
[AGENT][NEUTRAL] And the address and phone number that we have on file?
[CUSTOMER][NEUTRAL] Uh, it is [PII]. And her phone number, um, would probably be [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] Do you have a pen and paper so I can give you your policy number?
[CUSTOMER][NEUTRAL] Yes, go ahead.
[AGENT][NEUTRAL] OK, it's 02.
[AGENT][NEUTRAL] 58.
[AGENT][NEUTRAL] 356 2.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK. And um I apologize, you were wanting to know about some uh benefits?
[CUSTOMER][NEUTRAL] Uh, yes. Uh, basically, I am, um, currently pregnant and I am scheduled for a C-section at the hospital on [PII], um, which will obviously result in a short hospital stay. Um, it's, uh, you know, not emergency. It's, um, a scheduled and, um,
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Just because that was what I had with my first child. Um, and I wanted to know with it, it had pre-existing conditions, 0 months, but I didn't know if pregnancy would be eligible for the benefit amount.
[AGENT][NEUTRAL] Um, let me check.
[CUSTOMER][NEUTRAL] And our HR department here at work wasn't sure either because they said like you've only had the policy since January and you were pregnant before then, so it may not cover, but you could go ahead and call, so that's why I'm calling.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Let me check. I'm just going through your policy real quick.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] And you said your preexisting condition was 0?
[CUSTOMER][NEUTRAL] It does say 0. It says pre-existing period 0 months and then pre-existing conditions exclusion period 0 months is on the um like certificate schedule.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me just look it up.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] It looks like in your definitions um.
[AGENT][NEUTRAL] It looks like a sickness includes pregnancy and complications related to pregnancy. Um, so it would be under sickness and it looks like since you have a pre-existing condition of 0 months, um, I'm just making sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's kind of funny that pregnancy is a sickness. I'm like, yes, I can really, I I like it makes me laugh because I definitely feel that, feel that right now at 35 weeks pregnant, but um, check, check.
[AGENT][NEUTRAL] I know.
[AGENT][NEUTRAL] Yeah, I, I, I wouldn't have thought to look at pregnancy under the, the definition of sickness, so I thought that was [PII]. Um, it looks like it's 0 since you have that exclusion or since you have that pre-existing condition, and I'm not seeing it as an exclusion.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I'm just double checking to make sure.
[CUSTOMER][NEUTRAL] I mean, my thought was really like,
[CUSTOMER][NEUTRAL] Once I actually am in the hospital and all the things, and I get uh released, you know, to try. Um, and I mean, the worst case would be to have the claim denied because, you know, they dig a little deeper and see that it's not, I'm not eligible, but um from what I could see just from reviewing the packet, it seemed like it was a possibility.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm not seeing it as an exclusion.
[AGENT][NEUTRAL] Let me check.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Also, because I'm a school um employee, I was thinking like, I actually enrolled for it in October, but our benefits didn't take this, um, this particular benefit to insurance didn't take like um effect until January. So back when I enrolled in it, I didn't, I didn't have a preexisting condition. I didn't know that I was pregnant at the time.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um, but, you know, that gets a little tricky as to like when the policy is in effect and all those kind of things. So I just wanted to clarify.
[AGENT][NEUTRAL] It looks like it could be covered, um, because I am showing it as the sickness and it would be in your schedule of benefits and you have a zero waiting period um for the pregnancy as long as it wasn't, um, yeah, it looks like it's, it should be covered from what everything I'm reading.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. OK. Cool, that's wonderful news. So, um, all right, well, thank you. That was really it. I just wanted to um try to get some answers with that and um I appreciate your help.
[AGENT][POSITIVE] Great, if there's nothing else I can help you with, I hope you have a great day and thank you for calling APL.
[CUSTOMER][POSITIVE] Uh thank you so much. Bye bye.
[AGENT][NEUTRAL] Bye.