AccountId: 011433970860
ContactId: bba77700-d2e0-47ab-9488-912e9d836330
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 775919 ms
Total Talk Time (AGENT): 315372 ms
Total Talk Time (CUSTOMER): 436143 ms
Interruptions: 16
Overall Sentiment: AGENT=1.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/bba77700-d2e0-47ab-9488-912e9d836330_20250103T21:48_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEGATIVE] Uh, my name is [PII], and I have called several times. I have, I've had a policy with y'all for a long time, and I've asked y'all to send me a claim form for, you know, routine stuff, and I haven't received it yet and it's probably been 3 or 4 times I've asked I'll do that. How do I go about getting y'all to send me a form?
[AGENT][NEUTRAL] I'm so sorry, Ms. [PII]. Do you have that policy number handy and I can get it pulled up for you?
[CUSTOMER][NEUTRAL] I don't have a policy number. I just have to use my name and stuff like that to find it. I've had one. I'm with teacher teacher retirement in [PII].
[AGENT][NEUTRAL] OK, um, I can search for it with your social if you'd like.
[CUSTOMER][NEUTRAL] OK, uh, [PII].
[AGENT][NEUTRAL] All right, I see that right here. Thank you, thank you. And would you be able to verify for me, please, Ms. [PII], your date of birth?
[CUSTOMER][NEUTRAL] we
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I have never made a, I don't know if I've ever made a claim with you all, and I didn't know I was eligible to make some claims. And I said I was, and this goes back, I think [PII] or something. And uh I need, I need a form so I can get a claim ready to go. I want some form claim forms.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, absolutely. Um, let me see. I just need to verify some more information with you, but I definitely understand needing those forms to get them filled out.
[CUSTOMER][NEUTRAL] 00.
[CUSTOMER][NEGATIVE] Why have y'all not seen it? Why have y'all not seen it? I've called several times and you said it would be in the mail and it never has been in the mail.
[AGENT][NEUTRAL] I'm really sorry. I don't know why it's not going out, um, but let's make sure I have your address on file, right? Is that OK?
[CUSTOMER][NEUTRAL] Well, I want you to I want you to email me a form.
[AGENT][NEUTRAL] OK, I can email the form to you, but I do have to verify your mailing address, your phone number and your email before I can continue.
[CUSTOMER][NEUTRAL] OK. OK. OK. OK.
[CUSTOMER][NEGATIVE] But I keep, you know, I wait and I wait and it doesn't come and then I forget about it and get on something else and I never get the form.
[AGENT][NEUTRAL] OK, can you verify for me your mailing address on file and I'll get an email going for you?
[CUSTOMER][POSITIVE] And I was assured.
[CUSTOMER][NEUTRAL] [PII]. I don't want it mailed. I want it emailed to me.
[CUSTOMER][NEUTRAL] [PII], but I don't want it sent there. I want it emailed to me.
[AGENT][NEUTRAL] Absolutely, Ms. [PII], I have to verify your mailing address, your phone number and your email every time you call for any reason. I'm so sorry, but I will, I will get it in your email for sure. And could you verify for me?
[CUSTOMER][NEUTRAL] OK, I just told, OK, I just told you.
[CUSTOMER][NEUTRAL] Well, I'll have to give you the number.
[CUSTOMER][NEUTRAL] Where I want it sent. My name, my address is [PII]. My phone number is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Wonderful and then just that email on file, my friend.
[CUSTOMER][NEUTRAL] Uh, what now? I didn't understand you.
[AGENT][NEUTRAL] Oh, just the email address on file.
[CUSTOMER][NEUTRAL] What I
[CUSTOMER][NEUTRAL] I wanted to go to [PII].
[AGENT][NEUTRAL] Perfect. I have [PII] I'm sorry, yeah, [PII]. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Alright, perfect. And I just want to make sure I understand correctly which form you want. You're wanting the copy of the wellness form that you can submit yearly, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, perfect. I've got that.
[CUSTOMER][NEUTRAL] But I've never found it what how would that cover?
[AGENT][NEUTRAL] Um, so the wellness, let me pull up your actual policy documents so I can verify. Like, I don't want to tell you anything that's incorrect, um.
[CUSTOMER][NEUTRAL] Well, I'm not too worried about it because I haven't filed a claim 25 I think y'all told me.
[AGENT][NEUTRAL] Typically
[CUSTOMER][NEUTRAL] I pay a lot of money for this policy, and I mean if I've got my, I'm eligible to get some kind of reimbursement, but I never filed a claim that I know of maybe one or two.
[AGENT][NEUTRAL] All right. Let me pull that up for you.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let's
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, give me just a moment to find these benefits for you.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] that metal piece.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Sorry, there's like a lot of documents to look through, I think because the policy has been in place for so long and so I just have to open them all up and read through them all to find what I'm looking for.
[CUSTOMER][NEUTRAL] If you just go to another.
[CUSTOMER][NEUTRAL] This is
[CUSTOMER][NEUTRAL] Yeah there's the co-creator.
[AGENT][NEUTRAL] Alright, so it looks like it covers.
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] If I'm looking at this right, it looks like your policy covers um chemotherapy and radiation treatment, a daily hospital benefit, and a first incurrence and diagnosis benefit. I'm not showing on here any wellness benefits for this policy.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] I don't worry about it.
[CUSTOMER][NEUTRAL] Yeah, well, what is it worth that I haven't, I've been paying it, uh, I think it's about $100 a month. Well, it's 2005, is that right?
[AGENT][NEUTRAL] Yeah, so what I'm gonna do is I, I mean, I can still send you the claim form, but the claim form I'm gonna send you is gonna be that cancer claim form.
[CUSTOMER][NEUTRAL] OK, well I've had tents a little just those uh.
[CUSTOMER][NEUTRAL] The skin cancers that you get, you know, sometimes on your head. I've had that twice, but that's the only thing I've had. I don't know about anything with that either.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That was probably 10 years ago, maybe a little less.
[CUSTOMER][NEUTRAL] Out and talk it out.
[AGENT][POSITIVE] OK, I will definitely, I'm gonna get this put together for you, my friend, um.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] And he said he did.
[AGENT][NEUTRAL] And I do have
[CUSTOMER][NEUTRAL] So I don't have
[AGENT][NEUTRAL] I'm not showing like a wellness benefit that like covers on your policy for like mammograms or any of those.
[CUSTOMER][POSITIVE] thank you
[CUSTOMER][NEUTRAL] Um, but that's what I was checking on, um.
[CUSTOMER][NEUTRAL] OK. I thought it might cover me. I was told it covers mammograms and I didn't know and I
[AGENT][NEUTRAL] Some policies do, it just depends on the individual policy.
[CUSTOMER][NEUTRAL] Well, I have the one that y'all have for Louisiana teacher retirement, whatever that is. I don't know what it is, but that's what it is.
[CUSTOMER][POSITIVE] But it's pretty
[AGENT][NEUTRAL] I will, I mean, I don't think it would hurt to just send a claim in as a tester and see if anything happens. So I'll still get that claim form sent out your way. Um, I don't see it listed on your policy, but that doesn't mean
[CUSTOMER][NEUTRAL] So he asked me to doctor that one.
[CUSTOMER][NEUTRAL] How
[CUSTOMER][NEUTRAL] elevator and
[CUSTOMER][NEUTRAL] the doctor
[AGENT][NEUTRAL] I, I would still send one in and see what happens.
[CUSTOMER][NEUTRAL] OK, well, I have never sent one in and I take them every year.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Yeah, I would, I would send one in, see if anything happens if it gets approved and it shows you have benefits that maybe I just can't see or it's then go ahead and um.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Well, my sister has the same policy, and I think she said it covered her. She's a teacher, teacher retired from [PII].
[CUSTOMER][NEGATIVE] That's why I was checking it because I never filed anything and I thought, well, maybe there should be some should be covered but I keep paying as much as I pay and never ever been eligible to get anything.
[CUSTOMER][NEUTRAL] Any reimbursement or anything.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Yeah, um, I'm not, and I can't speak on behalf of your sister's policy just because I don't have her policy information and, um, and I can't talk about other people's policies.
[CUSTOMER][NEUTRAL] Well, let's see
[CUSTOMER][NEUTRAL] Well, she's with, she has the same house.
[CUSTOMER][NEUTRAL] Yeah, I know she, she has the same policy I have. I'm not asking you to verify anything because I know she has the same policy I have because I got to in a teacher retirement system.
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] Do you know if she got it the same year as you because the same groups can offer different coverage different years, even if they're in the same group and so then the policies can be different, like the policy offered in [PII] could be different than the one from [PII]. So sometimes you'll see like.
[CUSTOMER][NEUTRAL] I have no idea.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEGATIVE] I have no clue.
[AGENT][NEUTRAL] Some changes there just based on what what year they decided to honor that policy or offer it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah, well, I don't have.
[AGENT][NEUTRAL] Um, but I'll still send both claims out to you, and I definitely recommend going ahead and taking the time to at least put one wellness claim in, and that way if something does come up, then.
[CUSTOMER][NEUTRAL] No no.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You can keep, you can go back and submit them backwards, um, but then if it doesn't cover it, then you didn't waste your time filling out a bunch of them, you know what I mean?
[CUSTOMER][POSITIVE] Don't worry about it.
[CUSTOMER][NEUTRAL] Yeah, just, just check it and see if it works fine. If it doesn't work, that's OK too. I'm living without it anyway, so it doesn't matter.
[AGENT][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] I just hate to spend so much money on the policy and never, ever, I do everything right as the best I can, and then it, you know.
[AGENT][POSITIVE] I am so glad you haven't had, I mean, with the cancer policy, I'm glad you haven't really had to use it much.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Um, that's one of those, it's like, like my dad always told me like, wear a seat belt, you'd rather have it and not need it than need it and not have it and.
[CUSTOMER][NEUTRAL] I know it.
[CUSTOMER][NEUTRAL] That's correct. That's correct. Well, I'm not worried about it, uh, you know, I just that I thought, well, if it's, I have a disability policy for teachers, and one time, I didn't use it. I didn't know I was, what I was, I was sick for about 6 weeks, and I didn't know I was eligible to use it, and so I lost all the money. And they used me an example of what not to do. But they didn't bother to tell me I was eligible for it. Well, that's OK, but.
[AGENT][NEUTRAL] So,
[AGENT][POSITIVE] I'm so sorry about that.
[CUSTOMER][NEUTRAL] I didn't realize that I was eligible to get money so but I didn't file it so that's OK.
[CUSTOMER][NEUTRAL] But if you go ahead and send.
[AGENT][POSITIVE] Well, I sent that email out your way. It has both forms. If you ever need the cancer form, it's there and it has that wellness form on it, so you have both of them right there for whatever you need and
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And yeah and send one and give it a test and if it works you can send them, I mean you can send them back all the way back to [PII], um, and if it doesn't work then you only did one and you didn't waste a whole bunch of time.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] I get a room and it joins with us and you can.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] No, I don't wanna do that. Well, I, because that'd be work because I had some in [PII] and some in [PII]. Yeah, so I'm not gonna do all that if I don't have to. OK, I appreciate you and I hope I can get that because I like to say I, I, I've been assured 3 or 4 times that it's on the way. It was mailed to me, to my home [PII] address, but it's never gotten there, more than 1 time.
[AGENT][POSITIVE] Yeah, it is work.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] And then I get to go on something else and the only reason I'm doing this time is I've got a mammogram on the [PII] of whatever next Friday anyway.
[AGENT][POSITIVE] Oh yeah, OK, perfect.
[CUSTOMER][NEUTRAL] It's coming Friday.
[AGENT][NEUTRAL] Um, so,
[CUSTOMER][NEGATIVE] So I won't have it before I go, I have to make another trip back over there.
[AGENT][POSITIVE] Um, yeah, I think, great, let's get that filled out for this upcoming visit, and then, um, if there's anything else we can do to help you, Miss [PII], just give us a call. I don't know why they didn't come through, but we're gonna do our best to take care of you every time you call, OK?
[CUSTOMER][NEUTRAL] OK, well that should work.
[CUSTOMER][POSITIVE] Well, I know, so I just do the wellness check for when I go to this time on Friday. OK, I can do that. OK, thank you, darling. I appreciate you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yep, you betcha.
[AGENT][POSITIVE] My pleasure. You take care.
[CUSTOMER][NEUTRAL] OK, bye bye.
[AGENT][NEUTRAL] Bye bye.