AccountId: 011433970860
ContactId: bbaebb98-529b-4585-85b7-1f556f91c42c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 468980 ms
Total Talk Time (AGENT): 157693 ms
Total Talk Time (CUSTOMER): 151940 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/bbaebb98-529b-4585-85b7-1f556f91c42c_20250415T15:45_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. Um, I have a couple of questions. I don't really know like where to start, so I just wanted to tell you kind of what I was calling about. I have a hospital indemnity plan for you guys. Um, and I was, I, I had an extended hospital stay.
[CUSTOMER][NEUTRAL] And I wanted to know because I read something in the policy about there being a payout per day inpatients.
[CUSTOMER][NEUTRAL] And I wanted to call and see kind of about that.
[AGENT][NEUTRAL] OK. Do you have your policy number?
[CUSTOMER][POSITIVE] Yes, ma'am. Whenever you're ready.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] It is 02552172.
[AGENT][NEUTRAL] OK. And can I get your name and your date of birth?
[CUSTOMER][NEUTRAL] Yes, [PII], [PII].
[AGENT][POSITIVE] OK, thank you. And do you have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] OK, just need to verify a few other pieces of information. What is your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then your email address.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And it could be that I've registered using my school email. I'm, I'm a teacher.
[AGENT][NEUTRAL] OK, it looks like it's a school email. What's that?
[CUSTOMER][POSITIVE] OK, it would be [PII], oh gosh.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Do, oh hold on just one second, let me pull up my Outlook.
[CUSTOMER][NEUTRAL] Let me get it right for you.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][POSITIVE] OK, thank you so much. OK, and you said you had a recent, uh, inpatient hospital stay?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] Um, anything I quote is not a guarantee of payment. It's a basic outline of your policy. Let me see what the plan covers. Let me pull that up. Give me one moment.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, so it looks like for your policy.
[AGENT][NEUTRAL] There is a 2500 per day admission benefit when you're admitted to the hospital.
[AGENT][NEUTRAL] Um, it's a maximum of 4 days per calendar year, and then the hospital confinement benefit pays out a maximum of $50 per day.
[AGENT][NEUTRAL] A maximum of 5 days per calendar year.
[CUSTOMER][NEUTRAL] OK, how, how do I access those benefits?
[AGENT][NEUTRAL] Um, so you'll need to submit a claim form, um, which you can get on our website. Have you registered on our portal?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so on the portal, you'll see there's a claim form for hospital indemnity. You'll fill that out and then you'll want to attach.
[AGENT][NEUTRAL] Um, so you'll need a bill or itemization from the hospital that includes your diagnosis and then the procedure code, so like what you were seen for. So meaning like you were inpatient in the hospital and then that it has the diagnosis.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, if I could just ask you, so the first time that I was hospitalized was [PII].
[CUSTOMER][NEUTRAL] And that was, it was for like 12 hours, so I was admitted and then we were discharged within 12 hours.
[CUSTOMER][NEUTRAL] The 2nd time I was admitted into a hospital here in [PII].
[CUSTOMER][NEUTRAL] And I was there for probably like 5 hours and I was transferred to [PII].
[CUSTOMER][NEUTRAL] And I, I was there for 71 days. So,
[CUSTOMER][NEUTRAL] Would I
[CUSTOMER][NEUTRAL] Do the admission for like what is that 3 different admissions or is that just 2?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me see what the admission definition is. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm looking, give me one moment.
[CUSTOMER][POSITIVE] No, you're totally fine.
[AGENT][NEUTRAL] So hospital confinement is it's defined as 18 consecutive hours.
[AGENT][NEUTRAL] So it'd have to be for at least 18 hours that you were in the hospital?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, it looks like, so it seems like based on what you've told me that the [PII] stay would be the one that we can pay out on.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then the for the hospital admission because that was 2500 per day, correct?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that is
[CUSTOMER][NEUTRAL] OK, is
[AGENT][NEUTRAL] Trying to see if the it defines admission so.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Don't see an hour. Let's see.
[AGENT][NEUTRAL] OK, so the hospital admission benefit.
[AGENT][NEUTRAL] It is for when you are admitted to a hospital and confined as inpatient.
[AGENT][NEUTRAL] So, it's not payable if it's less than 18 hours.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so that would also still just be that we experience.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then I need to go file that claim myself.
[CUSTOMER][NEUTRAL] It's not done through the hospital, correct?
[AGENT][NEUTRAL] Um, some hospitals will do it for you. You can ask if they will, um, but, uh, you know, if they file it for you, then depending on how they file it, the payment could go to them.
[AGENT][NEUTRAL] Instead of you, so.
[CUSTOMER][POSITIVE] OK, OK. Thank you for telling me that.
[CUSTOMER][NEUTRAL] Alrighty. OK. Well, that's, that's kind of all I had today.
[AGENT][POSITIVE] OK. All right. Well, thank you for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, ma'am. You too. Thank you.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] OK bye bye.