AccountId: 011433970860
ContactId: c219803b-b01a-4cfc-a61a-43af12073571
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 780770 ms
Total Talk Time (AGENT): 394231 ms
Total Talk Time (CUSTOMER): 322671 ms
Interruptions: 7
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/c219803b-b01a-4cfc-a61a-43af12073571_20250408T14:53_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] Oh yes, this is [PII]. I've got uh several different policies with the American public and my husband had a stroke last year on [PII], and I don't know if anything I have would help with any of that or whatever, but he was in intensive care a few days and I've got an intensive care policy that goes with some of it or I'm just trying to find out what I need to do.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you with that, Ms. [PII]. What is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And do you have a policy number available?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do, OK. I've got one that's cancer, and I mean he didn't have cancer. And then this intensive care policy, but I'm thinking the intensive care might be linked on to the cancer or something, but I'm not sure, but just any one of these you want?
[AGENT][NEUTRAL] Yes, ma'am, that's fine.
[CUSTOMER][NEUTRAL] And I've also got a term license. OK, the intensive care I've got, uh, the number is [PII].
[AGENT][NEUTRAL] Thank you. And do you mind verifying your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, [PII]. My address is [PII].
[AGENT][NEUTRAL] All right, thank you. And can you also verify your email?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh yes, so all lower case, [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Well, let's see.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] I've got your intensive care policy pulled up now, of course, for those intensive care charges.
[AGENT][NEUTRAL] This would be the policy that you would.
[AGENT][NEUTRAL] File for the intensive care charges.
[AGENT][NEUTRAL] I'm checking your cancer policy as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] See if there's a heart attack and stroke.
[AGENT][POSITIVE] Benefit on that, so.
[CUSTOMER][NEUTRAL] When I went through and I was like reading the policy, but all that's fine to me and you know, and of course, you know, I taught school and when they come in and sell them, oh yeah, I'll take that and I mean I've, we've had different stuff and I know I should have filed on it for years but I never have.
[AGENT][NEUTRAL] No, you are fine. I, I mean, I understand. I'm the same way. It's like I know all this insurance, but when I get to looking at my own personal insurance, I'm like.
[AGENT][NEUTRAL] Hm, you know.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] And just one little work and I know, no good, you know, so.
[AGENT][NEUTRAL] Exactly, it's like a foreign language, but I'm here to help you any way I can. So let's, I do want to take a look at that cancer policy just to make sure that there's not a heart attack or stroke benefit on that as well. And I see you have that online account.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Well, I was thinking it might be.
[AGENT][NEUTRAL] Uh, that's what I'm gonna check cause we need to verify that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It does have a heart attack and stroke benefit on your cancer policy.
[AGENT][POSITIVE] So that's good.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So we'll need to file a claim one for your intensive care charges on your intensive care policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then on the cancer policy for the heart attack or stroke benefit.
[AGENT][NEUTRAL] So what they will need um on the intensive care policy for a claim.
[AGENT][NEUTRAL] Is an itemized hospital bill with diagnosis codes listing the intensive care room charges and the dates.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm writing it down.
[CUSTOMER][NEUTRAL] OK, itemized hospital um bill or whatever with the diagnosis codes and the ICU dates.
[AGENT][NEUTRAL] The room charges and that'll give us the dates that he was in the intensive care unit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] OK, and then what about the heart attack stroke?
[AGENT][NEUTRAL] And of course, there is a um claim form that will need to be completed with each claim as well, and it's the cancer claim form for both.
[CUSTOMER][NEUTRAL] OK, so it'll be two separate ones, yeah, OK, or you tell me, we're cutting out the same one or two separate ones?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The same one for both.
[AGENT][NEUTRAL] So, it'll be two separate claims, and you'll fill out the claim form for each policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If that makes sense.
[CUSTOMER][NEGATIVE] Yeah, that's just what gives me a pain in the butt.
[CUSTOMER][NEUTRAL] With the insurance, uh.
[AGENT][NEUTRAL] It, I know, and you can also upload the policy documents online. I see you have that active account.
[CUSTOMER][NEUTRAL] Yeah, I saw that. That's why I was reading it all last night and I'm thinking, oh goodness, I don't know what all this means. I mean, you know, in fact, I forgot I had anything about stroke, so, you know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, now, for the stroke,
[AGENT][NEUTRAL] We're going to need, of course, the cancer claim form.
[AGENT][NEUTRAL] And then we'll need the um.
[AGENT][NEUTRAL] Medical records indicating that he had a stroke.
[CUSTOMER][NEUTRAL] Thank goodness it wasn't major but.
[CUSTOMER][NEUTRAL] OK, and I read somewhere, I think it was on this, that um once you file a claim.
[CUSTOMER][NEUTRAL] With those you can only use it once or something.
[AGENT][NEUTRAL] For the um heart attack and stroke, that's right. But the critical illness, I mean, the intensive care is a per day benefit, so there's no max.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] How many, I mean, this is my fault, I guess, but how long can last from the time it happened to whatever because a couple of years ago, I fell down and broke both my legs, and well one couple, it's almost, I don't know, 6 or 8 now, but I was in intensive care for a few days too. Is that too late to file?
[AGENT][NEUTRAL] It is not. There's no time frame to submit a claim, as long as we have the supporting documents and your policy was active for the dates of service. You can submit a claim at any time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, it was.
[AGENT][NEUTRAL] And of course we'll need the same information.
[CUSTOMER][NEUTRAL] OK, and I also read.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right. I also read somewhere that like when you have like a pap smear or a mammogram or bone density or whatever, if, do I have that covered on whatever I've got too?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You do. I was fixing to mention that for you. There is a wellness benefit, a 6, uh-huh.
[CUSTOMER][NEUTRAL] OK, because, because I've had all those.
[AGENT][NEUTRAL] Yeah, so.
[CUSTOMER][NEUTRAL] And also stress tests. I've had a stress test. Is that covered too?
[AGENT][NEUTRAL] Um, if it is a cancer screening test, so the, the stress test would not be a cancer screening.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] Um, so.
[AGENT][NEUTRAL] You can file
[AGENT][NEUTRAL] And we pay one.
[AGENT][NEUTRAL] Prevention benefit per person per calendar year.
[AGENT][NEUTRAL] So it's per person and we pay $60. Now that is a verification of coverage on your policy, not a guarantee of payment, and there is a cancer wellness claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that is all you need to submit for each year for each.
[AGENT][NEUTRAL] Claim form?
[CUSTOMER][NEUTRAL] And there's no time frame there either because we do go to the dermatologist once a year and you know, OK.
[AGENT][NEUTRAL] No time frame.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Oh goodness, this is gonna give me a big headache.
[AGENT][NEUTRAL] Well, once you get it, the wellness is fairly easy now we will have to have the facility location and the name of the provider.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, but there, you just go online, then go under claims and forms to the cancer wellness.
[AGENT][NEUTRAL] Claim form
[AGENT][NEUTRAL] I think it might let's see where that's located. I don't think it's on the first page.
[AGENT][NEUTRAL] Under the claim forms, let's see.
[AGENT][NEUTRAL] Cancer claim form is, I think the wellness is like on page 3.
[AGENT][NEUTRAL] Just to let you know, so if you're looking for it.
[CUSTOMER][NEUTRAL] I mean, I was looking at that too and I mean there's, there's a million of them.
[AGENT][NEUTRAL] Yeah, it's on page 3, wellness and screening benefits claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's what it's called.
[CUSTOMER][NEUTRAL] And I'm sure there it lists what which ones you can do or whatever.
[AGENT][NEUTRAL] It, it does, uh, it's a pretty um exhaustive list, but if you have something that's not on the list, I think there is another option. You can choose other.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But it does, it is for a cancer screening.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Answers
[CUSTOMER][NEUTRAL] OK, so I need a form for intensive care for when he had a stroke and then a different form.
[CUSTOMER][NEUTRAL] For the stroke that's under the cancer plan.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And OK and so is that gonna be under.
[CUSTOMER][NEUTRAL] The part that's about the cancer policy I guess.
[AGENT][NEUTRAL] Right, so both for the.
[CUSTOMER][NEUTRAL] It's on that list of pages after page.
[AGENT][NEUTRAL] Right. So both of those are gonna be the cancer claim form. One, for his heart attack and stroke, for your, on your cancer policy, and the other for the intensive care charges. Same claim form, just different uh benefits that you're filing for.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I need to fill it out twice?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Or is it just gonna have both things listed on it?
[AGENT][NEUTRAL] You know, you could fill out one claim form and put both policy numbers on it and just use it for the same.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And just fill out one form and then just put it on each policy with the documents.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, I'm sure if it's not right they'll let me know.
[AGENT][NEUTRAL] Well, now you know that's true.
[CUSTOMER][NEUTRAL] Whatever.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][POSITIVE] But you know, if you're, if you get kind of confused or lost along the way, just give us a call back, you know, we're here to help you any way we can.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK, when I, when I pull it up and actually look at it, I'll, I'll do that.
[AGENT][NEUTRAL] I think that that'll make a difference too when you actually look at it. It sounds a little overwhelming just to hear everything. I would think anyway.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] OK. Well, you know, and, and they'll make off of me because I'm not gonna go back to to day one because, you know, you, after something like that happens, you put it out of your mind and it's gone. So anyway.
[AGENT][NEUTRAL] Right. Well, just now you're aware of your benefits and don't let any of these benefits go by without using them because they're your benefits.
[CUSTOMER][POSITIVE] Thank you so much for your help.
[CUSTOMER][NEUTRAL] I know. And, you know, I was busy and I was teaching.
[AGENT][POSITIVE] And girl, we could use all the help we can get.
[AGENT][NEUTRAL] Oh, yeah.
[CUSTOMER][NEUTRAL] Now that I'm retired, you know, here we go, so anyway.
[AGENT][POSITIVE] Now you've got time to deal with things like this, and thank you for being a teacher. My we, a lot of people in my family are teachers. I know the hard work and the care and the love that goes into it. So thank you for taking care of our, the children.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Yeah whether they're children or teenagers, you know, I mean.
[CUSTOMER][POSITIVE] Well thank you for thanking me.
[CUSTOMER][NEUTRAL] Right. That's what my son teaches well, junior high and now he's teaching high school and I'm thinking [PII], how do you do it in this day and time? But anyway, that was my thing. I said,
[AGENT][NEUTRAL] Y'all go through a lot?
[AGENT][NEUTRAL] I know my daughter teaches high school and.
[CUSTOMER][POSITIVE] Once I retired, I said I could never go back and get in that groove because, you know, but of course, I retired right before I broke my leg, which was a blessing that I could because, you know, I taught 3rd grade and I'm thinking, no, I'm not having all those little kids running around me like that. So anyway.
[AGENT][POSITIVE] Oh, wow.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Well, it has been a pleasure to assist you. Anything else I can help you with, Ms. [PII]?
[CUSTOMER][POSITIVE] Mm. Thank you for your help.
[CUSTOMER][POSITIVE] No, ma'am, that's it. Thank you very much.
[AGENT][POSITIVE] And thank you for calling APL. I hope you have a wonderful day and we'll look forward to helping you any way we can.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] OK, thank you. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.