AccountId: 011433970860
ContactId: c6f7c284-f53f-489a-a297-450665a1121b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1565849 ms
Total Talk Time (AGENT): 455622 ms
Total Talk Time (CUSTOMER): 314017 ms
Interruptions: 3
Overall Sentiment: AGENT=-0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/c6f7c284-f53f-489a-a297-450665a1121b_20250520T20:54_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]. My name is [PII], and we have an APL policy. Uh, the number is 508-566.
[AGENT][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] And it's under my, my husband's name, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One second.
[AGENT][NEUTRAL] And can I get a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, one moment, let me pull that up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Then can I get you to verify your date of birth, please?
[CUSTOMER][NEUTRAL] Mine is [PII].
[AGENT][NEUTRAL] OK, and your mailing address and the phone number we have on file?
[CUSTOMER][NEUTRAL] My address is [PII] and you probably have [PII]'s phone number [PII].
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And what questions did we have?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, is there, I, I was looking at some material, but it was a little bit dated. Is the age limit [PII]?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For claims?
[AGENT][NEUTRAL] Let me look at your policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just a moment while I pull that up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Sorry, give me just a moment while I look that up and double check.
[CUSTOMER][POSITIVE] OK, that's good.
[AGENT][NEUTRAL] Sorry, because this is an older file.
[AGENT][NEUTRAL] Everything was um scanned in, so I'm having to go page by page, so give me just a moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I understand. I tried to go online and figure it out, and I couldn't either.
[CUSTOMER][NEUTRAL] And I did see somewhere where it said something about Medicare, but I'm wondering if it just said this does not take place of Medicare.
[AGENT][NEUTRAL] OK, I can look that up.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Oh no. No, she's looking some stuff up.
[CUSTOMER][NEUTRAL] My, my two questions right now are, is the cap at [PII], age [PII], and I saw something about Medicare on it.
[CUSTOMER][NEUTRAL] But I didn't know if, I thought it said this doesn't take the place of Medicare.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] Yeah, and that sounds right, but I wanna double check.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] I didn't see it the first time. Let me check it again. I didn't see anything about age [PII] being cut, but let me double check.
[CUSTOMER][NEUTRAL] Well, we just wanna make sure if there's a cap on it, we don't wanna keep paying premiums.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] If we're not able to use it.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Because it is a cancer policy. Um, my first bet is that your, your Medicare would have to pay for it first, and this will pick up. I'm trying to double check.
[CUSTOMER][NEUTRAL] Well, I kinda got the feeling that based on what a diagnosis would be,
[CUSTOMER][NEGATIVE] For this, they pay this amount, and for this, they pay that amount, but maybe I'm wrong.
[AGENT][NEUTRAL] So I'm showing, and this is just a verification of benefits, not a guarantee of payment. Um, I am showing that your first occurrence and diagnosis benefit, you do have a benefit amount of up to $5000 and if you have chemo and radiation treatment, you're allotted up to $10,000 per calendar year.
[AGENT][NEUTRAL] And a daily hospital benefit of up to $300 per year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm not seeing anything on age [PII] though, so give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And, and [PII] has, he's in here too listening. I've got you on speakerphone.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can hear him a little bit.
[CUSTOMER][NEUTRAL] I see it.
[AGENT][NEUTRAL] Yeah, I'm not seeing anything about the age. I know that that's in some of our newer policies, but because this is an older policy, I don't know if they wrote it in later and amended it or if they just didn't have that for you.
[AGENT][NEUTRAL] So I'm going through everything just to make sure.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Because some of them do have that policy, but it is typically the newer policies.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And this one's just grandfathered in.
[CUSTOMER][POSITIVE] Hopefully, OK.
[CUSTOMER][NEUTRAL] Now is is my name and [PII]'s name both on it?
[CUSTOMER][NEUTRAL] Are we both covered by it?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] I am showing that you are covered on this as well. Let me double check.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, I do have both of y'all on here.
[CUSTOMER][NEUTRAL] I found people
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] I apologize this is taking just a little bit. Give me a moment.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I think so.
[CUSTOMER][NEUTRAL] It's that too. Yeah.
[CUSTOMER][NEUTRAL] I did find something that's titled Hospital intensive care coronary care unit Policy.
[CUSTOMER][NEUTRAL] And it says benefits reduced by 50% at age [PII].
[AGENT][NEUTRAL] At [PII]. Mhm.
[CUSTOMER][NEUTRAL] At [PII].
[AGENT][NEUTRAL] And see, I don't have that on your file so I might need to.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] OK, that has a different policy number on it too.
[AGENT][NEUTRAL] Let me see just real quick.
[AGENT][NEUTRAL] Let me see, because this policy is active.
[AGENT][NEUTRAL] Well, currently you only have one active policy with us, so you might be looking at something older.
[CUSTOMER][NEUTRAL] Yeah, yeah, this is dated [PII] and, and let me give you that policy number and you can plug it in later 101508568.
[AGENT][NEUTRAL] Does it say what type of
[AGENT][NEUTRAL] Yeah, I'm seeing that one on here and that one has lapsed.
[CUSTOMER][NEUTRAL] And that's an
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's lasted. Well, they changed the way some things were done. Right, right. So.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right. And anytime there's a change to your policy, even if it's one minor thing, you get an all new policy number. Um, it looks like this is an older cancer policy. That one was a, a cancer and critical illness policy, it looked like, and then you had another policy with us too, um, that lapsed in [PII]. It might just take me just a moment.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] It lapsed in [PII].
[AGENT][NEUTRAL] Yes, you had one that lasted in [PII] and that could just be because based off of what I'm looking at, it just changed, um, it looks like it could have just changed what was in your policy.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] Let me see here. Give me just a second. I think I've got an idea on how I can look for this.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, here we go. Let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, cause I'm just not seeing your policy documents in here.
[AGENT][NEGATIVE] That makes it a little bit trickier to find going through all of the documents that you have.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] There's a lot of documents to go through.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] And they're all scanned in so some of the images aren't fantastic.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Ever since the [PII]. Yeah.
[CUSTOMER][NEUTRAL] Yeah, that's what you did.
[CUSTOMER][POSITIVE] It's advantage.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, and, and I, I have a.
[CUSTOMER][NEUTRAL] A letter that says.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It's important that you read the enclosed policy, policy and any amendments attached very carefully, and that is dated.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that's for an older policy, so that wouldn't be for this one anymore. Um, I'm not showing anything that says it terms at 70 if or or 75, I will say, um, after looking at this and I don't see it.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, if it does end up terming because due to age they do, um, send you a letter in the mail.
[AGENT][NEUTRAL] Stating that so that you don't have to, so yeah, and when and I I believe it's once the policy holder so once um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Once your husband turned, yeah, right, it should trigger a response that we will send a message out or email out um I'm sorry, not email uh physical mail out stating that.
[CUSTOMER][NEUTRAL] Your age triggers.
[AGENT][NEGATIVE] Uh, because, no, we don't make you pay for it if you're not qualified for it anymore.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, yeah. OK. Um, so,
[AGENT][NEUTRAL] So yeah, just, yeah, so anytime you have an update to your.
[AGENT][NEUTRAL] To your mailing address or email or anything.
[CUSTOMER][NEUTRAL] Important. Keep it up, right?
[AGENT][NEUTRAL] Right. Anything like that, yeah, to keep it up, keep it updated, um, I, you did verify with me.
[AGENT][NEUTRAL] So that is your email or that is your mailing address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So as long as uh we have that mailing address on file and it is correct, you should be getting something.
[CUSTOMER][NEUTRAL] OK. Um, the next
[AGENT][NEGATIVE] If if it ends up being that it turns at that age, it might not because I don't see anything that says it does.
[CUSTOMER][NEUTRAL] OK. OK. Um, [PII] has been diagnosed with prostate cancer.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And at this point, um, it's a watch, wait and see, keep checking back. What is it? 6 months, [PII]? 3 months, every 3 months.
[AGENT][NEUTRAL] 3
[CUSTOMER][NEUTRAL] Yeah, um, is, is this the point where, um, he should go to the online service center?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And fill out some forms or
[AGENT][NEUTRAL] Yes, ma'am. So if he was diagnosed.
[CUSTOMER][NEUTRAL] What's the
[AGENT][NEUTRAL] Especially since I did show you that you do have a an initial diagnosis um benefit.
[AGENT][NEUTRAL] You'll want to go in to and I can.
[AGENT][NEUTRAL] It'll be in your portal. There should be a cancer claim form.
[AGENT][NEUTRAL] That you will fill out
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see if I can find it as well and give you the correct name.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, so cancer claim form you'll fill that out um and it should have a list of all of the paperwork that you'll need um we will need, um.
[AGENT][NEUTRAL] Typically, the pathology report showing that the initial diagnosis of cancer or if there's a new diagnosis, and it could include surgery, including biopsies, um, any itemized bill that you get, and sometimes they don't give you the itemized bill, they just send you a receipt. You wanna make sure to ask for the itemized medical bill from every provider that you have.
[AGENT][NEUTRAL] And then an explanation of benefits from your other medical carriers, so you stated that you had uh Medicare.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So you'll need an explanation of benefits from them showing that they have also um.
[AGENT][NEUTRAL] Paid any amounts towards the services?
[AGENT][NEUTRAL] And all of this will be on that claim form that cancer claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But the benefit that is paid from this plan.
[CUSTOMER][NEUTRAL] It it does not matter what Medicare is paid, correct?
[AGENT][NEGATIVE] I don't believe.
[AGENT][NEUTRAL] Are you asking
[CUSTOMER][NEUTRAL] I mean it's over and above anything it's it's a it's a lump sum payment.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Correct, that initial diagnosis is a lump sum payment of what I stated earlier, which I believe was 5000 or $10,000 and again, that is just a verification of benefits, not a guarantee of payment, but correct.
[CUSTOMER][NEUTRAL] OK, all right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And is there anything else I can help you all with?
[CUSTOMER][NEUTRAL] Have you
[CUSTOMER][NEUTRAL] Have you got other questions, [PII]? OK. And uh, what was your name again?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] [PII] and
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] The information we talked about today is on file anyway, so if we call the customer service number, anybody could talk to us about it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Correct, we'll have notes on that as well. And if you still, I will put in a request to have um your policy certificate, you should have gotten an actual certificate, not um several documents. I will request, request to have that put in there um that could take anywhere from uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 48 hours or more just because it is a digital document that we'll have to include, um, but I am going to go ahead and put in a request for that too. It might be a little bit easier to read as well. Um, and then next time.
[CUSTOMER][NEUTRAL] Do you want it by mail?
[CUSTOMER][NEUTRAL] Or email.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It doesn't matter. OK, you can either email it or US mail.
[AGENT][NEUTRAL] Well, once we get it uploaded into our system, you should be able to see it in your online portal.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Yeah, once it's all put in there it should be on your online portal. It'll just take it'll take some time to get uploaded in there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, [PII], um, I appreciate your information today.
[AGENT][NEUTRAL] I is there anything else I can help you with?
[CUSTOMER][NEUTRAL] I think that covers it.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] No, I think that's it. Thank you so much. Thank you.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] I hope you have a great day. Thank you for calling APL. All right, bye.
[CUSTOMER][POSITIVE] Have a good evening.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Bye.