AccountId: 011433970860
ContactId: de39773e-a123-4bde-abb3-eacbbce488ec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1479729 ms
Total Talk Time (AGENT): 274904 ms
Total Talk Time (CUSTOMER): 733083 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/de39773e-a123-4bde-abb3-eacbbce488ec_20250605T15:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] with Louisiana Citizens. Um, I have a quick question. I say it's quick. I got paid for a claim for a wellness.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, I got $100 so I went trying to figure it out. OK, so last time I got $100 for one and I got $50 for the other, um.
[CUSTOMER][NEUTRAL] What do you want me to give you?
[AGENT][NEUTRAL] You have your
[AGENT][NEUTRAL] Uh, policy number?
[CUSTOMER][NEUTRAL] Um, let's see, I got the thing in the mail, uh, policy number, you ready?
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 024.
[CUSTOMER][NEUTRAL] 91357.
[CUSTOMER][NEUTRAL] [PII], can I give you my cell number if we get disconnected?
[AGENT][POSITIVE] Yeah, absolutely.
[AGENT][NEUTRAL] What is it? Yes.
[CUSTOMER][NEUTRAL] You ready? [PII].
[AGENT][NEUTRAL] OK, and then can I verify your date of birth and first and last name?
[CUSTOMER][NEUTRAL] OK, so the date of birth is [PII].
[CUSTOMER][NEUTRAL] And what was the other one?
[AGENT][NEUTRAL] Uh, your last name?
[CUSTOMER][NEUTRAL] Last name is [PII]
[AGENT][NEUTRAL] And then the address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] On your
[CUSTOMER][NEUTRAL] [PII] you need me to spell it or you just verify?
[AGENT][NEUTRAL] Uh, just verify.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the city and state?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then the email address on file.
[CUSTOMER][NEUTRAL] The email I have is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what was the date of service?
[CUSTOMER][NEUTRAL] I just wanna
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so the
[CUSTOMER][NEUTRAL] The date I already got the check. I just wanted to get an explanation, you know, um, OK, so.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so the data service was [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it was a Pap smear. OK, so I got the $100 and then I was, it's the $50 I didn't get because for the critical illness, it said.
[CUSTOMER][NEUTRAL] The calendar year maximum for this benefit has been exhausted with the payment of this claim.
[AGENT][NEUTRAL] OK, um, uh, you're referring to the
[AGENT][NEUTRAL] OK, it looks like, yeah, let me, let me pull up your pulse.
[CUSTOMER][NEUTRAL] Well, let's, we'll do one, OK, yeah, yeah, so you pull it up. The only thing I'm gonna take, I'm trying to read a manual and it says the health screening. I see we get $50 payable for a wellness test.
[CUSTOMER][NEUTRAL] Payable for wellness tests, routine physical exam, or additional medical.
[CUSTOMER][NEUTRAL] You know, um, test.
[AGENT][NEUTRAL] Real quick, give me one moment.
[CUSTOMER][NEUTRAL] No, no, no, that's fine. I know you have to look me up. I just wanna understand how did I get the 100 because.
[CUSTOMER][POSITIVE] Trust me, I'm happy about the 100 because when I read this I was like, oh well, I thought it was only gonna be 50 then.
[AGENT][NEUTRAL] Um, yeah, I'm, I'm looking, hold on one moment.
[AGENT][NEUTRAL] OK, so it looks like um this is not a guarantee of payment basic outline of your policy. Uh, so it looks like for
[AGENT][NEUTRAL] Under your screening,
[AGENT][NEUTRAL] Um, this is on page 19 of the policy. It page 100.
[AGENT][NEUTRAL] So that's, that's.
[CUSTOMER][NEUTRAL] Page 100, that's where I don't see what you said it's so can you, is it in the when we log in is it there? Page would you just say what page what?
[AGENT][NEUTRAL] Uh, page 19. Have you set up your new account online?
[CUSTOMER][NEUTRAL] Page 9.
[CUSTOMER][NEUTRAL] Yeah, yeah, I realized I changed the website, so let me see page, let's see we have a manual that they gave us.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'm trying to see.
[CUSTOMER][POSITIVE] OK, it's on the wellness benefits.
[AGENT][NEUTRAL] Um, so it's under the schedule of benefits.
[AGENT][NEUTRAL] And then you have a benefit rider for cancer screenings.
[CUSTOMER][NEUTRAL] Hey, let me just go to 19. Let me see what 19 is for us.
[AGENT][NEUTRAL] Um, it probably is actually 14.
[AGENT][POSITIVE] Looks like page.
[CUSTOMER][NEUTRAL] OK, so I see page let's see well.
[CUSTOMER][NEUTRAL] Our so uh we must not have the same 16 you said?
[AGENT][NEUTRAL] Let me page 15.
[AGENT][NEUTRAL] 15.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 15, OK, so page 15, um.
[CUSTOMER][NEUTRAL] OK, so this is 13th, this is 14, and this is 15. Well, we must have a different book because mine says nonstop visa.
[CUSTOMER][NEUTRAL] Which is not you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is it is that is this thing online you said?
[AGENT][NEUTRAL] Yes, your policies are, yes, uh-huh, it's online on our site.
[CUSTOMER][NEUTRAL] Is this book page?
[CUSTOMER][NEUTRAL] It's online so let's see.
[AGENT][NEUTRAL] Under your, you'd have to log into your account.
[CUSTOMER][NEUTRAL] I am just gonna
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] This when you say page 15, that's online accessible for me?
[AGENT][NEUTRAL] Uh, so there's a, there should be a PDF file that's your policy certificate, and then under that.
[CUSTOMER][NEUTRAL] OK, oh wait, let's see, you know what, let me see.
[CUSTOMER][NEUTRAL] I had printed something the other day. Let me see if this is what I'm alive if this is it page.
[CUSTOMER][NEUTRAL] Only 1213.
[CUSTOMER][NEUTRAL] 1415.
[CUSTOMER][NEUTRAL] I know it says something to download critical illness, uh, it was the download document, but is that's not the one that says confined confined coronary artery disease, no, huh.
[AGENT][NEUTRAL] Um, so there's, so the policy certificate, did, did you download, download it from our site?
[CUSTOMER][NEUTRAL] No, it's.
[CUSTOMER][NEUTRAL] Yeah, I was in there the other yesterday was it [PII]day? It must have been alright, just give me a second.
[AGENT][NEUTRAL] Yeah,
[AGENT][NEUTRAL] It's a 54 page document.
[CUSTOMER][NEUTRAL] OK, I was just gonna.
[CUSTOMER][NEUTRAL] It's a 54 page let me see.
[CUSTOMER][NEUTRAL] Oh no this is about H APL HIPAA notice I guess that's not it, huh? it says uh.
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] Notice American Life, the beginning of it says it's probably not it. Let me see.
[CUSTOMER][NEUTRAL] Oh good, I let's, it's letting me log in now.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh my God, so does the verification code in this new thing now?
[AGENT][POSITIVE] Yes, it'll do that every time.
[CUSTOMER][NEUTRAL] Yeah, that's what I, I figured I was like I logged into it twice yesterday.
[CUSTOMER][NEUTRAL] And it
[CUSTOMER][NEUTRAL] Each time it asked for.
[CUSTOMER][POSITIVE] The good thing about it doesn't take long.
[AGENT][POSITIVE] Yeah, we just wanna make it as secure as possible.
[CUSTOMER][POSITIVE] Yeah, that's OK that's what we started to do on our end.
[CUSTOMER][POSITIVE] It's amazing.
[CUSTOMER][NEUTRAL] How people have time to hack into other people's stuff.
[AGENT][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] If you like that.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Come on, it was quicker yesterday than today.
[AGENT][MIXED] Yeah, we're still still working to get some of the bugs worked out but hopefully by the end of the week it'll be good.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, no, it was quick yesterday. I'm sorry, I was like.
[AGENT][NEUTRAL] Oh, no, you're fine.
[CUSTOMER][POSITIVE] No, yeah, that's good.
[CUSTOMER][POSITIVE] He did wow, got him.
[CUSTOMER][POSITIVE] Oh, it would help if I hit on their sent. I am so sorry. I'm sitting here waiting and the thing I was like I forget it tells you to send it.
[AGENT][NEUTRAL] Oh, you're fine.
[CUSTOMER][NEUTRAL] It takes getting used to this new one.
[AGENT][POSITIVE] Oh yeah, absolutely.
[CUSTOMER][NEUTRAL] I'm sorry, I stood there. I'm like, oh well, that's why, and that was, I was like I paid attention 8 like, OK, 819.
[AGENT][POSITIVE] Oh, you're you're totally fine. Don't worry about it.
[CUSTOMER][NEUTRAL] 81859 verify send there.
[CUSTOMER][NEUTRAL] Continue.
[CUSTOMER][NEUTRAL] Uh, at least I was paying attention that time.
[CUSTOMER][NEUTRAL] OK, alright, so um I am.
[CUSTOMER][NEUTRAL] OK, so where do I find that page, uh, skip, um, that you're telling me about? I just wanna read it uh to be, is it, is it the cover would you like to view your coverage details? Is that the one it says view policy detail? OK, so I'm in there, OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Does it have a document that you can pull up or click on?
[CUSTOMER][NEUTRAL] Right, oh, so then that's the one I did pull up then let's see, let's see, so I'm gonna download.
[CUSTOMER][NEUTRAL] The which one do I click on?
[AGENT][NEUTRAL] Uh, what are your options?
[CUSTOMER][NEUTRAL] OK, so I hit there it says my accident, obviously I don't want that one. It says the cancer and specified disease or the critical illness.
[AGENT][NEUTRAL] Uh, so it looks like this policy that we're talking about that has $100 is your
[AGENT][NEUTRAL] Uh, let's see what is this.
[CUSTOMER][NEUTRAL] The cancer and specified.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, the cancer and specified.
[AGENT][NEUTRAL] So it's not, it's not the critical illness that we process this under, we process it down here.
[CUSTOMER][NEUTRAL] OK, right.
[CUSTOMER][NEUTRAL] OK, so how do I click it so it tells me I just wanna get to that page.
[AGENT][NEUTRAL] So did it pull up the document?
[CUSTOMER][NEUTRAL] OK, then it must take a minute because the cursors are going, but I thought that's what, OK, so let me see something that's I thought that's what I printed yesterday so the critical illness we don't want. I bet you this is it. Let me see.
[CUSTOMER][NEUTRAL] Alright, give me a second.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Which page you said it was again?
[CUSTOMER][NEUTRAL] 19.
[AGENT][NEUTRAL] Well, so
[AGENT][NEUTRAL] Yes, that would be on the PDF document if you if you printed the PDF document from our.
[CUSTOMER][NEUTRAL] Yeah, oh yeah, there it is, it's finally going, OK, so, so let's see. OK, so it says download documents open here, yeah, this is sure if it same thing. OK, so I'm gonna go to page.
[AGENT][NEUTRAL] Website.
[AGENT][NEUTRAL] From
[CUSTOMER][NEUTRAL] 19
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, OK, I had it all on. OK, I'm reading it. OK, so that's where diagnose. OK, maximum there you go. That's the, it's $100. I thought it was $50. That's the only reason why I wanted to.
[CUSTOMER][NEUTRAL] No, OK, so that's why I got the 100, OK, so current page.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, where are you?
[CUSTOMER][NEUTRAL] Page
[CUSTOMER][NEUTRAL] 10
[CUSTOMER][NEUTRAL] Current page, how do I hit current page? Where are you?
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, you might have to on the pages you could put um custom and then put 19 and it should pull it up your printing.
[CUSTOMER][NEUTRAL] OK,
[CUSTOMER][NEUTRAL] Yeah, yeah, it's OK, so, OK, so, OK, so I, I see and so it paid the $100 for the calendar year.
[AGENT][POSITIVE] Yes, correct.
[CUSTOMER][NEUTRAL] Is that what it said? OK, let's see this, OK, give me one quick second.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] 19 page 19, where are you?
[CUSTOMER][NEUTRAL] OK, so the critical illness, that's what I wanna see. OK, 382. OK, so the critical, OK, so I understand how I got the 100. OK, so.
[CUSTOMER][NEUTRAL] Now
[CUSTOMER][NEUTRAL] The critical illness, it said I used it up for the, how did it say it?
[CUSTOMER][NEUTRAL] OK, the calendar year for this has been exhausted, so that means.
[CUSTOMER][NEUTRAL] What page would that be where it explains that you're only the time frame for that.
[AGENT][NEUTRAL] Which which policy are we talking about?
[CUSTOMER][NEUTRAL] Oh, so can we go to you're ready? It's 02491357.
[CUSTOMER][NEUTRAL] That would be the.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Um, that's the policy that paid you the $100.
[CUSTOMER][NEUTRAL] The.
[AGENT][NEUTRAL] Policy number you just gave me.
[CUSTOMER][NEUTRAL] Wait a minute.
[CUSTOMER][NEUTRAL] The policy number I just gave you. OK, [PII]. OK, great. I didn't exit out like I thought, OK, but OK, so my boss, I say my boss, the HR lady said that we're supposed to get 150.
[CUSTOMER][NEUTRAL] So last year if you look at.
[CUSTOMER][NEUTRAL] The critical OK like I got the $100 I'm fine. OK, so that was for the cancer policy, the wellness.
[AGENT][NEUTRAL] Huh.
[CUSTOMER][NEUTRAL] OK, so the one it looks like 2382.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] So doesn't, OK, so then this is, how about this? Does the critical illness pay the 50?
[AGENT][NEUTRAL] Um, let me pull up what that policy pays.
[CUSTOMER][NEUTRAL] You want me to give you that number? I'm looking at the policy.
[AGENT][NEUTRAL] Oh no, I, I've got it hold on.
[CUSTOMER][NEUTRAL] You got it. Can I put you on hold for one second? I'm just gonna go run and get it off the copy machine.
[AGENT][NEUTRAL] Sure, sure.
[CUSTOMER][POSITIVE] OK thanks.
[CUSTOMER][NEUTRAL] A page 19 on that document. OK, so you see last year for the if I'm, if this is how it goes, wait, hold on, I printed it up. OK, so last year we got the 50% off the critical illness.
[CUSTOMER][NEUTRAL] The policy number 24.
[CUSTOMER][NEUTRAL] 91
[CUSTOMER][NEUTRAL] 382.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 382 did I say it right?
[AGENT][NEUTRAL] Yeah, I've, I've got it pulled up.
[CUSTOMER][NEUTRAL] OK, so just, I just wanted to understand, so, OK, so going back to the cancer wellness one, the $100 so that one we get, that's yearly, right?
[AGENT][NEUTRAL] Um, so.
[CUSTOMER][NEUTRAL] The Pap smear mammogram.
[AGENT][NEUTRAL] Yeah, so this is for, so you're on your critical illness policy, it runs on your plan here.
[AGENT][NEUTRAL] Which runs May to May, so [PII].
[CUSTOMER][NEUTRAL] Hold on, let me write this down.
[CUSTOMER][NEUTRAL] OK, so you're saying the critical illness runs [PII] to [PII].
[AGENT][NEUTRAL] Well, [PII], so it runs on your plan year.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so it starts from [PII] to.
[CUSTOMER][NEUTRAL] The end of May basically is what you're saying.
[AGENT][NEUTRAL] Right, right.
[AGENT][NEUTRAL] And so, let me see this, so we, we paid out $50 that looks like it's for a
[AGENT][NEUTRAL] He's a mammogram
[CUSTOMER][NEUTRAL] It was the um mammogram I think it was let me see what it was.
[CUSTOMER][NEUTRAL] OK, yeah, right.
[AGENT][NEUTRAL] OK, I see the insured for the $50 for health screening and then $50 for mammogram.
[CUSTOMER][NEUTRAL] Wait,
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Right, because that was in [PII].
[CUSTOMER][NEUTRAL] Hold on, let me see.
[AGENT][NEUTRAL] OK, so this is the [PII].
[CUSTOMER][NEUTRAL] Uh, this is the ma'am.
[CUSTOMER][NEUTRAL] Yeah, because I'm, I'm looking at it now, yeah, because that was the mammogram that I did on [PII].
[AGENT][NEUTRAL] OK, let me pull up this claim real quick.
[CUSTOMER][NEUTRAL] Right, because what I was claiming for for the [PII] was for the Pap smear.
[AGENT][NEUTRAL] OK, can I put you on a brief hold?
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][POSITIVE] Oh yes, yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Are you there?
[AGENT][NEUTRAL] OK, I'm gonna send this back through to our claims department for review because from what I can tell it looks like the $50 should be compensable. um, what's a good contact?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Because it was two different types types tests, right? Because, OK, OK, that's what, OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] What is it? 5 [PII] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then is there a good email address, um, or what's your preferred method of communication?
[CUSTOMER][NEUTRAL] Oh, it doesn't matter. I mean, I, I guess if you could email it then it would be easier. Does that make sense? Like I just wanna understand like.
[AGENT][POSITIVE] Yeah, yeah, we can do that.
[CUSTOMER][NEUTRAL] Why I didn't get the OK like it's just so that I can understand for future um.
[CUSTOMER][NEUTRAL] The email is the one on file. You want me to tell it to you? [PII]
[AGENT][NEUTRAL] OK, yes.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] You want me to spell it?
[AGENT][NEUTRAL] No, no, I've got it on file.
[CUSTOMER][NEUTRAL] OK, um, [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, I'll send this back for review and then um if something, if we can't process it, we'll contact you back and let you know what, what, why not, so.
[CUSTOMER][NEUTRAL] OK, that makes sense. That's what I was calling. I just wanted to understand what, so look, I, when I was reading our stuff I was like, well, I didn't even think we were eligible for the 50, you know, it's supposed to be a, it's 100, right?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm looking at it [PII]t now diagnostic, OK, calendar year in a calendar year, can you explain me this calendar year starts when?
[AGENT][NEUTRAL] Calendar year is January to December.
[CUSTOMER][POSITIVE] OK, alright, thank you, that's what I wanted to make sure.
[AGENT][NEUTRAL] OK, I'll send this back through for you and then um when we get a determination, um we'll be able to contact you back or send a payment.
[CUSTOMER][NEUTRAL] January
[CUSTOMER][NEUTRAL] To December.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, so do you, you know what the difference is? The one I filed in [PII] was for the mammogram, the one I did this year, the [PII], was the pap, the bottom one's top one's bottom. OK, thank you.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right, yes, I see that. Uh-huh.
[CUSTOMER][NEUTRAL] OK, thank you. It wasn't for the same test is what I was trying to.
[AGENT][NEUTRAL] Right, I see it's two different tests, yeah.
[CUSTOMER][NEUTRAL] Make sure OK
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, we'll get that reviewed and then um is there anything else I can help with today?
[CUSTOMER][POSITIVE] No, this was perfect thank you.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] You too, [PII] bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.