AccountId: 011433970860
ContactId: e1f6db45-2571-4290-b29f-b010c6b2a038
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 232000 ms
Total Talk Time (AGENT): 78710 ms
Total Talk Time (CUSTOMER): 78983 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/e1f6db45-2571-4290-b29f-b010c6b2a038_20250523T16:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], this is [PII]. I talked to you earlier this morning.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And you sent me a uh policy. I went through this policy and uh I had a colonostomy on [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Is that something that is covered because according to what I'm reading it is.
[AGENT][NEUTRAL] Um, do you have your policy number again?
[CUSTOMER][NEUTRAL] Yes, um.
[CUSTOMER][NEUTRAL] 730492
[AGENT][NEUTRAL] OK, and then verify your date of birth and address for me.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, and then you're still at the [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me get that pulled up real quick.
[CUSTOMER][NEUTRAL] I'm looking at page 12.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And then it talks about um.
[CUSTOMER][NEUTRAL] According to the schedule, but I don't see it on the schedule of benefits.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] All right, give me just a moment.
[AGENT][NEUTRAL] OK, so what it is is you have a, it's actually under the diagnostic and prevention benefit, um, which is on page.
[AGENT][NEUTRAL] 25, um, so it pays $90 per calendar year per covered person and that's not a guarantee of payment basic outline of your policy.
[CUSTOMER][NEUTRAL] You say that you mean keep that keep saying that, but why is it not guaranteed if it's part of the policy?
[AGENT][NEUTRAL] Just because we can't if if for some reason you terminate coverage or don't pay your premium, we just always have to give that disclaimer. Something could change between now and when you submit the actual claim.
[AGENT][NEUTRAL] So that's why we always give that disclaim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, I'm paying the annual payment so I'm paid up until October so I shouldn't have a problem there, right?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] It's just a formality.
[CUSTOMER][NEUTRAL] OK, can I get you, can I get you to send me a claim?
[AGENT][NEUTRAL] Uh, sure, yeah, I can send you a claim form.
[CUSTOMER][NEUTRAL] Claim form, yeah, OK, uh, it's same email address [PII] and what I need to send with it, um, if you'll send that to me, I'd appreciate it.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, I'll get that sent over. Um, there should be a, basically, we'll need a copy of like an itemization that shows that, that you had a colonoscopy, the diagnosis, and then where it was rendered and uh billed them out. That will be on the claim form though, explaining what we need, but I'll get that sent your way right now.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thanks for calling APL. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah.