AccountId: 011433970860
ContactId: e4d594aa-3c24-4803-9b7f-e9a7f589fae5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 780380 ms
Total Talk Time (AGENT): 268192 ms
Total Talk Time (CUSTOMER): 277281 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/e4d594aa-3c24-4803-9b7f-e9a7f589fae5_20250123T21:39_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] Yes ma'am, I got a letter. Uh, my husband and I have a cancer policy and I've had it for many years, and I got a letter yesterday with a small little check and I, I just pulled my folder just to make sure I put this in there for record wise and whatever because it it was telling me the uh the intensive care coordinary uh care policy was no longer effect on him that he had turned [PII].
[CUSTOMER][NEUTRAL] And anyway it had a little $10 check in there but I wanna make notes in here and and there were some things that on the policy number on that letter didn't match the policy number I have and I'm sure it's with him because this guy's name and address, but I wanted to kind of see that and then kind of just explain to me that because I see some things in here that don't add up neither I don't have an updated policy because we've had this for a long time and maybe I need you to send me one or something.
[AGENT][POSITIVE] OK, yeah, I'd love to look into that with you. Can I have
[AGENT][NEUTRAL] Can I have your name real quick please? and
[CUSTOMER][NEUTRAL] [PII], I'm the spouse and I'm on there also. [PII].
[AGENT][POSITIVE] Perfect, Ms. [PII]. And what is the policy number you have?
[CUSTOMER][NEUTRAL] Alright, the policy number on this letter is 9H0100647.
[AGENT][NEUTRAL] 9010064
[CUSTOMER][NEUTRAL] 7.
[AGENT][NEUTRAL] 7, OK.
[CUSTOMER][NEUTRAL] That's not what's on all my.
[AGENT][NEUTRAL] What is
[AGENT][NEUTRAL] What's the policy number you have, um, listed on your records?
[CUSTOMER][POSITIVE] Thanks.
[CUSTOMER][NEUTRAL] Alright, hold on just a, I said that right here.
[CUSTOMER][NEUTRAL] Because I've got, I, I do that, you know, annual wellness visit and I've just looked at this last one which was just in 8824 and it got 004467-05.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's one I've been using for.
[CUSTOMER][POSITIVE] I just wanna make sure that's right, you know.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And it's about the letters about the intensive care coronary care policy that's what I was concerned with.
[AGENT][POSITIVE] You betcha. OK, perfect. I just wanna get.
[AGENT][NEUTRAL] It looks like that 44 number is the the one I am using too. OK, so.
[AGENT][NEUTRAL] Would you, I just need to verify some information and then we can dig all up into this. Would you be able to verify for me pretty please your date of birth, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect and then the mailing address on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then let's see the just the email and phone number on file if you can.
[CUSTOMER][NEUTRAL] Alright, [PII].
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] All right, um.
[AGENT][NEUTRAL] Seeing if there's any notes.
[CUSTOMER][NEUTRAL] I just happened to have been going through all my policies just in the last week and I got this yesterday and I thought let me call what's fresh on my mind.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] All right, so I do see that the.
[AGENT][NEUTRAL] ICU policy um did change from the couple's policy to the individual and it looks like they should have refunded you via check the $10.50 for the premiums received so that is absolutely what that one was for um.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Alright, my question is I pulled my, the, the card that came with all this one out and we took it out and down here it says.
[CUSTOMER][NEUTRAL] And like I said, I, I don't know what's changed. It says all ICCC benefits reduced by 50% at 875.
[CUSTOMER][NEUTRAL] That's what that's what I'm looking at on what I have.
[AGENT][NEUTRAL] And you're looking, that's the one on the cancer policy, right?
[CUSTOMER][NEUTRAL] Right, in hospital intensive care coronary care unit policy.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's what was given to me. That's what I have when we took this out.
[CUSTOMER][NEGATIVE] It's on it's like a little hardback.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Brochure type thing.
[CUSTOMER][NEUTRAL] But that's what I have 50% at 75%.
[AGENT][NEUTRAL] Let me pull up.
[AGENT][NEUTRAL] The policy documents on my side.
[CUSTOMER][NEUTRAL] It's kind of listed like under uh limitations and exclusions area.
[CUSTOMER][NEUTRAL] On this card.
[AGENT][NEUTRAL] I'm just trying to, I'm.
[AGENT][NEUTRAL] I am just trying to find your policy documents like I can see.
[AGENT][NEUTRAL] The application.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Well, we filed on it so I know I mean I use it yearly for the uh yearly screen uh cancer screening.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright and you said you found it under limits and exclusions?
[CUSTOMER][NEUTRAL] Yeah, that's what this is a little, a brochure.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] American public life like when we took it out.
[CUSTOMER][NEUTRAL] And on the back, yeah, that was the whole block said hospital intensive care coronary care unit policy and it's got a data benefit, double benefits, and just that part and down at the bottom it's a limitation exclusions and that's the last sentence there all I see slash CC benefits reduced by 50% at age [PII].
[CUSTOMER][NEUTRAL] Yeah, I wouldn't even know that until I got that letter and really realized that.
[CUSTOMER][NEUTRAL] And I had to look when I got the letter, I was gonna file it.
[AGENT][NEUTRAL] OK, yeah, um.
[AGENT][POSITIVE] I just, I'm so sorry because I'm trying to find like.
[AGENT][NEUTRAL] The same information you're looking at and I am.
[AGENT][NEUTRAL] I'm not seeing it.
[AGENT][NEUTRAL] But what I'm gonna do is, if you don't mind, I'm gonna put you just on a quick hold. I wanna try to maybe get.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Somebody on the line who.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Does these policies?
[AGENT][NEUTRAL] Um, like processes them, so maybe they'll have a little more experience with helping me find the right document that we're looking at, OK?
[CUSTOMER][NEUTRAL] And it's been a long time.
[AGENT][NEUTRAL] And just to make sure I'm looking at the right policy document this is on the coronary care intensive care policy, the 60419, right?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yes, so the hospital intensive care coronary care unit policy.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Perfect. That is the one I'm looking at. So I'm gonna put you on just a quick hold, Miss [PII]. Give me one second and let me see if I can get some more information, OK?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thanks.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][NEUTRAL] Calling APU this is [PII]. How may I assist you today?
[AGENT][NEUTRAL] Hey [PII], this is [PII] with the care team. How are you doing today?
[CUSTOMER][POSITIVE] Great. How are you doing?
[AGENT][POSITIVE] I'm doing wonderful. I need some help with um an intensive care coronary care policy. Am I in the right spot?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, perfect. I'm looking at policy number 60419 for a Ms. [PII].
[CUSTOMER][NEUTRAL] OK, I got it pulled up.
[AGENT][NEUTRAL] OK, um, so she has the policy with us. I can't find this policy certificate on Onase. I can see the back file application and correspondence, but she said that.
[AGENT][NEUTRAL] We dropped her husband um because he hit [PII], we refunded his premium, but she said that on her policy document, it shows that the limits and exclusions that his benefits dropped to 50% at age [PII], not that he would be dropped off the policy, and she's wanting some more information, but I just unfortunately, I'm not sure how to help her without being able to see the policy document. I wondered if maybe you knew something I didn't know.
[CUSTOMER][NEUTRAL] Um, no, cause I don't see it either. Um.
[CUSTOMER][NEUTRAL] Do we send a her request? Let me um
[CUSTOMER][NEUTRAL] I guess I may have to take her information and um.
[CUSTOMER][NEUTRAL] I'm not sure how to handle this because there's no policy out there and I think I have to wait to see the policy, and so I guess we would have to just call her back once we get it, but um you can send her through. I'll reach out to my supervisor and find out um.
[CUSTOMER][NEGATIVE] How is this supposed to go? I'm not sure if this is a hub request or not.
[AGENT][POSITIVE] OK, absolutely, and I'm so sorry because I should have just notated it as soon as you said it because I know I'm scatterbrained, but what was your name again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, [PII]. I'm, I'm really bad at that. I'm so sorry. Um, I will transfer her to you and I'll introduce you when we join, OK?
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] My pleasure.
[AGENT][NEUTRAL] Hi, Ms. [PII], are you still there with me?
[CUSTOMER][NEUTRAL] Um, yes, ma'am. Yes, ma'am.
[AGENT][NEUTRAL] Hey there, so I have Ms. [PII] on the line. Um, she does have a little more experience with these policies and I'm gonna let her take on over the call, um, and that way she can do her best to help you out, OK?
[CUSTOMER][NEUTRAL] That will work.
[AGENT][POSITIVE] Thank you so much. It was a pleasure talking to you, Ms. [PII]. You take care.
[CUSTOMER][NEUTRAL] OK. Uh-huh.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes ma'am. Hey, yes this is [PII] in.