AccountId: 011433970860
ContactId: eb8fb770-ad69-49dc-9078-e96e9ad8dd94
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 834890 ms
Total Talk Time (AGENT): 449648 ms
Total Talk Time (CUSTOMER): 265390 ms
Interruptions: 3
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/eb8fb770-ad69-49dc-9078-e96e9ad8dd94_20250312T20:16_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. My name is [PII].
[CUSTOMER][NEUTRAL] [PII] My policy number is
[CUSTOMER][NEUTRAL] 640393
[CUSTOMER][NEUTRAL] What else do you need?
[AGENT][NEUTRAL] Your phone number please, Ms. [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. So while I'm getting your policy information pulled up, how can I help you today?
[CUSTOMER][NEGATIVE] I have 2 questions. I filed a claim, but I got a letter that said, you got my claim, but I haven't heard anything else.
[AGENT][NEUTRAL] OK, so you filed a claim with the claim for yourself, Ms. [PII], that you're wanting to check status on?
[CUSTOMER][NEUTRAL] Yes, it was for myself.
[CUSTOMER][NEUTRAL] Yes, for myself.
[AGENT][NEUTRAL] OK, OK, and you're wanting to check claim status?
[CUSTOMER][NEUTRAL] For my cancer policy.
[CUSTOMER][NEUTRAL] Yes, crimes policy.
[AGENT][NEUTRAL] OK, yes ma'am. Well, I can help you with that. And Ms. [PII], give me a moment to get your information pulled up and I will need to verify several things with you first for security purposes and any information that I provide would be a verification of benefits and not a guarantee of payment. So one moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so first off, Ms. [PII], if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you and your home mailing address, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. The phone.
[CUSTOMER][NEUTRAL] Uh, actual.
[AGENT][NEUTRAL] Oh, I'm sorry. Yeah, that, that is what we have on file for you is your mailing address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Is that still correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. And the next piece of uh information, your phone number, and that is the same as the one you gave me, so that is your best contact number as well. Is that correct?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[AGENT][POSITIVE] Thank you. And lastly your email address, please?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] OK, thank you very much. All right, Ms. [PII], so I do see that we recently processed the claim for you and it went through processing last week on the [PII].
[AGENT][NEUTRAL] And there was a benefit paid in the amount of $10,000.
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] And that check, that was via check that that was paid to you. Now, the remarks on your explanation of benefits that you should also receive or you can also access it in your portal, Ms. [PII] because I can see that you have set up your online service center profile.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But it's like
[CUSTOMER][NEUTRAL] Well, when will I get that check?
[AGENT][NEGATIVE] Well, again, it was mailed. It went through nightly processing on the [PII], which was Thursday, so it wouldn't have mailed out till Friday.
[AGENT][NEUTRAL] So depending on the mail service, I mean, typically it's around 10 business days.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] So I would just be on the lookout for, but again, it would not have even mailed until last Friday.
[CUSTOMER][NEUTRAL] Right. Oh, I have, I had breast cancer in [PII].
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And in [PII], I was diagnosed with a second cancer.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And I'm taking a chemo pill for that, and that's what that was for. It's $24,000 a month.
[AGENT][NEUTRAL] Oh my goodness. Well, I can see that it states that is, I mean, medication and treatments are so expensive this day in time. So, um, I can see that the remark.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] It's a billion
[AGENT][NEUTRAL] Ma'am.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] No, I was just gonna read the remark that's actually on your explanation of benefits. It states the maximum payable for the chemotherapy, radiation therapy benefit has been met for this benefit period. That was the remark associated with it.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, here's my second question.
[CUSTOMER][NEUTRAL] On the wellness payment.
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] Um, I had my yearly mammogram.
[CUSTOMER][NEUTRAL] Does it pay for that?
[AGENT][NEUTRAL] Uh, uh, let me see what you're, um, give me just a moment to pull up some of your benefit information because I can't tell that just by looking.
[AGENT][NEUTRAL] At what I have pulled up, so one moment.
[CUSTOMER][NEUTRAL] Because I had, I had breast cancer. It started all this.
[CUSTOMER][NEUTRAL] So, on my wellness, the reason I'm asking is they found something again.
[CUSTOMER][NEUTRAL] And they want to do more mammograms and an ultrasound.
[CUSTOMER][NEUTRAL] How much would it pay on that if I submitted it for my wellman payment?
[AGENT][NEUTRAL] OK, so I can check to see what your wellness benefit is. Give me just a moment to look at that information for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you, [PII].
[AGENT][POSITIVE] You're welcome. Yes, ma'am. Certainly.
[CUSTOMER][NEUTRAL] Is it like a one time payment once a year for just one thing?
[AGENT][NEUTRAL] Yes, ma'am, for your, uh, for a screening, but I'm still
[AGENT][NEUTRAL] Looking for that. So just a moment.
[AGENT][NEUTRAL] And it's just gonna take me a moment to, to look at all of this.
[AGENT][NEUTRAL] Because of the time that you've had our policy, I have to look at all of your benefits a little different.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just one moment.
[CUSTOMER][NEUTRAL] You know, when I first took this policy out in [PII],
[CUSTOMER][NEUTRAL] was when I started with American Public Life. And
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] That policy was so good.
[CUSTOMER][NEGATIVE] That it continually went up every year. And finally, when the monthly premium got to $500 a month.
[CUSTOMER][NEGATIVE] I called him and I said, I can't pay that anymore.
[CUSTOMER][NEUTRAL] So that's when they switched me over and.
[CUSTOMER][NEUTRAL] I don't know, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Something in there, yeah.
[AGENT][NEUTRAL] Yeah, this one actually went, yes, from [PII]. This one, this particular policy went into effect.
[CUSTOMER][NEUTRAL] Right, OK.
[CUSTOMER][POSITIVE] Well, it was a reduction from what I used to have because it paid.
[CUSTOMER][POSITIVE] For every mile you went, it paid for every
[CUSTOMER][NEUTRAL] A lot of blood, you had a special thing in there, or if you needed to go in the air ambulance.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I mean it covered
[CUSTOMER][POSITIVE] It was a darn good policy.
[CUSTOMER][NEGATIVE] But I paid, I paid royally for it. $500 a month was outrageous.
[AGENT][NEUTRAL] Yes, ma'am, that's
[CUSTOMER][NEUTRAL] For a monthly premium.
[AGENT][NEGATIVE] That's a, yes, ma'am. That's a very costly.
[AGENT][NEUTRAL] Um, yes, that's a very costly premium. OK, so in looking at your schedule of benefits for your screening, your wellness extent, your cancer screening, that the benefits states actual charges not to exceed $75 per calendar year.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] With the ultrasound that I'm gonna have Monday.
[CUSTOMER][NEUTRAL] They're gonna do another mammogram.
[CUSTOMER][NEUTRAL] And an ultrasound. So it's just a flat $75 per year.
[CUSTOMER][NEUTRAL] For one, right?
[AGENT][NEUTRAL] Yes, ma'am. It is, mhm, um.
[CUSTOMER][NEGATIVE] They wouldn't pay 75 for the mammogram and $75 for the ultrasound.
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK, that's what I was asking.
[AGENT][NEUTRAL] That is
[AGENT][NEUTRAL] Yes, it's one test per year. And give me, yeah, give me just a second to, to look at something else.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You know, cancer.
[AGENT][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Is a billion dollars a day in industry.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am. I'm too familiar with it. So, uh, yeah, I unders I understand.
[CUSTOMER][NEUTRAL] It's, I know you are.
[AGENT][NEGATIVE] It can totally bankrupt people, especially, you know, if you don't have some type of help like these policies provide you, it can.
[CUSTOMER][NEUTRAL] I know, but still, that's not very much.
[CUSTOMER][NEUTRAL] 100, that's a drop in the bucket.
[AGENT][NEUTRAL] Not in the
[AGENT][NEUTRAL] Right, in the grand scheme of things, but again, you know, it is better than
[CUSTOMER][POSITIVE] It beats a sharp sticking enough, uh.
[AGENT][NEUTRAL] Not having
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] So, um, yes, ma'am. I was just verifying, but it, yes, it is the test, but not to exceed a $75 per year. So yes, ma'am, it would be one of those tests.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Which uh whether uh a mammal, if there's several tests that's listed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, which is a mammogram, a flexible sigmoidoscopy, chest X-ray, a hemacult stool analysis, Pap smear, Pap smear, excuse me, colonoscopy, a thermography, a PSA for, you know, obviously a man, a CA 125, which is a blood test for ovarian cancer.
[AGENT][NEUTRAL] A CEA, which is a blood test for colon cancer, and any other cancer screening test approved by the National Cancer Institute or American Cancer Society.
[CUSTOMER][NEUTRAL] Oh OK, OK.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] And when, yes, ma'am.
[CUSTOMER][POSITIVE] Well, thank you so much for your time, [PII].
[AGENT][NEUTRAL] Oh, absolutely, and if you're not aware of it though, you do also have a copy of your full policy in your portal where you can log in so that you can, it's in a PDF format.
[CUSTOMER][NEUTRAL] I'll be
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's like 41 pages, but it gives you all the different definitions and the test and your benefit amounts in there as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] OK. Well, you're welcome. So is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] No, [PII], thank you. I think I just need to watch the mail for my check.
[AGENT][NEUTRAL] Yes, ma'am, I would because like I said, the earliest date it would have been mailed out would have been [PII] since it was processed on the [PII]. So, um, definitely, you know, keep an eye out for it. Hopefully, maybe you'll even get it by the end of this week, but again, with the mail service.
[CUSTOMER][NEGATIVE] I wouldn't look for it till next weekend.
[AGENT][NEUTRAL] With the the mail service, uh, sometimes that can be a little tricky. Now you can log into your portal, Ms. [PII]. You can add in direct deposit information into your portal so that it for future, you know, benefits that we're able to pay, they could be direct deposited into your account, bank account versus having to send a check, but again that's.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's entirely up to you, but you do have that ability to do that and if you would like I can email you that user guide because it does even though you've already set up your profile it does give you some helpful information on like submitting information to us and also you know about the direct deposit so would you like for me to send that to you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, send it to me.
[AGENT][NEUTRAL] OK, well I'll send that in just a moment and the email that you're gonna receive will come from [PII] at [PII] and I will put in the subject line for you APL online service center so that you can recognize that is not being junk mail.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK. Well, you are certainly very welcome. Yes, ma'am. And again, is there anything else I can help you with?
[CUSTOMER][POSITIVE] Thank you, my dear.
[CUSTOMER][POSITIVE] Uh, thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Have a good rest of your week. Bye-bye.
[AGENT][POSITIVE] Well, I hope you do too. Yes, ma'am. And thank you again for calling APL.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right. Bye-bye.