AccountId: 011433970860
ContactId: f9f09fe1-4206-4c72-b12b-7ccbb95304b5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 345980 ms
Total Talk Time (AGENT): 139301 ms
Total Talk Time (CUSTOMER): 144287 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/f9f09fe1-4206-4c72-b12b-7ccbb95304b5_20250131T17:42_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, um, I need to file a claim and I honestly don't even know where to begin.
[AGENT][NEUTRAL] OK, I can give you instructions.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I recently had surgery, um.
[CUSTOMER][NEUTRAL] To remove uh a tumor from my breast.
[CUSTOMER][NEUTRAL] Um, and I, I gave them my policy number, uh, for my cancer insurance, and they never added it to the claim, and so I, I have to do it myself, I guess.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, yes, um, I can help you with the instructions. Um, may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, sure. My name is [PII].
[CUSTOMER][NEUTRAL] And my phone number is [PII].
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Um, I think so. It is.
[CUSTOMER][NEUTRAL] 254
[CUSTOMER][NEUTRAL] 0630
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] OK. And may I have your date of birth, mailing address and email address on file for verification?
[CUSTOMER][NEUTRAL] Sure, my date of birth is [PII].
[CUSTOMER][NEUTRAL] My email address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] My
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] I'm sorry. You may have my, you may have my work email. It's fine. It's [PII] either one is fine, [PII].
[AGENT][NEUTRAL] We have your work, yeah, we do. Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you. Mhm.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] What's the mailing address?
[CUSTOMER][NEUTRAL] My mailing address is [PII], and that's [PII].
[AGENT][NEUTRAL] Perfect, thank you. All right. OK. OK, so the first thing um you're gonna need is the claim form. Um, the claim form, you can find this through our website at [PII].
[CUSTOMER][NEUTRAL] Yeah, I'm there right now.
[AGENT][NEUTRAL] Again, that's OK. So you're gonna look for the counter claim form.
[AGENT][NEUTRAL] And you're gonna um download the form. The first page is, OK.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] I'm looking for the cancer one. Hang on.
[AGENT][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Cancer claim form. OK, I'm gonna download it.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The first page is gonna give you instructions on what's needed. But based on what you're telling me, um, what you're gonna need is an um pathology report. Um, you're gonna need the itemized bill from the surgeon and the anesthesiologist.
[AGENT][NEUTRAL] So that's what we're gonna need.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So, I have a question. It, so the, they took this lesion out of my breast because
[CUSTOMER][NEUTRAL] They, it's, it was uh benign, but they wanted to biopsy it because it could have turned into something else.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um, so does that count? I mean they're basically like.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] took it out to avoid the possibility of cancer.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] This, this cancer policy will pay if it's positive for cancer. Um.
[AGENT][NEUTRAL] If it was just a test, uh, like prevention, that's, that's not something that is covered unless it's just a regular test like a mammogram or something like that that you send in for that benefit for um wellness benefit, but if it's not positive for cancer, then it will not pay the surgery.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, I have one more question.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, I had a policy with y'all that lapsed, you know, because I had it through a different employer.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, and in the during the terms of that policy, I had like, um, my, the initial exams like my wellness exams, is it too late for me to file a claim for those?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, there's no timely filing limits for wellness exams. So those you can just submit.
[CUSTOMER][NEUTRAL] Even, even if it's on a policy that's lapsed.
[AGENT][NEUTRAL] Mhm. Even, mhm.
[CUSTOMER][NEUTRAL] I mean if because it was during that time I can still file for that? OK.
[AGENT][NEUTRAL] Mhm. Yeah, as long as the policy was active during the time of service, but we don't have any timely filing limits, so you can submit the claims at any time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][POSITIVE] OK. All right. um I appreciate your help. Thank you very much.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] No, not right now, thank you.
[AGENT][POSITIVE] OK, you're welcome and thank you for calling APL. Have a good day. Goodbye.
[CUSTOMER][NEUTRAL] You too. Bye-bye.