AccountId: 011433970860
ContactId: fabb4c41-34c9-4154-a34a-fcd7ece394db
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 893520 ms
Total Talk Time (AGENT): 370784 ms
Total Talk Time (CUSTOMER): 308811 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/fabb4c41-34c9-4154-a34a-fcd7ece394db_20250117T18:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APO. This is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. I don't know if I'm to the right department, but maybe you can help me. I am, uh, my name is [PII].
[CUSTOMER][NEUTRAL] And my date of birth?
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am, [PII]
[CUSTOMER][NEUTRAL] [PII] and I have a policy with you that I'm paying on, and I was wanting to know exactly what that policy covers.
[AGENT][NEUTRAL] [PII], I can help you with your benefits. Can I have a callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Wait a minute. [PII]. [PII] my goodness.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, can I get your policy number, please?
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Policy number I don't know that.
[AGENT][NEUTRAL] One moment please. I'm gonna ask for your social and then I'm gonna look you up in the system. One moment please.
[AGENT][NEUTRAL] May I have that number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], what policy would you be calling about today?
[CUSTOMER][NEUTRAL] OK, I think that I had a policy for intensive care and cancer.
[AGENT][NEUTRAL] All right. Could you please verify your date of birth, address, and email address, please?
[CUSTOMER][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] My address is [PII].
[CUSTOMER][NEUTRAL] My uh
[CUSTOMER][NEUTRAL] Email is [PII].
[CUSTOMER][NEUTRAL] I could have had an East text telephone uh email back then when I took this policy out and I don't remember what it was.
[AGENT][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I took it out with [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right. Thank you, thank you so much for verifying that information. So today you're calling to find out um what the policy covers?
[CUSTOMER][NEUTRAL] Yes, ma'am. And is it a one time thing or uh do you, can you keep using it or what?
[CUSTOMER][NEGATIVE] My husband's deceased, so I, I shouldn't be having it on him anymore.
[CUSTOMER][NEUTRAL] Do you see that or I mean, I don't know what you can see.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So it looks like um under the cancer policy.
[CUSTOMER][NEGATIVE] I'm, I'm getting a withdrawal every month.
[CUSTOMER][NEUTRAL] I'm getting a withdrawal on my bank statement every month so I just wanna make sure what I'm paying for.
[AGENT][NEUTRAL] OK, so under this cancel policy I see [PII] covered under this policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]. You know [PII]?
[CUSTOMER][NEUTRAL] OK. [PII] is deceased.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and how many times can you apply on that policy?
[AGENT][NEUTRAL] OK. Um, we
[AGENT][NEUTRAL] Let me explain how the policy works cause I'm not understanding what you mean apply. So, are you meaning how many times can you file a claim for a positive diagnosis of cancer or for the just the wellness?
[CUSTOMER][NEUTRAL] Yes, yes, that's, yes.
[CUSTOMER][NEUTRAL] No, I'm, I'm I'm asking how many times can you file a claim?
[AGENT][NEUTRAL] Under the wellness, you can.
[CUSTOMER][NEUTRAL] Because I've had breast cancer.
[AGENT][NEUTRAL] OK, you're talking about a positive diagnosis of cancer. A positive diagnosis of cancer, you can, um, if, if you have the one-time lump sum benefit, you only get that one time. But any treatment, you can file that for each treatment.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have, uh, I, you only get that one time and I'm still paying for it?
[AGENT][NEUTRAL] The lump sum, are you talking about the lump sum? The lump sum is just a one-time benefit. But all the other benefits such as chemo, radiation, surgery, transportation, all the other things that could be covered under your policy, is no, it's not just one time. It's every time that you receive that treatment, you get a benefit for it. The lump sum.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is what is only a one-time lifetime.
[AGENT][NEUTRAL] Benefit
[CUSTOMER][NEUTRAL] OK. What do I have the lump sum or do I have the treatment?
[AGENT][NEUTRAL] Let me look at your policy, but it, uh, some, um, they come with both.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] So your policy you have.
[CUSTOMER][NEUTRAL] OK, well
[AGENT][NEUTRAL] Um, chemo, radiation, and immunotherapy, which is $10,000 per calendar year.
[AGENT][NEUTRAL] Um, you have a.
[CUSTOMER][NEUTRAL] OK, well, let me, let me.
[AGENT][NEUTRAL] And so while I give you these benefits, just to let you know this is a verification of your coverage and not a guarantee for payment. Like I stated before, your chemo radiation is per year. If you receive any of those treatments, you will receive $10,000 per calendar year.
[CUSTOMER][NEUTRAL] I understand that. But I'm just saying that I, I had, uh, I thought on it back, uh.
[AGENT][NEUTRAL] OK, you
[CUSTOMER][NEUTRAL] In like 2000 and uh let's see, back in uh
[AGENT][NEUTRAL] 18
[CUSTOMER][NEUTRAL] 90
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] For yourself?
[CUSTOMER][NEUTRAL] I thought on that. Yes. Can you see that?
[AGENT][NEUTRAL] Um, see 2000 and.
[CUSTOMER][NEUTRAL] I had breast cancer.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK. So you wouldn't, OK, so you received already the, the, the lump sum $1000. All right. So you can't receive that lump sum $1000 again, but you can, you can receive the other benefits.
[AGENT][NEUTRAL] Chemo, radiation, immunotherapy, um, if you was admitted into the hospital, all those benefits, you can still receive those if you have been diagnosed with another cancer. But you can't receive that $1000 lump sum.
[CUSTOMER][NEUTRAL] OK. I had
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I did have breast cancer again and I had, I had to have both of my breasts removed. So I didn't fall on y'all because I thought that uh
[CUSTOMER][NEGATIVE] The lump sum mean that I couldn't get any more money from y'all. Is that true?
[CUSTOMER][NEUTRAL] Or should I, should I?
[AGENT][NEGATIVE] The lump sum for $1000 you can't get that again. All other benefits you can't apply for, yes.
[CUSTOMER][NEUTRAL] OK, so say that uh I had uh my breast removed last year, OK? Because of breast cancer again. OK?
[CUSTOMER][NEGATIVE] Can I fall on y'all and you're gonna give me, you're gonna pay me what it costing me to have my breasts removed or what are you saying?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What I'm stating, ma'am, is if you should have filed for us for surgery, you have a surgery benefit. If you have surgery due to a positive diagnosis of cancer, you could have submitted that claim for review for visits.
[CUSTOMER][NEUTRAL] OK, so can I do that now?
[AGENT][NEUTRAL] You can.
[CUSTOMER][NEUTRAL] OK, so I need to file with y'all about my surgery.
[CUSTOMER][NEUTRAL] And where do I need to send this to?
[AGENT][NEUTRAL] Our claim forms are located online at [PII].
[CUSTOMER][NEUTRAL] At what?
[AGENT][NEUTRAL] Am
[AGENT][NEUTRAL] Am public.
[CUSTOMER][NEUTRAL] Capital
[AGENT][NEUTRAL] A as in apple, M as in Mary, public, A in public.
[CUSTOMER][NEUTRAL] Is that capitalized?
[AGENT][NEUTRAL] No, ma'am. It does not have to be, no.
[CUSTOMER][NEUTRAL] Is it a capital
[CUSTOMER][NEUTRAL] I am public.
[CUSTOMER][NEUTRAL] At what?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That is the website where our claim forms are listed. You will find the form that says cancer claim form. That form you will fill out, um, on page one of that form, it tells you what you need to submit to us.
[CUSTOMER][NEUTRAL] OK, page one, OK, uh.
[CUSTOMER][POSITIVE] Thanks you submit.
[CUSTOMER][NEUTRAL] Yeah. OK. OK. OK, now let me ask you another question.
[CUSTOMER][NEUTRAL] My husband's deceased.
[CUSTOMER][NEUTRAL] So I need to take him completely off of the uh
[CUSTOMER][NEUTRAL] Off of the policy.
[AGENT][NEUTRAL] OK, that would not be in my area. I will get you over to customer service and they will let you know um.
[AGENT][NEUTRAL] About, you know, changing it from um.
[AGENT][NEUTRAL] You know, just, you know, just for yourself and what you need to submit to them as far as the death certificate and all that other stuff. Did you have any other questions for me, [PII] for concerning your claim?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yes, ma'am.
[CUSTOMER][NEUTRAL] Yes, ma'am. I just, uh, so I'm gonna send in where I had my breast removed and stuff, and then, uh, y'all are gonna review it and let me know what I, when I get back, OK? So.
[AGENT][NEUTRAL] Yeah, on page one, make sure you're looking at page one of that claim form because it's gonna tell you. You're gonna need to send in the pathology report um for the cancer because you have not filed with us in some years. So we do need a pathology report for the cancer along with the itemized billing. All that information is on page one, so make sure you're paying attention to page one and send in what we're asking.
[CUSTOMER][POSITIVE] Yes ma'am. OK, thank you very much for that and uh so it will pay on so does it cover um.
[CUSTOMER][NEUTRAL] On the policy that I have for myself, what else does it cover? It covers this every time just for the um.
[CUSTOMER][NEUTRAL] I understand that the lump sum is not there no more. I understand that, but if I have cancer again then it will cover for that, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, I just wanna make sure I understand everything, OK? Then, uh, I have a, do I have an intensive care policy?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on one moment, let me take a look and see.
[AGENT][NEUTRAL] OK. So, yes, ma'am. You do have an intensive care policy and this policy pays for intensive care being in intensive care and it's 325 um per day.
[AGENT][NEUTRAL] Of intensive care.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Now, if you can just get me over to someone that can help me if my husband's still on the policy, I can get him to go up.
[AGENT][NEUTRAL] OK, not a problem. Just one moment.
[CUSTOMER][POSITIVE] Hey, I appreciate your help so much.
[AGENT][POSITIVE] No problem, [PII]. Just one moment and I'll get you over to customer service.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey, [PII], this is [PII] in the Cancercu. I have a member, [PII]. Her policy is 687-412.
[CUSTOMER][NEUTRAL] give me one second, Ms. [PII].
[CUSTOMER][NEUTRAL] Oops
[CUSTOMER][POSITIVE] OK, and how can we help Miss [PII] today?
[AGENT][NEUTRAL] Um, she needs to remove her spouse off of the policy. I didn't ask her how long. Apparently he's been deceased maybe for a little while, and she thought he was removed, but he's not. She does have 3 other policies with us and so she needs to um get him removed off of the policy cause I don't believe she knew he was still on there.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Uh, sir, OK, dear, put Ms. [PII] on through and I will help her.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Thank you.