AccountId: 011433970860
ContactId: fb32200c-1b7d-49eb-9973-a2465f755edf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 435079 ms
Total Talk Time (AGENT): 187129 ms
Total Talk Time (CUSTOMER): 148350 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/fb32200c-1b7d-49eb-9973-a2465f755edf_20250107T16:17_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] and [PII] and um I have been diagnosed with breast cancer, so I was gonna file a claim, but I'm a little unsure what I am filing. I have two different forms that I've been looking at. One is the critical illness claim form, and then when I signed in, I can also pull up a cancer form, so.
[CUSTOMER][NEUTRAL] Do you, can you help me out on which one I need to file?
[AGENT][NEUTRAL] Mhm. Spell your first name for me, and if you could provide your policy number, I can take a look for you.
[CUSTOMER][NEUTRAL] OK, my name is [PII]
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] And then [PII]
[AGENT][NEUTRAL] OK, and your policy number?
[CUSTOMER][NEUTRAL] It just logged me out. Let me try it again.
[AGENT][NEUTRAL] OK. That's OK. Spell your last name for me again.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] [PII], OK, got it.
[AGENT][NEUTRAL] Let me get you
[CUSTOMER][NEUTRAL] And my policy
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Grab my policy number now. 239-020-8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me pull up your policy, get you verified, and then we can proceed with the claim form, OK?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And can, can you verify your date of birth and your complete mailing address, please?
[CUSTOMER][NEUTRAL] Yes, [PII] and [PII].
[AGENT][NEUTRAL] OK, and your email address on file?
[CUSTOMER][NEUTRAL] ID [PII].
[AGENT][NEUTRAL] OK, thank you for that. And so you're online trying to download a claim form. Are you trying to submit a cancer claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] Are you on [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Website.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] So, for your cancer claim, um, when you get to the home page at the upper right, do you see the claims and forms link?
[CUSTOMER][NEUTRAL] Yes, I'm on that one and I'm seeing a cancer claim form, and I was just not sure, do I need to fill that one out but there's nothing attached like my doctor has to fill out. The other one had a bunch of pages where the doctor had to fill out stuff, so that's my confusion on that one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] When you say the other one, what do you mean?
[CUSTOMER][NEUTRAL] The critical illness claim form.
[AGENT][NEUTRAL] OK. So depending on the product and what type of claim you're trying to submit, it may require different information. So if you're not trying to submit a claim under your critical illness, then the cancer, the cancer claim doesn't require.
[AGENT][NEUTRAL] Uh, the attending physician's, um, information.
[CUSTOMER][NEUTRAL] OK, so, but how do I get like it's asking like for biopsies and all those documentation on the cancer claim?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You would need to submit.
[CUSTOMER][NEUTRAL] So, but that's coming from the doctor.
[AGENT][NEUTRAL] Well, you would need to obtain the pathology report initially uh diagnosing your cancer from your oncologist's office.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So whatever they're listing here, initial diagnosis of the pathology report, the uh
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If you've had any treatment yet, uh, the itemized bill.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, let me write all this down here so I won't forget.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And and it's actually on the on page one of the claim form of what documents are required.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, so I had surgery so I need to send that into the bill for the surgery?
[AGENT][NEUTRAL] Yes, ma'am. The itemized bill for the surgery.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All the radiation, OK.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, I'll, I'll just follow what it says, but my doctor does not need to fill it out then on the cancer form.
[AGENT][NEUTRAL] Not if you're submitting the cancer form. And your cancer policy number is um
[AGENT][NEUTRAL] 13729.
[AGENT][NEUTRAL] 12.
[CUSTOMER][NEUTRAL] 1372912
[AGENT][NEUTRAL] Uh-huh. The one you gave me is, I think for your critical illness, but you're not filing a critical illness claim.
[CUSTOMER][NEUTRAL] What is the difference between them? I mean, what does, does it matter?
[AGENT][NEUTRAL] Well, your cancer is gonna, you know, it covers your chemo radiation, whichever type of therapy you have.
[CUSTOMER][NEUTRAL] You can see
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Critical illness covers certain critical illnesses.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I don't know if the cancer would be considered a critical illness. Um, let me look at that claim form real quick.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me look at the policy.
[AGENT][NEUTRAL] OK, so I do see that your policy is in your file that can be downloaded um.
[AGENT][NEUTRAL] Via our online service center, it'll tell you what your benefits are, as well as your cancer policy, what's covered under the policy.
[AGENT][NEUTRAL] So under the critical illness policy, it lists.
[AGENT][NEUTRAL] Under the schedule of benefits it lists the type of condition that's covered.
[AGENT][NEGATIVE] And I don't see. It says skin cancer.
[CUSTOMER][NEUTRAL] Nope.
[AGENT][NEUTRAL] And noninvasive, but it is invasive because it's breast.
[AGENT][NEUTRAL] OK, yeah, so I don't see it listed on this schedule as a covered item.
[AGENT][NEUTRAL] Under the critical illness, so you'll just submit the cancer policy.
[AGENT][NEUTRAL] I mean, the cancer claim form and the documents required.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. I will do that. Thank you.
[AGENT][NEUTRAL] And you do have the, you, you do have the cancer claim number, right?
[CUSTOMER][NEUTRAL] 1372912
[AGENT][POSITIVE] Correct. OK.
[CUSTOMER][POSITIVE] OK, thank you very much. I appreciate it.
[AGENT][NEUTRAL] Any other questions?
[AGENT][POSITIVE] You're welcome and thank you for calling APL Ms. [PII]. Have a good day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][NEUTRAL] Bye bye.