System You summarize insurance sales and service call transcripts for a quality-assurance team in India.
Transcripts may be in English, Hindi (Devanagari) or Hinglish. Always write the summary in English.
Return only a JSON object with these keys:
- outcome: what was decided, a few words
- need: what the customer wanted
- products: array of strings, each with the plan, cover and premium exactly as said on the call
- disclosures: array of {key, made, at} for each disclosure that applies to this call; key is one of ped, waiting, exclusions, free_look, market_risk, ncb, grievance, benefit_illustration, grace; made is true or false; at is a short exact quote from the transcript (omit when not made)
- medical: array of medical facts the customer gave
- objections: array of objections the customer raised
- flags: array of {key, note, at} for every mis-selling or data-leakage moment; key is one of guaranteed_returns (Guaranteed returns on a market-linked plan), ped_suppressed (Told to hide a medical condition), cover_misstated (Cover or rights misstated), pressure (False urgency), rebating (Off-book cashback or discount), otp_requested (OTP, PIN or card details asked); at is a short exact quote; empty array when the call is clean. A guarantee that is part of a non-linked guaranteed plan is not a flag.
- next: the follow-up the agent promised
- sentiment: positive, neutral or negative
- brief: two or three sentences
Rules: quote only figures said on the call. Never repeat a phone, PAN, Aadhaar, card, CVV, OTP or policy number.
Customer
TRANSCRIPT:
Agent (Pankaj): नमस्ते, पॉलिसीबाज़ार क्लेम सपोर्ट से पंकज। कॉल रिकॉर्ड हो रही है। बताइए गीता जी।
Customer (गीता): मेरे पति अस्पताल में भर्ती हैं, कैशलेस मना कर दिया गया। अस्पताल कह रहा है ₹65,000 जमा करो।
Agent (Pankaj): मैं देख रहा हूँ। बीमा कंपनी ने कैशलेस इसलिए रोका है क्योंकि डॉक्टर का नोट अधूरा है, क्लेम मना नहीं हुआ है।
Customer (गीता): तो अब क्या करें? हमारे पास इतने पैसे नहीं हैं।
Agent (Pankaj): मैं अस्पताल के इंश्योरेंस डेस्क से बात करके नोट दोबारा भिजवाता हूँ। हमारी टीम अस्पताल में भी जा सकती है।
Customer (गीता): कितना समय लगेगा?
Agent (Pankaj): आमतौर पर 3 से 4 घंटे। आपका टिकट नंबर PB-CL-22871 है। मैं 2 घंटे में आपको कॉल करूँगा।
Customer (गीता): ठीक है, जल्दी कीजिए।
Judged turngoogle/gemini-4-argon
Outcome: Agent to coordinate with hospital insurance desk to resubmit doctor's note for cashless claim
Need: Assistance with a halted cashless hospitalization claim where the hospital demanded a ₹65,000 deposit
Disclosures: none required
Medical: Husband is admitted to the hospital
Objections: Does not have ₹65,000 to deposit at the hospital
Risk flags: none
Next step: Agent will coordinate with the hospital insurance desk and call the customer back in 2 hours (resolution expected in 3 to 4 hours, ticket PB-CL-22871).
Sentiment: neutral
Summary: The customer called Policybazaar claim support because her husband's cashless hospitalization was put on hold and the hospital asked for a ₹65,000 deposit. The agent clarified that the claim was not rejected, only paused due to an incomplete doctor's note. The agent promised to coordinate with the hospital's insurance desk to resubmit the note, offered on-ground team assistance if needed, and committed to calling back in 2 hours.