That is an Alarm, But it's Not a Fire Alarm!
What's the Scenario? with PLRB
Benny’s Liquor, Fireworks & Gunpowder Emporium went up in flames last night. Motion-detector alarms caught the fire and automatically notified the police, who found the fire and called the local fire chief, but by the time they arrived it was too late. Now his insurer claims he violated his Protective Safeguards Endorsement by installing burglary alarms instead of actual fire alarms. Benny doesn't recall anything about this, but apparently it's some paper he signed when he bought the policy. Key Takeaways [ 00:37 ] - Benny’s shop burned down, and his insurer denied the claim due to a...
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Pork Shoulder Melts Insured’s Siding
What's the Scenario? with PLRB
Sam is a huge Bears fan. He sets up his brand new smoker in the backyard and put a perfectly seasoned pork shoulder on to cook all day -- just in time for the Sunday Night Bears v. Packers game. The smoker was near the side of the house, but not directly next to it. After 8 hours, the shoulder was tender and ready to eat… but the insured’s siding had melted. Sam seeks coverage for the replacement of the melted siding (and for the pork shoulder he dropped when he saw the damage). Notable Timestamps [ 00:23 ] - Sonia sets out a tragic game day scenario. [ 01:16 ] - Fire is often...
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Twists & Turns in Supplemental Endorsements
What's the Scenario? with PLRB
Curd Appeal sells the best-looking cheeses on the block, but over the long weekend their refrigerator broke down, and now their limburger isn’t the only thing that smells. The owner argues they are covered under the BP 00 03, but the adjuster spots some holes in their argument. The owner hits back with a supplemental endorsement they purchased, hoping to find coverage any way they can. Notable Timestamps [ 03:00 ] - The five-point process for property coverage analysis includes: covered property, direct physical loss, covered cause of loss, conditions, and additional...
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Sump Pump Supplemental Endorsement
What's the Scenario? with PLRB
“Simply the Vest” is a dry cleaning service with a basement full of supplies, tools, clothing, and… water. After a heavy rain, the owners discovered that their sump pump had failed, causing water to back up into the basement, resulting in damage to their property. Under their BP 00 03 form, coverage for this cause is firmly excluded. However, they paid for a supplemental endorsement with some interesting technicalities… Notable Timestamps [ 02:43 ] - When assessing coverage, always start with the underlying policy form before reviewing any endorsements, ensuring clarity on the initial...
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[CLIPS] "I Didn't Think a Diamond Could Chip!"
What's the Scenario? with PLRB
We are experiencing some technical difficulties with today’s episode, so instead I thought I would share two clips that were previously cut for time. In these clips, Dana Grodin and Alison McLaney, both of Gemcor and Digipraise, answer our burning questions about diamonds, lab-grown and natural. I’ll re-insert their introduction before we hop into the clips, but the rest of the material has never appeared on this feed before. You might have caught it if you subscribe to our YouTube channel, so if you like these quick hits head over there for more. Notable Timestamps [ 00:50 ]...
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[REPLAY] Join Us at the 2025 Large Loss Conference
What's the Scenario? with PLRB
This is a holiday week for the podcast, so we're replaying a classic episode. This episode has been lightly edited to remain accurate to the upcoming 2025 Large Loss Conference taking place at the Gaylord Texan Resort & Convention Center in Grapevine, TX on Wednesday November 12 through Friday November 14. We'll be back next week with our regularly scheduled episode. Today our adjuster is leveling up in their career and handling their first large loss property claim. The adjuster quickly runs into trouble-- where can a claims professional go for help? This November 12 - 14 in...
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Wind Blew Dirt On My Koi Fish
What's the Scenario? with PLRB
Today's insured looked out the window and saw that a windstorm with strong 50 MPH sustained winds had kicked up soil from their neighbor's farm fields. The soil accumulated in layers over their home, garage, pool, hot tub, and all their beautiful landscaping. The garage door was open, so their home carpentry workshop and storage was covered in dirt. Even their koi pond was buried in the soil. None of the buildings were structurally compromised, but the insured will need a professional cleaning. Notable Timestamps [ 08:03 ] - Direct physical loss can include the cost of exceptional...
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Is an eBike a Car? No. But is it a Motor Vehicle?
What's the Scenario? with PLRB
Beatriz is a city dweller who never learned how to drive a car. However, recently she got tired of the train and decided to get an E-bike. She bought an old E-bike off a friend, purchased a battery from AftermarketBatteries.biz, and soon was zipping through the streets. Her friends even got her a "bumper sticker" that reads "Beatriz's Car" for the side. But one night, it caught fire while charging outside her apartment door. Is it a covered motor vehicle under the standard ISO HO-3 form? Notable Timestamps [ 00:00 ] - E-bikes are becoming increasingly common in cities, raising new...
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Don’t Count Your Chicken Coops Before They’re Insured
What's the Scenario? with PLRB
A few months ago, today’s insured decided to jump into the latest trend for a lot of suburban dwellers, and he got some chickens! He built a chicken coop and a caged in area for the chickens to be safe from predators. The coop itself looks like a very large shed with a fenced-in area extending from the coop. The insured calls up their agent to ask if there’s coverage for the coop under their HO 00 03 03 22 policy covering their home and an attached garage. Notable Timestamps [00:00] - A homeowner built a large chicken coop and asked their insurer whether it was covered under their...
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The CLEAR Approach to Difficult Conversations
What's the Scenario? with PLRB
Mia is a mid-level claims specialist with about five years’ experience in the job. One afternoon, she gets a call from a customer named James. He’s frustrated—bordering on furious. He’s been waiting for an update about his property claim, and from his perspective, no one communicated anything. He feels ignored. He’s escalating. Mia can tell this is going to be a difficult conversation. But instead of reacting defensively—or shutting down—she mentally runs through the CLEAR model. Notable Timestamps [ 00:30 ] - The "CLEAR Method" module, developed with Equis Consulting,...
info_outlineHomeowner is relaxing one night, and all of the sudden there was a huge clap of thunder. It was so loud she thought it might have hit the house or somewhere in the yard … but everything looked ok. Six weeks later she got her normal water bill in the mail (billed quarterly), and to her surprise, it was outrageously high – $4,500. She knew she wasn’t taking that many showers and thought there must be a leak, so she called a plumber who came over, scoped a camera, and found a big leak underground next to the house. It looked like the underground pipe had burst open, not just deteriorated. The homeowner immediately knew what happened: lightning damaged the pipe 6 weeks ago.
Notable Timestamps
[ 00:15 ] - The insured wants coverage for 3 things: (1) the water bill, (2) the plumber’s invoice for the camera inspection, and (3) repairing the underground pipe, including the cost to dig out the land and replace it with sod to access the pipe. Policy = ISO HO 00 03 05 11
[ 01:45 ] - Trivia Time! Where is the lightning capital of the United States? What is the study of lightning called?
[ 03:35 ] - Now for a multiple choice: Is it Coverage A, Coverage B, or Coverage C? The answer is likely C! The water lost is personal property.
[ 04:18 ] - Newer policies state that water is Property Not Covered, but older ones don't. This only applies to homeowners losses; commercial properties have an exclusion that likely applies.
[ 06:00 ] - Whether Lightning or Accidental Discharge from a Plumbing System (or Zeus?), this is likely a covered cause of loss.
[ 07:00 ] - Once the insured demonstrates a direct physical loss, the burden shifts to the insurance company. So, if the insurer wants to investigate further, the insurer would pay for that.
[ 08:45 ] - As long as the insured's investigation (the plumber's investigative camera-scoping) was reasonable, it is likely covered even if it occurred prior to the claim being filed.
[ 10:00 ] - The pipe replacement is covered, and replacement costs generally include anything required to get to the repair. Land is typically Property Not Covered, but it's not the land that suffered the loss. The cost of digging to the pipe to repair it is likely covered.
[ 11:05 ] - But what if camera-scoping didn't work, and digging to the pipe was part of the investigative process? And, what if the damage to the pipe turned out to be wear and tear? In that scenario, tear-out costs would likely not be covered.
[ 12:15 ] - No case law advises on what is needed regarding replacing the land.
[ 13:00 ] - In the wear-and-tear scenario, a specific provision may apply to lead to coverage for tear-out costs, e.g. if water damage was caused by the leak.
[ 14:30 ] - Tim provides a recap of the scenario and the points above.
Your PLRB Resources
Constant Or Repeated Seepage Or Leakage Of Water — Burden Of Proof – PCQ.2022.06.27.jem.a - https://www.plrb.org/documents/constant-or-repeated-seepage-or-leakage-of-water-burden-of-proof-pcq-2022-06-27-jem-a/
Structure Settled After Water Escaped From Pipe – Earth Movement, Water Exclusion – PCQ.2022.04.13.twh.b - https://www.plrb.org/documents/structure-settled-after-water-escaped-from-pipe-earth-movement-water-exclusion-pcq-2022-04-13-twh-b/
Water Exclusion Might Not Include Metered Water – PCQ.2018.02.26.dwf.a - https://www.plrb.org/documents/water-exclusion-might-not-include-metered-water-pcq-2018-02-26-dwf-a/
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The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate.
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