What's the Scenario? with PLRB
A Texas adjuster gets an assignment for a simple hail damage claim. He anticipates having to argue with the roofing contractor, debate whether overhead and profit is owed, deal with the supplementing company, receive an appraisal demand, and finally face a lawsuit. About Our Guest Steven J. Badger, Partner, Zelle LLP [email protected] https://www.linkedin.com/in/steven-badger-467b0322/ Notable Timestamps [ 00:20 ] - Because of his years of experience, he knows that the 30 square comp shingle roof should cost about $20,000 to replace. (Amount provided is for reference and...
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Let’s say you’re a service provider in the insurance industry. You’ve been attending PLRB Conferences for a few years, and you’re thinking about taking the next step to increase exposure and build relationships with the right people in the industry. Notable Timestamps [ 01:20 ] - Exhibiting and sponsoring at the PLRB Claims Conference can be an impactful option, and PLRB has a variety of offerings to help each service provider reach their goals. [ 01:50 ] - For our trivia question today, last year at the Claims Conference we had over 3000 attendees, and over 950 of those...
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In the middle of the night, a burglar broke into the policyholder’s house. Nearby police arrived, and the suspect was apprehended. Debbie filed a claim for the police’s bullet holes in her house and cleanup of heating oil spilled when a bullet hit the tank. Notable Timestamps [ 00:15 ] - The bullet holes were all from police guns. 150 gallons of heating oil spilled in the basement. [ 01:40 ] - Heating oil tanks are most commonly found in what region of the United States? [ 03:30 ] - Tim reads through the Pollutants exclusion. Heating oil is most likely going to be considered a...
info_outlineWhat's the Scenario? with PLRB
Joining us next week? Enjoy this replay of our recent episode on the Claims Conference. A supervisor is leading a small but mighty teams of adjusters, and they're taking their team to Indianapolis this spring for the 2025 PLRB Claims Conference. The only problem? They’ve never been before and have no idea where to start. Notable Timestamps [ 00:15 ] - One more salute to our once and future host, Alissha Watley. [ 00:40 ] - Our team of claims professionals is headed to Indiana Convention Center in Indianapolis, IN for the 2025 PLRB Claims Conference, held on March 31 to April 2....
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Homeowner Lisa claims she was asleep when she woke up to smoke alarms blaring. She safely evacuated her home, but the fire destroyed her garage and spread to part of her home. The adjuster requests that Alex determine the fire’s cause. Notable Timestamps [ 00:15 ] - The scenario outlines a garage fire claim and a need to investigate the cause of the fire. [ 01:00 ] - When investigating a fire claim, is it origin and cause or cause and origin? Why? [ 03:00 ] - NFPA 921 provides standards for fire investigators conducting origin and cause investigations. [ 03:50 ] - Ring doorbell...
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Homeowner Jane Thompson lived 20 miles from the large Badone wildfire. One week after the fire department fully contained the wildfire, Jane called Evergreen Mutual and reported a strong smoke odor throughout her home. Notable Timestamps [ 00:20 ] - Jane also noticed discoloration on her walls and soot on her furniture. Jane was understandably concerned about her family’s health and potential long-term damage to her home and personal property. [ 01:10 ] - Can you name at least four of the major wildfires that have occurred in the US since 2016? [ 03:25 ] - The adjuster might...
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Just before purchasing a policy, the insured subcontractor says “I need to provide something called a ‘Certificate of Insurance’ to my general contractor,” and add them as an additional insured. What issues does this create from an underwriting or claims perspective? Notable Timestamps [ 00:15 ] - The adjuster is giving him the Coverage A limits to rebuild the house. But he is also making a claim for Fair Rental Value (Coverage D). ISO HO 00 03 05 11. Is there coverage? [ 01:07 ] - The team diagrams the parties. [ 01:43 ] - Employees, officers, and directors generally qualify as...
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The insured signed up for a “retrospective rating plan.” Under this plan, the insured promised to reimburse Unforgettable for its paid losses. The insurance company discovered invoices left unsent due to a computer programming error. Notable Timestamps [ 00:15 ] - Total Surprise Transportation promised to reimburse Unforgettable Insurance for its paid losses, including "Allocated Loss Adjustment Expenses." [ 01:25 ] - Tim asks for his paycheck to be decreased, and Brennan gets paid to buy a workbench. [ 02:43 ] - Usually premiums are calculated based on industry knowledge and...
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A concert attendee filed suit against a band's lead singer based on the singer's alleged "onslaught" of blows to the attendee's face, head, and body over a dispute. However, the singer's claimed that the confrontation only became violent when the attendee threw the first punch. Notable Timestamps [ 00:25 ] - The singer tendered the suit to his insurer, who agreed to defend under a reservation of rights, but is there a duty to defend? [ 01:25 ] - Seventies, eighties, nineties? The crew chats concerts. [ 02:30 ] - This scenario is based on New York Marine and General Ins. Co. v. Ness, 2021...
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A restaurant was hosting a funeral lunch. During the lunch, a gunman entered and shot an individual who was not related to the funeral reception, but who was in eyeshot of lots of the patrons and children. The victim survived & the gunman fled. Notable Timestamps [ 00:24 ] - The insured restaurant has a CGL policy and sought coverage after a group of the patrons filed a lawsuit against the restaurant alleging emotional distress [ 01:50 ] - The coverage crew discuss The Godfather and their favorite mob movies. [ 02:45 ] - Bodily Injury under the CGL policy is usually defined as...
info_outlineThieves cut through a fence to access the insured general contractor's job site’s and stole tools, a forklift, a pallet of marble tiles, and a truck loaded with precast concrete wall panels.
Notable Timestamps
[ 00:30 ] - The insured finds out that these losses are not covered under their standard CP forms.
[ 01:45 ] - The team discusses impressive thieves, the defintion of a CP policy, New Year's Resolutions, and vision boards.
[ 05:13 ] - The CP/BPP form generally applies while the property is on or within 100 feet of the premises described in the policy’s declarations. The job site is not the insured's listed place of business.
[ 07:05 ]- A Property Off Premises Coverage Extension exists, but applies only to property that is temporarily at a location the insured does not own, lease or operate.
[ 07:45 ] - Here, GC’s marble tiles and precast panels were not temporarily at the job site – they were going to be permanently installed there.
[ 08:30 ] - GC arguably “operated” the jobsite, as it had control over the site, including access etc.
[ 09:20 ] - The coverage extension also contains an exclusion for property in or on a vehicle, so that applies to eliminate coverage for the panels on the truck.
[ 09:40 ] - GC could have protected this property via Inland Marine Insurance.
[ 10:20 ] - Originally, “marine” insurance policies were written when virtually all commercial goods were transported by boat. However, due largely to the development of railroads, marine insurance was extended to provide “warehouse to warehouse” coverage.
[ 11:04 ] - While there are a number of inland marine forms, the most common are Builders Risk, Installation Floater, Contractors Equipment, and Motor Truck Cargo Liability.
[ 12:10 ] - Builder’s risk insurance covers buildings and other structures during the course of construction, including materials and supplies that will become a permanent part of the buildings or the structures, while on the jobsite or on the way to the jobsite.
[ 14:10 ] - Under the claim scenario here, the pallet of marble tiles and precast concrete wall panels would be covered, but not the the generators, concrete saw, or forklift, since they are not materials or supplies.
[ 15:10 ] - Jeff provides a recap of the scenario and the points above.
Your PLRB Resources
Inland Marine – Prop. Q&A 187 - https://www.plrb.org/documents/inland-marine-prop-qa-187/
Form – AAIS IM 7050 09 08 – Builders Risk - https://www.plrb.org/documents/form-aais-im-7050-09-08-builders-risk/
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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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