My Cheesecakes Spoiled After A Windstorm-- or a Windy Storm?
What's the Scenario? with PLRB
Release Date: 05/06/2025
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_outlineWhat's the Scenario? with PLRB
Messy Masonry, Inc. was hired as a subcontractor on a new home construction. Their job was to install two giant bay windows overlooking a lake, but they ended up splashing mortar on one of them. When they attempted to scrub it off, the window was scratched. As for the other window... another subcontractor, Outside the Lines Painting, was hired to paint the window frames, but accidentally sanded part of the windows in that process. The homeowner found the scratches months later. Notable Timestamps [ 00:00 ] - A construction scenario involves Messy Masonry splashing mortar and scratching...
info_outlineWhat's the Scenario? with PLRB
An insured filed a claim for a lost diamond earring. The stud and its match were scheduled as 1.00 Carat each, “I” color and SI clarity, for $8,000. Her insurer asked Gemcor create a match. When we received the mate, we ran our standard test and found something unexpected: the diamond wasn’t natural. It was lab-grown. In the years since its purchase, the replacement cost for lab-grown diamonds has plummeted. But the insured believed they were both natural, and wants a natural replacement. Notable Timestamps [ 00:58 ] - A client filed a claim for a lost diamond earring, but the...
info_outlineWhat's the Scenario? with PLRB
An insured brought her diamond ring to a local jeweler for a routine cleaning. The jeweler found damage and recommended filing a claim. Our team checked the original appraisal on file, which raised questions about the identified break. However, close analysis confirmed a different break in the girdle. The insured was entitled her to a like-kind replacement or cash if she surrendered the chipped stone. But, the insured does not want to surrender the diamond for sentimental reasons. Notable Timestamps [ 00:52 ] - The insured's diamond had a girdle break, and while entitled to replacement,...
info_outlineWhat's the Scenario? with PLRB
Warning, this scenario mentions suicide. The insured's 21-year-old son lives with them and suffers from depression. While the insured parents are away, their son goes through a breakup and decides to kill himself. He gets very drunk and douses the entire first floor in the gasoline they use for their lawnmower. He turns over a candle and goes upstairs to pass out. A neighbor called the police in time, and the young man was saved-- but the resulting fire consumed the house. Notable Timestamps [ 00:10 ] - John shares a serious scenario that raises pertinent coverage questions. [ 01:22 ] -...
info_outlineWhat's the Scenario? with PLRB
The adjuster on a hail claim receives a long list of line items that are "required by code." Once the old shingles are torn off, they find rot and gaps in the sheathing, and the contractor says a thicker sheathing is now required by code. Notable Timestamps [ 00:10 ] - Ice barriers, drip edges, a double felt underlayment... Searching the internet only leads the adjuster spiralling down a rabbit hole. [ 01:30 ] - What internet rabbit holes have you gone down? [ 04:28 ] - With PLRB's updated Address Report, members can provide an address and specify details such as rafter spans. [...
info_outlineWhat's the Scenario? with PLRB
The 100-year-old named insured died of natural causes. His daughter, the executor, inherited and moved into the home, continuing to pay the same bills—including insurance premiums. Four years later, a fire occurred, but the policy still listed her late father. Can it pay out? Notable Timestamps [ 00:10 ] - The daughter continued to pay the premiums, but did not contact the insurance company to advise them of her father's death. [ 01:30 ] - Trivia Time! Who was the oldest living person? [ 04:06 ] – Insurance policies generally follow the insureds, as defined by the policy, as opposed...
info_outlineWhat's the Scenario? with PLRB
A concrete foundation is crumbling due to a truck's sugar-contaminated sand delivery. Now, a court case hinges on whether the CGL auto exclusion applies: Did the damage occur in the truck or on the job site? Notable Timestamps [ 00:30 ] - At the outset, it seems the question (of whether the CGL or the BAC policy applies) turns on whether the damage occurred on the job site, at the concrete plant, or on the sand delivery truck. [ 05:01 ] - Sugar can be used in small, controlled amounts to delay concrete setting time, but higher concentrations can prevent proper curing. The contamination in this...
info_outlineWhat's the Scenario? with PLRB
This is a replay of an episode that originally aired on March 19, 2024. An insured’s detached garage burns down in a covered lightning strike, and somehow it’s not covered just because of a little side hustle? The PLRB crew hunt for coverage and find what the insurer can pay out on when an insured rents out their property without updating their insurance company. Notable Timestamps [ 00:17 ] - The insured remodeled their detached garage for use as an AirBNB rental, but never notified their insurer. The garage burned down, and the insured files a claim for the...
info_outlineWhat's the Scenario? with PLRB
Is a recycle bin a “vehicle”? Does a car antenna ripping a coat fall under the Vehicles peril? How about a poorly secured wedding dress in the backseat of a convertible? If you occasionally win a biking competition, does the loss of your bike trigger business property coverage? Join Mike, Tim, and Alissha for the lightning round and discuss bikes, eBikes, sleds, boats, and more. Notable Timestamps [ 00:15 ] - The insured is an avid cyclist who occasionally wins money from his hobby. Another cyclist cut him off and he crashed his bike into a tree while at a park, destroying...
info_outlineA windstorm knocks over a power line, causing hundreds of cheesecakes at a local restaurant to spoil. The owners have to close for a few days as they manufacture more. Their adjuster wants to know how to investigate the storm and power outage.
Notable Timestamps
[ 00:20 ] - The loss of desserts is always tragic, even lemon merengue.
[ 01:00 ] - Trivia: Which variety of cheesecake contains "quark"? Or should we say "Weißkäse"?
[ 01:50 ] - PLRB.org features a Weather and Catastrophe hub designed for insurance professionals and not for cat enthusiasts.
[ 02:17 ] - Users can get a full weather/cat report from the historical weather section of the Weather and Cat hub by entering an address and date range.
[ 03:11 ] - A full weather/cat report provides data including hail, wind, precipitation, lightning probability, storm reports, and watches/warnings.
[ 04:15 ] - For this scenario, the report showed evidence of strong winds, such as a 72 or 73 mile per hour gust reported near the scenario's location in Waco, Texas.
[ 06:08 ] - The PLRB hub also offers a power outage report tool which uses data from power outage US and covers 80% of the United States.
[ 07:18 ] - The power outage report can show the location of outages near the address, indicating that power was out in the general area.
[ 08:13 ] - Both the full weather/cat report and the power outage report can be combined to provide evidence, in this scenario for example, that a storm came through and knocked out power for the area.
[ 09:59 ] - Dylan provides a recap of the scenario and the points above.
Your PLRB Resources
Get a Full Weather/CAT Report (hail, wind, precipitation, more) - https://www.plrb.org/weather-cat/plrb-cat-data/
PLRB Catastrophe Services Launches New Power Outage Reports - https://www.plrb.org/documents/plrb-catastrophe-services-launches-new-power-outage-reports/?search=power%20outage%202025
Mankoff v. Privilege Underwriters Reciprocal Exch., No. 05-22-00963-CV, 2024 Tex. App. LEXIS 594 (Tex. App. 01/29/2024) (Court of Appeals of Texas, 5th District, applying TX law) [reviewed at PLRB, Prop. Ins. L. Rev. (2024)] - https://www.plrb.org/documents/mankoff-v-privilege-underwriters-reciprocal-exch-2024/?search=mankoff
Employees of member companies also have access to a searchable legal database, hundreds of hours of video trainings, building code materials, weather data, and even the ability to have your coverage questions answered by our team of attorneys (https://www.plrb.org/ask-plrb/) at no additional charge to you or your company.
Subscribe to this Podcast
Your Podcast App - Please subscribe and rate us on your favorite podcast app
YouTube - Please like and subscribe at @plrb
LinkedIN - Please follow at “Property and Liability Resource Bureau”
Send us your Scenario!
Please reach out to us at 630-509-8704 with your scenario! This could be your “adjuster story” sharing a situation from your claims experience, or a burning question you would like the team to answer. In any case, please omit any personal information as we will anonymize your story before we share. Just reach out to [email protected].
Legal Information
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.
Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License.
Font: Metropolis by Chris Simpson. SIL OFL 1.1.
Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription).
Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0).