Libsyn Directory

Does a Windstorm Deductible Apply to My Spoiled Cheesecakes?

Release Date: 05/13/2025

How Particular is "That Particular Part"?

What'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...

The Lab-Grown Mismatch: One Earring, One Surprise

What'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...

"You Can't Salvage My Mother's Ring!"

What'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,...

Suicide, Arson, and the Intentional Loss Exclusion

What'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 ] -...

Don’t Fall Down the Building Codes Rabbit Hole!

What'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. [...

Posthumous Premium Payor

What'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...

Sugar, Spice, and Everything Sand: The CGL Auto Exclusion

What'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...

[REPLAY] Detached Garage Converted to AirBNB

What'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...

[REPLAY] I Crashed My Bike Into a Tree

What'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...

[REPLAY] The Appraisal Process – Is it Still Useful to Resolve Disputed Claims?

What's the Scenario? with PLRB

This is a replay of an episode originally aired on Apr 22, 2025. An adjuster working on a complex property damage claim closes the file, having paid out on the claim. Then they receive a notice that the insured is demanding appraisal. They call up the insured, only to find out that the insured has no idea what’s going on. About Our Guest Steven J. Badger, Partner, Zelle LLP [email protected] https://www.linkedin.com/in/steven-badger-467b0322/ Notable Timestamps [ 00:20 ] - The insured signed a form on a tabet, presented to them by the contractor, without realizing it authorized a later...

More Episodes

A windstorm-caused power outage at the Cheesecake Manufactory led to the spoilage of hundreds of cheesecakes and a business income loss. The adjuster is questioning if the windstorm deductible applies to the claim, despite the power outage being the direct cause of the spoilage.

Notable Timestamps

[ 00:00 ] - The scenario presented involves a windstorm that caused a power outage, leading to spoiled cheesecakes and a claim for spoilage and lost business income, raising the central question of whether the windstorm deductible applies given the chain of events.

[ 01:30 ] - Trivia: Where did the maximum natural wind gust ever recorded occur?

[ 03:00 ] - The windstorm deductible endorsement states it applies to losses "caused directly or indirectly by windstorm or hail", but this language, even with "indirectly," can still lead courts to perform a proximate cause analysis, often leaving the "dominant and efficient cause" determination to a jury, unlike clearer anti-concurrent causation language.

[ 04:30 ] - While "directly or indirectly" might address some indirect causation issues, the very definition of "windstorm" is not straightforward and is heavily subject to interpretation by courts based on specific case facts.

[ 06:00 ] - Case law interpretations of "windstorm" can be narrow, such as a Rhode Island case finding high winds didn't qualify due to excessive rain; or surprising, like a Texas court holding a tornado was not a windstorm for deductible purposes.

[ 07:30 ] - Is a tornado the epitome of a windstorm? Depends on who you ask...

[ 09:00 ] - When two different endorsement provisions contain irreconcilable conflicts, such as both stating that "no other deductible applies" to the coverage they provide, a court might determine that no deductible applies at all.

[ 12:00 ] - The business income claim follows a chain of events from the windstorm to the power outage and then the spoilage. The business income loss specifically results from the inability to operate due to the spoiled inventory, which might also involve potential Extra Expense.

[ 13:30 ] - Brennan provides a recap of the scenario and the points above.

Your PLRB Resources

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

Turner Construction Co. v. ACE Prop. & Cas. Ins. Co., No. 04-4451-CV, 2005 WL 2837575, — F.3d — (2d Cir. 10/28/05) (applying Texas law) reviewed at PLRB, Prop. Ins. L. Rev. 6978 (2005)

Windstorm Deductible – Food Spoilage – BI – PCQ.2024.07.26.twh.a - https://www.plrb.org/documents/windstorm-deductible-food-spoilage-bi-pcq-2024-07-26-twh-a/?search=power%20outage%202024

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).

TOPICS