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_outlineJohn, a self-employed trucker, injures himself fixing his rig “Betsy” (1st PIP claim). Later, he’s hurt again when a mechanic’s shuttle van crashes (2nd PIP claim). Two accidents, two PIP claims—one while working, one as a passenger—make for a rough day.
Notable Timestamps
[ 00:17 ] - John has two injury claims in Michigan: a slip and fall while working on his truck (Injury 1) and being rearended while a passenger in a mechanic's shuttle van (Injury 2).
[ 01:02 ] - Michigan was once the most expensive state for car insurance but has fallen to the sixth most expensive according to insure.com as of May 25. Which was the cheapest?
[ 02:22 ] - Michigan's standard PIP statute under MCL § 500.3114 dictates that the named insured generally collects benefits under their own auto insurance policy, not the policy covering the vehicle involved in the accident.
[ 02:49 ] - There are exceptions to the Michigan PIP priority rule, including when an insured is injured as an occupant of a vehicle owned by or registered to their employer or while a passenger in a vehicle used in the business of transporting passengers.
[ 04:04 ] - For John's first injury (slip and fall), regarding the "owned by employer" exception, a Michigan appellate court in the reviewed case held the truck was owned by both John (the driver/title holder) and the leasing company (Shoulder Trucking).
[ 05:36 ] - The court in this scenario found that he was an employee of himself as an independent contractor, leading his commercial insurance carrier to take priority.
[ 07:09 ] - For John's second injury (shuttle van), the key statutory exception language relates to being a passenger in a vehicle "used in the business of transporting passengers".
[ 07:52 ] - The phrase "in the business of transporting passengers" is construed in Michigan using a two-prong test from a seminal case: 1) whether transporting passengers was the primary purpose for the vehicle's use, and 2) whether the transportation was incidental to the overall business or activity.
[ 08:55 ] - Applying the two-prong test to the mechanic's shuttle van involves considering factors like whether the service was free (suggesting incidental) or regularly offered (suggesting primary purpose or not incidental). The court in the case discussed did not decide this issue for the shuttle van, sending it back to the finder of fact.
[ 09:39 ] - Brennan provides a recap of the scenario and the points above.
Your PLRB Resources
Case Law Review: Smith v. Farm Bureau Mut. Ins. Co. of Mich. (2025) https://www.plrb.org/documents/smith-v-farm-bureau-mut-ins-co-of-mich-2025/
Case Law Review: Miclea v. Cherokee Ins. Co. https://www.plrb.org/documents/miclea-v-cherokee-ins-co/
PLRB State-By-State Survey on PIP, Michigan → “Priority” https://www.plrb.org/documents/michigan-pip-compendium/#priority
Case Law Review: Bender v. USAA Gen. Indem. Co. (2025) https://www.plrb.org/documents/bender-v-usaa-gen-indem-co-2025/
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