![[REPLAY] Is an Apple Watch a Watch? show art](https://assets.libsyn.com/item/39431610?height=50&width=50)
[REPLAY] Is an Apple Watch a Watch?
What's the Scenario? with PLRB
During this time of year as many people are exchanging presents, I’m sure you’re all wondering exactly how those various gadgets would be classified under the HO3 policy. So for this holiday week, we’re sharing a classic episode featuring an excellent coverage scenario. The insured, a father of 4, was out buying Christmas gifts for his children. This year he decided to splurge and buy each of them a drone and an Apple Watch. On his way back home, he stopped to get gas, and when he went into the minimart for coffee, a thief stole everything out of the back seat. The insured notified the...
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Fire on the Farm
What's the Scenario? with PLRB
Sod's Country Farms was raising 65,000 chickens when a fire burned down the poultry house. After a detailed investigation, the cause of the fire was undetermined. To further complicate matters, Sod's Country Farms didn't even own the chickens themselves, but raised them for a vendor. They want to know if the property loss of the animals is covered-- and what policy would be most appropriate. Notable Timestamps [ 00:00 ] - A poultry house fire destroys 65,000 chickens, but the insured doesn’t own the birds. [ 03:30 ] - Contract Growing is common in agriculture, with farmers...
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Train Your Team at PLRB.org!
What's the Scenario? with PLRB
Alex is a team leader working with a mix of experienced adjusters and brand-new claims professionals, some assigned to the field and others working behind a desk. Alex has to make sure his team has the training they need to approach their work with confidence. Luckily PLRB.org’s Education Hub has everything they need to succeed. Notable Timestamps [ 00:10 ] - The PLRB Education Hub supports team leaders like Alex with training for both new and experienced adjusters to build confidence in handling claims. [ 01:25 ] - Update #1: A new critical thinking course will help adjusters analyze...
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PLRB's Large Loss Conference: How Did It Go?
What's the Scenario? with PLRB
Jamie has been a property adjuster for some time now and is ready to graduate to larger and more complex losses involving hurricanes, construction defects, historic buildings, massive commercial structures, and more. Chris is a seasoned large loss adjuster looking to hone their practice in the casualty arena and network with others in their area. To address these questions, we’ll take them to the PLRB Large Loss Conference. Notable Timestamps [ 00:15 ] - The conference attracts adjusters ready to move into larger and more complex losses, giving them exposure to hurricanes, defects,...
info_outline![[REPLAY] PLRB Building Codes: Don't Fall Down the BC Rabbit Hole show art](https://assets.libsyn.com/item/39156170?height=50&width=50)
[REPLAY] PLRB Building Codes: Don't Fall Down the BC Rabbit Hole
What's the Scenario? with PLRB
This holiday week, we're sharing a classic episode about the PLRB Building Codes department. 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...
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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...
info_outline![[CLIPS]](https://assets.libsyn.com/item/38727545?height=50&width=50)
[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 ]...
info_outlineThe 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 to the property itself.
[ 05:01 ] - A "death clause" provides a grace period to ensure coverage for the legal representative of the deceased (such as the executor of the estate) with respect to the premises and property covered at the time of death. This provision allows the family time to address affairs following a death.
[ 06:15 ] – The grace period is not indefinite. Coverage under this clause typically ceases once the probate proceeding is finalized and the assets are distributed, as there is no longer a legal representative for the deceased. Some modern policies also include a hard cap, such as 180 days (approximately six months), for this grace period.
[ 10:20 ] – Insurance companies are generally not obligated to actively seek out information regarding a policyholder's death. Courts have affirmed that the responsibility lies with the policyholder or the person seeking coverage to notify the insurer of any changes to the situation.
[ 13:56 ] – Arguments appealing to "fairness" or doctrines like "mutual mistake" (where both parties are mistaken about a fact) typically do not succeed in court when the insurance company was unaware of the policyholder's death.
[ 17:33 ] – To prevent coverage lapses and ensure proper protection, it is critical for individuals or their families to contact their insurance agent or company to update policies, especially after a major life event like the death of a named insured.
[ 14:00 ] - Tim provides a recap of the points above.
Your PLRB Resources
Coverage Question: If Named Insured Dies, Does Non-Resident Legal Representative Have Duty To Maintain Heat?
https://www.plrb.org/documents/death-must-representative-maintain-heat/?search=duty%20to%20maintain%20heat%20representative
Ramsey v. Allstate Ins. Co. (6th Cir.) (2013)
https://www.plrb.org/documents/ramsey-v-allstate-insurance-co-6th-cir-2013/
Davis v. Westfield Ins. Co. (2022)
https://www.plrb.org/documents/davis-v-westfield-ins-co-2022/
Kantz v. Everett Cash Mut. Ins. Co. (2018)
https://www.plrb.org/documents/kantz-v-everett-cash-mut-ins-co-2018/
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.
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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 scenario@plrb.org.
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.
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