What's the Scenario? with PLRB
Welcome to “What’s the Scenario? with PLRB”, where we explore claims & coverage scenarios relevant to insurance professionals. I’m Brennan McLoughlin, and we’re taking a break this week after another successful PLRB Regional Innovation Summit. This week we’ll share a follow-up episode from the PLRB Weather team. A small grocery store specializes in farm-to-table meat and fish, locally sourced and priced at the high end of the market. After accepting their week’s shipment on a Wednesday evening, thunderstorms led to a power outage that spoiled the fish. Notable...
info_outlineWhat's the Scenario? with PLRB
Welcome to “What’s the Scenario? with PLRB”, where we explore claims & coverage scenarios relevant to insurance professionals. I’m Brennan McLoughlin, and for this holiday week we’ll be sharing a classic episode from the PLRB Weather team. A CAT Manager is making preparations for her CAT team in advance of Hurricane Francine, which approached the Louisiana coast in the second week of September, 2024. She reads something about spaghetti models, and something about Fast Track cyclones? Notable Timestamps [ 00:36 ] - The building owner submits the claim to their...
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A contractor was hired to renovate a kitchen. The homeowner was thrilled with the results, but asked for a few final punch-list items: adjusting the cabinet doors and replacing a damaged drawer pull. To reach the cabinets, the contractor moved the refrigerator, but failed to securely reconnect the ice maker supply line before leaving. Two days later, the homeowner discovered water throughout the kitchen and adjacent rooms after the line separated, damaging the newly renovated space and the surrounding flooring. Notable Timestamps [ 00:45 ] - Mike sets up today's scenario: a...
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A homeowner reports that the central air conditioning system stopped working during a summer heat wave. They sent their contractor's invoice to their insurance company. The adjuster has to review the invoice, the Declarations Page, and policy excerpts to handle the claim. But this isn’t a real claims file; this are mock claims documents as used in the PACE Designation Exam. Today we’ll explore how authentic assessment is leveraged to test real-world skills, and you can try your luck with this sample question. Notable Timestamps [ 01:24 ] - The exam includes basic recall questions that...
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An adjuster has decided to level up their career by earning their PACE-P Designation. They’ve completed the comprehensive educational program, prepared with the study guide, and are now sitting down to take the remotely proctored exam. Are they ready for it? Are you? Notable Timestamps [ 00:00:34 ] - The podcast explores the scenario of an adjuster who has completed an educational program and a study guide, and is now preparing to sit for the remotely proctored PACE Designation Exam. [ 00:04:04 ] - The PACE Designation program begins with an onboarding curriculum, consisting of three core...
info_outlineWhat's the Scenario? with PLRB
An adjuster has decided to level up their career by earning their PACE-P Designation. They’ve completed the comprehensive educational program, but don’t feel quite ready to sit down and take the PACE Designation Exam. So they download the PACE Study Guide and get started. Notable Timestamps [ 04:23 ] - The PACE Designation Program provides a comprehensive foundation of knowledge and practical skills tailored for claims professionals to succeed. [ 06:41 ] - Members can complete the Core Curriculum, the Personal Lines Property Track, and the Claims Intensives at no additional cost, and...
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A plumber was hired to perform work on a pipe on an insured home. In the course of that work, the plumber accidentally smashed his wrench into the pipe, damaging it. The water damaged nearby drywall and carpet. Notable Timestamps [ 00:44 ] - The j(5) exclusion specifically applies to property damage on that particular part of real property where operations are directly being performed. [ 01:14 ] - In contrast to the j(5) exclusion, the j(6) exclusion applies to any property that requires restoration, repair, or replacement because the work was performed incorrectly. [ 02:44 ] - If a plumber...
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A general contractor installs a commercial storefront window system. Because the flashing is installed incorrectly, rainwater enters the building during the first storm. The building owner sues the contractor, seeking the cost to remove and replace the defective window system and repair the water-damaged drywall and flooring inside. The contractor tenders the suit to its CGL insurer. Notable Timestamps [ 00:00:34 ] - A contractor faces a lawsuit after incorrectly installing window flashing that leads to water damage inside a building. [ 00:04:48 ] - A central issue in these claims is...
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Emma’s cousin Mark moved to the big city and left his horse at Emma’s ranch. For five years, she took care of the horse like it was one of her own. One day Mark took offense at one of Emma’s social media posts, and quietly removed the horse without her knowledge, believing he was the rightful owner. Emma was devastated and sued Mark, alleging emotional distress, mental pain and suffering, and loss of consortium. Mark’s insurer denied his defense on the basis that no bodily injury was claimed. Notable Timestamps [ 00:00:33 ] - The scenario involves a woman who sued her cousin for...
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The insured has spent months in an escalating dispute with his neighbor over the neighbor’s alleged violation of HOA rules and garish lawn decorations. Finally, the insured takes things too far by aiming his sprinkler at the neighbor’s newly painted shed, ruining an expensive paint job. The insured has been sued, and wants their insurance company to defend them in the lawsuit. Notable Timestamps [ 00:00:32 ] - This scenario involves an insured causing damage by ruining a neighbor's painted shed with a sprinkler, and expecting a defense. [ 00:01:17 ] - The PLRB's Frontlines newsletter is a...
info_outlineA major storm hits the city. Sarah’s bakery suffers roof damage, water leakage, and equipment loss. Sarah has heard lots of insurance job titles thrown around: policyholder, agent, broker, adjuster, underwriter, actuary-- who are all these people? In this preview of the PACE program's core on-boarding course, we'll explore the basics of the different roles in the insurance industry.
Notable Timestamps
[ 00:00 ] - The episode opens with a storm-damage scenario at Sara’s bakery, setting up a practical lens for understanding insurance roles and how multiple professionals intersect during a single claim event.
[ 00:59 ] - The lighthearted “Dec Page” segment underscores how real-world disruptions—like severe Midwest storms affecting travel—mirror the unpredictability that drives many insurance claims.
[ 04:42 ] - The PACE program is practical and scenario-driven, aiming to demystify industry jargon and help both newcomers and experienced professionals apply concepts across claims and underwriting contexts.
[ 06:25 ] - The "insurer" is the insurance company, while the "insured" is the policyholder.
[ 08:02 ] - Insurance roles are tied to broader processes, including application, underwriting, claims handling, and premium rating, reinforcing that each role fits into a larger operational lifecycle.
[ 10:11 ] - Agents typically represent the insurer (sometimes as captive or independent), while brokers represent the policyholder, helping match complex risks with appropriate carriers.
[ 12:13 ] - Agents and brokers often remain involved beyond policy purchase, serving as trusted first contacts when a loss occurs and guiding policyholders through the claims process.
[ 14:08 ] - Adjusters and claims professionals evaluate damage, determine coverage, and help restore policyholders, while TPAs and independent adjusters may be hired to handle claims on behalf of insurers.
[ 16:46 ] - Because titles vary widely, professionals are encouraged to clearly introduce their role to policyholders, improving understanding and trust during what can be a confusing claims experience.
[ 18:15 ] - Final takeaways reinforce core distinctions (insurer vs. insured), note that definitions may vary by policy, and highlight the importance of understanding agents, brokers, adjusters, and TPAs.
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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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