Your Neighbor's Attitude is Not an Occurrence
What's the Scenario? with PLRB
Release Date: 07/10/2026
What's the Scenario? with PLRB
We’re taking a break this week after our first-ever Knowledge Exchange. This collaborative learning event took place at PLRB headquarters and featured building codes topics, so this week we’ll share a classic episode from the PLRB Building Codes team. Surveillance video shows a woman wearing a salon cape exiting through the front door of a hair salon. She spends a few moments in front of the salon examining her hair in a large handheld mirror. On reentry, she stumbles on the second and falls. Notable Timestamps [ 00:32 ] - This is not her first time at the salon, and not her first...
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A kitchen fire damaged some cabinets and the microwave above the stove, and the insured hired a contractor to make the repairs. When the contractor needed to temporarily kill power to the outlet above the stove, they asked the insured where the breaker box was - only to be led to a basement bathroom, where opening the medicine cabinet mirror revealed the home’s electrical panel mounted behind it. Now the contractor is refusing to proceed until the insured’s entire electrical system is brought up to code. Notable Timestamps [ 00:43 ] - This scenario features a...
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The insured enjoyed having a lakeside home in the summer, where they could take a cruise on their boat in the evenings. But one winter, the frozen lake shoved ashore massive ice slabs, crushing a metal boat lift that had been stored on the shoreline for the winter. The lateral ice pressure then smashed into a permanent boathouse, buckling the vinyl siding, breaking through windows, and splitting the wooden framing. Ice chunks spilled onto the personal property left inside as well. The homeowner was left wondering whether they'd be frozen out of coverage for this loss. Notable Timestamps...
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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...
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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, 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...
info_outlineThe 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 valuable resource for staying updated on recent case law regarding property, auto, and liability insurance.
[ 00:05:29 ] - An insurance company's duty to defend is crucial because fighting even a completely invalid lawsuit still requires spending money on legal fees.
[ 00:07:32 ] - Courts have ruled that erecting a malicious spite fence is a deliberate action, meaning it is not an accidental occurrence covered by insurance.
[ 00:13:01 ] - Bizarre accidents, like special low-efficiency windows melting a neighbor's vinyl siding by focusing sunlight, can potentially be covered occurrences.
[ 00:16:53 ] - Determining whether mistaken actions count as occurrences depends heavily on specific state jurisdictions.
[ 00:20:19 ] - If an individual intentionally punches someone, there is usually no occurrence, regardless of whether they intended to cause a severe injury like a broken jaw.
[ 00:24:03 ] - Liability insurance only covers fortuitous losses, so if a primary action isn't an occurrence, exclusions for intentional acts do not require analysis.
Your PLRB Resources
HO651 - Occurrence Definition
https://members.plrb.org/documents/ho651-occurrence-definition
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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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).