What's the Scenario? with PLRB

Formerly "PLRB on Demand", this podcast feed is being rebooted as “What’s the Scenario? with PLRB.” Each week you’ll find a 20-minute episode that addresses a claims or coverage scenario and answers interesting insurance questions. Our PLRB team of Alissha Watley, Mike Brode, and Tim Havlir will discuss terrorism, pandemics, fireworks, NFTs, aggressive contractors, phone scams, matching, vacation rentals, and more. Stay subscribed to this feed and check back in the new year for a new podcast. Subscribe to this Podcast Your Podcast App - Please subscribe and rate us on your favorite podcast app YouTube - Please like and subscribe at youtube.com/@plrb/ LinkedIn - Please follow at “Property and Liability Resource Bureau” Send us your scenario! Please reach out to us 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. If you send us an audio clip, we may use the audio in the show, though again we will only include material we can anonymize. 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.

[REPLAY] Is an Apple Watch a Watch? 12/23/2025

[REPLAY] Is an Apple Watch a Watch? 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 police and submitted a claim under his ISO 1991-edition HO3. The adjuster considers this to be a covered Theft loss, but she knows there are specific provisions in the policy for watches and aircraft. Notable Timestamps [ 00:17 ] - A theft claim is submitted for four drones and four smartwatches under the 1991 HO3. The question arises whether special provisions for aircraft and watches applies. [ 01:27 ] - The team debates the merits of drones and smartwatches, their capabilities for wall damage and dog-scaring, and the wisdom of being notified emails the instant they are received. [ 03:09 ] - A $1,000 special limit of liability applies to theft of “watches.” Is an Apple Watch a watch? [ 03:42 ] - Alissha argues that smartwatches are too different from a basic time-telling watch, and is more like a phone. Smartwatches were likely not part of the original policy intent. [ 04:55 ] - Mike argues that it’s called an “Apple Watch” -- its makers and users consider it a watch, even if it’s more complex. [ 06:05 ] - The group quotes Shakespeare and Merriam-Webster; it tells the time and it’s on your wrist, so… [ 06:30 ] - Grassie v. Merrimack Mut. Fire Ins. Co., 291 A.2d 254 (N.H. 1972) (watches that were inoperable and kept in display case were still subject to special limit of liability for theft of watches). [ 07:00 ] - Ambiguities are construed in favor of the insured. So both sides need to hire a good lawyer. [ 07:52 ] - How would the policy treat an iPhone strapped to your arm? Coverage C would likely provide full coverage for a smartphone. [ 09:51 ] - “Property Not Covered” includes “aircraft”… but “model or hobby aircraft not used or designed to carry people or cargo” are covered. [ 10:20 ] - Toy drones likely fall under hobby aircraft. [ 11:15 ] - This scenario looked at what’s covered property, but a drone could also be a covered cause of loss, even if it destroys itself. [ 12:40 ] - Unlike BP and CP forms, there’s no concern about the loss happening off-premises; homeowners get worldwide coverage for Coverage C. [ 14:19 ] - In the 2022 ISO form, a $2,000 special limit of liability applies to model or hobby aircraft. [ 15:51 ] - Under the recovered property provision, if the thief is caught after the amount is paid, the insured can choose to return the payment or have the insurer salvage the goods. [ 18:00 ] - Tim provides a recap of the scenario and the points above. Your PLRB Resources FAQ, Drones and First Party Property Coverage, http://search.plrb.org/?DN=60514 FAQ, Is a Drone an Aircraft Under the CGL Policy?, http://search.plrb.org/?DN=56440 Coverage Question on “Is An Apple Watch Considered A Watch Or A Computer?” - https://search.plrb.org/?dn=58826&src=gsa 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/container.cfm?conlink=sec/cq/default.cfm) 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 - LinkedIN - Send us your Scenario! Please reach out to us 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 . 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). /episode/index/show/plrbpod/id/39431610

Fire on the Farm 12/16/2025

Fire on the Farm 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 raising animals owned by vendors. [ 05:20 ] - Under the ISO BOP, animals are generally excluded, but exceptions exist for animals owned by others and “boarded” by the insured. [ 07:00 ] - Courts may rely on dictionary definitions when policy terms like “boarded” are undefined. [ 09:00 ] - Adjusters should review the contract for risk transfer provisions, insurance requirements, and other-insurance clauses to understand responsibilities and potential overlap. [ 11:30 ] - Standard BOP coverage can fall short for farming operations. Specialized farm policies are designed to address poultry risks more directly through scheduling and declaration-based coverage. [ 13:30 ] - Declarations pages matter in agricultural losses. How buildings, poultry locations, and coverage types are defined can determine whether coverage applies or is excluded. [ 15:30 ] - Valuing large-scale poultry losses is complex, involving age, weight, market timing, pricing data, and delay to market, often guided by specific policy language on cash market value. [ 17:15 ] - Brennan summarizes the key points above. Your PLRB Resources Annotation: BP191 - Animals - https://members.plrb.org/documents/bp191-animals Podcast Episode: Don’t Count Your Chicken Coops Before They’re Insured - https://members.plrb.org/education/courses/dont-count-your-chicken-coops-before-theyre-insured Listeners can email education@plrb.org for help navigating resources, requesting new content, or getting tailored curriculum support. 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 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. 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). /episode/index/show/plrbpod/id/39428730

Train Your Team at PLRB.org! 12/09/2025

Train Your Team at PLRB.org! 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 information, decide when to bring in experts, and resolve claims fairly and in good faith. [ 02:20 ] - Update #2: The annual “Claims Resolution” webinar series will address ethics of automation, bad faith in AI, and how emerging tech affects investigations. [ 03:35 ] - Update #3: A new PLRB designation program aims to take adjusters from entry level through line-of-business-specific training with elective options. [ 05:05 ] - The Education Hub offers 200+ recorded webinars, podcasts, modules, and downloadable slide decks as an on-demand claims knowledge library. [ 06:35 ] - “Test Your Claims Knowledge” microlearning modules use flashcards, definitions, photos, and scenarios for quick, interactive training. [ 08:45 ] - Member companies can integrate PLRB courses, webinars, microlearnings, and even this podcast directly into their own LMS platforms. [ 12:55 ] - PLRB will help members curate custom courses by combining videos, quizzes, and interactives in any sequence to match specific training goals. [ 14:10 ] - The library includes 100+ non-CE modules, about 200 podcasts, some 250 recorded webinars, plus many shorter video series for flexible learning. [ 16:25 ] - Mike summarizes the key points above. Your PLRB Resources Upcoming Events: PLRB Conferences & More! https://www.plrb.org/events PLRB Education HUB: https://members.plrb.org/education Listeners can email education@plrb.org for help navigating resources, requesting new content, or getting tailored curriculum support. 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 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. 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). /episode/index/show/plrbpod/id/39338390

PLRB's Large Loss Conference: How Did It Go? 12/02/2025

PLRB's Large Loss Conference: How Did It Go? 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, historic buildings, and large commercial structures. [ 01:40 ] - Attendees include seasoned adjusters, newcomers to large loss work, EGAs, casualty specialists, and experts like engineers and forensic accountants, creating a fully integrated learning environment. [ 03:45 ] - Sessions use real or modeled claim scenarios to walk participants through years of handling, highlighting decision points, mistakes, successes, and insights from complex losses. [ 06:20 ] - Topics span property, casualty, liability, business interruption, food contamination, smoke damage, and multi-claimant events, ensuring relevance to a broad range of adjusters. [ 08:52 ] - Presenters use interactive tools—polling, role assignments, breakout groups, and scenario debates—to let attendees test coverage positions and compare investigative approaches. [ 11:45 ] - Networking is built into the event with receptions, meals, and vendor interactions, giving adjusters chances to reconnect with long-time colleagues and meet new industry partners. [ 13:15 ] - Intimate spaces and structured seating make it easy to meet people from across the country, fostering mentorship opportunities and cross-disciplinary conversations. [ 15:20 ] - Mike summarizes the key points above. Your PLRB Resources Upcoming Events: PLRB Conferences & More! https://www.plrb.org/events CE Course: A Deep Dive Into a Premises Liability Claim, Part 1 https://members.plrb.org/education/courses/a-deep-dive-into-a-premises-liability-claim-part-1 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 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. 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). /episode/index/show/plrbpod/id/39238425

[REPLAY] PLRB Building Codes: Don't Fall Down the BC Rabbit Hole 11/25/2025

[REPLAY] PLRB Building Codes: Don't Fall Down the BC Rabbit Hole 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 Address Report, members can provide an address and specify details such as rafter spans. [ 05:05 ] - PLRB's Building Codes Address Report provides the adopted building code for a specific address, ensuring it falls within the correct city boundaries (e.g., Parma, Ohio). [ 06:39] - Hail reports from NOAA are also included, allowing adjusters to confirm if hail was present in the area on the claim date. They also provide state-specific matching information, such as Ohio's "reasonable comparable appearance" standard. [ 08:27 ] - The report includes diagrams that visually differentiate between modern wood structural panels and older lumber sheathing (planks), explaining concepts like H-clips for edge support. [ 11:31 ] - The reports clarify requirements for common contractor-claimed line items, such as ice barriers, confirming if they are required (e.g., statewide in Ohio) and providing links to the source of this information. [ 14:14 ] - The "Ask a code question" button links to a form where building code experts will research the specific inquiry and provide citations and links back to the member. [ 15:44 ] - Ruth provides a recap of the points above. Your PLRB Resources Building Codes Hub & Address Report - https://members.plrb.org/building-codes FAQ: When is Double Underlayment Required? - https://www.plrb.org/documents/when-is-double-felt-underlayment-required/?search=When%20is%20Double%20Felt%20Underlayment%20Required? Ask a Building Code Question - https://www.plrb.org/building-codes/ask-plrb-building-code-question/ 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 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. 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). /episode/index/show/plrbpod/id/39156170

That is an Alarm, But it's Not a Fire Alarm! 11/18/2025

That is an Alarm, But it's Not a Fire Alarm! 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 protective safeguards endorsement violation. [ 01:05 ] - Benny had a motion detector burglar alarm instead of the required fire alarm and does not recall agreeing to the protective safeguards endorsement. [ 06:09 ] - Protective safeguards endorsements require the insured to maintain the specific safeguards named in the policy schedule as a condition of insurance. [ 06:59 ] - If the insured knows of any suspension or impairment in the safeguards, they must notify the insurer or risk losing coverage. [ 08:29 ] - If a safeguard is shut off due to breakage or leakage, repairs must be completed within 48 hours for notification to the insurer not to be necessary. [ 10:47 ] - Courts often follow the strict policy language; simply having a different type of alarm, even if it detected the fire, is not considered compliant. [ 12:04 ] - The protective safeguards endorsement is often found in commercial property or farm coverage, and courts tend to enforce strict compliance. [ 15:15 ] - Coverage can be denied even if the breach of the safeguard duty did not affect the outcome of the loss because compliance is a condition of the insurance. [ 18:11 ] - Beth provides a summary of the key takeaways. Your PLRB Resources Coverage Question: Fire Loss Involving Protective Safeguards Endorsement - https://www.plrb.org/documents/fire-loss-involving-protective-safeguards-endorsement/ Law Review: New Hamilton Liquor Store, Inc. v. Amguard Ins. Co. - https://www.plrb.org/documents/new-hamilton-liquor-store-inc-v-amguard-ins-co-2020/ 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 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. 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). /episode/index/show/plrbpod/id/39060675

Pork Shoulder Melts Insured’s Siding 11/11/2025

Pork Shoulder Melts Insured’s Siding 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 defined by courts using dictionary definitions, such as Merriam-Webster's: "the phenomenon of combustion manifested in light and heat". [ 04:38 ] - Scorching analysis suggests black marks may indicate oxidation and a glow (which could be fire damage), while brown marks often indicate high heat damage only. [ 06:58 ] - For insurance purposes, losses must be fortuitous; Sam was trying to smoke meat, not melt the siding, so the damage was fortuitous from his perspective. [ 08:37 ] - Most states rely on "proximate cause", i.e. the dominant or efficient cause that initiates the events, when analyzing causation for claims. [ 09:23 ] - Friendly fire is contained in its usual place (like a stove), while hostile fire is unexpected or uncontrolled and not in its intended location. However, this analysis is not typically used by modern courts. [ 11:43 ] - Sonia provides a recap of the points above. Your PLRB Resources The Future of Insurance Podcast - https://future-of-insurance.com/podcast/ Coverage Question: Smoker Melts Nearby Siding - https://www.plrb.org/documents/named-peril-coverage-smoker-melts-nearby-siding-pcq-2025-02-24-slc-a/ Coverage Question: Christmas Lights Scorched Couch: Is Couch Covered? - https://www.plrb.org/documents/fire-peril-scorched-couch/ 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 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. 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). /episode/index/show/plrbpod/id/38722165

Twists & Turns in Supplemental Endorsements 11/04/2025

Twists & Turns in Supplemental Endorsements 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 coverages/extensions. [ 04:37 ] - Mechanical breakdown (like a refrigerator going out) is often an excluded cause of loss in a standard policy. [ 07:18 ] - Supplemental endorsements for food spoilage are designed to work with the base policy and can specify limits and change base policy language. [ 08:59 ] - This food spoilage coverage extension insures against direct physical loss or damage to food stock or food merchandise contained in a refrigeration unit. [ 10:47 ] - The endorsement defines a covered cause of loss to include mechanical breakdown and power outage (change in temperature/humidity). [ 12:31 ] - This food spoilage endorsement often explicitly deletes the mechanical breakdown exclusion from the base policy, but only for that specific coverage extension. [ 13:41 ] - The food spoilage extension may only apply if the loss is not covered by Equipment Breakdown Insurance (an optional policy coverage). [ 14:10 ] - The optional Equipment Breakdown Protection Coverage in the BP 00 03 policy covers direct loss or damage caused by mechanical breakdown or electrical failure of machinery. [ 15:33 ] - The Equipment Breakdown Protection Coverage might exclude leakage at a valve or seal, which is a distinction that could make the supplemental endorsement the only source of coverage. [ 18:31 ] - Brennan provides a recap of the points above. Your PLRB Resources Property Question of the Week: Food Spoilage under BP and CP Forms – No Off-Premises Power Outage - https://www.plrb.org/documents/food-spoilage-under-bp-and-cp-forms/ Property Question of the Week: Mechanical Breakdown of Freezer: Food Covered? - https://www.plrb.org/documents/mechanical-breakdown-of-freezer-food-covered/ 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 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. 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). /episode/index/show/plrbpod/id/38897435

Sump Pump Supplemental Endorsement 10/28/2025

Sump Pump Supplemental Endorsement “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 coverage. [ 05:32 ] - Supplemental coverages given to an insured typically identify specific needs that they have in the transaction and provide clear limits for each supplemental coverage provided. [ 08:11 ] - Endorsements can provide additional coverage for water-related claims like backup and overflow or mold, which are generally types of losses that would otherwise be excluded. [ 11:18 ] - Determining coverage requires looking at the exact policy language, fitting it to the specific scenario, and matching facts to the policy language. [ 13:45 ] - Sump pump issues often involve power outages (necessitating battery backup) or mechanical breakdown, but each claim has to be assessed based on its individual merits. [ 15:23 ] - An endorsement providing additional water backup coverage may also modify or replace the existing water damage exclusion found in the underlying BP policy. [ 17:49 ] - If a loss isn't excluded under the underlying policy, the supplemental coverage-- which could be subject to a lower limit-- would not be needed. [ 16:18 ] - Brennan provides a brief conclusion. Your PLRB Resources Coverage Question: Sump Pump vs. Septic Pump - https://www.plrb.org/documents/sump-pump-vs-septic-pump-pcq-2024-09-24-dwf-b Property Question of the Week: Sewer Backup Coverage vs. Flood Exclusion - https://www.plrb.org/documents/sewer-backup-coverage-vs-flood-exclusion/ 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 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. 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). /episode/index/show/plrbpod/id/38804700

[CLIPS] "I Didn't Think a Diamond Could Chip!" 10/21/2025

[CLIPS] "I Didn't Think a Diamond Could Chip!" 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 ] - Introducing Dana Grodin & Ali McLaney of Gemcor & Digipraise. [ 03:33 ] - Beginning of the clip "I Didn't Think a Diamond Could Chip!" Although diamond is the strongest material known to mankind, it has weak points and structural bonds, meaning hardness does not equate to avoidance of chips. [ 05:00 ] - The myth of a "flawless" diamond is common, but most diamonds have clarity characteristics (crystals/clouds) that act as weak points visible under magnification. [ 06:15 ] - Gemcor determines if an imperfection breaks the surface, constituting damage, and investigates if the damage is new or pre-existing, noting mounting condition. [ 08:53 ] - Beginning of the clip "What is a Lab-Grown Diamond?" Lab grown diamonds are chemically and physically identical to natural diamonds. LGDs have exploded in popularity, now representing 50% of engagement ring sales. [ 09:45 ] - Unlike natural diamonds created over millions of years, LGDs are grown in a lab in about 30 days, resulting in them being thousands of dollars less expensive. [ 10:45 ] - Differentiation between natural and lab grown diamonds requires very high-quality, specialized equipment because standard diamond testers and visual inspection fail. [ 12:00 ] - Ethically, all lab grown diamonds should have a laser inscription (e.g., LG) on the girdle, but vendors sometimes omit this marking, creating significant disclosure risk. [ 16:18 ] - Brennan provides a brief conclusion. Your PLRB Resources Podcast Episode: "You Can't Salvage My Mother's Ring!" https://youtu.be/Ijph_AuQZq4 Podcast Episode: The Lab-Grown Mismatch: One Earring, One Surprise https://youtu.be/zp8UUIqQ9Q0 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 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. 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). /episode/index/show/plrbpod/id/38727545

[REPLAY] Join Us at the 2025 Large Loss Conference 10/14/2025

[REPLAY] Join Us at the 2025 Large Loss Conference 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 Grapvine, TX, join PLRB for the 2025 Large Loss Conference. Notable Timestamps [ 00:39 ] - Alissha asks HERSELF "what's the scenario?" This scenario features late notice, Category 3 water, and additional damage during a claim. [ 03:24 ] - Late notice issues? Attend the educational session "It’s Too Late, Baby, It’s Too Late: Navigating a Late Reported Large Loss" with Andy Rock (Rock Law Group). [ 04:34 ] - For water mitigation issues, check out "Interpreting the Microbiology of Storm Damage" with Jeremy Beagle (SDII Global). [ 05:05 ] - For other large storm issues, see "A Coastal Catastrophe: Navigating a Large Hurricane Loss in the Northeast" with Anthony Antonellis and Brendan Labbe (both of Sloane and Walsh LLP). [ 05:45 ] - The Large Loss Conference is intended for claims professionals involved in these losses or hoping to get experience with larger claims, as well as the experts, attorneys, and accountants who provide insights on these claims. [ 06:43 ] - The Large Loss Conference is differently structured than PLRB's other conferences. The educational sessions are 90 minutes long, often more focused on case studies, and involve more interactivity. [ 07:56 ] - Andrew features the educational session "Back to the Future: How Adjusters Can Use Forensic Meteorology in Hail and Wind Claims" with Howard Altschule (Forensic Weather Consultants). [ 08:48 ] - The Large Loss Conference features many casualty and personal lines sessions as well, such as "We Didn't Start the Fire: Was it Smoking or Smokin'" with David Heemann (Mutual of Enumclaw), Pete Fowler (Fowler Construction Consultants), and Jennifer Kalvestran (Anderson, McPharlin & Conners LLP). [ 11:08 ] - The conference's general session will feature "Whoever Said Insurance Was Boring? 30 Years of Fascinating Claims Stories" with Steve Badger (Zelle LLP). [ 11:56 ] - Most educational sessions are approved in FL, TX, DE, NC, and OK Continuing Education credit, and even some courses approved for GA CE credit! [ 12:56 ] - To register, visit PLRB.org and click on the banner on the main page OR the Events tab. Registration is free for members. [ 13:50 ] - Maria McNally will be available to discuss membership or website questions. [ 14:45 ] - Alissha provides a recap of the scenario and the points above. Your PLRB Resources PLRB's Events tab: https://www.plrb.org/plrb-events/ Direct Link to PLRB's Large Loss page: https://www.plrb.org/event/plrb-2025-large-loss-conference/ 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 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. 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). /episode/index/show/plrbpod/id/38574745

Wind Blew Dirt On My Koi Fish 10/07/2025

Wind Blew Dirt On My Koi Fish 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 cleaning effort for a dwelling or other structure, even if no permanent damage occurred. [ 10:20 ] - Water in a pool or pond is likely not covered property under a standard homeowners policy due to a "property not covered" provision for water. [ 11:23 ] - The cost to drain and refill a pool may be covered if necessary to repair damage to the structure itself. [ 13:46 ] - Personal property inside a building is only covered for windstorm damage if the wind first created an opening (like to the roof or siding) through which dirt or dust entered. [ 15:02 ] - Personal property located outside a building, such as patio furniture, would be covered for damage from wind or a dust storm. [ 16:35 ] - Animals, including koi fish, are generally excluded from personal property coverage in a standard policy, often requiring a special endorsement. [ 19:14 ] - Damage to landscaping, trees, shrubs, and plants is an additional coverage, and windstorm is typically not one of the few named perils that apply. [ 20:47 ] - Beth provides a recap of the points above. Your PLRB Resources TYCK: Wind Blew Dirt On My Koi Fish - https://members.plrb.org/education/courses/wind-blew-dirt-on-my-koi-fish Coverage Question: Overflow from a Sump: Does It Apply to Water from a Drainage Line? (Another Koi Fish Hypothetical) - https://www.plrb.org/documents/overflow-from-a-sump-does-it-apply-to-water-from-a-drainage-line-pcq-2017-06-07-jch-a 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 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. 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). /episode/index/show/plrbpod/id/38497475

Is an eBike a Car? No. But is it a Motor Vehicle? 09/30/2025

Is an eBike a Car? No. But is it a Motor Vehicle? 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 insurance questions, particularly around how coverage applies when losses occur. [ 02:23 ] - E-bike Trivia: Rainy Days & Freezing Batteries [ 04:12 ] - Coverage disputes often center on whether an e-bike qualifies as a motor vehicle under the HO3 form, with fire and theft being frequent causes of loss. [ 06:34 ] - E-bikes are classified into three classes based on speed and power, which affect where they can be ridden and complicate insurance coverage determinations. [ 08:24 ] - The 2022 HO3 form clarified that e-bikes with throttles are motor vehicles, unlike the 2011 edition, which did not define related terms. [ 11:42 ] - Pedal-assist-only e-bikes are generally not considered self-propelled, but throttle-equipped bikes risk being excluded as motor vehicles under certain policies. [ 13:22 ] - Policy language can lag behind technology, creating a gap where there is uncertainty in coverage. [ 16:14 ] - Expensive e-bikes may require endorsements for coverage, since they can fall into property-not-covered provisions under homeowners insurance. [ 17:05 ] - Urban fires linked to aftermarket batteries prompted new laws, such as requiring UL Certification in New York, to improve e-bike safety. [ 19:17 ] - Sonia provides a recap of the points above. Your PLRB Resources Coverage Question: Is an E-Bike Considered a Motor Vehicle in Minnesota? https://www.plrb.org/documents/is-an-e-bike-a-motor-vehicle-in-minnesota-pcq-2024-11-11-jch-a FAQ: E-Bikes and First Party Issues https://www.plrb.org/documents/e-bikes-and-first-party-issues/?search=ebike Recorded Webinar: Transportation Network Companies: Driving into the Future Webinar https://members.plrb.org/education/courses/transportation-network-companies-driving-into-the-future-webinar 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 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. 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). /episode/index/show/plrbpod/id/38406670

Don’t Count Your Chicken Coops Before They’re Insured 09/23/2025

Don’t Count Your Chicken Coops Before They’re Insured 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 2022 homeowners policy. [02:00] - The hosts dive into trivia, noting that chickens are genetically the closest living relatives to the T-Rex. [05:00] - Coverage depends on construction: a coop attached to the house may fall under Coverage A, but detached coops lean toward Coverage B or C. [07:30] - One key test is portability: if the coop can move with the owner, it likely counts as personal property under Coverage C. [10:00] - Courts consider a variety of factors, e.g. how the coop is affixed, its adaptation for use, and the owner’s intent to keep or move it. [12:30] - Some coops are deliberately not anchored to protect against flooding or predators, adding complexity to coverage classification. [14:25] - Similar issues arise with swing sets, pools, and other backyard structures—each must be evaluated individually. [15:15] - Selling eggs could cross the line into business use, potentially excluding coverage under standard homeowner policies. [18:00] - Coverage type affects settlement: Coverage B buildings may qualify for replacement cost, while Coverage C property is typically ACV. [20:00] - Beth provides a recap of the points above. Your PLRB Resources Coverage Question: Other Structures Used for Business – Raising Chickens https://www.plrb.org/documents/other-structures-used-for-business-raising-chickens/ Other Structures: Can Some Items Be Treated As Either Coverage A Or Coverage B Property? https://www.plrb.org/documents/other-structures-can-some-items-be-treated-as-either-coverage-a-or-coverage-b-property-pcq-2022-01-17-jem-a/?search=other%20structures 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 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. 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). /episode/index/show/plrbpod/id/38320905

The CLEAR Approach to Difficult Conversations 09/16/2025

The CLEAR Approach to Difficult Conversations 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, helps insurance professionals handle difficult circumstances and challenging customers effectively. [ 01:25 ] - The CLEAR Model is applied when an adjuster, Mia, handles a reassigned property claim from James, who is furious due to a lack of updates. [ 04:40 ] - "C" is for Connect; acknowledge the customer's emotions and frustration early to build trust and prevent escalation into a confrontational "fight or flight" situation. [ 07:05 ] - "L" is for Listen; allow frustrated customers to vent without interruption, actively hearing their concerns to gather clues and make them feel heard, without becoming defensive. [ 09:55 ] - "E" stands for Engage; avoid industry jargon and maintain a calm tone. Ask angry customers to list their top three priorities to shift them from emotional to logical thinking. [ 11:25 ] - "A" is for Acknowledge; recognize the customer's frustration without accepting blame or fault. This helps build trust and moves the conversation forward positively. [ 13:20 ] - "R" means Resolve; define next steps and set priorities to move the claim towards resolution. Under-promise and over-deliver on commitments to build trust and ensure follow-through. [ 16:35 ] - Mike provides a recap of the points above. Your PLRB Resources New Course: Handling Challenging People and Difficult Circumstances - https://members.plrb.org/education/courses/handling-challenging-people-difficult-circumstances-course Guest Site: Equis Consulting & their podcast “Leadership is the Conversation” - https://equisconsulting.com/ 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 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. 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). /episode/index/show/plrbpod/id/38228915

How Particular is "That Particular Part"? 09/10/2025

How Particular is "That Particular Part"? 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 a bay window, and Outside the Lines Painting sanding another window, damaging the glass. [ 01:26 ] - The "damage to property" exclusion, particularly j(5) and j(6), is a complex and often confusing aspect of the CGL policy. [ 03:43 ] - Courts have ruled that if damage results from work product done incorrectly, it's not an "occurrence" and therefore not covered by a CGL policy, even before exclusions are considered. [ 05:28 ] - The j(5) exclusion applies to property damage on "that particular part of real property" where the insured or subcontractors are performing operations, if the damage arises from those operations. [ 06:03 ] - The j(6) exclusion covers "that particular part of any property" requiring repair or replacement due to "your work" being incorrectly performed. [ 11:32 ] - Courts have viewed incidental tasks, such as cleaning up mortar, as part of "performing operations," meaning damage occurring during such tasks can fall under the exclusion. [ 17:13 ] - The specific scope of a subcontractor's contract, detailing what work they were hired to perform, is a crucial factor in determining the applicability of CGL policy exclusions. [ 17:37 ] - Brennan provides a summary of the key takeaways. Your PLRB Resources Upcoming Course: All About the CGL Damage to Property Exclusion - Coming Soon! Learning Path: What Part is "That Particular Part" in the CGL j.(5) and j.(6) Exclusions? - https://members.plrb.org/education/courses/what-part-is-that-particular-part-in-the-cgl-j5-and-j6-exclusions Advantage Homebuilding LLC v. Maryland Cas. Co. 470, F3d 1003 (10th Cir. Kan. 2006). https://www.plrb.org/documents/advantage-homebuilding-llc-v-maryland-cas-co-2007/ Alverson v. Northwestern Nat. Cas. Co., 559 N.W.2d 234 (S.D. 1997) https://www.plrb.org/documents/alverson-v-northwestern-natl-cas-co-1997/ Employers Mut. Cas. Co. v. Pires, 723 A.2d 295 (R.I. 1999) https://www.plrb.org/documents/employers-mut-cas-co-v-pires-1999/ 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 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. 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). /episode/index/show/plrbpod/id/38136270

The Lab-Grown Mismatch: One Earring, One Surprise 09/02/2025

The Lab-Grown Mismatch: One Earring, One Surprise 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 mate, initially thought to be natural and scheduled for $8,000, was unexpectedly discovered to be lab-grown, with its replacement cost having plummeted. [ 01:28 ] - Lab-grown diamonds are chemically and physically identical to natural diamonds, grown from a seed crystal in a lab, and only very high-quality equipment can differentiate them. [ 02:08 ] - The main difference for lab-grown diamonds is value, as they are not rare. Natural diamonds take millions of years, while lab-grown are created in 30 days, making them significantly less expensive. [ 06:12 ] - An insured's original appraisal correctly stated "lab grown," but underwriting dropped this crucial detail from the policy, as the industry lacked awareness of its importance years ago. [ 10:10 ] - If an insurance company pays for a pair and later discovers the remaining earring is lab-grown, salvage recovery is minimal, as there's no market to resell them when new ones can be easily manufactured. [ 11:27 ] - A lab-grown diamond pair purchased for $8,000 in 2001 (or $2,000 two years ago) can now be replaced by the original jeweler for $1,000 or less due to plummeting market prices. [ 14:04 ] - The purpose of insurance is to make the insured whole by replacing the item with like kind and quality, not necessarily the original dollar amount, which is impactful when lab-grown prices change quickly. [ 16:45 ] - Ali & Dana provide a recap of the points above. Your PLRB Resources CE Course: Jewelry Valuation & Adjustment - https://members.plrb.org/education/courses/jewelry-valuation-amp-adjustment Coverage Question: Wedding Ring Diamond Replaced W/O Notifying Insurer: ACV for Original Ring? - https://www.plrb.org/documents/tree-root-damage-fortuitous-or-non-fortuitous-pcq-2022-01-21-dwf-b/ 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 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. 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). /episode/index/show/plrbpod/id/38051635

"You Can't Salvage My Mother's Ring!" 08/26/2025

"You Can't Salvage My Mother's Ring!" 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, she didn't want to surrender it due to sentimental reasons. [ 01:54 ] - Dana & Ali introduce themselves, Gemcor, and Digipraise. [ 04:32 ] - When a claim involving a damaged stone is resolved, the stone belongs to the insurance company under the policy. However, the insured can often buy back the stone at its salvage value. [ 05:01 ] - Jewelry claims require empathy because insureds often have deep emotional and sentimental attachments to their pieces. Approaching these conversations sensitively is crucial for a positive resolution. [ 05:39 ] - For minor damage like a "small nick on the girdle," repairing the stone and compensating for loss in value is an option. This allows the insured to keep their original diamond and prevents further damage. [ 09:50 ] - Before a claim can move forward, an expert on behalf of the insurance company must inspect the jewelry to verify damage. This prevents premature replacement recommendations. [ 11:48 ] - Many clients are underinsured because they fail to update appraisals, leading to coverage being capped at outdated values and significant out-of-pocket costs. [ 16:48 ] - Diamond certifications with a map of imperfections are vital tools. They help distinguish between pre-existing flaws and new damage, which directly impacts coverage decisions. [ 15:44 ] - Ali & Dana provide a recap of the points above. Your PLRB Resources CE Course: Jewelry Valuation & Adjustment - https://members.plrb.org/education/courses/jewelry-valuation-amp-adjustment Coverage Question: Agreed Value Settlement For Repair Of Jewelry - https://www.plrb.org/documents/wedding-ring-diamond-replaced-w-o-notifying-insurer-acv-for-original-ring-pcq-2009-10-08/?search=diamond%20value 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 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. 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). /episode/index/show/plrbpod/id/37959720

Suicide, Arson, and the Intentional Loss Exclusion 08/19/2025

Suicide, Arson, and the Intentional Loss Exclusion 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 ] - The intentional loss exclusion ensures insurance covers fortuitous/accidental events, not property purposely destroyed for the prupose of collecting insurance proceeds. [ 02:00 ] - The intentional loss exclusion is clearly worded: if any insured commits an intentional act causing loss, no insured, even innocent ones, are entitled to coverage. [ 03:16 ] - Two criteria for the exclusion: the act must be by an insured, and committed with intent to cause loss, which can be difficult to prove. [ 04:53 ] - Courts consider if the perpetrator lacked the ability to form intent due to mental handicaps, mental health issues, or age, making the exclusion potentially inapplicable. [ 05:40 ] - Courts are now less friendly to the intoxication defense. The inferred intent doctrine holds that if a loss (like fire from gasoline) is "substantially certain to occur," intent is inferred, regardless of primary motive (e.g., suicide). [ 08:30 ] - Suicidal intent can be a defense, as individuals may not be in their right mind. However, the inferred intent doctrine makes recovery difficult if the actions were likely to cause property damage. [ 13:36 ] - In states with a Standard Fire Policy (SFP), which uses "conduct of the insured," innocent co-insureds might still recover, overriding tighter policy language. [ 17:20 ] - John provides a recap of the points above. Your PLRB Resources Annotation: Intentional Loss (HO90) https://www.plrb.org/documents/intentional-loss-ho90/#toc22 50-State Survey: Innocent Co-Insureds https://www.plrb.org/documents/table-of-contents-innocent-coinsured/ SEE ALSO: 988 Suicide & Crisis Lifeline - 988 offers 24/7 judgment-free support for mental health, substance use, and more. Text, call, or chat 988. samhsa.gov/mental-health/988 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 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. 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). /episode/index/show/plrbpod/id/37867465

Don’t Fall Down the Building Codes Rabbit Hole! 08/12/2025

Don’t Fall Down the Building Codes Rabbit Hole! 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. [ 05:05 ] - PLRB's Building Codes Address Report provides the adopted building code for a specific address, ensuring it falls within the correct city boundaries (e.g., Parma, Ohio). [ 06:39] - Hail reports from NOAA are also included, allowing adjusters to confirm if hail was present in the area on the claim date. They also provide state-specific matching information, such as Ohio's "reasonable comparable appearance" standard. [ 08:27 ] - The report includes diagrams that visually differentiate between modern wood structural panels and older lumber sheathing (planks), explaining concepts like H-clips for edge support. [ 11:31 ] - The reports clarify requirements for common contractor-claimed line items, such as ice barriers, confirming if they are required (e.g., statewide in Ohio) and providing links to the source of this information. [ 14:14 ] - The "Ask a code question" button links to a form where building code experts will research the specific inquiry and provide citations and links back to the member. [ 15:44 ] - Ruth provides a recap of the points above. Your PLRB Resources Building Codes Hub & Address Report - https://members.plrb.org/building-codes FAQ: When is Double Underlayment Required? - https://www.plrb.org/documents/when-is-double-felt-underlayment-required/?search=When%20is%20Double%20Felt%20Underlayment%20Required? Ask a Building Code Question - https://www.plrb.org/building-codes/ask-plrb-building-code-question/ 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 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. 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). /episode/index/show/plrbpod/id/37770315

Posthumous Premium Payor 08/05/2025

Posthumous Premium Payor 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 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. 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 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. 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). /episode/index/show/plrbpod/id/37671125

Sugar, Spice, and Everything Sand: The CGL Auto Exclusion 07/29/2025

Sugar, Spice, and Everything Sand: The CGL Auto Exclusion 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 scenario was due to a "failure to clean" the truck from a previous job. [ 08:57 ] - The CGL Auto Exclusion operates to ensure coverage falls under the proper policy. In this case, the property damage occurred on a truck, so it should not be handled by the CGL policy but by Business Auto Coverage. [ 13:02 ] - The CGL form defines property damage to include "loss of use", meaning that even if the sand itself wasn't physically damaged, its inability to be used for its intended purpose (making proper concrete) qualifies as property damage. [ 15:47 ] - The Business Auto policy "Care, Custody, and Control" exclusion applied because the concrete plant's employee made the error. [ 16:24 ] - Brennan provides a recap of the scenario and the points above. Your PLRB Resources In Brief: Clear Blue Specialty Ins. Co. v. Landrieu Concrete and Cement Industries, LLC, 2025 U.S. App. LEXIS 10563 (5th Cir. La. 5/1/25). https://www.plrb.org/documents/clear-blue-specialty-ins-co-v-landrieu-concrete-and-cement-industries-llc-2025/ Annotation: CGL Policy Key GL39 – Automobile Exclusion. https://www.plrb.org/documents/gl39-automobile-exclusion 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 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. 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). /episode/index/show/plrbpod/id/37590800

[REPLAY] Detached Garage Converted to AirBNB 07/22/2025

[REPLAY] Detached Garage Converted to AirBNB 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 property damage, contents, and nearby oak tree that also burned down. [ 02:40 ] - This scenario’s policy explicity does not cover structures “held for rental”, so this clause would apply even though no guests were present on the date of loss. [ 05:50 ] - The contents would likely be covered as long as the detached garage is not considered an “apartment.” [ 07:42 ] - However, the Special Limit of Liability would limit that contents recovery to $3,000 under this policy. [ 08:04 ] - AirBNB provides a form of coverage which they state is not insurance, but it likely applies only when guests were, at minimum, present. [ 09:52 ] - The oak tree is also covered, but likely limited to $500. [ 11:13 ] - In a variation on the scenario, the group discusses that property of tenants would likely not be covered. [ 13:26 ] - Fair rental value coverage only applies to covered losses. [ 14:50 ] - Clauses on “homesharing activities” are more frequently appearing in newer forms. [ 16:30 ] - Tim provides a recap of the scenario and the points above. Your PLRB Resources Adjuster Resource Sheet on Home Sharing Issues for Property Adjusters - Highlights of 2022 Revisions TO Section I ISO Homeowners Form - Coverage Question on “Home Sharing Endorsement Would Not Apply Where Tenant Rented Garage For More Than 30 Days” - Webinar on “Homeowners Liability Coverage: Current Trends” - 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/container.cfm?conlink=sec/cq/default.cfm) 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 - LinkedIN - Send us your Scenario! Please reach out to us 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 . 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). https://thenounproject.com/icon/garage-6216862/ https://fontawesome.com/icons/bolt-lightning?f=classic&s=solid /episode/index/show/plrbpod/id/37484330

[REPLAY] I Crashed My Bike Into a Tree 07/15/2025

[REPLAY] I Crashed My Bike Into a Tree 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 the bike. [ 01:13 ] - Mike & Alissha share personal stories, including a disastrous encounter with a parked car. [ 03:47 ] - The bike itself is Coverage C Personal Property as there’s an exclusion for motor vehicles, but not for vehicles. [ 07:04 ] - There is a Named Peril for losses caused by vehicles. Courts interpret this broadly to mean anything from boats to sleds; rollerblades and recycle bins might be pushing it. [ 09:22 ] - The force / weight / momentum of the vehicle must cause the loss. The team goes through a lightning quiz round exploring a variety of mini-scenarios on the vehicles peril. [ 13:53 ] - Depreciation can be subtracted when the bike is replaced if it was paid under ACV. [ 14:29 ] - Although the insured occasionally won money, that likely doesn’t qualify it as a business. [ 15:18 ] - eBikes present novel issues due to the motor vehicles exclusion, so PLRB has prepared detailed resources on this issue. [ 17:12 ] - Tim provides a recap of the scenario and the points above. Your PLRB Resources Detailed annotation on Vehicles Peril - Legacy podcast on “The Coverage Contrarian: E-Bike Coverage Under a Homeowners Policy” - Coverage Question on “E-Bike Excluded Under "All Other Motorized Land Conveyances" Language” - Adjuster Resource Sheet on “Analysis of Coverage for an E-Bike Accident under a Homeowners Policy” (includes a link to a 50-state compendium) - 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/container.cfm?conlink=sec/cq/default.cfm) 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 - LinkedIN - Send us your Scenario! Please reach out to us 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 . 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). https://fontawesome.com/icons/bicycle?f=classic&s=solid /episode/index/show/plrbpod/id/37403940

[REPLAY] The Appraisal Process – Is it Still Useful to Resolve Disputed Claims? 07/08/2025

[REPLAY] The Appraisal Process – Is it Still Useful to Resolve Disputed Claims? 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 sbadger@zellelaw.com 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 appraisal demand. [ 01:13 ] - Steve shares an anecdote about his appraisal training sessions & debates. [ 02:39 ] - Steve's review of the trends shows that contractor-driven appraisal demands are more common now than they used to be. [ 03:50 ] - Assignment of Benefits would raise other issues and would not be permitted in all states. [ 05:15 ] - The adjuster can begin addressing an appraisal demand by contacting the insured to ask if they are aware of the demand, if the work is complete in their opinion, and the amount they paid. [ 07:22 ] - In the states where Steve practices, the contractor performing the work (and the public adjuster on the claim) cannot also act as the appraiser. [ 08:45 ] - Steve leverages his presence on LinkedIn to call out illegal behavior. [ 10:11 ] - Zelle LLP has drafted an alternative appraisal clause addressing abuses in the appraisal process. Removing the appraisal clause entirely would simply increase litigation. [ 12:37 ] - The goal of appraisal is prompt amicable resolution of disputed claims. [ 13:15 ] - Steve provides a recap of the scenario and the points above. Your PLRB Resources Steve will be presenting at the Texas Hail Claims Conference on February 12-13, 2026 in Dallas. Recorded Webinar: Combatting Common Abuses and Schemes in CAT Claims - https://www.plrb.org/courses/combatting-common-abuses-and-schemes-in-cat-claims/ CE Course: Property Insurance Appraisal - https://www.plrb.org/courses/property-insurance-appraisal/ 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 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. 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). /episode/index/show/plrbpod/id/37233475

[REPLAY] Invoking “Our Option” – Increased Use of Preferred Contractor Networks 07/01/2025

[REPLAY] Invoking “Our Option” – Increased Use of Preferred Contractor Networks This is a replay of an episode originally aired on Apr 15, 2025. A Texas adjuster gets an assignment for a simple hail damage claim. He anticipates having to argue with the roofing contractor, debate whether overhead and profit is owed, deal with the supplementing company, receive an appraisal demand, and finally face a lawsuit. About Our Guest Steven J. Badger, Partner, Zelle LLP sbadger@zellelaw.com https://www.linkedin.com/in/steven-badger-467b0322/ Notable Timestamps [ 00:20 ] - Because of his years of experience, he knows that the 30 square comp shingle roof should cost about $20,000 to replace. (Amount provided is for reference and example purposes only.) [ 01:10 ] - For 34 years, Steve Badger has represented mostly the commercial property insurance industry, and for the past decade has focused on catastrophe, hail, and wind claims. [ 02:00 ] - Many policies allow the insurance company to replace the roof themselves through preferred contractors. [ 04:15 ] - Having an "preferred contract network" or "managed repair" endorsement can reduce ambiguity as compared to the base policy. [ 05:50 ] - Such endorsements could be optional or mandatory. [ 07:00 ] - Steve argues that these endorsements can be a win/win/win for the insurer, insured, and contractor. [ 08:20 ] - Steve explores the potential benefits of the endorsement, such as reduced deductibles. [ 09:15 ] - Invoking "our option" means that if-- for example-- the selected contractor floods the house, the insurer could be responsible. However, an endorsement in this style could allow the insured to choose to employ the network. Further, contractors in the network could assume the risk. [ 11:15 ] - Steve discusses industry interest in preventative solutions. [ 13:00 ] - Steve contrasts the contractor who put on the roof asking for a supplement to a separate company focused on supplementation, and shifts focus to the insured's needs. [ 16:10 ] - Steve provides a recap of the scenario and the points above. Your PLRB Resources Steve will be presenting at the Texas Hail Claims Conference on February 12-13, 2026 in Dallas. Recorded Webinar: Combatting Common Abuses and Schemes in CAT Claims - https://www.plrb.org/courses/combatting-common-abuses-and-schemes-in-cat-claims/ CE Course: Roofing Fraud: Don't Get Nailed - https://www.plrb.org/courses/roofing-fraud-dont-get-nailed/ 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 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. 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). /episode/index/show/plrbpod/id/37233460

Tree Roots Blocked Up My Kitchen Sink 06/24/2025

Tree Roots Blocked Up My Kitchen Sink The insured's kitchen sink wasn’t draining well. A plumber scoped the line and found tree roots blocking it. The only fix is to dig up and replace the pipe. The adjuster checked the HO3 (2011) exclusions but didn’t find one specifically for tree roots. Do others apply? Notable Timestamps [ 00:45 ] – The adjuster checks the ISO HO3 (2011) policy but finds no explicit exclusion for damage caused by tree roots. [ 04:44 ] – Tree root damage exclusions can exist in some policies, but are rare. If clearly written, they’re usually enforceable. [ 05:30 ] – Lacking that, adjusters must look at general exclusions. The team explores all possibilities, including wear and tear, inherent vice, and non-fortuitous loss. [ 06:14 ] – Does wear and tear apply? Tree root intrusion may be interpreted as gradual, expected deterioration, not sudden damage. [ 07:14 ] – "Insurance covers risks, not costs." Damage expected to happen over time (like root growth) may fall outside coverage. [ 10:12 ] – Earth movement was suggested as an exclusion. It's debatable whether tree roots pushing soil could qualify as "earth movement." [ 12:08 ] – Inherent vice is another possible exclusion, if pipe failure resulted from defective materials rather than external damage. [ 13:03 ] – Faulty maintenance or neglect may apply if the homeowner ignored known tree root issues or failed to maintain the system. [ 14:01 ] – If pipe damage is covered, costs to dig up the lawn may also be covered as part of the repair. [ 15:00 ] – But if the loss is excluded, tear-out costs likely aren’t covered unless tied to investigation or specifically included. [ 16:04 ] – The bottom line: coverage depends on facts, foreseeability, and exclusions. Without a tree root exclusion, outcomes are uncertain. Your PLRB Resources FAQ: Tree Root Losses - https://www.plrb.org/documents/tree-root-losses/ Coverage Question: Tree Root Damage: Fortuitous or Non-Fortuitous? - https://www.plrb.org/documents/tree-root-damage-fortuitous-or-non-fortuitous-pcq-2022-01-21-dwf-b/ 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 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. 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). /episode/index/show/plrbpod/id/37134695

Murder Mystery: Diminution in Value 06/10/2025

Murder Mystery: Diminution in Value A wealthy couple is murdered after a glamorous party—jewelry stolen, town abuzz. Their estate files an HO3 claim for the stolen jewelry and loss in home value due to the stigma. But does the policy cover reputational "diminution in value"? Notable Timestamps [ 00:37 ] - The scenario involves a wealthy couple poisoned in their mansion, with jewelry stolen and a claim submitted under their HO3 policy ISO 2011 edition. [ 01:39 ] - Trivia Time! Who are the six main characters of the board game Clue? [ 03:40 ] - Diminution in value refers to a property's market value being less than before a loss, even after full physical repair, due to stigma. [ 04:35 ] - The common argument against covering diminution in value is that policies typically cover physical loss and physical repair, not consequential or economic losses. [ 06:16 ] - First-party auto and property policies share similar loss settlement language. [ 07:47 ] - In Royal Capital Dev., LLC v. Maryland Cas. Co., No. S12Q0209, 2012 WL 1909842, — S.E.2d — (Ga. 5/29/12) [reviewed at PLRB, Prop. Ins. L. Rev. 8462 (2012)], the court allowed for diminution in value in a first-party property claim, drawing an analogy to auto claims. [ 08:50 ] - If there were physical traces like blood or bullet holes from the murders, it could potentially establish a physical loss, strengthening an argument for diminution in value, even if the cleanup cost itself is minimal. [ 10:28 ] - Real estate experts or appraisers could testify by comparing the home's value without the incident to similar properties affected by negative events. [ 13:04 ] - It's crucial to check your jurisdiction; while Georgia allows it, many states disallow it, and others have no specific case law on the matter. [ 14:00 ] - Tim provides a recap of the points above. Your PLRB Resources FAQ: Diminution in Value in First Party Property Claims - https://www.plrb.org/documents/diminution-in-value-in-first-party-property-claims/ Coverage Question: Pet Dog Attacked Owner; Blood on Carpet - https://www.plrb.org/documents/pet-dog-attacked-owner-blood-on-carpet-pcq-2023-10-27-twh-b/ 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 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. 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). /episode/index/show/plrbpod/id/36926115

Michigan PIP Puzzles 06/03/2025

Michigan PIP Puzzles John, 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/ 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 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. 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). /episode/index/show/plrbpod/id/36758355

Your Insurance Policy Will Decide When You’re Done Ridesharing 05/27/2025

Your Insurance Policy Will Decide When You’re Done Ridesharing A "FastFeast" driver ends their shift but forgets to log out of the app. On the way home, they crash—and their insurance denies the claim. Why? They were still “on the job.” In the gig economy, one tap can mean the difference between coverage and denial. Notable Timestamps [ 00:01 ] - The core scenario involves a driver for the delivery app FastFeast who had an accident on the way home after their shift and whose insurance claim was denied because they were still logged into the app. [ 02:07 ] - A ghost kitchen is a delivery-only establishment with no physical storefront that exists solely on delivery apps. Some ghost kitchens are linked to existing restaurants, like one possibly operating out of Chuck E. Cheese kitchens... [ 05:14 ] - Many personal auto policies, including older ones still in use, contain a livery or public conveyance exclusion that can apply if the vehicle is being used for ridesharing. [ 07:15 ] - Applying the livery exclusion may lead to coverage issues when a rideshare driver is actively transporting passengers during an accident. [ 08:10 ] - Under older livery language, it becomes ambiguous if an accident occurs while a driver is merely logged into the app awaiting an assignment but not actively carrying passengers or property. [ 11:11 ] - The definition of "livery" in these exclusions has been debated in courts; a majority interpret it to include both passengers and property (cargo), while a minority have limited it to passengers only. [ 14:21 ] - Modern exclusionary language for transportation network companies (TNCs) is designed to be less ambiguous than older livery clauses, often excluding coverage simply if the driver is logged into the TNC's digital network, regardless of whether they have an active customer. [ 17:09 ] - Brennan provides a recap of the scenario and the points above. Your PLRB Resources Coverage Question: “Does The “Livery Or Public Conveyance” Exclusion Apply To An Insured Logged Onto Door Dash But Not Making A Delivery? 2024.06.19” https://www.plrb.org/documents/does-the-livery-or-public-conveyance-exclusion-apply-to-an-insured-logged-onto-door-dash-but-not-making-a-delivery/?search=ride%20sharing%20exclusion Coverage Question: “Does A Rideshare Exclusion Apply To An Insured Who Is Only Logged On To The Uber App? – 2024.03.04” https://www.plrb.org/documents/does-a-rideshare-exclusion-apply-to-an-insured-who-is-only-logged-on-to-the-uber-app-2024-03-04/?search=ride%20sharing%20exclusion Emerging Issues: “Does a PAP Provide Coverage for Delivery Drivers Using Personal Vehicles with the Emergence of Ride-sharing Services Like Uber/Lyft/Grubhub? “https://www.plrb.org/documents/does-a-pap-provide-coverage-for-delivery-drivers-using-personal-vehicles-with-the-emergence-of-ride-sharing-services-like-uber-lyft-grubhub/?search=ride%20sharing%20exclusion#passorprop Case Law Review: Bender v. USAA Gen. Indem. Co. (2025) https://www.plrb.org/documents/bender-v-usaa-gen-indem-co-2025/ 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 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. 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). /episode/index/show/plrbpod/id/36693125

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