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 [email protected]. 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.

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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/36693125

My Insurance Policy has a Death Clause! 05/20/2025

My Insurance Policy has a Death Clause! Our insured, a widow with two adult kids, dies in a house fire. Her son, who planned to move out soon, escapes unharmed. Her daughter, who lives out of state but stores a drum set in the basement, is the executrix and returns home to handle next steps and insurance. Notable Timestamps [ 01:00 ] - The son planned to move into his girlfriend’s apartment by the end of the month [ 02:00 ] - The death clause in the HO3 form is explained as a critical provision ensuring the dwelling remains covered after the named insured's death until the estate can be settled. [ 03:00 ] - The policy language of the death clause states that the legal representative of the deceased is insured for the premises and property. [ 04:00 ] - A legal representative is typically the judicially appointed executor or administrator, not just an heir. [ 05:00 ] - Courts have generally held that the death clause overrides the personal property of others clause, which would likely preclude coverage for the daughter's drum set as she was not a resident insured at the time of the fire. [ 06:00 ] - The son, who was living in the house at the time of the fire, is covered for his personal property, though he cannot make a claim for the dwelling itself. [ 08:00 ] - The son's ALE coverage would cease if he moves in with his girlfriend, and the daughter is not entitled to ALE because she was not a member of the household at the time of the named insured's death. [ 09:00 ] - The difference in ALE coverage for the son and daughter reflects the insurance policy's goal to maintain the pre-loss situation, covering the resident son but not the non-resident daughter. [ 10:00 ] - Coverage under the death clause is intended as a temporary measure providing peace of mind to the family while they settle affairs, and it ends once the estate is settled. [ 11:00 ] - If the legal representative deeds the house to themselves after the named insured's death but before a loss, coverage under the original policy terminates because the insurance follows the named insured's personal interest, not just the property. [ 12:00 ] - Once the property is deeded to new owners (even family members), they must obtain their own insurance for coverage. [ 13:00 ] - John provides a recap of the scenario and the points above. Your PLRB Resources Annotation on the Death Clause - https://www.plrb.org/documents/death-ho120/?search=death Coverage Question: “Does the Death Clause Prevent the Insurer From Cancelling the Policy?” - https://www.plrb.org/documents/does-the-death-clause-prevent-the-insurer-from-cancelling-the-policy-pcq-2019-11-19-twh-a/?search=death%20clause Case Law Review: “Insurable Interest Lost When Executor Transferred Property To Self” - https://www.plrb.org/documents/archer-v-cotton-states-mutual-ins-co-2010/ 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/36630865

Does a Windstorm Deductible Apply to My Spoiled Cheesecakes? 05/13/2025

Does a Windstorm Deductible Apply to My Spoiled Cheesecakes? A windstorm-caused power outage at the Cheesecake Manufactory led to the spoilage of hundreds of cheesecakes and a business income loss. The adjuster is questioning if the windstorm deductible applies to the claim, despite the power outage being the direct cause of the spoilage. Notable Timestamps [ 00:00 ] - The scenario presented involves a windstorm that caused a power outage, leading to spoiled cheesecakes and a claim for spoilage and lost business income, raising the central question of whether the windstorm deductible applies given the chain of events. [ 01:30 ] - Trivia: Where did the maximum natural wind gust ever recorded occur? [ 03:00 ] - The windstorm deductible endorsement states it applies to losses "caused directly or indirectly by windstorm or hail", but this language, even with "indirectly," can still lead courts to perform a proximate cause analysis, often leaving the "dominant and efficient cause" determination to a jury, unlike clearer anti-concurrent causation language. [ 04:30 ] - While "directly or indirectly" might address some indirect causation issues, the very definition of "windstorm" is not straightforward and is heavily subject to interpretation by courts based on specific case facts. [ 06:00 ] - Case law interpretations of "windstorm" can be narrow, such as a Rhode Island case finding high winds didn't qualify due to excessive rain; or surprising, like a Texas court holding a tornado was not a windstorm for deductible purposes. [ 07:30 ] - Is a tornado the epitome of a windstorm? Depends on who you ask... [ 09:00 ] - When two different endorsement provisions contain irreconcilable conflicts, such as both stating that "no other deductible applies" to the coverage they provide, a court might determine that no deductible applies at all. [ 12:00 ] - The business income claim follows a chain of events from the windstorm to the power outage and then the spoilage. The business income loss specifically results from the inability to operate due to the spoiled inventory, which might also involve potential Extra Expense. [ 13:30 ] - Brennan provides a recap of the scenario and the points above. Your PLRB Resources PLRB Catastrophe Services Launches New Power Outage Reports - https://www.plrb.org/documents/plrb-catastrophe-services-launches-new-power-outage-reports/?search=power%20outage%202025 Turner Construction Co. v. ACE Prop. & Cas. Ins. Co., No. 04-4451-CV, 2005 WL 2837575, — F.3d — (2d Cir. 10/28/05) (applying Texas law) reviewed at PLRB, Prop. Ins. L. Rev. 6978 (2005) Windstorm Deductible – Food Spoilage – BI – PCQ.2024.07.26.twh.a - https://www.plrb.org/documents/windstorm-deductible-food-spoilage-bi-pcq-2024-07-26-twh-a/?search=power%20outage%202024 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/36538540

My Cheesecakes Spoiled After A Windstorm-- or a Windy Storm? 05/06/2025

My Cheesecakes Spoiled After A Windstorm-- or a Windy Storm? A windstorm knocks over a power line, causing hundreds of cheesecakes at a local restaurant to spoil. The owners have to close for a few days as they manufacture more. Their adjuster wants to know how to investigate the storm and power outage. Notable Timestamps [ 00:20 ] - The loss of desserts is always tragic, even lemon merengue. [ 01:00 ] - Trivia: Which variety of cheesecake contains "quark"? Or should we say "Weißkäse"? [ 01:50 ] - PLRB.org features a Weather and Catastrophe hub designed for insurance professionals and not for cat enthusiasts. [ 02:17 ] - Users can get a full weather/cat report from the historical weather section of the Weather and Cat hub by entering an address and date range. [ 03:11 ] - A full weather/cat report provides data including hail, wind, precipitation, lightning probability, storm reports, and watches/warnings. [ 04:15 ] - For this scenario, the report showed evidence of strong winds, such as a 72 or 73 mile per hour gust reported near the scenario's location in Waco, Texas. [ 06:08 ] - The PLRB hub also offers a power outage report tool which uses data from power outage US and covers 80% of the United States. [ 07:18 ] - The power outage report can show the location of outages near the address, indicating that power was out in the general area. [ 08:13 ] - Both the full weather/cat report and the power outage report can be combined to provide evidence, in this scenario for example, that a storm came through and knocked out power for the area. [ 09:59 ] - Dylan provides a recap of the scenario and the points above. Your PLRB Resources Get a Full Weather/CAT Report (hail, wind, precipitation, more) - https://www.plrb.org/weather-cat/plrb-cat-data/ PLRB Catastrophe Services Launches New Power Outage Reports - https://www.plrb.org/documents/plrb-catastrophe-services-launches-new-power-outage-reports/?search=power%20outage%202025 Mankoff v. Privilege Underwriters Reciprocal Exch., No. 05-22-00963-CV, 2024 Tex. App. LEXIS 594 (Tex. App. 01/29/2024) (Court of Appeals of Texas, 5th District, applying TX law) [reviewed at PLRB, Prop. Ins. L. Rev. (2024)] - https://www.plrb.org/documents/mankoff-v-privilege-underwriters-reciprocal-exch-2024/?search=mankoff 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/36445425

A Flipped Van, a Plumber on Shrooms, and the BOP Policy 04/29/2025

A Flipped Van, a Plumber on Shrooms, and the BOP Policy A plumber drove the company truck the wrong way on a busy highway for some time before he realized, panicked, swerved, and flipped the truck. Police believe he was on illegal drugs, although he disputes it. His employer claims equipment damage under their BOP policy. Notable Timestamps [ 00:25 ] - The plumber (the business) is now making a claim under their businessowners policy, BP 00 03 07 13, for the $50,000 worth of plumbing equipment and parts damaged in the accident. [ 01:45 ] - This episode was filmed at the 2025 PLRB Claims Conference in Indianapolis, right in the middle of the Expo hall at the PLRB booth! [ 04:00 ] - The BOP: The hottest dance craze, or finally a policy too large for a pocket? [ 04:40 ] - BOP policies are primarily on-premises forms, but a small amount of coverage exists for Off-Premises Coverage for property in the course of transit or at a premises the insured does not own, lease, or operate. [ 06:24 ] - The highway is probably not a "premises." As for whether a van can be a premises, that might be a topic for a future episode. [ 07:30 ] - The tools were not intended to be removed and left at the job site, so they would likely not be considered in transit. [ 09:30 ] - Dishonest or criminal acts are excluded, and arguably it is not necessary to wait for a criminal conviction to qualify as a "criminal act." [ 12:00 ] - If the driver was under the influence and another car swerved into its lane, one could argue that the accident would have happened anyway. In this case, if the influence of drugs is proven, it likely caused the loss. [ 13:35 ] - The dishonest or criminal acts exclusion does not apply to "acts of destruction." There is no intent here so it's unlikely, but the case law is limited. [ 16:00 ] - Tim provides a recap of the scenario and the points above. Your PLRB Resources Annotation: BP34 - Personal Property Off Premises - https://www.plrb.org/documents/bp34-personal-property-off-premises/?search=%22In%20Transit%22%20coverage%20in%20the%20BP%2000%2003%2007%2013 Coverage Question: In Transit; Stop For Gas Does Not Mean That Money Was Not In Transit At Time Of Loss - https://www.plrb.org/documents/in-transit-stop-for-gas-does-not-mean-that-money-was-not-in-transit-at-time-of-loss-pcq-2022-08-18-jem-b/?search=%22In%20Transit%22%20coverage%20in%20the%20BP%2000%2003%2007%2013 Recorded Webinar: Product Liability Cases Involving Emerging Risks: Vaping/Marijuana/Toxic Torts - https://www.plrb.org/courses/marijuana-cannabis-hemp-drugs/lessons/product-liability-cases-involving-emerging-risks-vaping-marijuana-toxic-torts/ 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/36225265

The Appraisal Process – Is it Still Useful to Resolve Disputed Claims? 04/22/2025

The Appraisal Process – Is it Still Useful to Resolve Disputed Claims? 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 [email protected] 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/36224270

Invoking “Our Option” – Increased Use of Preferred Contractor Networks 04/15/2025

Invoking “Our Option” – Increased Use of Preferred Contractor Networks 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 [email protected] 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/36136545

The PLRB Insurance Services Expo & You 04/08/2025

The PLRB Insurance Services Expo & You Let’s say you’re a service provider in the insurance industry. You’ve been attending PLRB Conferences for a few years, and you’re thinking about taking the next step to increase exposure and build relationships with the right people in the industry. Notable Timestamps [ 01:20 ] - Exhibiting and sponsoring at the PLRB Claims Conference can be an impactful option, and PLRB has a variety of offerings to help each service provider reach their goals. [ 01:50 ] - For our trivia question today, last year at the Claims Conference we had over 3000 attendees, and over 950 of those were insurance company staff. Of those, how many do you think were senior staff? [ 04:05 ] - The Insurance Services Expo includes a wide variety of exhibitors and sponsors, from traditional segments like independent adjusting and forensics to technology services like claims management software and AI solutions to other ancilliary services. [ 05:22 ] - Among other benefits, exhibiting and sponsorship can provide visibility, stature, and credibility as service providers build strong relationships in the industry. [ 06:30 ] - A variety of sponsorship opportunities are available to fit the needs of different service providers, from physical branding to digital signage to booth services. [ 07:50 ] - Service providers take full advantage of the benefits of the conference by attending educational sessions, doing their own entertaining, and making connections in the Expo. [ 08:37 ] - Unique opportunities like Wifi sponsorship and keycard sponsorship provide novel avenues to make connections with attendees. [ 09:15 ] - Return On Investment is a top concern for many service providers, and building relationships over time at the PLRB Claims Conference is often a fruitful experience for those who make the investment. [ 10:28 ] - The 2025 Claims Conference in Indianapolis provided plenty of space for conferencegoers to make connections. [ 11:50 ] - Many new offerings are anticipated, including-- as a show notes sneak peek-- creative services like social media templates and press releases. [ 13:30 ] - Tom provides a recap of the scenario and the points above. Your PLRB Resources Email [email protected] Contact Tom O'Dowd at [email protected] Prospective Sponsors: https://web.cvent.com/event/aa96efc9-539f-4558-bb0b-c31895d0abbf/websitePage:f7750b7c-c5d4-47e9-b3ba-24b0f244d6c8 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/36047105

The Police Shot My Heating Oil Tank (and a Burglar) 04/01/2025

The Police Shot My Heating Oil Tank (and a Burglar) In the middle of the night, a burglar broke into the policyholder’s house. Nearby police arrived, and the suspect was apprehended. Debbie filed a claim for the police’s bullet holes in her house and cleanup of heating oil spilled when a bullet hit the tank. Notable Timestamps [ 00:15 ] - The bullet holes were all from police guns. 150 gallons of heating oil spilled in the basement. [ 01:40 ] - Heating oil tanks are most commonly found in what region of the United States? [ 03:30 ] - Tim reads through the Pollutants exclusion. Heating oil is most likely going to be considered a pollutant. [ 04:45 ] - When pollutants are released, it's usually caused by something else. This policy narrows down the analysis by listing the perils covered in Coverage C. [ 05:55 ] - Let's run through the Coverage C perils... how about explosion? There was a trial-level court case from Pennsylvania in the '90s that held a gunshot could be considered an explosion for the named peril. [ 07:55 ] - "Riot and civil commotion" probably envisions multiple people, or at least a larger area. [ 09:00 ] - Is it finally time for malicious mischief? No, it was the bullets from the police, and they were not causing the mischief. [ 09:30 ] - The peril for theft includes attempted theft, so this peril is a possibility. [ 10:45 ] - "Sudden and accidental tearing apart, cracking, burning or bulging of a steam or hot water heating system"... was the heating oil tank part of the hot water heating system for the home? [ 12:00 ] - Volcanic eruption? Probably not, but it is valuable to step through the policy to look for coverage. [ 13:13 ] - The governmental action exclusion applies to the destruction of covered property by order or governmental or public authority. [ 14:00 ] - "Order" usually means a search warrant, or something more formal than what occurred in this scenario. [ 14:45 ] - If the police officer's conduct exceeds the scope of the warrant, that may fall outside of the exclusion as well. [ 16:15 ] - Tim provides a recap of the scenario and the points above. Your PLRB Resources Coverage Question: Governmental Action Exclusion – Raid Pursuant to Warrant - https://www.plrb.org/documents/governmental-action-exclusion-raid-pursuant-to-warrant-pcq-2023-04-30-twh-a/?search=governmental%20action Coverage Question: Governmental Action or Civil Authority Exclusions Not Applicable Where Damage from Apprehending Suspect - https://www.plrb.org/documents/governmental-action-or-civil-authority-exclusions-not-applicable-where-damage-from-apprehending-suspect-pcq-2020-08-18-eks-a/?search=governmental%20action Annotation: Pollutants; Smoke from Industrial Operations (HO131) - https://www.plrb.org/documents/pollutants-smoke-from-industrial-operations-ho131/ 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/35841345

[REPLAY] Join Us at the 2025 Claims Conference 03/28/2025

[REPLAY] Join Us at the 2025 Claims Conference Joining us next week? Enjoy this replay of our recent episode on the Claims Conference. A supervisor is leading a small but mighty teams of adjusters, and they're taking their team to Indianapolis this spring for the 2025 PLRB Claims Conference. The only problem? They’ve never been before and have no idea where to start. Notable Timestamps [ 00:15 ] - One more salute to our once and future host, Alissha Watley. [ 00:40 ] - Our team of claims professionals is headed to Indiana Convention Center in Indianapolis, IN for the 2025 PLRB Claims Conference, held on March 31 to April 2. [ 01:50 ] - The team reminisces about past conferences and tornado alarms. [ 02:40 ] - Stop by the registration desk to get your badge. If you're in town on Sunday, check out the Orientation for First-Time Attendees, and then the Claims Conference Welcome Reception. [ 04:17 ] - On Monday morning, kick off with the general session "The Power of Uncertainty" by Renee Bruns of Renee Bruns Coaching & Consulting, LLC. [ 04:40 ] - The Insurance Services Expo is a great place to connect with new products and service providers. [ 05:11 ] - PLRB will be hosting a booth at the Claims Conference, featuring lightning talks from PLRB staff and guests. [ 07:30 ] - Select from over 100 educational sessions to choose from, across 14 educational tracks. Get your CE Credits and the training you need to succeed. [ 10:30 ] - Lunchtime! The lunch hour is a great chance to check out the Expo hall and build connections. Who said there's no such thing as a free lunch? [ 11:36 ] - On Tuesday, check out PLRB Presents for short impactful talks; Future of Insurance for a thought leadership panel hosted by PLRB CEO Bryan Falchuk; and the Women's Walk coordinated by Girls Give Back. [ 13:00 ] - On Wednesday, stick around for a Backyard BBQ Luncheon. [ 14:16 ] - Register at PLRB.org under the Events tab. [ 15:05 ] - Mike provides a recap of the scenario and the points above. Your PLRB Resources Visit plrbclaimsconference.org or download the PLRB app to register, find a hotel, sign up for your sessions, and more. 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/35841390

Investigating a Garage Fire 03/25/2025

Investigating a Garage Fire Homeowner Lisa claims she was asleep when she woke up to smoke alarms blaring. She safely evacuated her home, but the fire destroyed her garage and spread to part of her home. The adjuster requests that Alex determine the fire’s cause. Notable Timestamps [ 00:15 ] - The scenario outlines a garage fire claim and a need to investigate the cause of the fire. [ 01:00 ] - When investigating a fire claim, is it origin and cause or cause and origin? Why? [ 03:00 ] - NFPA 921 provides standards for fire investigators conducting origin and cause investigations. [ 03:50 ] - Ring doorbell cameras or security footage is one source of origin and cause information. Footage may be automatically deleted, or the camera owner may refuse to cooperate. [ 05:55 ] - The team discusses raccoons, dogs, and bike bandits caught by Ring cameras. [ 08:15 ] - Garage fires can be hard to investigate because they often contain a large number of items and are often disorganized. These fires can burn quickly leaving little intact. [ 11:05 ] - Neighborhood watch apps like "Citizen" can establish suspicious activity at the time of the loss. In this scenario, this leads to eyewitness reports about the cause of the fire. [ 13:15 ] - Canvassing the neighborhood can help provide information, and experts can help investigate via forensic methods. [ 14:10 ] - The insurance company determines that Lisa’s policy covers the fire damage, but liability may extend to the guests who knocked over the battery charger. [ 14:35 ] - Tonda provides a recap of the scenario and the points above. Your PLRB Resources CE Course: Adjusting 21st Fire and Explosion Claims: Investigative Tools and Techniques - https://www.plrb.org/courses/adjustingfireclaims/ CE Course: Investigating and Resolving Different Types of Wildfire Losses - https://www.plrb.org/courses/investigating-and-resolving-different-types-of-wildfire-losses/ Wildfires Map (includes recent historical wildfires) - https://www.plrb.org/wildfires/ 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/35840610

It’s Getting Smokey in Here 03/18/2025

It’s Getting Smokey in Here Homeowner Jane Thompson lived 20 miles from the large Badone wildfire. One week after the fire department fully contained the wildfire, Jane called Evergreen Mutual and reported a strong smoke odor throughout her home. Notable Timestamps [ 00:20 ] - Jane also noticed discoloration on her walls and soot on her furniture. Jane was understandably concerned about her family’s health and potential long-term damage to her home and personal property. [ 01:10 ] - Can you name at least four of the major wildfires that have occurred in the US since 2016? [ 03:25 ] - The adjuster might focus on the HVAC system, walls, and attic as these are the most likely to show signs of smoke infiltration and fire-related damage: smoke and soot can get pulled into the HVAC system; porous materials like drywall can absorb smoke; attics often have exposed insulation, which can easily trap soot and smoke particles. [ 05:25 ] - A wipe test can reveal a layer of soot in areas not typically exposed to household pollutants, like inside closed cabinets. [ 06:34 ] - Documentation and photographs are essential to fire and smoke investigation and claims. [ 07:50 ] - Weather and fire reports can trace the wildfire’s smoke plume trajectory. [ 08:20 ] - NOAA can provide satellite imagery and local air quality index reports on the applicable area. [ 09:20 ] - PLRB.org's Weather / CATs hub provides weather data and analysis, including wildfire bulletins and address searches. [ 10:33 ] - Public cellphone location data can corroborate the timeline of smoke exposure, e.g. a spike in wildfire evacuation alerts and reduced activity in the area. [ 11:30 ] - Industrial hygenists can perform environmental testing that can detect char and ash particles consistent with materials burned in the nearby wildfire. [ 12:02 ] - Tonda provides a recap of the scenario and the points above. Your PLRB Resources CE Course: Adjusting 21st Century Fire and Explosion Claims: Investigative Tools and Techniques - https://www.plrb.org/courses/adjustingfireclaims/ CE Course: Investigating and Resolving Different Types of Wildfire Losses - https://www.plrb.org/courses/investigating-and-resolving-different-types-of-wildfire-losses/ Wildfires Map (includes recent historical wildfires) - https://www.plrb.org/wildfires/ 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/35740910

Hand Me That Certificate (of Insurance)! 03/11/2025

Hand Me That Certificate (of Insurance)! Just before purchasing a policy, the insured subcontractor says “I need to provide something called a ‘Certificate of Insurance’ to my general contractor,” and add them as an additional insured. What issues does this create from an underwriting or claims perspective? Notable Timestamps [ 00:15 ] - The adjuster is giving him the Coverage A limits to rebuild the house. But he is also making a claim for Fair Rental Value (Coverage D). ISO HO 00 03 05 11. Is there coverage? [ 01:07 ] - The team diagrams the parties. [ 01:43 ] - Employees, officers, and directors generally qualify as insureds while acting within the scope of their authority. [ 03:36 ] - Endorsements may limit coverage for the additional insured to claims for vicarious liability of the named insured. [ 04:35 ] - First, we must examine whether the insurer owes the additional insured a duty of defense and indemnification under the liability policy. The prime contractor is an insured for purposes of this analysis. [ 06:00 ] - Second, we examine whether the prime contractor’s tender of the defense under the indemnification provisions of the subcontract constitutes a covered claim against the named insured under the liability policy. The prime contractor is a claimant for purposes of this analysis. [ 07:55 ] - Certificates of Insurance typically include the name of insured, the policy dates, the policy identification number, the coverage type, and limits. [ 08:35 ] - What happens when the Certificate and the policy come into conflict? [ 10:35 ] - Certificates of Insurance usually state: “THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES." [ 11:17 ] - Let's say the endorsement making the Certificate-holder an additional insured was accidentally omitted from the policy. Case law is inconsistent, but the Certificate's disclaimer is often upheld. [ 12:41 ] - Let's say the agent made representations on the policy. This would raise issues of actual authority (less likely) and apparent authority (possible). [ 14:53 ] - Brennan provides a recap of the scenario and the points above. Your PLRB Resources CE Course: Underwriting Issues in Insurance Claims - https://www.plrb.org/courses/underwriting-issues-in-insurance-claims/ Handout: https://www.plrb.org/wp-content/uploads/2024/10/UnderwritingIssues-Scenarios.pdf Coverage Question: Is a General Contractor Entitled to a Defense Based Solely on a Certificate of Insurance? - https://www.plrb.org/documents/is-a-general-contractor-entitled-to-a-defense-based-solely-on-a-certificate-of-insurance-2005-06-21/ Related Case Law: Mingji Ave4 Realty, LLC v. Colony Ins. Co. (2024) - https://www.plrb.org/documents/mingji-ave4-realty-llc-v-colony-ins-co-2024 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/35522350

My Insurance Company Forgot to Bill Me... 03/04/2025

My Insurance Company Forgot to Bill Me... The insured signed up for a “retrospective rating plan.” Under this plan, the insured promised to reimburse Unforgettable for its paid losses. The insurance company discovered invoices left unsent due to a computer programming error. Notable Timestamps [ 00:15 ] - Total Surprise Transportation promised to reimburse Unforgettable Insurance for its paid losses, including "Allocated Loss Adjustment Expenses." [ 01:25 ] - Tim asks for his paycheck to be decreased, and Brennan gets paid to buy a workbench. [ 02:43 ] - Usually premiums are calculated based on industry knowledge and similar businesses. Under a retrospective rating plan, an initial premium is assessed, then adjusted based on the insured’s actual losses. [ 03:55 ] - “Allocated Loss Adjustment Expenses” or ALAE are the costs associated with specific claims, and the “Unallocated Loss Adjustment Expenses” refer to more general overhead that goes into running the claims department. [ 05:09 ] - These plans allow the insured to hang onto their cash right up until the claim settles, rather than spending their reserves throughout the process. [ 05:58 ] - To successfully invoke laches, a defendant must prove the plaintiff delayed filing suit an unreasonable and inexcusable length of time from the time the plaintiff knew or reasonably should have known of its claim against the defendant; and (2) the delay resulted in material (financial) prejudice or injury to the defendant. [ 08:50 ] - Equitable estoppel prevents one party who has made certain representations from taking unfair advantage of another when the party making the representations changes its position to the prejudice of the party who relied upon the representations. [ 10:24 ] - Under the clean hands doctrine, a court sitting in equity will not provide shelter or aid to a party who seeks the benefit of their own wrongdoing. The doctrine generally does not apply to law actions like a breach of contract claim. [ 11:33 ] - Who really has clean hands here? What would the impact be on the insured's financial situation? The team discusses fairness in this context. [ 12:52 ] - Brennan provides a recap of the scenario and the points above. Your PLRB Resources CE Course: Underwriting Issues in Insurance Claims - https://www.plrb.org/courses/underwriting-issues-in-insurance-claims/ Handout: https://www.plrb.org/wp-content/uploads/2024/10/UnderwritingIssues-Scenarios.pdf 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/35522075

Singer Sings Against Assailant to Get a Defense 02/25/2025

Singer Sings Against Assailant to Get a Defense A concert attendee filed suit against a band's lead singer based on the singer's alleged "onslaught" of blows to the attendee's face, head, and body over a dispute. However, the singer's claimed that the confrontation only became violent when the attendee threw the first punch. Notable Timestamps [ 00:25 ] - The singer tendered the suit to his insurer, who agreed to defend under a reservation of rights, but is there a duty to defend? [ 01:25 ] - Seventies, eighties, nineties? The crew chats concerts. [ 02:30 ] - This scenario is based on New York Marine and General Ins. Co. v. Ness, 2021 WL 510624 (E.D. Cal. 1/12/21), linked below. [ 03:30 ] - "Four Corners" means looking only at the Complaint, and "Eight Corners" means looking at the insurance policy as well. Both phrases refer to ignoring outside evidence and focusing on the claims made for the purposes of determining the Duty to Defend. [ 04:30 ] - The court determined that the insured's claims raised a factual issue about the insured's intent. The exclusion for Expected or Intended Injury would not apply in cases of self-defense. [ 05:45 ] - The court found that when there are extrinsic facts from the insured, it is incorrect to assume that only the attendee's allegations matter, so they found a duty to defend. [ 06:15 ] - Courts might sometimes punish "creative pleading", but nevertheless often Complaints will include allegations of negligence, which in this case would have prevented a coverage dispute. [ 08:30 ] - States treat "extrinsic evidence rules" differently. Texas courts allow evidence that solely addresses coverage and does not contradict the facts in the Complaint. This scenario would fail the second prong. [ 09:45 ] - Florida would not permit an insurer to allege extrinsic evidence to dispute the duty to defend, whereas Hawaii or New York might. Some caselaw suggests that if an exclusion clearly applies, extrinsic evidence may be allowed. [ 12:20 ] - Expediency drives many of these rules, as well as insurers' decisions between Declaratory Judgment and denial. [ 13:20 ] - One South Carolina case required an insurer to look at extrinsic evidence. [ 14:30 ] - Can an insurer use an endorsement to permit the introduction of extrinsic evidence in disputes about the duty to defend? A Washington court has yet to answer this question in Developers Surety and Indemnity Co. v. Alis Homes, LLC, 2018 WL 1792182 (W.D. Wash. 4/16/18), reviewed at PLRB, Com. Liab. Ins. L. Rev. 5511 (2018). https://www.plrb.org/legacy-documents?DN=66854 [ 15:40 ] - A California case held that extrinsic evidence could establish a duty to defend-- that's this scenario, linked below. [ 17:35 ] - Michele provides a recap of the scenario and the points above. Your PLRB Resources On the admissibility of extrinsic evidence regarding an insurer's duty to defend, Commercial General Liability Policy Annotation Key GL37 - https://www.plrb.org/legacy-documents?DN=43173 Expected or intended injury exclusion, see Commercial General Liability Policy Annotation Key GL71 - https://www.plrb.org/legacy-documents?DN=43211 Law Review California Federal District Case - https://www.plrb.org/documents/new-york-marine-and-general-ins-co-v-ness/ 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/35381755

Shooter Shatters Funeral Reception 02/18/2025

Shooter Shatters Funeral Reception A restaurant was hosting a funeral lunch. During the lunch, a gunman entered and shot an individual who was not related to the funeral reception, but who was in eyeshot of lots of the patrons and children. The victim survived & the gunman fled. Notable Timestamps [ 00:24 ] - The insured restaurant has a CGL policy and sought coverage after a group of the patrons filed a lawsuit against the restaurant alleging emotional distress [ 01:50 ] - The coverage crew discuss The Godfather and their favorite mob movies. [ 02:45 ] - Bodily Injury under the CGL policy is usually defined as "sickness or disease sustained by a person, including death, resulting from any of these at any time." [ 04:50 ] - "O-H..." In Ohio, the case law is clear-cut: emotional distress does not qualify as bodily injury. Not even if a murder happens at a funeral. [ 07:15 ] - If ulcers or other symptoms arise after an upsetting scene, that would greatly increase the likelihood of the claim being considered "bodily injury." [ 08:20 ] - "...I-O" 31 states follow Ohio's lead. [ 09:30 ] - A California court found that "dry mouth" established bodily injury. How about embarrassment? High blood pressure? Case law can be found for many types of "bodily injury." [ 12:00 ] - If the gunman made physical contact with a bystander, that is a factor courts look to that could strengthen the case for bodily injury. [ 13:25 ] - A scenario where a claimant alleges their alcoholism was caused by his termination from a job presents a gray area, though the little case law available suggests psychological or psychiatric trauma may be too attenuated from the loss. [ 15:05 ] - Sleeplessness qualified as bodily injury in a New Hampshire case, and did not qualify in a New Jersey case. Seattle courts are still undecided. [ 16:55 ] - "Fuzzy" is a technical legal term. [ 17:25 ] - Michele provides a recap of the scenario and the points above. Your PLRB Resources CGL’s bodily injury definition, see PLRB Commercial General Liability Policy Annotations / GL7 – Bodily Injury Defined: https://www.plrb.org/documents/gl7-bodily-injury-defined/#_Ohio Coverage Reply, Is Emotional Distress a Bodily Injury? https://www.plrb.org/documents/is-emotional-distress-a-bodily-injury-in-ohio-cq2024-11-25fjg/?search=bodily%20injury Coverage Reply, Would Negligent Infliction of Emotional Distress Be Covered under a CGL Policy? https://www.plrb.org/documents/would-negligent-infliction-of-emotional-distress-be-covered-under-a-massachusetts-cgl-policy-2022-01-06/?search=bodily%20injury%20emotional 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/35288520

Here Comes Fair Rental Value in the Backstretch 02/11/2025

Here Comes Fair Rental Value in the Backstretch The insured owns a house in Louisville, KY, near Churchill Downs. Every year, prior to the first Saturday in May, he rents his house out for two weeks. He secured a renter for $3,000. However, a week before the Derby, his home was destroyed in a fire. Notable Timestamps [ 00:15 ] - The adjuster is giving him the Coverage A limits to rebuild the house. But he is also making a claim for Fair Rental Value (Coverage D). ISO HO 00 03 05 11. Is there coverage? [ 01:36 ] - Trivia Time! The Kentucky Derby was first run in what year? 1898, 1920, 1842, or 1875? [ 03:30 ] - Fair Rental Value is covered if a covered loss makes that part of the residence premises rented to others or "held for rental" not fit to live in. [ 05:20 ] - "Held for rental" could apply to someone advertising a rental, or someone with a contract for rental (even if breached due to the loss). [ 06:16 ] - Fair Rental Value can mean a much higher price than most equivalent units, if it's the week before the Kentucky Derby. [ 07:29 ] - Fair Rental Value can be informed by prior history of unit rental price for that specific unit or similar nearby units, and it can be affected by the time of year or even the significance of sporting events. [ 08:50 ] - The sporting event's impact on pricing would not be affected by the renter's intent to attend or not. [ 09:25 ] - Claiming ALE is likely inconsistent with claiming FRV. Did the insured intend to live in the house, and therefore they need ALE to make them whole for the living space they lost? Or did the insured intend to rent the house, and therefore they need FRV to make them whole for the rental they lost? [ 11:32 ] - A partial use, partial rental situation might justify claiming both ALE and FRV. [ 12:35 ] - The paucity of caselaw on Fair Rental Value means that uncertainty is high but variation among the states is low. [ 13:15 ] - The 2022 ISO HO form made significant changes relating to homesharing apps, and excluded coverage for FRV specifically when homesharing activities are involved. [ 14:45 ] - Tim's "policies in his pocket" are color-coded! [ 15:55 ] - If the home was repaired prior to the Derby, but the tenant had cancelled, FRV would likely not apply. The relevant ISO policy specifically excludes coverage for cancellations of agreements. The end of the Period of Restoration closes the window on FRV. [ 17:25 ] - Tim provides a recap of the scenario and the points above. Your PLRB Resources Fair Rental Value For Home Up For Rent At Time of Loss – PCQ.2013.06.11a (Cov Question) - https://www.plrb.org/documents/fair-rental-value-for-home-up-for-rent-at-time-of-loss-pcq-2013-06-11a/ ALE: Travel Costs to Rental Property – PCQ.2014.05.09a (Cov Question) - https://www.plrb.org/documents/ale-travel-costs-to-rental-property-pcq-2014-05-09a/ Fair Rental Value (HO38) (Annotation) - https://www.plrb.org/documents/fair-rental-value-ho38/ 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/35197095

A Bank Robber Fried My Toaster 02/04/2025

A Bank Robber Fried My Toaster A bank robber in a high speed chase from the police and smashed into a tree on the insured's premises. A large limb fell on power lines, and the insured's home sustained a power surge. The insured claims electrical damage to his refrigerator, toaster, and TV. Notable Timestamps [ 00:20 ] - The adjuster sees the insured had a standard ISO HO 00 03 05 11. Is there coverage for these household items under that form? [ 01:35 ] - Trivia time! This 1967 American film starring Warren Beatty and Faye Dunaway follows the exploits of bank robbers in the Depression-Era South. [ 03:00 ] - Coverage A generally applies, in part, to electronics permanently attached to the realty-- if you turned the house upside-down and shook it, what would NOT fall out? [ 04:36 ] - Coverage A or Coverage C factors: 1. actual physical annexation to the property, 2. application or adaptation to the use or purpose to which the realty is devoted, and 3. intention (or lack thereof) to make it a permanent installation. [ 05:11 ] - If the insured was moving to a new home, what would they leave behind? Not the toaster or, with any likelihood, the television. Even wall-mounted televisions are easily removed. [ 07:00 ] - This refrigerator has an ice maker, so it's linked to the plumbing. It's often not taken upon moving. [ 07:35 ] - Coverage B only comes into play if you're storing your lawnmower in a refrigerator. [ 08:36 ] - Sometimes refrigerators are built in to match the surrounding cabinets. [ 09:30 ] - We'll assume these fall under Coverage C, and that the insured isn't living in that backyard fridge to get Coverage D to apply. [ 10:30 ] - Proximate cause analysis would apply to this complex chain of causation, but most adjusters would likely give the insured the benefit of the doubt if any named peril played a meaningful role in bringing about the loss. [ 11:00 ] - Malicious mischief? It's a consideration, but sorry Mike, there are other intervening causes here. [ 12:05 ] - Going through the options, several named perils might apply: Artificially Generated Electrical Current, Falling Objects, or Vehicles. [ 13:00 ] - Sudden and Accidental Damage from Artificially Generated Electrical Current sounds like it should apply, but the text says it does not apply to objects with electronic components. [ 14:18 ] - The Vehicles peril just says "vehicles." [ 15:00 ] - If the insured is driving, you might run into an intentional loss exclusion issue, and innocent co-insured concerns. [ 16:00 ] - The insured can get paid for the tree, even though the list of perils is shorter for that particular coverage, because the loss was caused by a vehicle not owned or operated by a resident. [ 17:35 ] - Tim provides a recap of the scenario and the points above. Your PLRB Resources Power Surge Damages Appliances- PCQ.2006.06.01a - https://www.plrb.org/documents/power-surge-damages-appliances-pcq-2006-06-01a/ Artificially Generated Electrical Current (HO77) - https://www.plrb.org/documents/artificially-generated-electrical-current-ho77/ Does Additional Coverage Apply To Tree Struck By Insured Vehicle After Collision?- PCQ.2012.04.17a - https://www.plrb.org/documents/does-additional-coverage-apply-to-tree-struck-by-insured-vehicle-after-collision-pcq-2012-04-17a/ 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/35136670

You Can Take the CL Out of the CGL... 01/28/2025

You Can Take the CL Out of the CGL... This claim involves contractual issues between a general contractor and an electrician. The electrician got his wires crossed and caused some damage, and now there’s lawyers throwing around phrases like “contractual indemnity” and “additional insureds” and “insured contracts.” Notable Timestamps [ 00:34 ] - Nate is a longtime personal lines adjuster switching to commercial lines and taking over a claim from a retiring adjuster. [ 01:40 ] - Call (630) 509-8704 to leave a voicemail with your anonymous adjuster story! Mike shares his own story! What can you do about a drunken sailor... [ 04:00 ] - CGL policies typically exclude liability assumed under a contract. Typically, two-party contracts are not occurrences because a breach of contract is not a matter of chance or fortuity. The GL policy is not a performance contract or a guarantee of work product or quality. [ 06:35 ] - However, CGL policies have an EXCEPTION to the EXCLUSION that keeps out two-party contracts. The exception permits coverage for "insured contracts"-- basically three-party contracts like the one where a general contractor contracted with an insured electrician, and then the homeowner's property got damaged. [ 09:15 ] - Contractual indemnity is created by a contract to assume another party's tort liability, whereas an additional insured is created by an endorsement in the insurance policy specifically naming the party to be insured. [ 11:32 ] - An Additional Insured endorsement may include some limitations, but otherwise the named additional insured has the same rights as the insured who signed up for the policy. [ 11:55 ] - Additional Insured have broader rights than a contractual indemnitee, but they also have broader responsibilities: the same responsibilities as the original insured to cooperate, act timely, etc. [ 13:21 ] - A contractual indemnitee can refuse responsibilities like providing certain documents, but miss out on perks like getting a defense provided by the insurance company. [ 14:45 ] - The CGL policy provides these differing options as a way of providing flexibility for different situations. [ 15:12 ] - Not to get "distracted", but the CGL also carves out an exception for "sidetrack" agreements-- agreements pertaining to the train tracks extending out of factories and warehouses. [ 16:50 ] - Mike provides a recap of the scenario and the points above. Your PLRB Resources 50-State survey on Indemnity Agreements - https://www.plrb.org/documents/agreements-to-indemnify-and-general-liability-insurance/ CE Course on Contractual Indemnity and Additional Insured Liability - https://www.plrb.org/courses/contractual-indemnity-and-additional-insured-liability/ Advanced Issues: Road Trip Through the CGL Policy recorded webinar - https://www.plrb.org/courses/advanced-issues-road-trip-through-the-cgl-policy/ 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/35035860

Join Us at the 2025 Claims Conference 01/21/2025

Join Us at the 2025 Claims Conference A supervisor is leading a small but mighty teams of adjusters, and they're taking their team to Indianapolis this spring for the 2025 PLRB Claims Conference. The only problem? They’ve never been before and have no idea where to start. Notable Timestamps [ 00:15 ] - One more salute to our once and future host, Alissha Watley. [ 00:40 ] - Our team of claims professionals is headed to Indiana Convention Center in Indianapolis, IN for the 2025 PLRB Claims Conference, held on March 31 to April 2. [ 01:50 ] - The team reminisces about past conferences and tornado alarms. [ 02:40 ] - Stop by the registration desk to get your badge. If you're in town on Sunday, check out the Orientation for First-Time Attendees, and then the Claims Conference Welcome Reception. [ 04:17 ] - On Monday morning, kick off with the general session "The Power of Uncertainty" by Renee Bruns of Renee Bruns Coaching & Consulting, LLC. [ 04:40 ] - The Insurance Services Expo is a great place to connect with new products and service providers. [ 05:11 ] - PLRB will be hosting a booth at the Claims Conference, featuring lightning talks from PLRB staff and guests. [ 07:30 ] - Select from over 100 educational sessions to choose from, across 14 educational tracks. Get your CE Credits and the training you need to succeed. [ 10:30 ] - Lunchtime! The lunch hour is a great chance to check out the Expo hall and build connections. Who said there's no such thing as a free lunch? [ 11:36 ] - On Tuesday, check out PLRB Presents for short impactful talks; Future of Insurance for a thought leadership panel hosted by PLRB CEO Bryan Falchuk; and the Women's Walk coordinated by Girls Give Back. [ 13:00 ] - On Wednesday, stick around for a Backyard BBQ Luncheon. [ 14:16 ] - Register at PLRB.org under the Events tab. [ 15:05 ] - Mike provides a recap of the scenario and the points above. Your PLRB Resources Visit plrbclaimsconference.org or download the PLRB app to register, find a hotel, sign up for your sessions, and more. 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/34900235

Installation Floaters? I Still Don’t Own a Boat! 01/14/2025

Installation Floaters? I Still Don’t Own a Boat! In our last podcast, thieves cut into a job site and stole a variety of tools, equipment, and materials. The general contractor had hired a subcontractor to install the plumbing system. Copper piping to be installed at the job site and owned by the sub were also stolen. Notable Timestamps [ 00:45 ] - Last week's scenario is expanded to discuss the impact on subcontractors. [ 01:50 ] - The PLRB crew discusses inside jobs, boats, and gap coverage. [ 02:50 ] - Subcontractors more often prefer Installation Floaters as opposed to Builders Risk. [ 04:00 ] - The Installation Floater form generally covers materials, fixtures, and equipment that will become a permanent part of the completed project. [ 05:30 ] - The coverage typically ends once the items are installed. So, these copper pipes would be covered under an installation floater. [ 08:00 ] - Despite the name "floater," waterborne equipment is specifically excluded. Unless Mike opens up a seafood restaurant with some unusual decor... [ 09:13 ] - The Contractors Equipment form covers mobile machinery used by a contractor or subcontractor as part of their construction work. [ 10:50 ] - The Motor Truck Cargo form provides coverage for the cargo or goods being transported by a trucking or freight transportation company: the risks associated with transportation. [ 12:32 ] - The trucking company might be liable for the panels because they were on their truck, but they might be covered under their Motor Truck Cargo coverage, depending on its delivery status. [ 13:30 ] - Jeff provides a recap of the scenario and the points above. [ 16:20 ] - A very special (and hopefully temporary) farewell to PLRB's longtime podcast host, Alissha Watley! Your PLRB Resources Inland Marine – Prop. Q&A 187 - https://www.plrb.org/documents/inland-marine-prop-qa-187/ Discussion of the definition of equipment and machinery - PLRB, Commercial Property Forms Annot. Key CP941 - https://www.plrb.org/legacy-documents?DN=46384 Installation Floater Coverage - https://www.plrb.org/documents/installation-floater-coverage/ 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/34746870

Inland Marine? I Don’t Even Own a Boat! 01/07/2025

Inland Marine? I Don’t Even Own a Boat! Thieves cut through a fence to access the insured general contractor's job site’s and stole tools, a forklift, a pallet of marble tiles, and a truck loaded with precast concrete wall panels. Notable Timestamps [ 00:30 ] - The insured finds out that these losses are not covered under their standard CP forms. [ 01:45 ] - The team discusses impressive thieves, the defintion of a CP policy, New Year's Resolutions, and vision boards. [ 05:13 ] - The CP/BPP form generally applies while the property is on or within 100 feet of the premises described in the policy’s declarations. The job site is not the insured's listed place of business. [ 07:05 ]- A Property Off Premises Coverage Extension exists, but applies only to property that is temporarily at a location the insured does not own, lease or operate. [ 07:45 ] - Here, GC’s marble tiles and precast panels were not temporarily at the job site – they were going to be permanently installed there. [ 08:30 ] - GC arguably “operated” the jobsite, as it had control over the site, including access etc. [ 09:20 ] - The coverage extension also contains an exclusion for property in or on a vehicle, so that applies to eliminate coverage for the panels on the truck. [ 09:40 ] - GC could have protected this property via Inland Marine Insurance. [ 10:20 ] - Originally, “marine” insurance policies were written when virtually all commercial goods were transported by boat. However, due largely to the development of railroads, marine insurance was extended to provide “warehouse to warehouse” coverage. [ 11:04 ] - While there are a number of inland marine forms, the most common are Builders Risk, Installation Floater, Contractors Equipment, and Motor Truck Cargo Liability. [ 12:10 ] - Builder’s risk insurance covers buildings and other structures during the course of construction, including materials and supplies that will become a permanent part of the buildings or the structures, while on the jobsite or on the way to the jobsite. [ 14:10 ] - Under the claim scenario here, the pallet of marble tiles and precast concrete wall panels would be covered, but not the the generators, concrete saw, or forklift, since they are not materials or supplies. [ 15:10 ] - Jeff provides a recap of the scenario and the points above. Your PLRB Resources Inland Marine – Prop. Q&A 187 - https://www.plrb.org/documents/inland-marine-prop-qa-187/ Form – AAIS IM 7050 09 08 – Builders Risk - https://www.plrb.org/documents/form-aais-im-7050-09-08-builders-risk/ 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/34746830

[REPLAY] The Coverage Contrarian: CGL Coverage for Engine Servicing and Workmanship 12/31/2024

[REPLAY] The Coverage Contrarian: CGL Coverage for Engine Servicing and Workmanship For the next two weeks over the holidays, we’re going to feature some excellent podcasts from before we rebranded as “What’s the Scenario? with PLRB.” These segments were called “The Coverage Contrarian,” and they featured PLRB coverage attorneys Michele Hunter, Eric Friedmann, and Frank Gagliardi as they argued vociferously about coverage issues big and small. This week, we’ll explore the scenario of an insured repair business that repaired a valve on a large boat so poorly that the whole engine was damaged. Let’s listen in. Key Takeaways The critical inquiry in a defective or faulty workmanship case is, the scope of the insured's agreed upon, contracted work. Under the majority view, the damage to the engine would likely be considered damage to other property, because the insured was not hired to work on the whole engine itself. Under the minority view, working on an interconnected part of an engine would be considered working on the engine as a whole. Your PLRB Resources PLRB on Demand (Classic Podcast Episodes) - https://www.plrb.org/education/education-resources/?general_index%5BrefinementList%5D%5Blms_type%5D%5B0%5D=Podcast&general_index%5BsortBy%5D=general_index%3Apublished_on%3Aasc 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/34559705

[REPLAY] The Coverage Contrarian: E-Bike Coverage Under a Homeowners Policy 12/24/2024

[REPLAY] The Coverage Contrarian: E-Bike Coverage Under a Homeowners Policy For the next two weeks over the holidays, we’re going to feature some excellent podcasts from before we rebranded as “What’s the Scenario? with PLRB.” These segments were called “The Coverage Contrarian,” and they featured PLRB coverage attorneys Michele Hunter, Eric Friedmann, and Frank Gagliardi as they argued vociferously about coverage issues big and small. This week, we’ll explore the scenario of an e-bike slamming into a tree. Key Takeaways In any coverage issue involving an E-Bike, the first step is to consider the jurisdiction you're in, and whether that particular state excludes E-Bikes from its definition of "motor vehicle." If an E-Bike is not considered a "motor vehicle," there is no coverage, and no reason to consider the motor vehicle exclusion. And the second EQUALLY IMPORTANT step is to see whether the particular Homeowners policy has coverage for "motorized vehicles" or "recreational motor vehicles." Because then, there may be coverage for an E-Bike accident on the insured premises or for a rented E-Bike. Your PLRB Resources PLRB on Demand (Classic Podcast Episodes) - https://www.plrb.org/education/education-resources/?general_index%5BrefinementList%5D%5Blms_type%5D%5B0%5D=Podcast&general_index%5BsortBy%5D=general_index%3Apublished_on%3Aasc 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/34559670

There's a Gap in My Roof! 12/17/2024

There's a Gap in My Roof! The insured's roof will need to be replaced. Upon removal of the asphalt shingles, the roofing contractor finds that the existing roof deck has gaps. Now, the contractor is requesting removal of the existing spaced sheathing and installation of new half-inch OSB. Notable Timestamps [ 00:30 ] - The scenario concerns the devastation that followed Hurricane Helene. [ 01:15 ] - Mike shares a story about getting stranded up on a roof, and Rosen shares his childhood shenanigans. [ 03:49 ] - A riddle: What kind of house is fully enclosed but it has no roof? [ 06:00 ] - The deck holds the roof covering. In some cases it can be boards, and spaced decking or skip sheathing is where there is a "skip" between each panel. [ 07:00 ] - Spaced sheathing is most common with coverings made from wood, e.g. cedar shake wood shingles, to provide ventilation to prevent improper curing and bending. [ 07:14 ] - Spaced sheathing is not compatible with asphalt shingles. [ 08:20 ] - The issues arise when cedar shake is covered with asphalt shingle, but then a storm requires removal of the shingle & shake. [ 09:20 ] - Some contractors propose removing all the sheathing, but a three-eighth inch overlay can be installed over the spaced sheathing. [ 11:10 ] - Without some small gap between the planks, seasonal changes would cause expansion and contraction that lead to bowing. Gaps that are too large can lead to nails not being attached to anything securing it. [ 13:30 ] - The industry consensus seems to prefer gaps between one-eighth inch and one-quarter inch. [ 14:25 ] - There's a misconception that planked sheathing cannot be used with asphalt shingles, but IRC R803.1 disagrees. [ 15:40 ] - Rosen provides a recap of the scenario and the points above. Your PLRB Resources Recorded Webinar: Asphalt Shingle Roofs: Top 10 Code Questions - https://www.plrb.org/courses/asphalt-shingle-roofs-top-10-code-questions/ Clickable Diagram: Residential Roof Toolkit - https://www.plrb.org/building-codes/building-component/#roof_toolkit Spaced Sheathing Does the Deck Need to be Replaced - https://www.plrb.org/documents/sheathing-spaced-sheathing-does-the-deck-need-to-be-replaced/?search=sheathing%20gap 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/34358765

[REPLAY] The Coverage Contrarian: The Expected or Intended Injury Exclusion 12/17/2024

[REPLAY] The Coverage Contrarian: The Expected or Intended Injury Exclusion Today we’re going to feature an excellent podcast episode from before we rebranded as “What’s the Scenario? with PLRB.” These segments were called “The Coverage Contrarian,” and they featured PLRB coverage attorneys Michele Hunter, Eric Friedmann, and Frank Gagliardi as they argued vociferously about coverage issues big and small. This week, we’ll explore how the expected or intended injury exclusion applies when a person punches another in the jaw without knowing their own strength. Let’s listen in. Key Takeaways When considering whether this exclusion applies to a given claim, one must always know three things: the jurisdiction whose law would govern the version of the exclusion contained in the policy you're dealing with; and most importantly, one must know all of the relevant facts bearing on the application of the exclusion. Your PLRB Resources PLRB on Demand (Classic Podcast Episodes) - https://www.plrb.org/education/education-resources/?general_index%5BrefinementList%5D%5Blms_type%5D%5B0%5D=Podcast&general_index%5BsortBy%5D=general_index%3Apublished_on%3Aasc 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 [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/34559730

Will Insurance Pay for the Minibar? 12/10/2024

Will Insurance Pay for the Minibar? The named insured's home underwent a total loss. The insured wants coverage for a place to stay while his home is being rebuilt. The insured wants to know the scope of Loss of Use coverage, and exactly how many bags of M&Ms he can snag from the minibar. Notable Timestamps [ 00:25 ] - The insured also lives with his girlfriend, which may come into play later. [ 01:00 ] - Are minibars even a thing anymore? [ 02:23 ] - ALE is triggered when the insured premises is unfit to live in, and applies to any necessary increase in living expenses incurred to maintain its normal standard of living. [ 03:50 ] - “Expenses” could include house rental, meals, drink, tips, transportation, heating, lighting, laundry, etc., but the insured must be able to show an increase in expenses. [ 04:37 ] - ALE is not intended to cover a shortfall in personal property coverage. [ 05:30 ] - ALE is analogous to Extra Expense under commercial policies, but Extra Expense can be more expansive. [ 06:40 ] - Is alcohol a daily expense? ALE can include laundry, restaurants and tips, etc. if it can be shown the expense is more than normal. [ 07:40 ] - The live-in girlfriend would be considered a member of his household, but ALE only applies to the insured's additional expenses. [ 09:30 ] - In 2022, ISO added some language to allow ALE to cover expenses by residents of the household who are relatives or dependents. [ 10:55 ] - The girlfriend may have to prove her residency. [ 12:10 ] - ALE only applies when there is a covered cause of loss. [ 13:10 ] - If the home is only partially fit to live in, an insured can still incur ALE. If the kitchen is uninhabitable, ALE may cover restaurants. [ 14:30 ] - If a guest's visit was planned pre-loss, the insured's expenses for the guest may be covered. [ 16:30 ] - Pet boarding expenses are also likely included in ALE expenses. [ 17:35 ] - John provides a recap of the scenario and the points above. Your PLRB Resources PLRB, Homeowners Annot. Key HO37 - https://www.plrb.org/legacy-documents?DN=77 Adjuster Resource Sheet: ALE Claims - https://www.plrb.org/documents/adjuster-resource-sheet-ale-claims/ ALE or FRV: Insured Decides to Stay on Premises in Cottage But Loses Rent from Current Tenants - PCQ.2024.03.22.slc.a - https://www.plrb.org/documents/ale-or-frv-insured-decides-to-stay-on-premises-in-cottage-but-loses-rent-from-current-tenants-pcq-2024-03-22-slc-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 with your scenario! This could be your “adjuster story” sharing a situation from your claims experience, or a burning question you would like the team to answer. In any case, please omit any personal information as we will anonymize your story before we share. Just reach out to [email protected]. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0). /episode/index/show/plrbpod/id/34358705

What's the Scenario? with PLRB

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