Advertise on podcast: What's the Scenario? with PLRB

The insured enjoyed having a lakeside home in the summer, where they could take a cruise on their boat in the evenings. But one winter, the frozen lake shoved ashore massive ice slabs, crushing a metal boat lift that had been stored on the shoreline for the winter. The lateral ice pressure then smashed into a permanent boathouse, buckling the vinyl siding, breaking through windows, and splitting the wooden framing. Ice chunks spilled onto the personal property left inside as well. The homeowner was left wondering whether they'd be frozen out of coverage for this loss.   Notable Timestamps   [ 01:26 ] - The hosts introduce the scenario, inspired by a LinkedIn post from "LO$$ RATIO" (Curtis Goldsborough) about flooding in northern Michigan pushing lake ice into shoreline structures.   [ 05:10 ] - Mike and Brennan walk through the basics of Coverage A (dwelling), B (other structures), and C (personal property) before digging into which one applies to a boathouse and boat lift.   [ 06:50 ] - Because Coverage C is a named-perils coverage that only applies to personal property inside a building, the boat lift and boathouse themselves would need to qualify under Coverage B instead.   [ 08:08 ] - The hosts debate whether the "weight of ice, snow, or sleet" peril applies when the ice pressure is lateral rather than straight down, noting PLRB's coverage attorneys treat lateral pressure as still falling within the "weight" definition since gravity is the propelling force.   [ 09:38 ] - They discuss what makes a structure like a boathouse qualify as a Coverage B "other structure" rather than personal property: permanence, attachment to the land, and whether it's routinely removed each season.   [ 11:42 ] - Once classified as an "other structure," the boathouse runs into the freezing/thawing/pressure/weight of water or ice exclusion, which lists specific structures like piers, wharves, and docks.   [ 13:04 ] - Because insurance exclusions are construed narrowly against the drafter, the hosts conclude a boat lift and boathouse likely don't fall under that exclusion's "pier, wharf, or dock" language, since the policy could have said "boathouse" but didn't.   [ 14:34 ] - Before wrapping up, the hosts flag two more exclusions worth checking: what actually moved the ice (surface water, waves, flooding) and whether earth movement contributed to the damage.   [ 16:21 ] - Brennan and Mike recap the three key takeaways on boathouse and boat lift coverage under a standard homeowners policy.   Your PLRB Resources   Policy Annotation: Weight of Ice, Snow or Sleet (HO67) - https://members.plrb.org/documents/weight-of-ice-snow-or-sleet-ho67   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).

Welcome to "What's the Scenario? with PLRB", where we explore claims & coverage scenarios relevant to insurance professionals. I'm Brennan McLoughlin, and we're taking a break this week after another successful PLRB Regional Innovation Summit. This week we'll share a follow-up episode from the PLRB Weather team. A small grocery store specializes in farm-to-table meat and fish, locally sourced and priced at the high end of the market. After accepting their week's shipment on a Wednesday evening, thunderstorms led to a power outage that spoiled the fish.   Notable Timestamps [ 00:36 ] - Another insured claims their back shed was hit by lightning, damaging expensive equipment.   [ 01:32 ] - The team discusses tips for what to do during a power outage. [ 02:47 ] - On PLRB.org, on the Weather Hub, you can click Power Outage Report and enter in an address and date to see historical power outage reports in a grid with 1km x 1km squares. [ 05:55 ] - The data can only demonstrate a probability that an outage occurred at the selected address. [ 06:50 ] - The data does not include the cause of the power outage. [ 07:00 ] - The lightning report data includes satellite data during a given 1-hour period for both in-cloud and cloud-to-ground lightning. [ 09:40 ] - These reports can be used to confirm causality in a claim. [ 10:24 ] - Tim & Mike chime in! Food spoilage claims can lead to confusion because the clauses frequently change. In these situations, it's best to read the policy carefully. Is there a distinction between on-premises and off-premises? Does it mention power failures as well as power surges? Is there an ensuing loss clause? The policy may also have an endorsement for food spoilage. [ 12:43 ] - CP and BP form have an exclusion for artificially-generated electrical current, which would not apply in a lightning claim. [ 03:24 ] - Andrew provides a recap of the scenario and the points above. Your PLRB Resources Get a Power Outage Report - https://www.plrb.org/weather-cat/power-outage-reports/ Get a Lightning Report - https://www.plrb.org/weather-cat/researching-lightning-data/ Adjuster Resource Sheet: Food Spoilage Claims Under Commercial Forms for Property Adjusters - https://www.plrb.org/documents/adjuster-resource-sheet-food-spoilage-claims-commercial/ 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).

Welcome to "What's the Scenario? with PLRB", where we explore claims & coverage scenarios relevant to insurance professionals. I'm Brennan McLoughlin, and for this holiday week we'll be sharing a classic episode from the PLRB Weather team.   A CAT Manager is making preparations for her CAT team in advance of Hurricane Francine, which approached the Louisiana coast in the second week of September, 2024. She reads something about spaghetti models, and something about Fast Track cyclones?   Notable Timestamps [ 00:36 ] - The building owner submits the claim to their property insurer, looking for coverage for a new bollard. They have a standard CP 00 10 10 12, which does not include coverage for fences if the cause of loss was an accidental vehicle crash.  [ 01:21 ] - The PLRB team discuss pasta recipes. [ 02:47 ] - Hurricane Francine caused a great deal of damage to homeowners and businessowners by the Louisiana coast. [ 04:35 ] - Andrew shares some screenshots, available on the YouTube version of this podcast. [ 05:02 ] - An error cone is shown, demonstrating the suspected path of the hurricane. [ 05:28 ] - Spaghetti models show the various paths Francine might have taken. [ 05:46 ] - Peak storm surge forecasts color code area by feet of storm surge. [ 06:44 ] - The "Best Track" includes line, point data, and cumulative wind history. [ 07:20 ] - Spaghetti models are a forecasting tool that provides multiple expectant paths. Tracks closer together indicate certainty. These are available on PLRB.org or via API. [ 08:33 ] - Andrew demonstrates how spaghetti models can change over time. Error cones may be superimposed on the spaghetti models. [ 10:17 ] - Storm surge is the rise in seawater caused solely by the storm's winds pushing the water onto shore. Soup gets involved now. [ 11:15 ] - Best Track is a representation of the tropical cyclone's direction and intensity. The Best Track wind swath shows how the storm changed. [ 12:10 ] - Catastrophe Managers can use these forecasting tools in resource allocation. Best Track data can assist in estimating claim ratios. Claims Adjusters can use Best Track data to assist in claims decisions. Underwriters can use this historical data in risk assessment. [ 13:19 ] - Andrew provides a recap of the scenario and the points above. Your PLRB Resources Tropical Storm Francine: https://www.plrb.org/weather-cat/2024-francine/ Spaghetti Models: https://www.plrb.org/documents/view-tropical-cyclone-track-spaghetti-models/ Best Track Data: https://www.plrb.org/documents/view-national-hurricane-center-tropical-cyclone-best-track-maps/ 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).

A contractor was hired to renovate a kitchen. The homeowner was thrilled with the results, but asked for a few final punch-list items: adjusting the cabinet doors and replacing a damaged drawer pull. To reach the cabinets, the contractor moved the refrigerator, but failed to securely reconnect the ice maker supply line before leaving. Two days later, the homeowner discovered water throughout the kitchen and adjacent rooms after the line separated, damaging the newly renovated space and the surrounding flooring.   Notable Timestamps   [ 00:45 ] - Mike sets up today's scenario: a contractor's punch-list visit ends with a disconnected ice maker line and water damage throughout a newly renovated kitchen.   [ 05:08 ] - Brennan and Mike revisit the CGL's j(5) and j(6) exclusions, which apply only to ongoing operations on the particular part of the property being worked on -- not completed work.   [ 08:03 ] - Once an operation is complete, the Damage to Your Work exclusion takes over, precluding coverage for property damage to the insured's own completed work -- unless a subcontractor did that work.   [ 09:51 ] - "Your work" and the "products-completed operations hazard" are both specifically defined policy terms, complete with a three-part test for exactly when work is deemed done.   [ 11:37 ] - The team finds the carve-out they were looking for: coverage turns on whether the work "has not been completed or abandoned."   [ 14:45 ] - The kitchen renovation was substantially complete, so the water damage likely falls under the Your Work exclusion.   [ 15:19 ] - Either way, some damage may still be covered -- reconnecting the ice maker wasn't really the contractor's "work," so the resulting damage to the flooring is arguably separate, covered damage.   Your PLRB Resources   Coverage Question: Is This an Ongoing or Completed Operation? https://members.plrb.org/documents/is-this-an-ongoing-or-completed-operation-2025-08-25fjg   Adjuster Resource Sheet: Faulty Work https://members.plrb.org/documents/adjuster-resource-sheet-faulty-work   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).

A homeowner reports that the central air conditioning system stopped working during a summer heat wave. They sent their contractor's invoice to their insurance company. The adjuster has to review the invoice, the Declarations Page, and policy excerpts to handle the claim. But this isn't a real claims file; this are mock claims documents as used in the PACE Designation Exam. Today we'll explore how authentic assessment is leveraged to test real-world skills, and you can try your luck with this sample question. Notable Timestamps [ 01:24 ] - The exam includes basic recall questions that require the test-taker to produce knowledge on the spot, such as defining key terms and claims handling concepts. [ 03:03 ] - Application questions go a step beyond simple recall by providing a specific claim scenario and challenging the test-taker to determine how to properly handle it. [ 04:26 ] - Authentic assessment utilizes research questions designed to mimic real-world tasks, presenting professionals with mock documents to analyze and interpret. [ 06:15 ] - A sample question asks test-takers to review a contractor's invoice, a declarations page, and policy excerpts to solve a central air conditioning failure. [ 08:11 ] - Just like in real life, test-takers must filter through extraneous details within the provided mock documents to locate the relevant facts needed to resolve the claim. [ 10:47 ] - By carefully reviewing the policy limits and endorsements, the test-taker can correctly deduce that the sample claim is covered but strictly capped at $10,000. [ 13:29 ] - Ultimately, this rigorous testing methodology elevates the designation's value by ensuring that credential holders are practically equipped to handle real-world claims. Your PLRB Resources PACE Designation Program https://www.plrb.org/pace-program/ 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).

An adjuster has decided to level up their career by earning their PACE-P Designation. They've completed the comprehensive educational program, prepared with the study guide, and are now sitting down to take the remotely proctored exam. Are they ready for it? Are you? Notable Timestamps [ 00:00:34 ] - The podcast explores the scenario of an adjuster who has completed an educational program and a study guide, and is now preparing to sit for the remotely proctored PACE Designation Exam. [ 00:04:04 ] - The PACE Designation program begins with an onboarding curriculum, consisting of three core courses that teach foundational insurance concepts, industry jargon, and claims handling. [ 00:04:32 ] - Participants can progress to a seven-course Personal Property Lines track detailing claim evaluation and resolution, and later choose a la carte electives known as Claims Intensives for more niche topics. [ 00:11:52 ] - The exam is divided into three timed segments: a 35-minute Core Curriculum unit, a 65-minute Personal Lines Property unit, and a 35-minute Claims Intensive unit, which do not have to be taken on the exact same day. [ 00:13:03 ] - Because the exam is strictly timed, test-takers must answer and immediately move forward, as the system does not allow them to return to previous questions once a response has been selected. [ 00:15:45 ] - Helpful exam strategies recommended by the hosts include reading questions fully, identifying qualifying keywords like "best" or "always," and actively eliminating the incorrect answer options. [ 00:17:28 ] - Earning the PACE-P designation means joining a select group of recognized professionals after passing a proctored, two-and-a-half-hour exam that tests skills using authentic claim documents. Your PLRB Resources PACE Designation Program https://www.plrb.org/pace-program/ 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).

An adjuster has decided to level up their career by earning their PACE-P Designation. They've completed the comprehensive educational program, but don't feel quite ready to sit down and take the PACE Designation Exam. So they download the PACE Study Guide and get started. Notable Timestamps [ 04:23 ] - The PACE Designation Program provides a comprehensive foundation of knowledge and practical skills tailored for claims professionals to succeed. [ 06:41 ] - Members can complete the Core Curriculum, the Personal Lines Property Track, and the Claims Intensives at no additional cost, and receive a discounted rate on the final PACE Designation Exam. [ 07:59 ] - The PACE Designation Exam takes roughly two and a half hours, but the timed multiple-choice sections can be split up and completed across different days. [ 10:37 ] - Using the PACE Study Guide is highly recommended, as members often take months to finish the program and need a thorough refresher before testing. [ 11:57 ] - The PACE Study Guide includes a suggested four-week calendar that structures your preparation, breaking down lessons, flashcards, and outlines. [ 13:33 ] - A new digital flashcard and glossary feature allows test-takers to search for specific terms and isolate their studying to specific courses. [ 15:20 ] - The flashcards utilize a spaced repetition learning method, bringing back concepts you mark as difficult more frequently to enhance memory. [ 18:19 ] - Once you successfully earn your PACE-P designation, you can proudly display your new credential on your resume, email, and social media pages. Your PLRB Resources PACE Personal Lines Property Study Guide https://members.plrb.org/education/courses/pace-personal-lines-property-study-guide 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).

A plumber was hired to perform work on a pipe on an insured home. In the course of that work, the plumber accidentally smashed his wrench into the pipe, damaging it. The water damaged nearby drywall and carpet. Notable Timestamps [ 00:44 ] - The j(5) exclusion specifically applies to property damage on that particular part of real property where operations are directly being performed. [ 01:14 ] - In contrast to the j(5) exclusion, the j(6) exclusion applies to any property that requires restoration, repair, or replacement because the work was performed incorrectly. [ 02:44 ] - If a plumber accidentally breaks a pipe while working on it, fixing the pipe is probably excluded, but resulting damage to nearby drywall and carpet may be covered. [ 04:32 ] - General liability insurance typically isn't meant to cover general carelessness. [ 08:29 ] - Courts interpreting exclusions broadly might deny coverage, reasoning that the particular part being worked on encompasses the entire project or property. [ 10:50 ] - When courts interpret exclusions narrowly, they restrict the exclusion to just the defective part being worked on, which can result in broader insurance coverage. [ 13:49 ] - For a botched oil change causing engine failure, a narrow interpretation excludes only the oil and filter, while a broad view excludes the whole engine. [ 15:07 ] - Defective workmanship that results in damage to other property, or to work that is not the insured's own product, can be considered a covered occurrence. Your PLRB Resources Adjuster Resource Sheet: Faulty Work https://members.plrb.org/documents/adjuster-resource-sheet-faulty-work 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).

A general contractor installs a commercial storefront window system. Because the flashing is installed incorrectly, rainwater enters the building during the first storm. The building owner sues the contractor, seeking the cost to remove and replace the defective window system and repair the water-damaged drywall and flooring inside. The contractor tenders the suit to its CGL insurer. Notable Timestamps [ 00:00:34 ] - A contractor faces a lawsuit after incorrectly installing window flashing that leads to water damage inside a building. [ 00:04:48 ] - A central issue in these claims is determining if an insurance company actually owes defense and indemnity when a contractor's work causes property damage. [ 00:06:26 ] - Commercial liability insurance is designed to cover unpredictable accidents and occurrences rather than serving as a guarantee for a contractor's faulty work. [ 00:08:53 ] - Under the majority legal view, such as in Alabama, faulty workmanship does not qualify as an occurrence because the work was done purposefully without fortuity. [ 00:10:00 ] - A growing minority view, seen in states like Pennsylvania and Colorado, broadly interprets these incidents as accidents unless the contractor intended the damage. [ 00:10:55 ] - Even if a situation qualifies as an occurrence under a state's laws, insurers may still rely on specific policy exclusions, like j(5) and j(6), to limit coverage. [ 00:11:26 ] - While the majority view denies indemnity for faulty workmanship itself, defective work that damages other property can still be classified as an occurrence. Your PLRB Resources Adjuster Resource Sheet: Faulty Work https://members.plrb.org/documents/adjuster-resource-sheet-faulty-work 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).

Emma's cousin Mark moved to the big city and left his horse at Emma's ranch. For five years, she took care of the horse like it was one of her own. One day Mark took offense at one of Emma's social media posts, and quietly removed the horse without her knowledge, believing he was the rightful owner. Emma was devastated and sued Mark, alleging emotional distress, mental pain and suffering, and loss of consortium. Mark's insurer denied his defense on the basis that no bodily injury was claimed. Notable Timestamps [ 00:00:33 ] - The scenario involves a woman who sued her cousin for emotional distress and mental suffering after he quietly removed his horse from her ranch. [ 00:04:37 ] - At this stage of litigation, the focus is not on whether the cousin owes damages, but strictly whether his insurance owes him a legal defense. [ 00:07:29 ] - The plaintiff's complaint relies entirely on emotional damages like loss of consortium and mental pain, notably lacking standard liability allegations like property damage. [ 00:08:57 ] - The defining legal question is whether pure mental pain and emotional distress can satisfy the standard insurance definition of a bodily injury, sickness, or disease. [ 00:12:11 ] - In jurisdictions following the majority rule, such as Ohio, courts have established that pure emotional distress or PTSD without physical harm does not equal bodily injury. [ 00:15:56 ] - Alternatively, courts in minority rule states like New York view emotional trauma as potentially equal to physical injury because they find standard policy language ambiguous. [ 00:18:28 ] - To satisfy the bodily injury requirement in a majority state, the plaintiff must usually demonstrate physical manifestations of their distress, such as headaches or nausea. [ 00:23:14 ] - Insurance professionals can utilize PLRB.org's 50-State Surveys on emotional distress as a convenient tool to quickly check the controlling case law and rules within specific states. Your PLRB Resources 50-State Survey - Emotional Distress as Bodily Injury https://members.plrb.org/documents/50-state-survey-introduction-emotional-distress-as-bodily-injury 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).

The insured has spent months in an escalating dispute with his neighbor over the neighbor's alleged violation of HOA rules and garish lawn decorations. Finally, the insured takes things too far by aiming his sprinkler at the neighbor's newly painted shed, ruining an expensive paint job. The insured has been sued, and wants their insurance company to defend them in the lawsuit. Notable Timestamps [ 00:00:32 ] - This scenario involves an insured causing damage by ruining a neighbor's painted shed with a sprinkler, and expecting a defense. [ 00:01:17 ] - The PLRB's Frontlines newsletter is a valuable resource for staying updated on recent case law regarding property, auto, and liability insurance. [ 00:05:29 ] - An insurance company's duty to defend is crucial because fighting even a completely invalid lawsuit still requires spending money on legal fees. [ 00:07:32 ] - Courts have ruled that erecting a malicious spite fence is a deliberate action, meaning it is not an accidental occurrence covered by insurance. [ 00:13:01 ] - Bizarre accidents, like special low-efficiency windows melting a neighbor's vinyl siding by focusing sunlight, can potentially be covered occurrences. [ 00:16:53 ] - Determining whether mistaken actions count as occurrences depends heavily on specific state jurisdictions. [ 00:20:19 ] - If an individual intentionally punches someone, there is usually no occurrence, regardless of whether they intended to cause a severe injury like a broken jaw. [ 00:24:03 ] - Liability insurance only covers fortuitous losses, so if a primary action isn't an occurrence, exclusions for intentional acts do not require analysis. Your PLRB Resources HO651 - Occurrence Definition https://members.plrb.org/documents/ho651-occurrence-definition Employees of member companies also have access to a searchable legal database, hundreds of hours of video trainings, building code materials, weather data, and even the ability to have your coverage questions answered by our team of attorneys (https://www.plrb.org/ask-plrb/) at no additional charge to you or your company. 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).

During a recreational adult hockey league practice, the goalie skated backward into the crease after a drill and grabbed the top crossbar of the net while stretching and joking with other players. The ice had recently been resurfaced, and the net had not yet been properly secured to the ice. As the goalie leaned his body weight onto the frame, the goal tipped backward and struck him. In a negligence claim between the goalie and the arena, which team takes the blame? Notable Timestamps [ 01:03 ] - Establishing negligence requires meeting four elements, which include having a duty owed, a breach of that duty, a proximately caused injury, and damages. [ 02:20 ] - Even when negligence is successfully established during litigation, there are still potential defenses available, such as assumption of risk and contributory negligence. [ 04:50 ] - The assumption of risk doctrine might still apply even if a player is violating a rule during a game, as participants generally expect potential injury during physical activities. [ 07:11 ] - Some states utilize contributory negligence, which can technically bar a plaintiff from any recovery if they are found to have contributed at all to the incident. [ 11:03 ] - Comparative negligence rules vary, with some states allowing recovery if a person is up to 50% liable, while others require the individual's negligence to be 49% or less. [ 11:51 ] - Under a pure comparative standard, an injured person who is found to be 90% at fault for an incident can still recover the remaining 10% of their respective damages. [ 14:34 ] - In cases involving severe injuries, juries can sometimes be influenced to make decisions inconsistent with the letter of the law. [ 16:29 ] - The outcomes of these negligence defenses heavily depend on the specific state where the case is taking place, the laws that apply, and the overall makeup of the jury pool. Your PLRB Resources Negotiation Strategies in Bodily Injury Claims     https://members.plrb.org/education/courses/negotiation-strategies-in-bodily-injury-claims 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).

As we hit our next holiday week and listen to the sounds of fireworks, we'd like to share a classic episode featuring the insurance implications of fireworks. So fire up the grill, and put this episode on the speakers.   Is there an exclusion for stupid? Join Alissha, Mike, and Tim to discuss bad decisions, wedding rings stuck on fingers, dumpster fires, and whether the choice to set off a firework inside a house is considered "intentional" under the policy.   Notable Timestamps   [ 00:17 ] - The insured's son set off a firework in the house for the excitement, causing fire damage. The homeowners file a property claim.   [ 01:26 ] - Alissha, Mike, and Tim discuss their opinions on fireworks, sneaking over the state line, exploding toys, dog ownership, and dumpster fires.   [ 04:12 ] - There's no exclusion for "stupid" (i.e. negligence), at least not prior to the loss.   [ 07:34 ] - There is an exclusion for intentional loss. "Intent" usually applies both when the actor intends the consequence, and when they know the consequences are substantially certain to result.   [ 08:46 ] - The fact that the son was intoxicated would not establish an insanity defense.   [ 10:36 ] - The son was living in the house, even though he spent much of the year at college, and would be considered an insured so no subrogation is possible.   [ 11:50 ] - For very young children, their young age can imply that they are not appreciating the consequences of their actions and that can speak to intent.   [ 13:04 ] - The team discusses scenarios where an adult intentionally set a fire so that her husband could heroically put it out, where someone breaks a ring to get it off their swelling finger, and where someone smashes a window to break into their own house.   [ 17:24 ] - Tim provides a recap of the scenario and the points above.   Your PLRB Resources   Homeowners annotation on the intentional loss exclusion - https://search.plrb.org/?dn=37&src=gsa   Does a Farm Policy Cover Injury to a Semi Driver Caused by Water Balloons Tossed from Insured's Vehicle? - https://search.plrb.org/?dn=17362&src=gsa   Cutting Off Ring That is Stuck On Swollen Finger… Intentional Loss? - https://search.plrb.org/?dn=67944&src=gsa   Is Damage to Property of Others Coverage Available Under a Homeowners Policy for a Window Broken by the Insured Tenant's Son at a Rental Property? - https://search.plrb.org/?dn=73010&src=gsa   CE course on Intentional Versus Negligent Conduct For Casualty Adjusters - https://www.plrb.org/public2/dislearn/description.cfm?mod=p0056   CE course on Subrogation Claims - https://www.plrb.org/public2/dislearn/description.cfm?mod=p0050   Webinar on Fire Loss Investigation Strategies - https://www.plrb.org/distlearn/webinars/vplayer.cfm?vid=w0024   Employees of member companies also have access to a searchable legal database, hundreds of hours of video trainings, building code materials, weather data, and even the ability to have your coverage questions answered by our team of attorneys (https://www.plrb.org/container.cfm?conlink=sec/cq/default.cfm) at no additional charge to you or your company.   Subscribe to this Podcast   Your Podcast App - Please subscribe and rate us on your favorite podcast app   YouTube - 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). https://thenounproject.com/icon/firework-152487/ https://thenounproject.com/icon/firework-1758560/

As a claims executive leader, Awais Farooq built and oversaw coverage frameworks, liability investigations, reserve governance, and total loss protocols. He believed that institutional fluency would make his own claim predictable. Then he struck a deer on his motorcycle and suffered a significant leg injury. His claim was segmented across bodily injury, property damage, and total loss. Each function operated correctly. Yet without a single point of ownership, the experience felt operationally sound but emotionally fragmented. Notable Timestamps [ 00:37 ] - Awais Farooq experienced a motorcycle accident that resulted in a claim that was handled with operational soundness but felt entirely emotionally fragmented. [ 04:29 ] - The accident occurred close to home when Awais encountered a deer on the road, attempted to turn around to avoid it, but unfortunately crashed into another deer. [ 06:24 ] - Despite the insurance company being highly digitally advanced with text message communications, Awais had to navigate three separate adjusters who did not communicate with one another. [ 08:01 ] - A major gap exists in the insurance industry where automation and process improvements often overlook the end consumer, losing track of the primary goal to restore the person completely. [ 12:52 ] - Awais channeled his frustrations into writing a book titled The Future Isn't Fully Automated, which explores how technology must integrate with essential human connection in claims. [ 13:39 ] - The claims journey consists of information gathering, documentation, and decisioning; streamlining the first two phases can empower adjusters to focus primarily on delivering decisions. [ 15:00 ] - Awais discusses the possibility of an individualized user experience akin to Amazon, ensuring that claimants have a single point of contact rather than feeling like one of millions of claims. [ 17:00 ] - A technically compliant claim can still fail the human experience test.  Your PLRB Resources https://www.linkedin.com/in/awais-farooq/ 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).

Right now we're traveling back from this week's successful Eastern Regional Conference. So this week, as we head into summer, we're sharing an episode on how to take advantage of all the services that the PLRB Weather/CATs department has to offer.   A supervisor leads a team of very needy CAT adjusters! Over the course of the year, the supervisor fields many questions as it comes up in their claims. Was there hail on X date? Was there lightning in the area? This hurricane is coming soon, where can I get news about it? Winter weather caused a slip and fall!! Where can I find information on wildfire perimeters and California evacuations? For help herding all these cats, we'll head to PLRB.org.   Notable Timestamps [ 00:00 ] - The episode introduces a scenario where a supervisor fields constant weather-related questions from cat adjusters, highlighting the need for a centralized, reliable source for hail, lightning, hurricanes, wildfires, and more. [ 02:15 ] - The team previews multiple scenarios—winter storms, hail, lightning, power outages, tornadoes, hurricanes, and wildfires—showing the breadth of searchable weather data available to support claim investigations. [ 03:16 ] - Using a winter slip-and-fall in Iowa City, Iowa, the report pulls verified storm data from the National Weather Service, including freezing rain reports and hourly observations to validate conditions on the date of loss. [ 07:42 ] - For hail damage in Illinois, radar-derived data and verified hail reports allow adjusters to map proximity, estimated hail size, and associated severe thunderstorm warnings tied to a specific date and address. [ 09:53 ] - Lightning reports provide daily probability percentages and satellite detection data, helping assess commercial equipment claims while noting limits in resolution and cloud-to-cloud versus cloud-to-ground distinctions. [ 12:25 ] - Power outage searches archive data every ten minutes via PowerOutage.us, identifying outage timing, affected customers, and likely storm causes—critical for business interruption investigations. [ 14:09 ] - A tornado case study of the Mayfield event demonstrates wind reports, damage points, and EF-scale path polygons, enabling precise analysis of storm track and intensity relative to a property. [ 17:31 ] - Wildfire tools include historical perimeters like the Garnett Fire, evacuation zones, thermal hotspots, smoke analysis from National Oceanic and Atmospheric Administration data, and hurricane spaghetti models—underscoring a single portal for comprehensive weather intelligence. [ 17:49 ] - Dylan summarized upcoming PLRB Weather/CATs developments. Your PLRB Resources Weather/CATS Hub - https://members.plrb.org/weather-cat/ 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).