Shows
What's the Scenario? with PLRBDo Jewelry Appraisals Lock In Insurance Payout Amounts?The insured felt like she did everything right. She insured the ring when she bought it, kept it scheduled on her policy, kept up with maintenance, and filed a claim right away when it was stolen. She even submitted the original appraisal for $22,000 so the insurance company would know how much to write on the check. So she was shocked when the insurance payout was only $14,000. Apparently diamonds are cheaper today, but she thinks: "shouldn't the appraisal lock in the cost?" Notable Timestamps [ 00:45 ] - An insured may assume an appraisal amount guarantees payout, but jewelry claims often...
2026-01-1620 minWhat's the Scenario? with PLRBHogging the Blame for a Fire LossSwine & Dine Farms underwent a devastating loss when a ventilation system shut off, resulting in the deaths of 2,400 hogs. Swine & Dine didn't own the hogs: they were contract growers raising the hogs for an "integrator," the contract owner of the animals who is not suing for the value of the lost hogs. What liability coverage is available for these folks? Notable Timestamps [ 00:41 ] - A ventilation failure led to the suffocation of thousands of hogs raised by a Contract Grower. [ 04:47 ] - This scenario centers on farm commercial liability policies, not property coverage. [ 05:20...
2026-01-0918 minWhat's the Scenario? with PLRB[REPLAY] What's Your Elevator Pitch?As you prepare your new year's resolutions, take a moment to ask, "What's your elevator pitch?" This holiday week, we're sharing a classic episode featuring an inspirational and thought-provoking scenario that you can bring into your personal and professional life. A claims adjuster is out at a party when they are asked: "So, what do you do for a living?" Our adjuster responds with just: "I'm in insurance claims." That's an "Oh no" moment. Turns out their cousin had a terrible experience on a claim and our adjuster is going to hear all about it, ending in: "...
2025-12-3019 minWhat's the Scenario? with PLRBFire on the FarmSod's Country Farms was raising 65,000 chickens when a fire burned down the poultry house. After a detailed investigation, the cause of the fire was undetermined. To further complicate matters, Sod's Country Farms didn't even own the chickens themselves, but raised them for a vendor. They want to know if the property loss of the animals is covered-- and what policy would be most appropriate. Notable Timestamps [ 00:00 ] - A poultry house fire destroys 65,000 chickens, but the insured doesn't own the birds. [ 03:30 ] - Contract Growing is common in agriculture, with farmers raising animals owned by vendors.
2025-12-1621 minWhat's the Scenario? with PLRBTrain Your Team at PLRB.org!Alex is a team leader working with a mix of experienced adjusters and brand-new claims professionals, some assigned to the field and others working behind a desk. Alex has to make sure his team has the training they need to approach their work with confidence. Luckily PLRB.org's Education Hub has everything they need to succeed. Notable Timestamps [ 00:10 ] - The PLRB Education Hub supports team leaders like Alex with training for both new and experienced adjusters to build confidence in handling claims. [ 01:25 ] - Update #1: A new critical thinking course will help adjusters analyze information, decide...
2025-12-0917 minWhat's the Scenario? with PLRBPLRB's Large Loss Conference: How Did It Go?Jamie has been a property adjuster for some time now and is ready to graduate to larger and more complex losses involving hurricanes, construction defects, historic buildings, massive commercial structures, and more. Chris is a seasoned large loss adjuster looking to hone their practice in the casualty arena and network with others in their area. To address these questions, we'll take them to the PLRB Large Loss Conference. Notable Timestamps [ 00:15 ] - The conference attracts adjusters ready to move into larger and more complex losses, giving them exposure to hurricanes, defects, historic buildings, and large commercial structures.
2025-12-0221 minWhat's the Scenario? with PLRB[REPLAY] PLRB Building Codes: Don't Fall Down the BC Rabbit HoleThis holiday week, we're sharing a classic episode about the PLRB Building Codes department. The adjuster on a hail claim receives a long list of line items that are "required by code." Once the old shingles are torn off, they find rot and gaps in the sheathing, and the contractor says a thicker sheathing is now required by code. Notable Timestamps [ 00:10 ] - Ice barriers, drip edges, a double felt underlayment... Searching the internet only leads the adjuster spiralling down a rabbit hole. [ 01:30 ] - What internet rabbit holes have you gone down? [ 04:28...
2025-11-2518 minWhat's the Scenario? with PLRBThat is an Alarm, But it's Not a Fire Alarm!Benny's Liquor, Fireworks & Gunpowder Emporium went up in flames last night. Motion-detector alarms caught the fire and automatically notified the police, who found the fire and called the local fire chief, but by the time they arrived it was too late. Now his insurer claims he violated his Protective Safeguards Endorsement by installing burglary alarms instead of actual fire alarms. Benny doesn't recall anything about this, but apparently it's some paper he signed when he bought the policy. Key Takeaways [ 00:37 ] - Benny's shop burned down, and his insurer denied the claim due to a protective...
2025-11-1821 minWhat's the Scenario? with PLRBPork Shoulder Melts Insured's SidingSam is a huge Bears fan. He sets up his brand new smoker in the backyard and put a perfectly seasoned pork shoulder on to cook all day -- just in time for the Sunday Night Bears v. Packers game. The smoker was near the side of the house, but not directly next to it. After 8 hours, the shoulder was tender and ready to eat… but the insured's siding had melted. Sam seeks coverage for the replacement of the melted siding (and for the pork shoulder he dropped when he saw the damage). Notable Timestamps [ 00:23 ] - So...
2025-11-1113 minWhat's the Scenario? with PLRBTwists & Turns in Supplemental EndorsementsCurd Appeal sells the best-looking cheeses on the block, but over the long weekend their refrigerator broke down, and now their limburger isn't the only thing that smells. The owner argues they are covered under the BP 00 03, but the adjuster spots some holes in their argument. The owner hits back with a supplemental endorsement they purchased, hoping to find coverage any way they can. Notable Timestamps [ 03:00 ] - The five-point process for property coverage analysis includes: covered property, direct physical loss, covered cause of loss, conditions, and additional coverages/extensions. [ 04:37 ] - Mechanical breakdown (like a refrigerator...
2025-11-0421 minWhat's the Scenario? with PLRBSump Pump Supplemental Endorsement"Simply the Vest" is a dry cleaning service with a basement full of supplies, tools, clothing, and… water. After a heavy rain, the owners discovered that their sump pump had failed, causing water to back up into the basement, resulting in damage to their property. Under their BP 00 03 form, coverage for this cause is firmly excluded. However, they paid for a supplemental endorsement with some interesting technicalities… Notable Timestamps [ 02:43 ] - When assessing coverage, always start with the underlying policy form before reviewing any endorsements, ensuring clarity on the initial coverage. [ 05:32 ] - Supplemental coverages give...
2025-10-2820 minWhat's the Scenario? with PLRB[REPLAY] Join Us at the 2025 Large Loss ConferenceThis is a holiday week for the podcast, so we're replaying a classic episode. This episode has been lightly edited to remain accurate to the upcoming 2025 Large Loss Conference taking place at the Gaylord Texan Resort & Convention Center in Grapevine, TX on Wednesday November 12 through Friday November 14. We'll be back next week with our regularly scheduled episode. Today our adjuster is leveling up in their career and handling their first large loss property claim. The adjuster quickly runs into trouble-- where can a claims professional go for help? This November 12 - 14 in Grapvine, TX, join...
2025-10-1415 minWhat's the Scenario? with PLRBWind Blew Dirt On My Koi FishToday's insured looked out the window and saw that a windstorm with strong 50 MPH sustained winds had kicked up soil from their neighbor's farm fields. The soil accumulated in layers over their home, garage, pool, hot tub, and all their beautiful landscaping. The garage door was open, so their home carpentry workshop and storage was covered in dirt. Even their koi pond was buried in the soil. None of the buildings were structurally compromised, but the insured will need a professional cleaning. Notable Timestamps [ 08:03 ] - Direct physical loss can include the cost of exceptional cleaning effort for...
2025-10-0723 minWhat's the Scenario? with PLRBIs an eBike a Car? No. But is it a Motor Vehicle?Beatriz is a city dweller who never learned how to drive a car. However, recently she got tired of the train and decided to get an E-bike. She bought an old E-bike off a friend, purchased a battery from AftermarketBatteries.biz, and soon was zipping through the streets. Her friends even got her a "bumper sticker" that reads "Beatriz's Car" for the side. But one night, it caught fire while charging outside her apartment door. Is it a covered motor vehicle under the standard ISO HO-3 form? Notable Timestamps [ 00:00 ] - E-bikes are becoming increasingly common in cities...
2025-09-3021 minWhat's the Scenario? with PLRBDon't Count Your Chicken Coops Before They're InsuredA few months ago, today's insured decided to jump into the latest trend for a lot of suburban dwellers, and he got some chickens! He built a chicken coop and a caged in area for the chickens to be safe from predators. The coop itself looks like a very large shed with a fenced-in area extending from the coop. The insured calls up their agent to ask if there's coverage for the coop under their HO 00 03 03 22 policy covering their home and an attached garage. Notable Timestamps [00:00] - A homeowner built a large chicken coop and asked their...
2025-09-2321 min
What's the Scenario? with PLRBThe CLEAR Approach to Difficult ConversationsMia is a mid-level claims specialist with about five years' experience in the job. One afternoon, she gets a call from a customer named James. He's frustrated—bordering on furious. He's been waiting for an update about his property claim, and from his perspective, no one communicated anything. He feels ignored. He's escalating. Mia can tell this is going to be a difficult conversation. But instead of reacting defensively—or shutting down—she mentally runs through the CLEAR model. Notable Timestamps [ 00:30 ] - The "CLEAR Method" module, developed with Equis Consulting, helps insurance professionals handle difficult circumstances and challe...
2025-09-1619 min
What's the Scenario? with PLRBHow Particular is "That Particular Part"?Messy Masonry, Inc. was hired as a subcontractor on a new home construction. Their job was to install two giant bay windows overlooking a lake, but they ended up splashing mortar on one of them. When they attempted to scrub it off, the window was scratched. As for the other window... another subcontractor, Outside the Lines Painting, was hired to paint the window frames, but accidentally sanded part of the windows in that process. The homeowner found the scratches months later. Notable Timestamps [ 00:00 ] - A construction scenario involves Messy Masonry splashing mortar and scratching a bay window...
2025-09-1020 min
What's the Scenario? with PLRBThe Lab-Grown Mismatch: One Earring, One SurpriseAn insured filed a claim for a lost diamond earring. The stud and its match were scheduled as 1.00 Carat each, "I" color and SI clarity, for $8,000. Her insurer asked Gemcor create a match. When we received the mate, we ran our standard test and found something unexpected: the diamond wasn't natural. It was lab-grown. In the years since its purchase, the replacement cost for lab-grown diamonds has plummeted. But the insured believed they were both natural, and wants a natural replacement. Notable Timestamps [ 00:58 ] - A client filed a claim for a lost diamond earring, but the mate...
2025-09-0220 min
What's the Scenario? with PLRB"You Can't Salvage My Mother's Ring!"An insured brought her diamond ring to a local jeweler for a routine cleaning. The jeweler found damage and recommended filing a claim. Our team checked the original appraisal on file, which raised questions about the identified break. However, close analysis confirmed a different break in the girdle. The insured was entitled her to a like-kind replacement or cash if she surrendered the chipped stone. But, the insured does not want to surrender the diamond for sentimental reasons. Notable Timestamps [ 00:52 ] - The insured's diamond had a girdle break, and while entitled to replacement, she didn't want to...
2025-08-2619 min
What's the Scenario? with PLRBSuicide, Arson, and the Intentional Loss ExclusionWarning, this scenario mentions suicide. The insured's 21-year-old son lives with them and suffers from depression. While the insured parents are away, their son goes through a breakup and decides to kill himself. He gets very drunk and douses the entire first floor in the gasoline they use for their lawnmower. He turns over a candle and goes upstairs to pass out. A neighbor called the police in time, and the young man was saved-- but the resulting fire consumed the house. Notable Timestamps [ 00:10 ] - John shares a serious scenario that raises pertinent coverage questions. [ 01:22...
2025-08-1920 min
What's the Scenario? with PLRBDon't Fall Down the Building Codes Rabbit Hole!The adjuster on a hail claim receives a long list of line items that are "required by code." Once the old shingles are torn off, they find rot and gaps in the sheathing, and the contractor says a thicker sheathing is now required by code. Notable Timestamps [ 00:10 ] - Ice barriers, drip edges, a double felt underlayment... Searching the internet only leads the adjuster spiralling down a rabbit hole. [ 01:30 ] - What internet rabbit holes have you gone down? [ 04:28 ] - With PLRB's updated Address Report, members can provide an address and specify details such as...
2025-08-1218 min
What's the Scenario? with PLRBPosthumous Premium PayorThe 100-year-old named insured died of natural causes. His daughter, the executor, inherited and moved into the home, continuing to pay the same bills—including insurance premiums. Four years later, a fire occurred, but the policy still listed her late father. Can it pay out? Notable Timestamps [ 00:10 ] - The daughter continued to pay the premiums, but did not contact the insurance company to advise them of her father's death. [ 01:30 ] - Trivia Time! Who was the oldest living person? [ 04:06 ] – Insurance policies generally follow the insureds, as defined by the policy, as opposed to the prop...
2025-08-0521 min
What's the Scenario? with PLRBSugar, Spice, and Everything Sand: The CGL Auto ExclusionA concrete foundation is crumbling due to a truck's sugar-contaminated sand delivery. Now, a court case hinges on whether the CGL auto exclusion applies: Did the damage occur in the truck or on the job site? Notable Timestamps [ 00:30 ] - At the outset, it seems the question (of whether the CGL or the BAC policy applies) turns on whether the damage occurred on the job site, at the concrete plant, or on the sand delivery truck. [ 05:01 ] - Sugar can be used in small, controlled amounts to delay concrete setting time, but higher concentrations can...
2025-07-2920 minWhat's the Scenario? with PLRB[REPLAY] Detached Garage Converted to AirBNBThis is a replay of an episode that originally aired on March 19, 2024. An insured's detached garage burns down in a covered lightning strike, and somehow it's not covered just because of a little side hustle? The PLRB crew hunt for coverage and find what the insurer can pay out on when an insured rents out their property without updating their insurance company. Notable Timestamps [ 00:17 ] - The insured remodeled their detached garage for use as an AirBNB rental, but never notified their insurer. The garage burned...
2025-07-2219 minWhat's the Scenario? with PLRB[REPLAY] I Crashed My Bike Into a TreeIs a recycle bin a "vehicle"? Does a car antenna ripping a coat fall under the Vehicles peril? How about a poorly secured wedding dress in the backseat of a convertible? If you occasionally win a biking competition, does the loss of your bike trigger business property coverage? Join Mike, Tim, and Alissha for the lightning round and discuss bikes, eBikes, sleds, boats, and more. Notable Timestamps [ 00:15 ] - The insured is an avid cyclist who occasionally wins money from his hobby. Another cyclist cut him off and he crashed his bike...
2025-07-1520 minWhat's the Scenario? with PLRB[REPLAY] The Appraisal Process – Is it Still Useful to Resolve Disputed Claims?This is a replay of an episode originally aired on Apr 22, 2025. An adjuster working on a complex property damage claim closes the file, having paid out on the claim. Then they receive a notice that the insured is demanding appraisal. They call up the insured, only to find out that the insured has no idea what's going on. About Our Guest Steven J. Badger, Partner, Zelle LLP sbadger@zellelaw.com https://www.linkedin.com/in/steven-badger-467b0322/ Notable Timestamps [ 00:20 ] - The insured signed a form on a tabet, presented...
2025-07-0816 minWhat's the Scenario? with PLRB[REPLAY] Invoking "Our Option" – Increased Use of Preferred Contractor NetworksThis is a replay of an episode originally aired on Apr 15, 2025. A Texas adjuster gets an assignment for a simple hail damage claim. He anticipates having to argue with the roofing contractor, debate whether overhead and profit is owed, deal with the supplementing company, receive an appraisal demand, and finally face a lawsuit. About Our Guest Steven J. Badger, Partner, Zelle LLP sbadger@zellelaw.com https://www.linkedin.com/in/steven-badger-467b0322/ Notable Timestamps [ 00:20 ] - Because of his years of experience, he knows that the 30 square comp shingle roof should cost about $20,000 to...
2025-07-0119 min
What's the Scenario? with PLRBTree Roots Blocked Up My Kitchen SinkThe 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 exclus...
2025-06-2418 min
What's the Scenario? with PLRBMurder Mystery: Diminution in ValueA 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 th...
2025-06-1016 min
What's the Scenario? with PLRBMichigan PIP PuzzlesJohn, 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 i...
2025-06-0321 min
What's the Scenario? with PLRBYour Insurance Policy Will Decide When You're Done RidesharingA "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...
2025-05-2719 min
What's the Scenario? with PLRBMy 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...
2025-05-2016 min
What's the Scenario? with PLRBDoes 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...
2025-05-1320 min
What's the Scenario? with PLRBMy 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 ca...
2025-05-0617 min
What's the Scenario? with PLRBA Flipped Van, a Plumber on Shrooms, and the BOP PolicyA 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...
2025-04-2919 min
What's the Scenario? with PLRBThe 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 sbadger@zellelaw.com https://www.linkedin.com/in/steven-badger-467b0322/ Notable Timestamps [ 00:20 ] - The insured signed a form on a tabet, presented to them by the contractor, without realizing it authorized a later appraisal demand.
2025-04-2216 min
What's the Scenario? with PLRBInvoking "Our Option" – Increased Use of Preferred Contractor NetworksA Texas adjuster gets an assignment for a simple hail damage claim. He anticipates having to argue with the roofing contractor, debate whether overhead and profit is owed, deal with the supplementing company, receive an appraisal demand, and finally face a lawsuit. About Our Guest Steven J. Badger, Partner, Zelle LLP sbadger@zellelaw.com https://www.linkedin.com/in/steven-badger-467b0322/ Notable Timestamps [ 00:20 ] - Because of his years of experience, he knows that the 30 square comp shingle roof should cost about $20,000 to replace. (Amount provided is for reference and example purposes only.) [ 01:10...
2025-04-1519 min
What's the Scenario? with PLRBThe PLRB Insurance Services Expo & YouLet'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...
2025-04-0816 min
What's the Scenario? with PLRBThe 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...
2025-04-0118 min
What's the Scenario? with PLRB[REPLAY] Join Us at the 2025 Claims ConferenceJoining 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...
2025-03-2819 min
What's the Scenario? with PLRBInvestigating a Garage FireHomeowner 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...
2025-03-2516 min
What's the Scenario? with PLRBIt's Getting Smokey in HereHomeowner 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...
2025-03-1815 min
What's the Scenario? with PLRBHand 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...
2025-03-1117 min
What's the Scenario? with PLRBMy 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...
2025-03-0416 min
What's the Scenario? with PLRBSinger Sings Against Assailant to Get a DefenseA 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...
2025-02-2519 min
What's the Scenario? with PLRBShooter Shatters Funeral ReceptionA 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...
2025-02-1820 min
What's the Scenario? with PLRBHere Comes Fair Rental Value in the BackstretchThe 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...
2025-02-1119 min
What's the Scenario? with PLRBYou 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...
2025-01-2820 min
What's the Scenario? with PLRBJoin Us at the 2025 Claims ConferenceA 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 ] - S...
2025-01-2119 min
What's the Scenario? with PLRBInstallation 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 f...
2025-01-1418 min
What's the Scenario? with PLRBInland 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...
2025-01-0718 minWhat's the Scenario? with PLRB[REPLAY] The Coverage Contrarian: CGL Coverage for Engine Servicing and WorkmanshipFor 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...
2024-12-3122 minWhat's the Scenario? with PLRB[REPLAY] The Coverage Contrarian: E-Bike Coverage Under a Homeowners PolicyFor 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 i...
2024-12-2418 min
What's the Scenario? with PLRBThere'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...
2024-12-1718 minWhat's the Scenario? with PLRB[REPLAY] The Coverage Contrarian: The Expected or Intended Injury ExclusionToday 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:
2024-12-1725 min
What's the Scenario? with PLRBWill 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...
2024-12-1020 minWhat's the Scenario? with PLRBGetting Mileage Out of That (Insurance Claim)The insured landlord spent considerable expense driving back and forth to the loss site in order to check on the contractors and make sure the building repairs were going smoothly. The insured submits their mileage to the adjuster for reimbursement. Notable Timestamps [ 00:30 ] - The team celebrates the fiftieth episode! Sort of. [ 01:38 ] - In this scenario, the insured requests payment for driving back and forth to the loss site, which was his decision. [ 03:34 ] - Can we find coverage here? We can try three avenues... [ 04:11 ] - First, it's not really part of the...
2024-12-0319 minWhat's the Scenario? with PLRBAnti-Concurrent Air Conditioning?Cassie and her neighbor were constantly on each other's nerves. One night, the neighbor snuck onto Cassie's property and jammed a stick into the A/C condenser fan blades out of spite, causing the mechanicals on the unit to break down. Notable Timestamps [ 00:29 ] - The adjuster's manager points out the exclusion for mechanical breakdown, prefaced by anti-concurrent causation language. The adjuster still feels this loss was in the nature of a vandalism loss and should be covered. [ 01:45 ] - Trivia question! What sitting US Senator was assaulted by his neighbor while mowing his lawn? [ 02:45...
2024-11-2616 minWhat's the Scenario? with PLRBA Bouncer Tossed Me From a SpeakeasyAt the downtown speakeasy, there's jazz in the air and the moonshine is reasonably priced. Maybe too reasonably priced, because a few of the speakeasy's patrons are getting belligerent. Soon half the bar is fighting, and the bouncer flips his assailant to the ground. Notable Timestamps [ 00:34 ] - When the bouncer flips the assailant, he is on his way to defend a waiter and trying to defend himself. [ 01:30 ] - The crew discusses hidden speakeasies... [ 04:00 ] - The legal backdrop is that the injured patron is arguing that the speakeasy's insurer has more money to settle...
2024-11-1915 minWhat's the Scenario? with PLRBFighting Fry Cooks Take It OutsideIt's not easy work standing over a hot fryer making french fry rings all day, so today's fry cook isn't in the best mood when the cashier starts complaining. After the lunch rush, the employees sneak out and step over to the neighboring gas station parking lot for a fistfight. Notable Timestamps [ 00:26 ] - At DonutBurgers, two employees are still on the clock and in their uniforms when they leave the premises for a fight. [ 01:39 ] - Cold or hot? Curly or shoestring? Salt or no salt? The team discusses the best fast food fries. [ 03:25...
2024-11-1215 minWhat's the Scenario? with PLRBSlip and Fall Slipped Insured's MindA restaurant hired a plowing service. One night, before the service plowed the lot, a grandmother exits her car, slips and falls, and breaks her hip. The woman sues, but the restaurant did not report the injured woman's claim to their insurer for six months. Notable Timestamps [ 00:26 ] - By the time the insurer learned of the loss, the injured person had already obtained a judgment against the insured. [ 01:35 ] - How do you walk on ice? [ 03:28 ] - A CGL's notice provision likely requires "immediate notice", "notice as soon as practicable", or "prompt notice". Courts...
2024-11-0519 minWhat's the Scenario? with PLRBA Storm Spoiled My Insured's FishA 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 se...
2024-10-2917 minWhat's the Scenario? with PLRBCyclones, Insurance & A Bowl of Spaghetti (Models)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...
2024-10-2217 minWhat's the Scenario? with PLRBBumping Brewery BollardsA brewery owner had bollards installed outside the building for safety purposes. One day a teenager veered off the road into one of the bollards, damaging it and the car. The adjuster is wondering if there should be no coverage on the basis that a bollard is a fence. Notable Timestamps [ 00:26 ] - 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. [ 01:34 ] - Trivia time! What...
2024-10-1519 minWhat's the Scenario? with PLRBThe Stairs Made Me Trip and Fall!Surveillance video shows a woman wearing a salon cape exiting through the front door of a hair salon. She spends a few moments in front of the salon examining her hair in a large handheld mirror. On reentry, she stumbles on the second and falls. Notable Timestamps [ 00:32 ] - This is not her first time at the salon, and not her first time through the door that day. [ 01:16 ] - Tripping and falling is a common experience. [ 02:45 ] - The team watch & react to the video (only available for staff). [ 04:08 ] - Ruth details the...
2024-10-0816 minWhat's the Scenario? with PLRBJoin Us at the 2024 Large Loss ConferenceToday our adjuster is leveling up in their career and handling their first large loss property claim. The adjuster quickly runs into trouble-- where can a claims professional go for help? This October 23 to 25 in Tampa, join PLRB for the 2024 Large Loss Conference. Notable Timestamps [ 00:39 ] - Alissha asks HERSELF "what's the scenario?" This scenario features late notice, Category 3 water, and additional damage during a claim. [ 01:57 ] - The team talks Tampa taco trucks & Cuban cuisine. [ 03:24 ] - Late notice issues? Attend the educational session "It’s Too Late, Baby, It’s Too Late: Navigating a Late...
2024-10-0117 minWhat's the Scenario? with PLRBI Burned Tomatoes So I Need a New DeckThe insured was making fried green tomatoes when they had to help a neighbor with an emergency. The tomatoes caught fire, and damaged the kitchen. The city building inspector came to sign off on the kitchen repairs, and noticed the rear deck was improperly constructed. Notable Timestamps [ 00:27 ] - The policyholder is asking her insurance company to include fixing the deck as part of her fire claim. Since the deck wasn't touched by the fire, the adjuster denied it. Now the public adjuster is coming back seeking coverage for the deck under the Ordinance or Law Additional Coverage.
2024-09-2417 minWhat's the Scenario? with PLRBThat Cosmetic Damage is Excluded!After a storm, a warehouse roof seems to leak more often, and a manager notices some water pooling on the edge. The adjuster's inspection reveals only minor dents, and the policy has a cosmetic damage exclusion. The manager argues the damage is not cosmetic. Notable Timestamps [ 00:19 ] - The manager even hires an expert to contest coverage. [ 01:25 ] - Tim and Mike discuss the leaks in the PLRB offices. [ 02:46 ] - See prior episode "That Damage is Just Cosmetic!" for the version of this scenario with no exclusion. [ 03:50 ] - When cosmetic damage exclusions first...
2024-09-1618 minWhat's the Scenario? with PLRBThat Damage is Just Cosmetic!One day a hailstorm hits a bike manufacturer's warehouse, and the property owner is overwhelmed by the loud sounds of the hail hitting the metal roof. But when the adjuster gets up on the roof, the dents turn out to be minor, arguably cosmetic. Notable Timestamps [ 00:18 ] - Despite the dents appearing to be cosmetic, the insured requests a new roof. [ 01:08 ] - Jeff and Mike compete for the best "dad joke." [ 01:53 ] - The hail was "direct" and "physical", but was it a "loss"? If the roof is now leaking, that would qualify...
2024-09-1020 minWhat's the Scenario? with PLRBGame Show Time! What Kind of Vehicle Is It?Anytime something with wheels leads to a claim, Parker's colleagues come to Parker to find out whether the claim should fall under the CGL policy or the auto policy… or a secret third option. Notable Timestamps [ 00:22 ] - Mike details the above scenario. [ 01:15 ] - An "auto" would usually be covered under Business Auto policy, whereas "mobile equipment" would typically be covered under CGL. [ 02:20 ] - "Auto" means: 1. A land motor vehicle, "trailer" or semitrailer designed for travel on public roads; . . . However, "auto" does not include "mobile equipment". [ 03:15 ] - For the full de...
2024-08-2719 minWhat's the Scenario? with PLRBWho's Been Living in My House?The named insured has retired and moved to his condo in Florida. His adult daughter accepted a new job in the city her father is leaving, so she and her two children have moved into the insured dwelling. A fire occurred destroying the entire home and all of its contents. Notable Timestamps [ 00:37 ] - John details the above scenario. [ 02:30 ] - Who is "You"? "You" is the named insured or insureds indicated in the Declarations, and the spouse of that person if the spouse is a household resident. [ 03:45 ] - How does the insurance...
2024-08-2020 minWhat's the Scenario? with PLRBSurface Water on a Roof? It's Those Kids Again!Tree-lined residential drive in Boston, MA. The neighborhood kids were playing baseball in the street, and the big kid hit a home run; ball landed on the roof. It was a flat roof with a drain in the middle of it. The ball somehow rolled right onto the drain and completely blocked the top of it. The poor homeowner had no idea, and heavy rains came through that night, causing several inches of water to build up on the roof, eventually finding its way inside the house. This caused $20,000 in water damage to the interior of the building, and...
2024-08-1320 minWhat's the Scenario? with PLRBWhat's Your Personal Elevator Pitch?A claims adjuster is out at a party when they are asked: "So, what do you do for a living?" Our adjuster responds with just: "I'm in insurance claims." That's an "Oh no" moment. Turns out their cousin had a terrible experience on a claim and our adjuster is going to hear all about it, ending in: "You claims people are all cheaters!" Notable Timestamps [ 00:36 ] - Today's scenario begins as an interpersonal encounter about explaining your career in insurance, but the elevator pitch is applicable even on claims. [ 02:05 ] - What our claims professional...
2024-08-0619 minWhat's the Scenario? with PLRBHow to DECIDE to Handle a ClaimMungle's Crackers manufactures crackers shaped like exotic land and sea animals, among other food products. Apparently there was a bad batch of their latest line of Platy-Pies, because reports of moldy bags of pastries covered their social media and they had to recall many bags of the high-fructose treats. One angry customer got ill after his snack and has already filed a lawsuit against the company. Notable Timestamps [ 00:15 ] - Today's scenario will be Mike's debut as a host! [ 00:37 ] - This Notice of Loss landed on the desk of our adjuster Ralph, who is...
2024-07-3019 minWhat's the Scenario? with PLRBThe New PLRB.orgAn adjuster is assigned a property loss claim. The insured's house is in South Zanesville, Ohio on Cinema Drive, and they experienced hail damage to a portion of their roof on June 16. Their homeowners policy was only recently purchased on June 1 of this year. This claim brings up a number of questions, and luckily the adjuster is an employee of a PLRB member company, so they log on to PLRB.org. When they log in using their company email, they realize that PLRB.org has recently been upgraded with a new look and a member-structured approach. How can the...
2024-07-2320 minWhat's the Scenario? with PLRBA Not-So-Routine Oil ChangeSo the insured, being the diligent car owner and maintenance-oriented person that he is, appears at his auto shop for a routine oil change. However, the insured auto shop failed to adequately tighten the oil drain plug, causing all of the installed oil to leak out. According to the insured, this was a routine oil change, performed every six months, and there must have been a mistake in the drain plug tightening process. As a result, the engine completely seized, causing the entire engine to need to be replaced. Notable Timestamps [ 00:15 ] - The customer files...
2024-07-0918 minWhat's the Scenario? with PLRBEngagement Ring MishapA man lived in his house with his girlfriend at the time. Things were going so well, he bought an engagement ring, took her to Mexico for vacation, proposed in Cancun, and she said yes. He gave her the ring. She wore it the rest of the vacation, then packed it in her suitcase … but when she got home and opened up the suitcase, it was gone! The girlfriend had no HO or renters insurance because she lived with her boyfriend. The man had his own HO policy, but he hadn't gotten around to scheduling the ring. Not...
2024-07-0217 minWhat's the Scenario? with PLRBThe Extra Diligent HomeownerA 90 year old red maple hangs over the insured's house. One of the branches looks like it might fall, and if it does, it's going to cause some major damage to the sun room. The insured knows this and is a diligent homeowner. One day the weather forecaster says major storms are coming through later in the week – wind and flooding are likely – so the insured hires a tree company to remove the limb safely in advance and also pays to get sandbags down on the low side of his property facing the river. The weather forecaster was right, a bi...
2024-06-2518 minWhat's the Scenario? with PLRBA Friendly Fire?Old brick mansion in New Jersey with a fireplace that the insured uses in the winter. During a routine cleaning, the chimney sweep noticed some cracking in the chimney bricks. He says (1) it's probably due to age and normal use because over time the heat from the fires takes a toll; he says (2) in his estimation the cracking has existed for 3+ years. Notable Timestamps [ 00:15 ] - He encourages the insured to submit an insurance claim anyway. Policy = ISO HO 00 03 05 11. The adjuster knows there is an exclusion for "cracking" but also knows that fire is a covered peril. Is...
2024-06-1818 minWhat's the Scenario? with PLRBThere's Blood Everywhere...A young couple lives together in St. Pete, Florida. Their friend was vacationing in Italy for a month and asked them to dog sit for her 3 year old pit bull rescue, who had a checkered past but was doing well lately. The couple took in the dog, and one night they threw a dinner party. Out of nowhere, the dog attacked one of the guests, biting him in the leg. In the resulting chaos, blood got all over the expensive white wool carpet. The man got his leg treated at the hospital, he was fine– not suing! – the dog was...
2024-05-1417 minWhat's the Scenario? with PLRBMy Tenants Trashed My HouseThe insured bought a house in Oregon and took out insurance under a 2011 ISO HO3. He lived there for a month, but then moved back to California and started renting out the Oregon house to a local couple. Six months later, the couple disappeared with no trace and the house had been trashed. Walls were dirty; carpet was dirty; graffiti in the bathroom, hole in the bedroom wall; bottles and cans everywhere; dog urine. The insured wanted his homeowners insurer to pay for a full Coverage A cleanup and restoration. Notable Timestamps [ 00:16 ] - The homeowner...
2024-04-3015 minWhat's the Scenario? with PLRBWildfire Smoke Never Went AwayThe insured is a homeowner in Oregon. There were wildfires in the forests around his neighborhood, but the fire never got closer than 3 miles from his house, so he never had to evacuate. Nevertheless, the smoke was thick in his area, and enough of it penetrated into the inside of the house to leave a faint but noticeable smoky odor that does not seem to be going away. The insured is requesting smoke remediation to be performed in his house and on some of his contents. Notable Timestamps [ 00:18 ] - The interior and exterior of the...
2024-04-1618 minWhat's the Scenario? with PLRBHelp! They Stole My Facebook Followers![Recorded LIVE at the 2024 Claims Conference in Boston, MA!] The two head pastors of a megachurch had a falling out. One pastor left to start his own ministry, but just before he did, he changed the megachurch's Facebook password. He now has exclusive control of the account and sole access to the 100k+ followers, so the church filed a theft claim with its first-party insurer. Is this a direct physical loss to the church's property? Are Facebook followers even "property" with any means of valuation? Notable Timestamps [ 00:23 ] - Two pastors had a falling out, and...
2024-03-2613 minWhat's the Scenario? with PLRBDetached Garage Converted to AirBNBAn insured's detached garage burns down in a covered lightning strike, and somehow it's not covered just because of a little side hustle? The PLRB crew hunt for coverage and find what the insurer can pay out on when an insured rents out their property without updating their insurance company. Notable Timestamps [ 00:17 ] - The insured remodeled their detached garage for use as an AirBNB rental, but never notified their insurer. The garage burned down, and the insured files a claim for the property damage, contents, and nearby oak tree that also...
2024-03-1919 minWhat's the Scenario? with PLRBI Crashed My Bike Into a TreeIs a recycle bin a "vehicle"? Does a car antenna ripping a coat fall under the Vehicles peril? How about a poorly secured wedding dress in the backseat of a convertible? If you occasionally win a biking competition, does the loss of your bike trigger business property coverage? Join Mike, Tim, and Alissha for the lightning round and discuss bikes, eBikes, sleds, boats, and more. Notable Timestamps [ 00:15 ] - The insured is an avid cyclist who occasionally wins money from his hobby. Another cyclist cut him off and he crashed his bike...
2024-03-1220 minWhat's the Scenario? with PLRBThe New Cabinet Doesn't MatchIt's a very common coverage question: does the insurance company really need to pay to replaced undamaged materials just because the replacement for the damaged materials doesn't quite match? Alissha, Mike and Tim bring this highly visual subject to an audio-only medium with concrete tips on bringing objectivity and expertise to a subjective issue. Notable Timestamps [ 00:19 ] - Just one of the insured's kitchen cabinet doors was damaged in a covered loss. The damaged cabinet was discontinued by the manufacturer, so the adjuster suggested an alternative. The insured would like all of...
2024-03-0519 minWhat's the Scenario? with PLRBThere's Honey in the WallsIn this episode, Mike, Alissha, and Tim answer everything you've ever wanted to know about bees, as long as you wanted to know if damage by bees was covered under homeowners insurance, if honey seeping through the walls is considered an ensuing loss, whether honey can be considered a "secretion," and if bees should be considered "birds." Notable Timestamps [ 00:27 ] - Honeybees have infested the insured's walls. The insured will have to get the bees removed, and repair any damage leaking honey may have caused. [ 01:58 ] - Mike shares...
2024-02-2717 minWhat's the Scenario? with PLRBHelp! All My Apes are GoneNFTs may not be fungible, but they are transferable, and they are sometimes stolen with no traditional recourse. The PLRB crew discuss Bored Apes, acronyms, whether pixels are physical, and whether the internet is just a fad. Coverage topics include direct physical loss, special limits of liability, Property Not Covered, and more. Notable Timestamps [ 00:38 ] - An erstwhile member of the Bored Ape Yacht Club clicked a malicious link and his NFTs were transferred to an unknown source. The police were unable to assist. [ 01:06 ] - An NFT or "...
2024-02-2019 minWhat's the Scenario? with PLRBMy Son Set Off Fireworks in My HouseIs 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.
2024-02-1320 minWhat's the Scenario? with PLRBMy Grandparents Paid a Phone ScammerWhat do AI voice clones, $3,000 in wired cash, a lost wedding ring, and a Toledo prison have in common? This episode on the coverage issues presented when a family member-- or a business-- falls for a scam. The team discusses the various types of scams out there and what may and may not be covered under most insurance policies. Notable Timestamps [ 00:18 ] - Grandma got a call from someone claiming to represent a charity. She wired $3,000 to an overseas account. Her family researched and found the company did not exist, and helped...
2024-02-0619 minWhat's the Scenario? with PLRBAggressive Contractors Target Your InsuredMost contractors are honest actors, but how can an adjuster handle a situation in which a contractor takes an aggressive approach, or insists on cutting the insured out of communications? The PLRB crew discusses the difficulties posed by these situations and what some legislatures and doing to address them. Notable Timestamps [ 00:35 ] - Hypothetical contractors say that they are paying the insured's deductible, so the insurance company should only deal with them directly, not the insured. [ 03:25 ] - Some contractors apply high-pressure urgent sales tactics, and require down payments...
2024-01-3018 minWhat's the Scenario? with PLRBThe Next COVID Shutters Your Insured's BusinessThe next pandemic strikes a local hospital, resulting in a business income loss as the facility is closed for cleaning. Does the presence of the virus on the surfaces to be cleaned represent a "direct physical loss" sufficient for coverage? Tim, Alissha, and Mike will explore a scenario nobody wants to think about, applying case law from the post-COVID era. Notable Timestamps [ 00:34 ] - A hypothetical outbreak of Ebola means that a hospital needs to shut down significant portions of its premises for two weeks to have the area cleaned. Are they...
2024-01-2320 minWhat's the Scenario? with PLRBTerrorist Attack Damages Insured BusinessA terrorist attack causes massive property damage, including to an insured business. The adjuster assigned to the claim is sure they've seen something in the policy about terrorism disclosure or terrorism caps, but isn't sure what. In this episode, Tim, Alissha, and Mike will explore the TRIA act which enables coverage for minor terrorism losses, and why it likely does not apply to this scenario. Notable Timestamps [ 01: 40 ] - This episode concerns a real-life event, the 2020 Christmas Nashville bombing, in which the individual who set off the bomb died, several others were...
2024-01-1617 minWhat's the Scenario? with PLRBIntroducing What's the Scenario? with PLRBAlissha, Tim, and Mike introduce a complete rebranding of PLRB's podcast as "What's the Scenario? with PLRB", starting with a mini-scenario on a bear attack. Notable Timestamps [ 00:16 ] - A family went camping, only for their personal property to be destroyed by a bear. [ 01:41 ] - The team introduces themselves. Alissha Watley is Senior Meetings Manager at PLRB responsible for some of PLRB's annual conferences. Tim Havlir is Property Coverage Counsel at PLRB with years of experience answering coverage questions. Mike Brode is Vice President of Educational and Technical...
2024-01-0912 minWhat's the Scenario? with PLRBPLRB's Podcast SurveyHow can PLRB's podcast best serve you? Share your thoughts with this quick survey. https://www.plrb.org/pub/pod
2023-05-3001 minWhat's the Scenario? with PLRBCoverage for Freeze Claims and Winter Storms with PLRB's Tim HavlirThis episode of PLRB on Demand will feature Tim Havlir, Property Coverage Counsel at PLRB. In his work in the property legal department at PLRB, Tim analyzes, researches and writes about a variety of first party coverage issues. He also responds to members' property insurance coverage inquiries on a daily basis, and today we have one such question we received from a member, who requested a training on coverage issues involving freeze claims for 1st party homeowners losses. Winter storm losses claims open up a variety of issues for adjusters. Because winter storms often trigger other perils...
2023-01-2434 minWhat's the Scenario? with PLRBPLRB Resources & Modern Mentorship, with Equis ConsultingThis episode of PLRB on Demand will feature an interview with PLRB's own Mike Brode, Vice President of Educational & Technical Services. Mike's review of the structure of PLRB at the top of this episode is a great primer on what PLRB members can access, from the "Ask a Coverage Question" feature to our historical weather data and building codes database. Our guest host for today is Ron D. Cripe, Program Designer at Equis Consulting. This interview premiered as an episode of Equis Consulting's podcast "Leadership is the Conversation: a discussion with today's top business leaders on topics...
2022-11-0129 minWhat's the Scenario? with PLRBAn Interview with PLRB President Tom MallinToday's podcast will serve as a retrospective of Tom's forty-four years at PLRB. We'll hear about his early work as Research Counsel answering member questions, his role in the creation of PLRB's heavily used Search reference database, and the service enhancements that have improved PLRB's offerings during Tom's years as President. We'll learn how Tom guided PLRB through a radical transformation. 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...
2022-10-0436 minWhat's the Scenario? with PLRBPLRB's Outstanding Claims Professional Awards 2021: Javier MatusThis is an industry where claims professionals deal with a high volume of claims, time demands, and customers who are distressed due to the loss they just sustained. As a result, some claims professionals can become complacent or even jaded, but the best ones continue to grow, to challenge themselves, and to look at each claim as an opportunity to help their insureds at a time when they need it most. This year, we were pleasantly overwhelmed by the number of submissions we received from claims supervisors from all around the country who nominated their best and brightest for the...
2022-02-2237 min
What's the Scenario? with PLRBIntroducing PLRB on DemandThe 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. Listeners should rely on guidance from their companies and counsel as appropriate. © PLRB 2019. Music: Nimbus. Eveningland. Sound Effect: Woosh 2. XxChr0nosxX. Freesound.org. Creative Commons 0.
2019-09-0402 min