What's the Scenario? with PLRB

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 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 Conve...

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 c...

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 Yea...

For the next two weeks over the holidays, we're going to feature some excellent podcasts from before we rebranded as "What's the Scenario? with PLRB." These segments were called "The Coverage Contrarian," and they featured PLRB coverage attorneys Michele Hunter, Eric Friedmann, and Frank Gagliardi as they argued vociferously about coverage issues big and small. This week, we'll explore the scenari...

For the next two weeks over the holidays, we're going to feature some excellent podcasts from before we rebranded as "What's the Scenario? with PLRB." These segments were called "The Coverage Contrarian," and they featured PLRB coverage attorneys Michele Hunter, Eric Friedmann, and Frank Gagliardi as they argued vociferously about coverage issues big and small. This week, we'll explore the scenari...

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 a...

Today we're going to feature an excellent podcast episode from before we rebranded as "What's the Scenario? with PLRB." These segments were called "The Coverage Contrarian," and they featured PLRB coverage attorneys Michele Hunter, Eric Friedmann, and Frank Gagliardi as they argued vociferously about coverage issues big and small. This week, we'll explore how the expected or intended injury exclus...

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 thin...

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 dri...

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 adjust...

At 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 hims...

It'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 lea...

A 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...

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 discusse...

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 st...

A 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 boll...

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 falli...

The 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 c...

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 o...

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...

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...

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...

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...

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 int...