What's the Scenario? with PLRB

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...

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 ...

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 ...

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 professional...

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,...

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 f...

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 deni...

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 involve...

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...

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 con...

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 ...

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 ...

We're calling "foul ball!" A spectator at a local minor league baseball game was injured when a foul ball zipped through a tear in the safety net and broke his arm. The spectator claims that the stadium owed him a safe environment, that it knew about the tear and didn't fix it, and that the mascot wasn't even that funny. To score, our litigant is going to have to run all four bases of the core elements of negligence: duty, breach, ...

A cat jumps on the stove to get leftovers, accidentally turns a burner, and starts a kitchen fire. The homeowner has heard of an exclusion that applies to damage caused by animals owned or kept by an insured, and is concerned that the fire will not be covered. Exactly how mad should the homeowner be with their cat? (And how long can they stay mad at that face?)

Notable Timestamps

[ 00:00 ] - A kitchen fire caused by a pet can initi...

Wildfire claims are emotional, public, and inconsistent across carriers, so adjusters often become the face of "no." Using a real fire example, we'll explore empathy, advance payments, uneven guidance, social media comparisons, and follow-through as tools to protect our reputation.

Notable Timestamps

[ 00:09 ] - Wildfire claims can be highly emotional and public, and adjusters often become the visible representative of difficult co...

[REPLAY] This week, check out a podcast featured in PLRB's new PACE Program:

"The new PLRB Advanced Coverage Education (PACE) designation is more than a credential. It's a powerful way to strengthen your claims expertise.

PACE begins with a Core Curriculum that builds a foundation in insurance basics and the claims process. From there, professionals can grow through Business LineTracks that support field-specific development, and C...

The roof of a 100-year-old farmhouse suddenly collapses under the weight of water. The building was insured under a farm policy that, in this case, only provided coverage for personal property and not the dwelling or real property. The insured claims that the carpet, water heater, and even ceiling tiles are all personal property, and therefore covered! What is a fixture?

Notable Timestamps

[ 00:00 ] - The episode explores how fixtu...

A foot of stormwater in your home, and a contractor saying "Let's dry it in place?" That was the scenario explored in Courtney Makris' PLRB Presents talk "When the Storm Hits Home: Courtney's Personal Journey through Hurricane Helene," and today Mike & Brennan will look at that scenario through the lens of the Categories & Classes of water, with the help of a PACE Program exercise.

Notable Timestamps

[ 00:06 ] - The episode...

A fire broke out in the insured's basement, where various household and personal items were stored. The insured husband is a recreational pilot. His wife is an accountant. Their two children and dog also live in the home with them. The fire caused heavy smoke and heat damage throughout the basement and adjoining utility room. The insured provided a personal property inventory form listing everything believed to be damaged or destro...