The property services division of the Property & Liability Resource Bureau, PLRB, provides services with respect to the following lines of insurance business typically identified on an insurer's annual statement:
The liability services division of the PLRB services the following lines of insurance business typically identified on an insurer's annual statement:
The property services and the liability services of PLRB are separate memberships and are separately invoiced on an annual basis. An insurer can pay for and receive just the property services, just the liability services, or both.
Although the focus of all of our services is the claims handling needs of member insurers, many of our services and programs are highly relevant to insurers' training, legal, and underwriting departments, as well as to a whole spectrum of claims service providers.
Any insurance company or underwriting organization licensed to do property or casualty business in the United States can become a subscriber member of PLRB. Annual dues are based on the amount of the company's direct written premiums in the lines of insurance serviced by the property services and liability services divisions of PLRB.
Any business which provides claims services directly to PLRB member insurers is eligible to become a PLRB affiliate member under the terms of the PLRB affiliate member program. Annual dues are based on the business' number of employees and percentage of operations related to insurance claims.
The Products and Services Committee and the Property and Liability Advisory Board meet annually to review our performance and suggest new projects. We then estimate costs for implementation of their recommendations and prepare a budget. This budget is presented for approval to the Board of Directors, which consists of member company CEOs and other top executives.
After setting a budget for the forthcoming year, the Board of Directors establishes a Dues Schedule, which allocates our operating costs among the members based upon their direct written premiums in lines serviced by the property services and liability services divisions of PLRB. PLRB maintains a reserve to avoid special assessments and provide financial stability. This reserve is conservatively invested unless needed.
In the true sense of a trade association, our purpose is to offer our members those products and services that we can provide more efficiently or economically than they can generate for themselves. More specifically, as stated in its Bylaws, the purposes and objectives of the Property & Liability Resource Bureau are:
· To concern itself with, and encourage productivity and efficiency in, the property and liability loss and claim adjustment processes of members and the industry as a whole;
· To disseminate information on property and liability issues among members and within the insurance industry; and
All of PLRB's services and programs are available to insurer members on an unlimited basis in exchange for payment of the annual member dues assessment. Any staff member of an insurer member can take full advantage of all our services. Member insurers can print out and photocopy as many copies of any of our information as they like. There is no fine print; there are no hidden charges, no "ups or extras." To protect the value of membership and to help control our liability exposure, we do ask that members limit distribution of our materials and services to their employee staff and their retained defense counsel.
Insurer members can accurately budget for their use of PLRB services and completely control the extent of their usage of our services over any given period of time. PLRB provides up-to-the-minute on-line service usage reports to each member on demand through our Member Administration system.
PLRB Affiliate Member employees are entitled to unlimited Web access to those Web services included within the PLRB Affiliate Member Program. Affiliate Members also receive discounted pricing for attending, exhibiting at, and sponsoring PLRB educational meetings and conferences.
PLRB's www.plrb.org home page is the gateway to the most comprehensive source of proprietary property and liability claims information on the planet.
All these and more are easily accessible from PLRB's home page with just a few mouse clicks, without ever leaving the PLRB Web umbrella.
The main frame of our home page also provides constant updates in the areas of developing property and liability insurance case law, tests of your property coverage and claims handling knowledge, developing weather and catastrophic events, coming meetings and seminars, and breaking news stories involving "hot topics" such as recent major storms. Insurer members and Affiliate Members receive weekly Front Lines e-mail updates informing them of newly available materials with active links from those e-mails to our home page; this e-newsletter currently reaches more than 30,000 readers each week.
PLRB Search is a vast repository of property and liability insurance legal and claims handling information, constantly being updated, revised, and added to. Printed out, the contents would fill more than 30 lineal feet of shelf space. The subject and text fields of more than 33,000 documents are searchable by word or phrase, by state, and the search engine we use also supports sophisticated Boolean searches, as well as ordinary table of contents browsing. Among the contents available to insurer members:
Property Services Resources
Emerging Issues in Property Insurance
This document alerts and inform loss managers of the latest property case law or other trends being observed by PLRB staff attorneys. It is the first document listed in the Table of Contents of PLRB Search. This document acts as a convenient one-stop source for information PLRB has developed on breaking news and emerging trends. The Emerging Issues document first provides a list of documents within PLRB Search which deal with these emerging issues. The document also contains a brief description of each issue and the document our staff has created to discuss that issue.
At this writing, the listed Emerging Issues we see as the subject of increasing property insurance coverage litigation, legislation, and regulation are:
· Chinese Drywall
· H1N1 (Swine Flu)
· Green Buildings
· Madoff/Ponzi Schemes
· Same Sex Marriage
This list will be expanded and contracted in response to claims and legal developments.
The Emerging Issues document links our members directly to the relevant staff-created discussion of that topic. These discussions are constantly being updated as new events--in the form of new court opinions, legislation, regulation, or policy language changes--occur. These discussions link both to more general PLRB discussions of coverage issues and to outside sources of information on the Web. Thus, by starting with the Emerging Issues document, PLRB members can very quickly find an up-to-date discussion of emerging trends in property insurance coverage law.
Frequently Asked Questions
Detailed analysis of coverage questions most frequently asked of PLRB staff. This list of topics is regularly updated to address current trends in issues of greatest current concern to our members.
Homeowners Annotations–Section I – Analytical, key-numbered discussions of the property-related provisions of the ISO Homeowners forms including related key endorsements dealing with special computer coverage, earthquake, inflation guard, mold, other structures increased limits, personal property replacement cost, scheduled personal property, open perils coverage for personal property, water backup and sump overflow, and windstorm/hail deductible. AAIS form references are also included.
Homeowners Forms Section II Liability Coverages – Analytical, key-numbered discussions of each liability insurance-related provision of the ISO Homeowners forms. (Also in liability services Search)
Businessowners Property Annotations – Analytical key-numbered, provision-by-provision discussion of the ISO Businessowners Special Property Coverage Form BP 00 03 (including prior BP 00 02 versions) and Businessowners Common Policy Conditions forms.
Commercial Property Forms Annotations – Analytical, key-numbered discussions of each provision of common ISO Commercial Property forms and endorsements, addressing editions up through the 2007 versions.
Business Income Coverage Annotations – Analytical, key-numbered discussions of the ISO CP 00 30 Business Income Coverage Form (and Extra Expense) and related endorsements addressing form editions through 2007.
Builders' Risk Coverage Annotations - Analytical key-numbered complete annotation of the American Association of Insurance Services (AAIS) IM 7050 09 08 Builders' Risk Coverage Scheduled Jobsite Form Comprehensive Form. Builders' Risk coverage often overlaps with or is intended to dovetail with inland marine installation floaters. During 2010 we will add a Q&A discussion of the issues which frequently arise under inland marine installation floaters to further discuss the first-party insurance coverages typically present in building construction scenarios.
Question & Answer Reference Services
Property Question & Answer Reference Service – More than 180 detailed discussions of frequently posed property insurance coverage questions.
Test Your Coverage Knowledge and Test Your Claims Knowledge - Popular alternating weekly features of our Web site pose coverage or technical claims knowledge scenarios and then give staff analysis of the questions raised by those scenarios. Past entries are all cataloged in our database for information retrieval, self-study, or internal training purposes.
Claims Magazine Articles – Dozens of property coverage issues in Q&A format originally published in Claims Magazine.
Many coverage issues addressed in ten or more states by statute or case law are discussed in state-by-state format with links to each state's discussion from maps and/or 50-state grids. The topics span statutory/regulatory issues, the definition of insured persons, exclusions and perils, causation, conditions, and valuation, including:
Adjuster Licensing Statutes – Detailed state-by-state summary of licensing requirements for adjusters with links to full statutory and regulatory text. (Also in liability services Search)
Condominium Statutes – State-by-state full text of condominium statutes. (Also in liability services Search)
Fraud Annotations – State-by-state discussion of cases, statutory, and regulatory law relevant to the concealment or fraud provisions of property forms. Also included is a state-by-state compendium of SIU creation, fraud warning, fraud plan, fraud investigation division of insurance department, and fraud reporting immunity statutes. (Also in liability services Search)
Proof of Loss - State-by-state discussion of the effect of policy provisions and statutes requiring the filing of proof of loss by the insured.
Same-Sex Marriages/Civil Unions and Who Is an Insured - state-by-state discussion of issues such as:
· How does a legal same-sex marriage in one state impact coverage in a state that does not recognize such marriage?
· Does a "civil union" create a spousal relationship and thus make the partner an insured for purposes of homeowners or other personal lines insurance policies which make the "spouse" an insured or named insured?
Suit Limitation Annotations – State-by-state interpretation of the suit limitation provision and state statutes governing the time within which an insured may sue on a property policy.
Storage Tank Statutes – State-by-state full text of state statutes dealing with clean up of spills from storage tanks. (Also in liability services Search)
Tax and Demolition Lien Laws - State-by-state discussion of the insurer's duties under statutes authorizing governmental liens against property insurance proceeds, together with links to full statutory text.
Unfair Claims Settlement Practices Acts and Regulations – links to state-by-state full text of statutes and regulations for all states. (Also in liability services Search)
Valued Policy Laws Annotations – State-by-state discussion of the various valued policy laws and applicable case law, plus a distance learning module about valued policy laws.
Residency Compendium – State-by-state discussion of insured status as affected by status as a child or college student, or by military service, divorce, domicile, or dual residency. (Also in liability services Search)
Common Law Marriage – State-by-state discussion of the effect of this doctrine on status of a person as an insured. (Also in liability services Search)
Exclusions & Perils – State-by-state discussion of the interpretation of perils and exclusions for collapse, earth movement, intentional loss, ordinance or law, settling and wear and tear, and water damage.
Innocent Coinsured Recovery - State-by-state discussion of whether innocent insureds can recover under property insurance in the event of fraud, misrepresentation, arson, or other intentional acts by another insured in light of the misrepresentation or fraud clause and the intentional loss exclusion.
Causation Annotations – State-by-state discussion of the causation rules applied by courts in determining whether a loss is covered under a property insurance policy, including the doctrine or concurrent causation, the effect of the common anti-concurrent causation preface, ensuing/resulting loss provisions, and the meaning of proximate cause.
Appraisal – State-by-state discussion of the scope of property insurance appraisal, initiation of the process, the qualifications of appraisers and umpires, the workings of the appraisal process, what should be on the appraisal award, and the legal effect of the appraisal award.
Actual Cash Value - Detailed discussion of the definition of ACV applied by the courts of each state to various types of commercial and residential personal property as well as real estate, as well as whether depreciation can be applied to partial losses.
Matching – State-by-state discussion of statutory, regulatory, case law, and practical issues bearing on the issue of matching replaced or repaired property to undamaged property after a loss.
Catastrophe Bulletins – Examine coverage, regulatory, and statutory issues frequently arising in particular disaster scenarios, allowing easy retrieval of these materials when future similar catastrophes occur, or when information contained in these bulletins might be helpful in researching similar coverage issues arising in non-catastrophe situations. The bulletins deal with coverage issues arising in events such as hurricanes, earthquakes, toxic spills, nuclear accidents, terrorist attacks, and riots.
Condominium Issues - addresses some of the most frequently asked questions regarding residential condominium coverage and underwriting issues, including:
· the nature of a condominium, its unique characteristics, how it compares with other types of home ownership, and the history of the condominium in the United States;
· the many documents that govern condominium ownership, including condo statutes, association declarations, association by-laws, deeds for individual units, and insurance policies for unit-owners and how they mesh with the condo documents and with insurance policies issued to condo associations;
· claims and underwriting issues arising with unit-owner's policy, such as the reasons to cover a condo unit under an HO-6 rather than an HO-3, the reasons it is important to maintain adequate Coverage A limits, the reasons to watch the scope of supplemental loss assessment coverage, the question of whether the loss assessment coverage and Coverage A should respond to a loss within the Association deductible;
· summaries of relevant case law; and
· an appendix containging relevant policy language of ISO and AAIS unit-owner's forms and the ISO condominium association form.
Earthquake Reference List & Materials - List links to key discussions of earthquake-related materials which will both allow our members to quickly find particular information related to earthquake issues and allow our staff to quickly provide information to our members in the event of another major earthquake. Information in the database includes:
· earthquake data, current and historical, searchable via PLRB Map by geographic area and time period;
· coverage documents and catastrophe bulletins discussing the earth movement exclusions and coverage endorsements in standard Homeowners, Businessowners, and Commercial Property policies, the handling of loss payment after an earthquake when proceeds are claimed by both mortgagor and mortgagee, a brief summary of California statutes concerning earthquake losses, and a link to the text of the California Insurance Code Earthquake Insurance Provisions;
· earthquake training tool called "The Adjuster's Guide to Earthquake Losses," consisting of an overview, glossary, a discussion of the nature of earthquakes, basic earthquake coverage and adjusting issues, and a guide to loss inspection and distinguishing earthquake from non-earthquake damage;
· Claims Conference handouts from "Earthquake Claims Handling," "Earthquake Coverage: Handling Earthquake Claims," and "Earthquake Damage Assessment and Repair," the three-workshop series taught by California Earthquake Authority personnel, completion of which earns attendees their California Earthquake Claims Handling Accreditation certificate; and
· "Strategies for a Mega-Earthquake Response," an update of the Earthquake Project's 1990 report, "CEO Strategies for an Earthquake Claims Response: Failing to Plan is Planning to Fail," bringing the recommendations up to date for the Internet age and in the light of the property claims experiences in the aftermath of such mega-disasters as Hurricane Katrina.
Foreclosure Activity and the Mortgage Clause - an updated and comprehensive discussion of the mortgage clause, focusing specifically on foreclosure issues seen during the economic downturn, addressing the broad range of issues, court decisions, and applications to everyday coverage questions which constantly come in the current real estate market.
"Green" Buildings, Building “Green”, and “Green” Property Insurance Coverage - comprehensive look at the issues "green" construction raises for the property insurance claims world, discussing what it means to "build green," including a look at some prominent organizations that provide "green" certification, and also discussin "green" insurance, including what it covers and some potential coverage issues.
Underwriters Legal Reference Manual – Contains information about coverages of particular interest to underwriters, including cancellation and nonrenewal, principles of insurance contract interpretation, replacement and guaranteed replacement cost coverage, concealment and misrepresentation in the application, and pollution.
Guiding Principles and Other Insurance – Detailed discussion of the historical Guiding Principles for first-property insurance apportionment, as well as the "other insurance" rules for apportioning insurance coverages developed by various courts.
Glossary of Legal Terms – Alphabetical simplified lexicon of legal terms used in PLRB publications and by courts and legislatures.
Winter Loss Coverages – Detailed discussions of frequently asked winter-related coverage questions.
Pollution and Contamination Annotations – A detailed analysis of potential pollution and contamination claims under property insurance policies, plus a discussion of the application of the suit limitation and policy period defenses to a continuous or progressive pollution or contamination loss, a discussion of asbestos removal and abatement issues under property policies, and a state-by-state discussion of the application of the building ordinance or law exclusion.
Mold, Mildew, Fungus, and Fungi – Technical discussion of mold science. (Also in liability services Search)
Reservation of Rights Letters and Nonwaiver Agreements – Detailed discussion of the use and effect of these common claims investigation document. (Also in liability services Search)
Case Law Reviews
Property Insurance Law Review – Analyses of relevant nationwide property insurance case law, continuously published since 1977, over 8,500 pages in all. Originally these were published monthly; in recent years they have been published at least weekly on our home page as Property Legal Updates. Links to free versions of the full court opinion text are included where available.
Homeowners Liability Insurance Law Review – Analyses of relevant Homeowners Section II law from across the country, continuously published since 1988, more than 3,000 pages in all. Originally these were published monthly; in recent years they have been published at least weekly on our home page as Liability Legal Updates. Links to free versions of the full court opinion text are included where available. (Also in liability services Search)
Over 15,000 individual coverage questions submitted over the past 30 years by the claims and underwriting staffs of PLRB's member insurers are analyzed by PLRB staff attorneys. The questions deal with personal and commercial lines property, inland marine, and Homeowners Section II Liability coverages. The questions state the facts dealt with, applicable policy language, the staff analysis, and the detailed reasoning supporting that analysis. In hard copy, these materials would occupy about ten lineal feet of shelf space.
Training and Education
Adjusters Encyclopedia – Detailed discussions of a number of technical subjects related to loss adjustment including alarm system functions and evaluation; concrete; contractor/subcontractor estimates and relationships; computer hardware and electronic equipment losses; drain sewer and septic systems; earthquake; estimating; exterior walls; fine art; hardwood flooring; fraud; NIDR Fire and Smoke Damage Repair; roofs; safety; scoping an estimating; stonework; subrogation; swimming pools; water damage restoration; and window glass.
Adjuster Safety: Hazardous Materials – Provides basic information for adjusters to achieve personal protection in a hazardous environment.
Adjuster's Guide to Builders Risk Losses – Provides and explanation of the builder's risk policy, soft costs endorsements, and coverage, including what the company person needs to know about construction contracts and terminology; explains the builder's risk loss adjustment process in a step-by-step manner.
Carpet Primer - A Guide for Adjusters – Discusses various features and terminology that can assist adjusters in identifying the quality of carpeting.
Catastrophe Claims Management Manual – This manual can assist in comprehensive planning for catastrophe claims response. It suggests what preparations should be made by the home office, the regional office, and adjusters. It provides useful action checklists for both planning and response. It also deals with post-catastrophe communications with insureds, the media, and others.
Catastrophe Duty Sensitivity Training – Focuses both on adjuster skills for dealing with insureds who have claims arising from natural catastrophes and the problems of adjuster stress and supervisory response to adjuster stress
Cause/Origin Research & Evaluation (C/ORE) Kit – Step-by-step procedures for adjusters to follow in separating those fire losses that warrant prompt adjustment from those that call for additional investigation. The procedures include testing early assumptions of cause, identification of potential motives for incendiarism, documenting physical facts and statements, and recognizing subrogation opportunities. Separate procedures are provided for commercial and residential properties.
Adjusting Commercial and Industrial Equipment Losses – This manual explains how to apply a systematic and intelligent approach to handling these types of highly specialized and technical claims.
Adjusting Commercial Inventory and Income Losses – Describes basic accounting terms and principles and the processes and documentation required for the accurate resolution of commercial in-sight and out-of-sight inventory losses and income losses.
Depreciation and Actual Cash Valuation of Personal Property – This publication helps determine the appropriate actual cash value of non-real estate property, based not on depreciation tables, but on the logic of valuation itself.
Guidebook to Electronic Losses – Assists in the evaluation of "high-tech" losses and provides background information on electronic equipment. It covers: methods of evaluating a loss; identification of typical elements that contaminate electronics; methods to save and return equipment to a usable state; valuation of electronic equipment; coverage of service contracts; and a glossary of electronic terms.
Adjusting Hail Damage to Residential Roofing – Covers how red cedar shakes and shingles can recover from hail impacts without the need to be replaced; granule loss to composition roofing products and how to avoid unwarranted repairs; identification and analysis of non-hail-caused roofing problems; and measuring and estimating techniques.
Hazardous Materials Guide – Guide to sites that may contain hazardous materials and how to deal with possible exposure to hazardous materials.
Just the Facts: Effective Claims Interviewing – Focuses on the various stages of the interview and gives numerous examples of questioning techniques.
Lightning and Electrical Losses: An Adjuster's Guide – Complicated processes and terminology are explained in everyday terms. There are checklists and product-specific information designed to assist the adjuster in detecting legitimate lightning and power surge losses. It is also a powerful tool for inside adjusters, offering information on a variety of appliances and fixtures.
Motor Truck Cargo Loss - An Adjusters Handbook – Contains step-by-step instructions for adjusters who are only occasionally confronted with motor truck cargo claims. It is a field guide to help the adjuster meet the technical and legal requirements under shippers' and carriers' coverages.
On the Road to Basic Adjusting – Eight peril-driven modules on winter losses, water damage, theft, windstorm, hail, vandalism and malicious mischief, fire, and lightning. Guides for students, supervisors, and coaches are also included.
In-House Educational Series – A monthly series, continuous from 1983 to 2000, on coverage, technical, and loss adjustment topics. The series can be used for reference, individual study, or group study. Each issue contains questions and answers to test mastery of the material presented.
Property Loss Mitigation Procedures and Techniques – Presents numerous methods to reclaim damaged items and minimize ensuing loss. Looks at stabilization and neutralization measures, identifying sources of damage, the transition stage of recovery, and repair techniques.
Solving Matching Problems and Estimating Unique and Quality Construction – Suggests successful procedures for locating hard-to-find materials and establishing a price for materials not listed in unit price databases.
Business Income Worksheet/Template: A Tool for Adjusters - This tool, built around a Microsoft Excel spreadsheet, is designed to help the user calculate a business interruption loss for a small to midsize businesses (e.g. retail, restaurant) where the loss results from a short period of interruption (indemnity period less than 30 days). While this tool is not intended to calculate business interruption losses for manufacturing or service businesses, the small to midsize businesses to which the tool does apply account for the vast bulk of business income claims handled by property adjusters.
Claims Conference and Other Educational Meeting Handouts
Detailed group study and reference materials generated by industry experts retained by PLRB to conduct the workshops and seminars at our annual Claims Conferences and other educational meetings such as mold, terrorism, large losses, regional adjusters conferences, construction defects, and PLRB/FDCC meetings. The topics deal with a vast array of both legal and technical aspects of property and liability coverages and are grouped under the general headings of: adjusting property, business interruption, casualty; catastrophes; fraud; fungus; general interest (e.g., soft skills, communication, business writing); large loss; management; property coverage; special investigations (fraud); subrogation; and technology. In addition to archiving these handouts in our Search database, the most recent handouts are also available on the Seminar Handouts page of our Web site. (Also in liability services Search)
Liability Services Resources
A vast repository of liability insurance legal and claims handling information, constantly being updated, revised, and added to. The subject and text fields of thousands of documents are searchable by word or phrase, or by state, and the search engine also supports sophisticated Boolean searches, as well as ordinary table of contents browsing. In addition to the parts of the property services Search database noted above as also being part of the liability services Search database, the contents include:
Frequently Asked Questions
Detailed analysis of coverage questions most frequently asked of liability legal staff.
Our Policy Annotations form the backbone of our reference services. Each volume contains an exhaustive analysis of the interpretation and application of policy provisions.
Annotations to the Readable Homeowners Forms Section II Liability Coverages - A line-by-line analysis and interpretation of the Homeowners Section II liability coverages. Decisions construing ISO and non-ISO language are discussed and compared.
Personal Auto Policy Annotations - A 900-page comprehensive analysis of the personal auto policy containing separate sections on liability, med pay, UM, and physical damage coverages, as well as a discussion of the policy's general provisions. Like the Homeowners Annotations, this volume begins with the ISO language but also discusses judicial interpretation of coverages under a broad spectrum of manuscript auto policy forms. The impact of relevant statutes on auto policy coverages is also examined.
Commercial General Liability Insurance Policy Annotations - This line-by-line analysis includes discussion of the "care, custody or control" exclusion, "occurrence," advertising injury, and the pollution exclusion. It addresses how courts have interpreted the ISO 1973, 1986, 1988, 1993, 1998, 2001, 2004, and 2007 CGL forms.
Garage Policy Annotations - This volume addresses common coverage issues that arise under Garage Liability/Garagekeepers coverages. Analysis encompasses all sections of auto and non-auto liability, workmanship, primary/excess issues, auto bailment, and physical damage coverage areas, as well as a discussion of the policy's general provisions. Like the other liability services annotations, this volume begins with the ISO language and goes on to discuss judicial interpretation of coverages under a broad spectrum of policy forms.
Underinsured Motorists Endorsements Annotations - This is a line-by-line analysis of the ISO Underinsured Motorists Endorsement form. Topics include: "insured" defined; "legally entitled to recover"; "underinsured motor vehicle" defined; and stacking. As with our other annotations, this volume begins with the ISO language but also includes judicial interpretation of coverages under other policy forms. The impact of relevant statutes on UIM coverages is also examined.
Annotations To Commercial Liability Pollution Endorsement Forms - This publication analyzes new, selected ISO Commercial General Liability endorsements. We've begun with an analysis of pollution endorsements dealing with named peril loss, short-term pollution events, and designated pollutant coverage.
Auto, Commercial, and HO Liability Q&As - These publications contain frequently asked questions from our members, representing industry-wide problems or concerns. Often, these questions involve issues not specifically addressed in existing statutory or case law. These publications focus on interpreting and applying principles of coverage analysis to new or unusual issues.
Claims Magazine Articles - Coverage Analysis columns written on liability insurance issues by liability coverage staff for Claims magazine take a Q&A format.
Coverage Question of the Week – This popular weekly feature of our Web site poses coverage scenarios and then give staff analysis of the questions raised by those scenarios. Past entries are all cataloged in our database for information retrieval, self-study, or internal training purposes.
Automobile Diminished Value Coverage - This volume contains summaries of auto physical damage case law from all 50 states that deal with the measure of recovery for a damaged vehicle. Selected cases address how courts have interpreted ACV, cost of repair, diminution of value, fair market value, and other related topics.
Jury Instructions - State-by-state listing of standard civil practice jury instructions, often with links to state Web sites for up-to-date wording.
Late Notice - State-by-state discussion of whether prejudice is required in order to make late notice of a claim a defense to liability insurance coverage.
Material Misrepresentations in Auto Policies – state-by-state discussion of the effect of the insured's misrepresentation on auto liability coverage, including agent error, burden of proof, statutory basis for rescission, whether upon misrepresentation the policy is void ab initio or merely cancelled upon renewal, and the effect of third party injury or damage on the insurer's remedies.
Named Driver Exclusion – State-by-state discussion of the validity and effect of a named driver exclusion in an auto policy.
Notice of Settlement - State-by-state listing of statutes and regulations requiring insurers to give notice to third-party claimants and their representatives about settlement of claims. Some states see such laws as a necessary response to documented instances of theft by attorneys who had forged their clients’ endorsements on settlement checks and pocketed the proceeds. Such states have determined that the opportunity for forgery and concealment of theft would be measurably reduced by providing the third party liability claimant with notice that a claim had been paid.
Rental Car Coverage - This publication addresses—on a state-by-state basis—liability coverage issues which often need to be resolved where a rental vehicle is involved in an accident. Subjects covered in this volume include statutes and case law relating to priority of coverage, the question of whether a rental car company's self-insurance qualifies as "other insurance," coverage for unauthorized/unlisted drivers, and coverage for physical damage to rental vehicles.
UM/UIM Compendium – state-by-state look at various aspects of uninsured and underinsured motorists coverage, including: statutory authority; minimum limits; whether UM/UIM coverage is mandatory or discretionary; whether written rejection of UM/UIM coverage is required; whether liability limits must match UM/UIM coverages; whether there are offsets for payments from third parties (i.e. liability insurers); whether the offsets apply to the UM/UIM limits or to the total damages; whether there are offsets for med-pay, workers' compensation, and/or no-fault insurance; whether stacking is permitted; test for when a vehicle is "underinsured"; whether UM/UIM property damage coverage is available; requirements for UM/UIM settlement and subrogation protection; and any additional unique UM/UIM issues for each state.
Pollution Clean-Up Costs: The Issue of "Damages" Under Commercial Liability Policies - This is a state-by-state compendium of case law analyzing the issue of pollution cleanup costs as "damages" under commercial liability policies.
Digests of State Insurance Laws – Links to state-by-state digests of insurance-related laws in Best's Digest, published by A. M. Best.
Techno-Torts in Commercial Liability Policies - An analysis of emerging commercial liability coverage exposures arising under Personal Injury and Advertising Injury coverages. Topics of discussion include trademark infringement, electronic advertising exposures, and other developing issues connected with cyberspace.
Negotiation Techniques – Discussion of best practices and techniques which can be helpful to casualty adjusters during claims settlement negotiations.
Science of Settlement - A guide to calculating the reasonable settlement value of virtually any claim or lawsuit and a corresponding "case management" program designed to achieve that goal.
Premises Liability Law - This volume provides claims people with practical guidelines for evaluating and investigating premises liability claims. A multi-jurisdictional methodology helps adjusters consider the duty of care common to most premises liability claims. Individual tabbed sections address slip-and-fall, dangerous conditions, and liability for criminal acts. Each section of this volume also contains quick-reference flow charts to assist in the decision-making process of analyzing liability.
Mediation Techniques - This publication reviews techniques and strategies usable in mediating property damage and personal injury cases. Areas of analysis include: Pre-mediation investigation, mediation procedures, evidentiary matters, negotiation approaches, risk/benefit of litigation, high/low agreements, and other helpful tips for successful mediation.
Adjuster's Guide - This manual presents: (1) considerations for drafting reservation of rights and nonwaiver letters along with sample letters; (2) flow chart/decision trees for determining liability in slip and fall cases; (3) state-by-state duty to defend summaries containing state specific case law, and (4) "scripted" hypothetical loss scenarios showing persuasive and tactful dialog for adjusters.
Insurance Coverage Issues For The Year 2000 Problem - Liability Policy Considerations - Insurers faced Year 2000 computer date clock liability claims exposures under various liability coverages. This white paper analyzed the sources of coverage disputes that arose under the CGL policy, Directors and Officers coverages, and Errors and Omissions policies. Also included is a discussion of the ISO Y2K commercial liability endorsements.
Case Law Reviews
Our staff attorneys research and report on all current, relevant case law across the country to keep members informed of the most up-to-date legal precedent. All of the liability services' Law Reviews are now published on our home page under the Liability Legal Updates heading and added to the database at least weekly, include summaries of decisions from courts at all levels, and include free links to the full text of the court opinions where possible. Our law reviews incorporate analyses of these cases and comment on how the decisions can be applied to claims scenarios. They point out potentially troublesome judicial approaches and explain how the newest opinions relate to existing case law. They also direct the reader to other liability services publications which discuss related subjects.
Auto Insurance Law Review - Covers decisions on auto liability, UM, UIM, physical damage, and no-fault coverages.
Commercial Liability Insurance Law Review - Focuses on latest developments in commercial liability insurance case law relating to CGL, Businessowners, and Garage policies.
Environmental Liability Insurance Law Review - Covers the critical and rapidly evolving environmental liability insurance case law.
Homeowners Liability Insurance Law Review - Reports on decisions involving Homeowners Section II liability coverage.
Individual coverage questions submitted over the past 20 years by the claims and underwriting staffs of liability services member insurers are analyzed by liability services staff attorneys. The questions deal with Homeowners Section II Liability, Auto, CGL, Businessowners, Garage, and other third-party liability coverages. The questions state the facts dealt with, applicable policy language, the staff analysis, and the detailed reasoning supporting that analysis.
Subrogation and Recovery
A variety of case law and other materials dealing with subrogation and recovery under commercial, auto, and homeowners liability coverages have been gathered conveniently.
CGL Training Materials
A series of short, focused training exercises dealing with some of the most common troublesome coverage issues has been developed. Topics include: construction defects; damage caused by car wash operations; total pollution exclusion issues; other insurance clause scenarios; defective concrete; and patent and trademark infringement.
In-House Educational Series
A series on coverage, technical, and loss adjustment topics. The In-House series has been written with prompt, cost-effective claim resolutions in mind. Each issue provides intermediate level adjusters with specific technical information as well as effective claim resolution strategies tailored to that particular type of claim. The procedures and approaches detailed in this series are designed to reduce both indemnity and loss adjustment expenses.
As an alternative to doing their own research in the PLRB or database, member insurers can consult with, or request legal and technical informational research by PLRB staff attorneys. Questions may be submitted from our Web site coverage question form, by e-mail, by phone, by fax, or even by mail. Handling over 12,000 requests annually, our lawyers are committed to providing fast responses, thoroughly researched, and with sound, unbiased analysis. House counsel use the Lawline to improve their efficiency. Claims staff use the Lawline to test their own conclusions, as a second opinion, or as good-faith file documentation. Underwriters use it for advice on their coverage questions.
The PLRB staff is called upon daily to interpret both standard and manuscript policy language in the context of a wide spectrum of loss scenarios. Since we answer thousands of coverage questions from a large and diverse group of carriers each year, many of whom do not use standard ISO or AAIS form language, we are uniquely qualified to review and comment upon new policy language submitted to us by product development personnel, underwriters, and claims people of member insurers. Our attorneys are familiar with words or phrases that might be unfavorably interpreted and can suggest language that has a history of favorable judicial construction.
Following significant disasters, and sometimes in advance of a disaster such as a landfalling hurricane, PLRB's legal staff anticipates coverage and other legal issues likely to arise during the claims response and quickly provides member insurers with analysis of relevant statutory and case law. In addition, our Catastrophe Services staff provides a continuous stream of information vital to the catastrophe response teams of member insurers and Affiliate Members.
The PLRB Claims Conference & Insurance Services Expo is the largest property and liability claims educational event in the industry. It is an intensive three and a half days of 90-minute concept sessions and technical clinics, half-day workshops and seminars, exhibits, and other training and networking events allowing experienced claims personnel to study, analyze, and debate hypothetical claims situations, theories, and practices with their peers, lawyers, accountants, and other professionals. Over 110 topics, 30 of which deal with liability/casualty subjects, are currently offered. Those with multi-line responsibilities can choose to attend any combination of property and liability sessions. Most sessions qualify for Continuing Education Units from those states with CEU requirements for insurer staff adjuster licensing. The materials from all Conference sessions are available on line to all PLRB member and affiliate employees and meeting attendees within weeks of the meeting. Registration is free, of course, to all member insurer staff, and Affiliate Member employees receive discounted pricing.
Regional Adjusters, Large Loss, and "Hot Topic" Conferences
PLRB runs Eastern, Central, and Western Regional meetings each year, with each drawing about 600 attendees. Each attendee can attend eight 90-minute breakout sessions dealing with 28 topics relating to core property and liability claims adjusting skills. Each attendee also receives electronic access to the materials from all 28 topic sessions for reference or further education back at the office. Those not able to attend can still benefit from the meeting handouts by accessing them on line.
The annual Large Loss Conference focuses on $100,000+ claims in three tracks: commercial lines property claims; personal lines property claims; and casualty claims. It features new and emerging strategies, technologies, and services that adjusters and experts can use to more effectively manage and control large, complex property and casualty claims. It is characterized by adjuster-led presentations, with extensive audience participation, and the opportunity to learn together with many of the industry’s finest performers. The Large Loss Conference is for Large Loss Supervisors and Managers, GAs, EGAs, Complex Case Managers, those who aspire to this level of claim handling, and service providers who work with these types of claims.
As members' training and educational needs develop, PLRB responds flexibly. For example, during 2001 - 2003, PLRB ran such programs dealing with mold and terrorism issues. A construction defect litigation symposium was conducted in 2004. In cooperation with the Federation of Defense and Corporate Counsel (FDCC), PLRB conducts live or Web-based "Critical Issues" seminars dealing with the most important claims legal issues of the day.
And, again, registration for these meetings is free for all member insurer staff and Affiliate Member employees receive discounted pricing.
PLRB provides an ever-growing growing inventory of self-study distance learning modules. These modules vary in type from those which can be completed in just a few minutes, to those which present more in-depth material lasting an hour or so, to those offering multiple hours of adjuster Continuing Education (CE) and mandatory attorney Continuing Legal Education (CLE) credit.
Our most recent modules, which are all CE/CLE-accredited modules, consist of audio-visual materials prepared by PLRB staff, by the industry's leading claims service providers, or which originate "Live From the Claims Conference," capturing the experience of attending our property and liability Claims Conference sessions. The "Live from the Claims Conference" modules come complete with handouts, PowerPoint presentations, audience questions and interaction, and have full-motion audio/video streaming and captioning.
Our CE/CLE-accredited modules provide self-paced learning from any Web-enabled workstation or PC. Test results are tracked by PLRB and can also be tracked by individual members. Certificates of completion can be printed out and PLRB has automated much of the process of applying for and receiving CE credits for those modules which are CE-approved. A list of the topics offered, with links to the course descriptions, CE-approvals, and the courses themselves, can be viewed here.
Our current production schedule of CE/CLE-accredited modules calls for us to release new modules totaling at least 16 hours of credit each year. Thus, adjusters and attorneys can satisfy their CE/CLE license-maintenance requirements entirely through completion of such modules--all without any travel, registration, or CE-credit expense.
PLRB's Construction Reference Materials provide adjusters with tools that will help them settle claims in a knowledgeable and cost-effective way. They provide a detailed technical reference for home and light commercial claims. Issues addressed include material identification, installation, estimating, damageability and repairability. These materials fill in where estimating systems leave off, and offer great assistance to the inexperienced and veterans alike.
PLRB presents a continuing series of monthly webinars. These webinars have three purposes:
· PLRB Services Training: PLRB staff offers insurer staff training in how to take maximum advantage of all that PLRB offers them in Web resources. These webinars focus on either our property coverage resources, our liability coverage resources, or our catastrophe services.
· Hot Topics: Expert presenters deal with emerging issues in either the liability or property coverage or adjustment areas.
· Fine-Tuned Adjuster Series: "Soft subjects" such as customer service, productivity, and management are dealt with in these webinars. While not offering CE credit due to state restrictions, these lunchtime presentations have proved vastly popular with our members staffs, with many garnering 800 to 1,000 participants.
The need for current and accurate weather and catastrophe information is crucial to the efficient operation of a property claims department. PLRB provides a continual flow of data to its insurer members and Affiliate Members via the Catastrophe Services Department. It can be obtained in a variety of formats, including: a readable document, a spreadsheet, geocoded data, readable maps, and viewable charts. All information provided is carefully edited by the Catastrophe Services Department, so the data meets the specific needs of PLRB member insurers.
The center of PLRB’s Catastrophe Services information system is the on-line database accessible through PLRB's Weather/Cats home page. This system is updated seven days a week. It provides the members with current information on tornado, hail, wind, lightning probability, flood, earthquake, tropical storms and hurricanes, major fires, explosions, hazardous materials events, riots, blackouts, and other occurrences that are likely to cause multiple claims.
The daily on-line Severe Storm and Occurrence Summary, as well as all other weather and catastrophe information we provide, is available from convenient drop-down menus from the top of the PLRB Weather/Cats home page. The Severe Storm and Occurrence Summary is updated each morning and throughout the business day, as developments warrant. Users can click on the hyperlink that lists the day’s or the weekend’s occurrences for a complete report. The report also includes links to lightning probability charts, the Surface Analysis and Occurrence Number Chart, the Precipitation Summary, and the Occurrence Tracking Chart. The report provides a spreadsheet of the day's data.
PLRB Catastrophe Services also provides all data in geocoded ArcView and MapInfo Geographic Information Systems (GIS) formats. PLRB eases the use of PLRB's geocoded data, as well as providing a simple method for member insurers to overlay their geocoded business data on maps by making available to members our own purpose-built geocoding software, the PLRB Desktop Mapper.
Going further, our internet mapping system, PLRB Map, allows PLRB members and affiliates to conduct address-specific historical claims and underwriting research for all data in our system--lightning probability, tornado, hail, wind, flooding, wild fire, earthquake, etc. The data is displayed on a map, the features of which include state, county, city, and ZIP code boundaries, as well as streets, rivers, lakes, railroads, etc. The data also includes time-stamped satellite and aerial survey images as part of the overlay selections. PLRB Map thus adds a spatial view to the text and tabular views. Loading PLRB Map data onto your computer and using the available PLRB Desktop Mapper or other GIS software, you can overlay your company's book of business on a map showing catastrophe events while still protecting the proprietary information in your book of business.
For 2010, PLRB Map is being enhanced with hourly mapped raw data on severe weather events, providing current geocoded reports to loss managers about on-going events throughout the life of a storm system. PLRB Map is also being further enhanced by using geocoded Shapefiles to outline boundaries of severe weather and other activity on maps.
All our daily reports are also available as archived historical information for events which damaged property going back to 1950. This archive allows accurate historical claims investigation and underwriting research and analysis for any spot in the United States. The occurrences included are: tornadoes, hail greater than .75", wind in excess of 58 MPH, flooding, earthquakes of magnitude 5.0 Richter Scale or greater, major fires such as wildland/urban interface conflagrations, hazardous materials events, explosions, riots, blackouts, and other miscellaneous events such as ice storms. The data are presented in a readable text format or as GIS data files. The information is also presented in graphical formats, such as the popular lightning probability charts that are obtained by entering a date range and submitting the search.
The Catastrophe Main Page also links to catastrophe-oriented reference materials, such as policyholder communication documents for both personal and commercial lines, and a Catastrophe Claims Management Manual to help members plan their own catastrophe response.
Severe Weather Forecast
Information about the chance of severe weather, based on forecasts from the National Weather Service Storm Prediction Center, is also available from the Catastrophe Main Page. Information is updated by the Storm Prediction Center automatically throughout the day. The daily Threats Assessment provides an summary of seismic and weather-related risks that could produce large numbers of property claims. It includes geocoded versions of the high risk storm areas in the ArcView and MapInfo formats, viewable charts and maps, and links to government scientific Web sites for more detailed data.
Watches and Warnings
Current Tornado, Severe Thunderstorm, Flood, Tropical Storm, and Hurricane watches and warnings issued by the National Weather Service Storm Prediction Center and National Hurricane Center are also linked to the Catastrophe Main Page.
Data regarding active and inactive Atlantic and Pacific storms includes a log of all U. S. watches and warnings. Also included are charts and maps of the projected and actual track, the projected and actual landfall analyzed by ZIP code, and actual landfall wind speed tables. The data are provided in a readable text version, as a spreadsheet, with graphical maps and charts, with satellite images, and with radar images. Geocoded data are provided in both the ArcView and the MapInfo formats when the storm is forecast to make landfall on the United States. This may be utilized in your Geographic Information System by overlaying the forecast wind-speed fields on your book-of-business. Tropical Storm and Hurricane watches and warnings provided by the National Hurricane Center are linked from the Web site.
Disasters inevitably put pressure on an insurer's usual ability to find the expert help it needs in adjustment and restoration of losses, both in the disaster areas and elsewhere in the country. PLRB provides an alphabetical list of all our affiliate member claims service providers showing basic location and contact information, with links to each firm's Web site.
To dig deeper, PLRB's Service Provider Directory is an on-line resource powered by ClaimsPages which can help you locate the expert claims service providers you need when your usual preferred provider resources are stretched thin. This service is available free of charge to any PLRB insurer or PLRB Affiliate Member.
Over a million claims service providers in 400 categories are indexed. Searching is flexible since you can either search by state or by service category.
Access our Service Provider Directory service from the left menu bar of our home page at the Locate Providers button. Click on the Locate Providers button, then select "Click Here to Search for Providers by Keyword/Category or County/City/State using ClaimsPages.com." The Directory then allows you to either choose a service category or a state to begin the search.
Whether you use the by-state or by-category method of searching, the system then automatically searches a database of over a million businesses for firms which match the selections you've made and then automatically builds and displays a list of all service providers fitting your selected requirements.
The retrieved list screen displays:
1. an option to search surrounding counties;
2. an option to conduct a new search;
3. explanation of ClaimsPages' star notation and the PLRB notation found next to listings; and
4. listed Search results, including (where available):
a. company name;
c. PLRB or ClaimsPages subscription information or affiliation;
d. telephone number;
e. e-mail message link;
f. link to the Web site of the particular vendor which opens a new browser window to display the particular vendor's Web site;
g. link to any ClaimsPages graphic advertisement associated with that particular vendor which opens a new browser window to display the particular vendor's advertisement graphic page; and
h. link to a map of the office location for the vendor.
Note that PLRB affiliate members automatically appear at the top of the retrieved list.
PLRB has a Web-based mechanism for insurer and affiliate members to request litigation support from other members and affiliates in the form of amicus curiae ("friend of the court") briefs. You can access this service by clicking on the "Coverage Research" button in the left bar of our home page and then selecting "Amicus Curiae" from the top bar.
PLRB staff is there by phone or Web to answer your questions regarding our products and services. We are proactive in teaching members how to get the biggest bang for their membership buck by offering:
· On-line PowerPoint tutorials
· Hands-on training classes at our educational conferences
· Monthly Webinars on searching for material accessible through our website
· Membership Administration functions by which managers can track their staff usage of our resources and services and obtain an analysis of the cost/benefit ratio of their company's membership.
PLRB is not just a resource for you to get information from. We are a trade association that values the experience and expertise that each member brings to the organization. As such, there are all kinds of opportunities to become involved in our organization. From speaking at one or more of our conferences on a desired topic, to participating behind the scenes on one of our committees. We listen to what our members are interested in and let them shape the direction we take both in research projects by staff as well as topics to be presented at our conferences. So, get involved! This is not just an organization for the claims industry, but rather the claims industry's organization.