Is a “Loss” an “Occurrence”?

Insurance policies define “Occurrence.”  Generally, policies define an “occurrence” as an “accident” or “repeated exposure to the same or similar” conditions.  Liability policies require an occurrence for coverage and require an insured to give prompt notice of any “occurrence” that could result in a claim. First-party coverage, however, often does not rely on the word “occurrence.”  Most policies require an insured to give prompt notice of a “loss.”  Recently, the United States District Court for the Western District of Virginia determined if “occurrence” and “loss” meant the same thing and what impact the use of each word had on an insured’s duty to timely report a first-party claim. In Wheeler v. Standard Fire Ins. Co., 2016 U.S. Dist. LEXIS 38255, Wheeler suffered damage to her barn when trees fell on the porch of the barn.  Thinking that the barn repair cost would be less than her deductible, Wheeler had unidentified day laborers repair the damage.  She did not notice any other damage at the time. Several months after the repair, Wheeler heard rumbling noises and then the foundation basement wall of the barn collapsed on the same side of the barn where the trees fell.  Wheeler reported the earlier damage and the wall collapse to her insurer.  Experts determined that the trees falling months earlier led to the wall collapsing.  Despite that, the insurer denied coverage for several reasons, the first that Wheeler did not “promptly” report her “loss” to the insurer. The insurer claimed that Wheeler should have reported her claim when the trees fell on the barn. The Honorable Norman K. Moon first noted that “occurrence” is...

Gary Reinhardt to Speak at the Eastern Regional Adjusters Conference of The Property & Liability Resource Bureau

KPM LAW’s Gary Reinhardt, Managing Partner of KPM’s Coverage & Fraud Department, will present at The Property & Liability Resource Bureau’s Eastern Regional Adjusters Conference in Atlanta, Georgia, on November 10-11, 2015.  An AV-rated attorney who serves as General Counsel to the International Association of Special Investigation Units, Gary is speaking on the latest trends and strategies in property fraud claims. Gary and the team at KPM LAW hope to see you at this valuable two-day conference.  More information can be found at http://www.plrbregionalconferences.org/.  ...