 
                Failing to Understand the Contract it Wrote Cost the Sox
Barry Zalma
Nov 14, 2023
Read the full article at https://lnkd.in/gNfgmR7E and see the full video at https://lnkd.in/gDcqJayb and at https://lnkd.in/grwE7Y4u and at https://zalma.com/blog plus more than 4650 posts.
The Chicago White Sox, Ltd., et al (the White Sox plaintiffs), and State Automobile Mutual Insurance Company (State Auto), the insurer for defendant We Clean Maintenance and Supplies, Inc. (We Clean) disputed whether the White Sox were additional insureds of We Clean’s policy with State Auto.
After a patron was injured at a Chicago White Sox game, he sued the White Sox plaintiffs alleging that State Auto had wrongfully denied coverage. The circuit court granted summary judgment in favor of State Auto.
In Chicago White Sox, Ltd. et al v. State Automobile Mutual Insurance Company et al, No. 1-23-0101, 2023 IL App (1st) 230101-U, Court of Appeals of Illinois (November 8, 2023)
BACKGROUND
The White Sox plaintiffs entered into a series of written agreements with We Clean who agreed to provide cleaning services for all home games played by the Chicago White Sox during the applicable baseball season.
In 2011 Raymond Myles was injured as he was walking down a ramp. Myles sued. The lawsuit was ultimately settled for an undisclosed amount.
We Clean was insured by State Auto under a commercial general liability insurance policy.
The circuit court granted State Auto’s motion for summary judgment because there was no contract requiring the White Sox to be an additional insured.
ANALYSIS
Without a written agreement there was no basis for finding additional insureds and the circuit court properly granted summary judgment in favor of State Auto.
CONCLUSION
The circuit court properly granted summary judgment since there was no written agreement between We Clean and the White Sox plaintiffs requiring the White Sox plaintiffs to be named as additional insureds under We Clean’s policy, the White Sox plaintiffs were not entitled to coverage by State Auto.
ZALMA OPINION
Reading the full policy is a requirement of everyone who is involved in acquiring or making claims against an insurance policy. The White Sox failed to create a contract with We Clean requiring it to make the White Sox an additional insured. Since it failed to include that requirement in the We Clean contract the White Sox gave up the right to be an additional insured of We Clean and the Sox and its insurer was obligated to defend it without help from We Clean’s insurer.
(c) 2023 Barry Zalma & ClaimSchool, Inc.
Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.
Subscribe to my substack at https://lnkd.in/gNfgmR7E; Go to Barry Zalma videos at Rumble.com at https://lnkd.in/d-SNCQES to the Insurance Claims Library – https://lnkd.in/gwEYkxD. blog and the videos and let them subscribe to the blog and the videos.
Subscribe to my substack at https://lnkd.in/gNfgmR7E; Go to Barry Zalma videos at Rumble.com at https://lnkd.in/d-SNCQES to the Insurance Claims Library – https://lnkd.in/gwEYkxD.
The Professional Claims Handler
Post 5218
Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-8-barry-zalma-esq-cfe-zdwsc, see the full video at https://rumble.com/v70zl4s-the-zalma-philosophy-of-claims-handling-part-8.html and at https://youtu.be/MIYcF71ffRQ, and at https://zalma.com/blog plus more than 5200 posts.
Claims Commandment X – Thou Shall Not Pretend to be a Lawyer
Some experienced and professional claims people know the law in their area of expertise better than most lawyers.
Adjusters should be adjusters and leave lawyering to lawyers. Similarly, lawyers should be lawyers and never try to be adjusters.
Claims Commandment XI – Thou Shall Empathize With the Claimant
Everyone presenting a claim is unhappy, disturbed, shocked, injured and needs help.
Empathy is identification with and understanding of another’s situation, feelings, and motives. It is the ability to understand another person’s circumstances, point of view, thoughts, and feelings....
HOW TO CREATE AN EXCELLENCE IN CLAIMS HANDLING PROGRAM
See the full video at https://rumble.com/v70wb2i-the-zalma-philosophy-of-claims-handling-part-6.html and at https://youtu.be/tL5nDKPEs40 and at https://zalma.com/blog plus more than 5200 posts.
Post 5217
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry.
An Excellence in Claims Handling program begins with a statement in the insurer’s claims manual or statement of professionalism that it is dedicated to providing excellence in claims handling to every insured who presents a claim.
The excellence in claims handling program should include, at a minimum:
A series of lectures supported by text materials explaining:
A definition of insurance.
How to read and understand an insurance policy.
How to interview an insured, witness, or claimant.
How to assist an insured in the insured’s obligation to ...
The Professional Claims Handler
Post 5216
Read the full article at https://www.linkedin.com/pulse/zalma-philosophy-claims-handling-part-5-barry-zalma-esq-cfe-jde8c, see the full video at https://rumble.com/v70q4x8-the-zalma-philosophy-of-claims-handling-part-5.html and at https://youtu.be/6b9tZQsEkB4, and at https://zalma.com/blog plus more than 5200 posts.
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry.
Standards to be a Professional Claims Adjuster
The Insurance claims professional should be a person who:
1.    Can read and understand the insurance policies issued by the insurer.
2.    Understands the promises made by the policy.
3.   Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
4.    Are competent investigators.
5.    Have empathy and recognize the difference between empathy and sympathy.
6.    ...
The Professional Claims Handler
Post 5219
Posted on October 31, 2025 by Barry Zalma
An Insurance claims professionals should be a person who:
Can read and understand the insurance policies issued by the insurer.
Understands the promises made by the policy.
Understand their obligation, as an insurer’s claims staff, to fulfill the promises made.
Are competent investigators.
Have empathy and recognize the difference between empathy and sympathy.
Understand medicine relating to traumatic injuries and are sufficiently versed in tort law to deal with lawyers as equals.
Understand how to repair damage to real and personal property and the value of the repairs or the property.
Understand how to negotiate a fair and reasonable settlement with the insured that is fair and reasonable to both the insured and the insurer.
How to Create Claims Professionals
To avoid fraudulent claims, claims of breach of contract, bad faith, punitive damages, unresolved losses, and to make a profit, insurers ...
 
            
        
                    
        The History Behind the Creation of a Claims Handling Expert
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster
When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.
I was initially sat at a desk reading a text-book on insurance ...
 
            
        
                    
        The History Behind the Creation of a Claims Handling Expert
The Insurance Industry Needs to Implement Excellence in Claims Handling or Fail
Post 5210
This is a change from my normal blog postings. It is my attempt. in more than one post, to explain the need for professional claims representatives who comply with the basic custom and practice of the insurance industry. This statement of my philosophy on claims handling starts with my history as a claims adjuster, insurance defense and coverage lawyer and insurance claims handling expert.
My Training to be an Insurance Claims Adjuster
When I was discharged from the US Army in 1967 I was hired as an insurance adjuster trainee by a professional and well respected insurance company. The insurer took a chance on me because I had been an Army Intelligence Investigator for my three years in the military and could use that training and experience to be a basis to become a professional insurance adjuster.
I was initially sat at a desk reading a text-book on insurance ...
