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Insurance Claims professional presents articles and videos on insurance, insurance Claims and insurance law for insurance Claims adjusters, insurance professionals and insurance lawyers who wish to improve their skills and knowledge. Presented by an internationally recognized expert and author.
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February 21, 2025
No Coverage for Criminal Acts

Concealing a Weapon Used in a Murder is an Intentional & Criminal Act

Post 5002

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In Howard I. Rosenberg; Kimberly L. Rosenberg v. Chubb Indemnity Insurance Company Howard I. Rosenberg; Kimberly L. Rosenberg; Kimberly L. Rosenberg; Howard I. Rosenberg v. Hudson Insurance Company, No. 22-3275, United States Court of Appeals, Third Circuit (February 11, 2025) the Third Circuit resolved whether the insurers owed a defense for murder and acts performed to hide the fact of a murder and the murder weapon.

FACTUAL BACKGROUND

Adam Rosenberg and Christian Moore-Rouse befriended one another while they were students at the Community College of Allegheny County. On December 21, 2019, however, while at his parents’ house, Adam shot twenty-two-year-old Christian in the back of the head with a nine-millimeter Ruger SR9C handgun. Adam then dragged Christian’s body across the road in front of his parents’ home and left it in a wooded park.

After their adult son shot and killed his twenty-two-year-old former classmate at their house, the parents allegedly delayed discovery of the murder weapon and the victim’s body. Based on that delay, the victim’s mother sued the homeowners in state court for the intentional infliction of emotional distress. The homeowners then sought legal representation under two of their insurance policies – their homeowner’s policy and their umbrella policy.

It took over two months for the police to find Christian’s body. The gun turned up a month after Christian’s killing – produced by Martha Laux. She told police that she had found a handgun along a trail while walking her dog in North Park, a large public park in Allegheny County. Over a month after receiving the handgun, homicide detectives found Christian’s body. They later learned not only that the weapon used to kill Christian was already in police custody but also that Laux was the marriage counselor for Adam’s parents, Kimberly and Howard Rosenberg.

Based on the delayed discovery of her son’s body, Christian’s mother, T. Lee Rouse, sued the Rosenberg parents in the Court of Common Pleas of Allegheny County, Pennsylvania.

District Court Decision

The District Court rejected the claims by the homeowners and upheld the insurers’ denial-of-coverage decisions. The District Court’s decision in this appeal brought by the homeowners’s insurer denied coverage on several grounds, including that the claim against the homeowners did not relate to an accident. The umbrella insurer likewise denied coverage on that basis as well as several other grounds, including that an insurer’s promise to defend an insured for criminal acts is contrary to public policy and thus unenforceable under Pennsylvania law.

Was There an Accident?

The District Court examined whether the injuries alleged in the complaint resulted from an accident. Under the Rosenbergs’ homeowner’s policy, Chubb’s duty to defend depended on whether the injuries resulted from an accident. The allegations against the Rosenbergs involved intentional actions, specifically the concealment of the handgun that would have implicated their son and led to the earlier discovery of the victim’s body. The District Court concluded that the injuries did not result from an accident, and Chubb had no duty to defend under the homeowner’s policy.

Public Policy Against Insuring Criminal Acts

The court also addressed the issue of public policy. The Hudson policy included an unexpected-or-unintended injury clause, which introduced subjective considerations into the meaning of ‘occurrence’. However, the District Court held that any duty to defend would not be enforceable because Pennsylvania law forbids insuring criminal acts as contrary to public policy.
Discussion

Under the Rosenbergs’ homeowner’s policy, Chubb’s duty to defend depended on whether Rouse’s alleged injuries resulted from ‘an accident.’ Although the policy itself does not define ‘accident,’ Pennsylvania courts have defined that term as meaning the culmination of forces working without design, coordination or plan. The allegations against the Rosenbergs do not involve such chance. Rather, Rouse alleged that the Rosenbergs acted intentionally by concealing the handgun that would have implicated Adam and led to the earlier discovery of Christian’s body.

ZALMA OPINION

For liability insurance to respond to a request for defense or indemnity of a tort lawsuit the suit must allege that the actions of the defendants were neither intended nor expected by the insured, i.e., an accident. The acts of the parents, hiding the gun used in the killing and making the discovery of the body more difficult they acted intentionally to cause harm to the family of the deceased and to protect their son from responsibility for his criminal act. In addition the Third Circuit concluded that it is against the public policy of the state to allow insurance protection for criminal acts.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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00:08:09
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February 20, 2025
Electronic Notice of Renewal Sufficient

Renewal Notices Sent Electronically Are Legal, Approved by the State and Effective
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Washington state law allows insurers to deliver insurance notices and documents electronically if the party has affirmatively consented to that method of delivery and has not withdrawn the consent. The Plaintiffs argued that the terms and conditions statement was not “conspicuous” because it was hidden behind a hyperlink included in a single line of small text. The court found that the statement was sufficiently conspicuous as it was bolded and set off from the surrounding text in bright blue text.

In James Hughes et al. v. American Strategic Insurance Corp et al., No. 3:24-cv-05114-DGE, United States District Court (February 14, 2025) the USDC resolved the dispute.

The court’s reasoning focused on two main points:

1 whether the ...

00:09:18
February 19, 2025
Post Procurement Fraud Prevents Rescission

Rescission in Michigan Requires Preprocurement Fraud
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Lie About Where Vehicle Was Garaged After Policy Inception Not Basis for Rescission

This appeal turns on whether fraud occurred in relation to an April 26, 2018 renewal contract for a policy of insurance under the no-fault act issued by plaintiff, Encompass Indemnity Company (“Encompass”).

In Samuel Tourkow, by David Tourkow v. Michael Thomas Fox, and Sweet Insurance Agency, formerly known as Verbiest Insurance Agency, Inc., Third-Party Defendant-Appellee. Encompass Indemnity Company, et al, Nos. 367494, 367512, Court of Appeals of Michigan (February 12, 2025) resolved the claims.

The plaintiff, Encompass Indemnity Company, issued a no-fault insurance policy to Jon and Joyce Fox, with Michael Fox added as an additional insured. The dispute centers on whether fraud occurred in...

00:07:58
February 18, 2025
The Too Honest Jeweler

A True Crime Story of Insurance Fraud
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This is a fictionalized true crime story of insurance fraud explaining why insurance fraud is a “Heads I Win, Tails You Lose” situation for insurers. The story that follows is designed to help everyone understand how insurance fraud in America is costing everyone who buys insurance thousands of dollars every year and why insurance fraud is safer and more profitable for the ­­­perpetrators than any other crime.

The jeweler had learned to cut diamonds in Antwerp. For ten years he worked in a small office grinding facets onto stones of half a carat or less. The boredom of the job infuriated him. He had no future.

He decided to immigrate to the United States where he could use his skills. He turned his savings into small diamonds which he purchased below wholesale from...

00:14:17
February 07, 2025
From Insurance Fraud to Human Trafficking

Insurance Fraud Leads to Violent Crime
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CRIMINAL CONDUCT NEVER GETS BETTER

In The People v. Dennis Lee Givens, B330497, California Court of Appeals, Second District, Eighth Division (February 3, 2025) Givens appealed to reverse his conviction for human trafficking and sought an order for a new trial.

FACTS

In September 2020, Givens matched with J.C. on the dating app “Tagged.” J.C., who was 20 years old at the time, had known Givens since childhood because their mothers were best friends. After matching, J.C. and Givens saw each other daily, and J.C. began working as a prostitute under Givens’s direction.

Givens set quotas for J.C., took her earnings, and threatened her when she failed to meet his demands. In February 2022, J.C. confided in her mother who then contacted the Los Angeles Police Department. The police ...

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February 06, 2025
No Mercy for Crooked Police Officer

Police Officer’s Involvement in Insurance Fraud Results in Jail
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Von Harris was convicted of bribery, forgery, and insurance fraud. He appealed his conviction and sentence. His appeal was denied, and the Court of Appeals upheld the conviction.

In State Of Ohio v. Von Harris, 2025-Ohio-279, No. 113618, Court of Appeals of Ohio, Eighth District (January 30, 2025) the Court of Appeals affirmed the conviction.

FACTUAL BACKGROUND

On January 23, 2024, the trial court sentenced Harris. The trial court sentenced Harris to six months in the county jail on Count 15; 12 months in prison on Counts 6, 8, 11, and 13; and 24 months in prison on Counts 5 and 10, with all counts running concurrent to one another for a total of 24 months in prison. The jury found Harris guilty based on his involvement in facilitating payments to an East Cleveland ...

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February 05, 2025
EXCUSABLE NEGLECT SUFFICIENT TO DISPUTE ARBITRATION LATE

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To Dispute an Arbitration Finding Party Must File Dispute Within 20 Days
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EXCUSABLE NEGLECT SUFFICIENT TO DISPUTE ARBITRATION LATE

In Howard Roy Housen and Valerie Housen v. Universal Property & Casualty Insurance Company, No. 4D2023-2720, Florida Court of Appeals, Fourth District (January 22, 2025) the Housens appealed a final judgment in their breach of contract action.

FACTS

The Housens filed an insurance claim with Universal, which was denied, leading them to file a breach of contract action. The parties agreed to non-binding arbitration which resulted in an award not

favorable to the Housens. However, the Housens failed to file a notice of rejection of the arbitration decision within the required 20 days. Instead, they filed a motion for a new trial 29 days after the arbitrator’s decision, citing a clerical error for the delay.

The circuit court ...

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