Insurer’s Exclusion for Claims of Assault & Battery is Effective
Post 5250
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Bar Fight With Security is an Excluded Assault & Battery
In The Cincinnati Specialty Underwriters Insurance Company v. Mainline Private Security, LLC, et al., Civil Action No. 24-3871, United States District Court, E.D. Pennsylvania (December 16, 2025) two violent attacks occurred in Philadelphia involving young men, Eric Pope (who died) and Rishabh Abhyankar (who suffered catastrophic injuries). Both incidents involved security guards provided by Mainline Private Security, LLC (“Mainline”) at local bars. The estates of the victims sued the attackers, the bars, and Mainline for negligence and assault/battery. The insurer exhausted a special limit and then denied defense or indemnity to Mainline Private Security.
INSURANCE COVERAGE
Mainline had purchased a commercial general liability policy from The Cincinnati Specialty Underwriters Insurance Company (“CSU”), which included a specific exclusion limiting coverage for claims arising out of assault and battery to $250,000. This coverage was exhausted, and CSU sought a declaratory judgment that it was not obligated to defend or indemnify Mainline or an additional insured (Mikey II) for the lawsuits.
Claims:
The lawsuits against Mainline and the bars were based on both negligence and assault/battery. CSU argued that all claims fell within the assault and battery exclusion of the policy.
LEGAL ANALYSIS\
Policy Exclusion:
The key legal issue was whether the negligence claims in the underlying lawsuits were covered by the assault and battery exclusion in CSU’s policy. The exclusion was broad, covering not only direct assault and battery but also failures to prevent such acts, failures to provide adequate security, and negligent hiring, supervision, or training of employees involved in assault/battery, all of which were within the ambit of the exclusion.
Pennsylvania Law:
The court applied Pennsylvania law, which interprets insurance contracts according to their plain meaning and enforces clear and unambiguous language. The court found the exclusion language to be clear, unambiguous and comprehensive.
Causation Standard:
Under Pennsylvania law, “arising out of” in policy exclusions is interpreted as “but for” causation—if the injury would not have occurred but for the assault/battery, the exclusion applies.
Negligence Claims:
The court reviewed the specific negligence allegations and found that all were causally linked to the assault and battery incidents. The exclusion covered not only intentional acts but also related negligence, such as failure to provide adequate security or properly train staff.
CONCLUSION AND JUDGMENT
Summary Judgment:
The court granted summary judgment in favor of CSU, holding that all claims in the Pope and Abhyankar lawsuits fell within the assault and battery exclusion. Since the $250,000 coverage limit had been exhausted, CSU had no further duty to defend or indemnify Mainline or Mikey II.
Illusory Coverage Argument:
The court rejected this, noting that CSU was not required by law to offer the coverage and that the policy did provide coverage in other circumstances.
IMPORTANT CONCLUSIONS
Assault and battery exclusions in liability policies can encompass related negligence claims if the injuries are causally connected to assault/battery. Courts will enforce clear and unambiguous exclusion language under Pennsylvania law. Once the specified coverage limit for excluded claims is exhausted, the insurer’s duty to defend or indemnify ends.
Because all the claims in the Pope and Abhyankar lawsuits are covered by CSU’s assault and battery exclusion, CSU’s duty to defend and indemnify Mainline and Mikey II is limited to the $250,000 supplemental coverage. And because this $250,000 has been fully eroded through the payment of defense costs and settlements from other claims CSU has no duty to defend or indemnify Mainline or Mikey II for the Pope and Abhyankar lawsuits.
The $250,000 limit in coverage for these claims has been exhausted, and therefore CSU is not obligated to defend or indemnify Mainline or Mikey II in the Pope and Abhyankar lawsuits.
ZALMA OPINION
Since the first liability insurance policy was written – perhaps in clay tablets in ancient Sumeria, insurers limited the limits of the insurance to fortuitous acts, accidents. Assault and Battery causing injury are always, by definition, intentional acts. To avoid argument insurers wrote into their policies clear and unambiguous assault and battery exclusions, as did CSU. CSU provided an extra coverage agreeing to insure against claims of Assault and Battery up to $250,000 of expense and indemnity payments. Once the $250,000 was exhausted coverage stopped and the insureds are left to defend themselves and pay any judgments from their own assets.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Happy Law Day
ZIFL – Volume 30, Issue 9 – May 1, 2026
Read the full article at https://www.linkedin.com/pulse/zalmas-insurance-fraud-letter-may-1-2026-barry-zalma-esq-cfe-2tywc, see the video at at and at https://zalma.com/blog plus more than 5300 posts.
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
ZIFL – Volume 30, Issue 9 – May 1, 2026
Zalma’s Insurance Fraud Letter (ZIFL) continues its 30th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year and is written by Barry Zalma.
DOJ Creates National Fraud Enforcement Division
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When Abalone Died As a Result of Multiple Causes The Efficient Proximate Cause Requires Payment
Post number 5345
Read the full article at https://www.linkedin.com/pulse/efficient-proximate-cause-doctrine-saves-claim-barry-zalma-esq-cfe-yndlc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.
In American Abalone Farms, LLC v. Star Insurance Company et al., H052643, California Court of Appeals, Sixth District (April 27, 2026) the Court of Appeals dealt with an insurance coverage issue that required application of the efficient proximate cause doctrine.
FACTS
American Abalone Farms, LLC ("American Abalone" ) operates an aquaculture farm in Santa Cruz County, California, raising abalone in tanks. In August 2020, the CZU Lightning Complex Fires led to a prolonged power outage and road closures near the farm. As a result, the farm’s water pumps failed, causing the death of most of the ...
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See the video at and at and at https://zalma.com/blog plus more than 5300 posts.
In United Services Automobile Association and State Farm Mutual Automobile Insurance Company v. Anthony Wenzell, 2026 CO 25 (Colo. Apr. 27, 2026) Anthony Wenzell was rear-ended in a car accident. He had a significant prior 2014 accident that required back surgery.
Wenzell claimed underinsured-motorist (UIM) benefits under three policies: (1) the tortfeasor’s liability policy, (2) his own primary UIM policy with State Farm, and (3) an excess UIM policy issued by USAA (under his brother’s policy, which contained an “other insurance” clause making USAA’s coverage excess over any collectible insurance).
After receiving the claims, both USAA and State Farm repeatedly requested that Wenzell execute comprehensive medical-release authorizations so they could obtain his full medical records and ...
It is Fraud to Make the Same Claim Twice
Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.
Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages
Post number 5347
No One is Entitled to be Paid for the Same Loss Twice
In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.
BACKGROUND
In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.
PROCEDURAL HISTORY
State Farm filed motion for summary...
It is Fraud to Make the Same Claim Twice
Read the full article at https://www.linkedin.com/pulse/fraud-make-same-claim-twice-barry-zalma-esq-cfe-c4g8c and at https://zalma.com/blog.
Chutzpah: After Being Paid for a New Roof Insured Makes Second Claim For Same Damages
Post number 5347
No One is Entitled to be Paid for the Same Loss Twice
In Mohammed Ali Khalili v. State Farm Lloyds, No. 14-25-00611-CV, Court of Appeals of Texas (April 30, 2026) Khalili maintained a State Farm Lloyds homeowners insurance policy for decades. In 2008 he filed a roof-damage claim; State Farm paid him to replace the entire roof (shingles and gutters). Khalili never replaced the roof and repeated his claim.
BACKGROUND
In 2021 he filed a second roof claim. State Farm’s inspectors found the roof “very old” with extensive non-storm-related damage. The claim was denied because (1) the damage did not exceed the deductible and (2) State Farm had already paid for a full roof replacement.
PROCEDURAL HISTORY
State Farm filed motion for summary...
What Must be Done after Notice of a Claim is Received by the Insurer
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A first party property policy does not insure property: it insures a person, partnership, corporation or other entity against the risk of loss of the property. Before an insured can make a claim for indemnity under a policy of first party property insurance the insured must prove that there was damage to property the risk of loss of which was insured by the policy. The obligation imposed on the insured ...
