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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Anti-Public Adjuster Clause Is Effective in New York
Post number 5301
Read the full article at https://www.linkedin.com/pulse/public-adjusters-attempt-represent-insured-subject-zalma-esq-cfe-rubfc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.
Insurers May Contractually Prevent an Insured from Hiring a Public Adjuster
In Peter Barbato & North Jersey Public Adjusters Inc. v. Interstate Fire & Casualty Company, et al, No. 25-cv-5312 (JGK), United States District Court, S.D. New York (December 15, 2025) the plaintiffs, Peter Barbato and North Jersey Public Adjusters, Inc. (“NJPA”), filed suit against several insurance companies, including Interstate Fire & Casualty Company, Independent Specialty Insurance Company, and certain Underwriters at Lloyd’s of London.
FACTS
NJPA is a New Jersey-based public adjusting firm licensed in New York. The dispute centers on ...
Anti-Public Adjuster Clause Is Effective in New York
Post number 5301
Read the full article at https://www.linkedin.com/pulse/public-adjusters-attempt-represent-insured-subject-zalma-esq-cfe-rubfc, see the video at and at and at https://zalma.com/blog plus more than 5300 posts.
Insurers May Contractually Prevent an Insured from Hiring a Public Adjuster
In Peter Barbato & North Jersey Public Adjusters Inc. v. Interstate Fire & Casualty Company, et al, No. 25-cv-5312 (JGK), United States District Court, S.D. New York (December 15, 2025) the plaintiffs, Peter Barbato and North Jersey Public Adjusters, Inc. (“NJPA”), filed suit against several insurance companies, including Interstate Fire & Casualty Company, Independent Specialty Insurance Company, and certain Underwriters at Lloyd’s of London.
FACTS
NJPA is a New Jersey-based public adjusting firm licensed in New York. The dispute centers on ...
Proof of Highly Contaminated Water is Required for Extra Payments
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Facts
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Insurance Condition Requires Following the Intent of the Parties
Post number 5307
Principles of Contract Interpretation Compels Reading Contract as Written
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In Eastside Floor Supplies, Ltd. v. SCS Agency, Inc., Hanover Insurance Company, et al., No. 2024-01501, Index No. 609883/19, 2026 NY Slip Op 01488, Supreme Court of New York, Second Department (March 18, 2026)
In May 2019, a fire damaged business personal property belonging to the plaintiffs, which was stored in portable storage containers at their Manhattan premises. At the time of the fire, the plaintiffs were insured under a businessowners insurance policy (BOP) issued by the defendant Hanover Insurance Company which provided general coverage for business personal property, and which included a specific extension for “Business Personal Property Temporarily in Portable Storage Units” (the portable storage ...
ERISA Saves Fraudulent Claims Suit
Post number 5306
Read the full article at https://www.linkedin.com/pulse/failure-provide-well-pled-facts-defeats-most-action-zalma-esq-cfe-b4zuc and at https://zalma.com/blog plus more than 5300 posts.
Allegations of Fraudulent Insurance Billing Must be Pleaded with Specificity
In Genesis Laboratory Management LLC v. United Healthcare Services, Inc. and Oxford Health Plans, Inc., No. 21cv12057 (EP) (JSA), United States District Court, D. New Jersey (March 13, 2026) Genesis Laboratory Management LLC (“Genesis”), a New Jersey-based molecular diagnostic and anatomic pathology laboratory, provided COVID-19 related testing services and submitted claims for reimbursement as an out-of-network provider to United Healthcare Services, Inc. (“United”) and Oxford Health Insurance, Inc. (“Oxford”). Metropolitan Healthcare Billing, LLC (“Metropolitan”), owned by the same individual as Genesis, handled the billing for Genesis.
FACTUAL BACKGROUND
United and Oxford, who administer both ERISA and ...
ERISA Saves Fraudulent Claims Suit
Post number 5306
Read the full article at https://www.linkedin.com/pulse/failure-provide-well-pled-facts-defeats-most-action-zalma-esq-cfe-b4zuc and at https://zalma.com/blog plus more than 5300 posts.
Allegations of Fraudulent Insurance Billing Must be Pleaded with Specificity
In Genesis Laboratory Management LLC v. United Healthcare Services, Inc. and Oxford Health Plans, Inc., No. 21cv12057 (EP) (JSA), United States District Court, D. New Jersey (March 13, 2026) Genesis Laboratory Management LLC (“Genesis”), a New Jersey-based molecular diagnostic and anatomic pathology laboratory, provided COVID-19 related testing services and submitted claims for reimbursement as an out-of-network provider to United Healthcare Services, Inc. (“United”) and Oxford Health Insurance, Inc. (“Oxford”). Metropolitan Healthcare Billing, LLC (“Metropolitan”), owned by the same individual as Genesis, handled the billing for Genesis.
FACTUAL BACKGROUND
United and Oxford, who administer both ERISA and ...
