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18 hours ago
State Regulatory Action does not Eliminate Effect of Exclusion

See the video at https://lnkd.in/grQRRWa5 and at https://lnkd.in/gH8gtAr2, and at https://zalma.com/blog plus more than 5250 posts.

Insurance Policy Exclusions Must be Enforced as Written
Post number 5272

Pollution With a State Permit is Still Excluded

In Griffith Foods International, Inc., et al. v. National Union Fire Insurance Company Of Pittsburgh, Pa, No. 131710, Supreme Court of Illinois, 2026 IL 131710 (January 23, 2026) Griffith Foods International, Inc., and its successor Sterigenics U.S., LLC, operated a medical-equipment sterilization facility in Willowbrook, Illinois. Local residents alleged that for over 35 years, the facility emitted ethylene oxide (EtO), which they claimed caused cancer and other serious illnesses.

The policyholders sought a declaration that National Union Fire Insurance Company of Pittsburgh, PA, was obligated to defend them in the underlying mass tort litigation, based on two CGL policies issued for the facility between September 1983 and September 1985.

The two policies required the insurer to “defend any suit against the insured seeking damages on account of *** bodily injury” that “occur[red] during the policy period” and “personal injury” arising out of “offenses committed during the policy period.” The CGL policies included a standard pollution exclusion, which is the subject of this appeal. The pollution exclusion bars coverage for “bodily injury or property damage arising out of the discharge, dispersal, release or escape of smoke, vapors, soot, fumes, acids, alkalis, toxic chemicals, liquids or gases, waste materials or other irritants, contaminants or pollutants into or upon land, the atmosphere or any water course or body of water.”

THE QUESTION FROM THE SEVENTH CIRCUIT

“In light of the Illinois Supreme Court’s decision in [American States Insurance Co. v. Koloms, 177 Ill.2d 473 (1997)] what relevance, if any, does a permit or regulation authorizing emissions (generally or at any particular levels) play in assessing the application of a pollution exclusion within a standard-form commercial general liability policy?”

LEGAL ISSUE

The key legal issue was the interpretation of the pollution exclusion in the CGL policies, which excludescoverage for bodily injury or property damage resulting from the release of pollutants, including toxic chemicals and gases, into the environment.

ANALYSIS

The Court reasoned that the pollution exclusion is triggered by the nature of the contaminant released and the resulting injury, not by whether the release was authorized or regulated. Past decisions confirmed that the exclusion applies regardless of compliance with permits or regulatory standards. Thus, the presence of a permit or regulation authorizing emissions does not influence the scope or application of the exclusion; coverage is barred so long as the injury results from pollutants as defined in the policy.

OPINION

The Supreme Court of Illinois, responding to the certified question from the Seventh Circuit, held that a permit or regulation authorizing emissions — whether generally or at specific levels — does not affect the interpretation or application of the pollution exclusion clause in a standard-form commercial general liability (CGL) insurance policy. The Court’s answer was clear: such regulatory authorizations are irrelevant when determining coverage under the pollution exclusion.

The plain language of the pollution exclusion states that coverage is barred for litigation involving “the discharge, dispersal, release or escape of smoke, vapors, soot, fumes, acids, alkalis, toxic chemicals, liquids or gases, waste materials or other irritants, contaminants or pollutants into or upon land, the atmosphere or any water course or body of water.”

The fact that the IEPA permitted the EtO emissions does not change this analysis. The pollution exclusion says nothing about permitted or authorized pollution, and courts must not inject terms and conditions different from those agreed upon by the parties.

In addition, the pollution exclusion in CGL policies was drafted in response to the insurance industry’s concerns about increasing, costly environmental litigation. Declining to apply the pollution exclusion simply because the pollution was permitted by the State would undermine the pollution exclusion’s very purpose. In sum, in determining whether the pollution exclusion in a CGL policy applies, the Supreme Court held that it is irrelevant whether the underlying pollution is permitted or not.

CONCLUSION

For the foregoing reasons, the Supreme Court answered the certified question as follows: “a permit or regulation authorizing emissions (generally or at any particular levels) has no relevance in assessing the application of a pollution exclusion within a standard form commercial general liability policy.”

ZALMA OPINION

The Supreme Court of Illinois interpreted the insurance policies as they are written and refused to add language that was not in the policy to provide coverage for the alleged polluters. The polluters claimed having a permit changed the fact that they polluted the atmosphere. No coverage because the exclusion was clear and unambiguous.

(c) 2026 Barry Zalma & ClaimSchool, Inc.

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00:08:14
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January 26, 2026
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Post number 5271

See the video at and at and at https://zalma.com/blog plus more than 5250 posts.

The Insurance Contract Never Indicated that Coverage was Limited to Activities Specifically Described

In Mollie R. Lerner v. Bela LLC d/b/a The Perch Hotel, et al., CIVIL No. 25-1546 (FAB), United States District Court, D. Puerto Rico (January 21, 2026) Plaintiff Mollie R. Lerner, a North Carolina resident visiting Puerto Rico, rented a bicycle from The Perch Hotel while staying at a nearby Airbnb. While riding the bicycle back, she encountered a steep hill and, upon attempting to brake, was unable to slow down. She lost control, fell over the handlebars, and was subsequently struck by a truck, resulting in serious injuries.

ALLEGATIONS

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January 23, 2026
No Right of Subrogation in Pennsylvania for Spoliation

Subrogation Limited to What Was Paid by Insurer to Insured

Post number 5270

Posted on January 23, 2026 by Barry Zalma

See the video at https://lnkd.in/gGpPXhu2 and at https://lnkd.in/g6h3_aNR

In Erie Insurance Exchange A/S/O Bates Collision, Inc. James Myers, Anita Morgan, Lossie Auto Service, And Benedictine Sisters Of Erie, Inc. v. United Services Automobile Association v. Bates Collision, Inc., No. 19 WAP 2024, No. J-23-2025, Supreme Court of Pennsylvania (January 21, 2026) Erie attempted to obtain coverage for spoiliation of evidence against the property insurer.

FACTUAL BACKGROUND

On January 22, 2017, a fire broke out at Bates Collision, Inc., resulting in substantial damage to both the facility and several vehicles stored inside. Erie Insurance Exchange, as insurer for Bates and the affected vehicles, paid more than $1.6 million to its insureds under its insurance policy, which allowed Erie to pursue reimbursement for its payments.

Erie, acting as subrogee for Bates and the other insured parties, ...

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January 22, 2026
Defrauded Insurers in New Jersey Await Direction from the Supreme Court

PIP Fraud Disputes Should Never be Limited to Arbitration
Post number 5269

Read the full article at https://lnkd.in/gn7YmPny, see the video at https://lnkd.in/g4HzAf2r and at https://lnkd.in/gTFNBc_Z, and at https://zalma.com/blog plus more than 5250 posts.

In Government Employees Insurance Co. et al v. Active Medical Care, P.C. et al, No. 2:24-cv-10909 (BRM) (JRA), United States District Court, D. New Jersey (January 9, 2026) Defendants moved to Compel Arbitration and Stay the Proceedings (“Motion”). Plaintiffs Government Employees Insurance entities opposed.

Defendants’ Motion to Compel Arbitration and Stay the Proceedings was administratively terminated, and it was further ordered that the parties shall jointly notify the Court as soon as a decision is issued by the New Jersey Supreme Court in the appeal of Allstate New Jersey Insurance Company, et al. v. Carteret Comprehensive Medical Care, P.C., et al. Supreme Court Docket No.: 090337.

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You’re reading, until you reach the paywall, from the free part of Excellence in Claims Handling until you reach the paywall. You should consider joining as a paid member to get full access to articles for members only, to our news, analysis, insurance coverage, claims, insurance fraud and insurance webinars, by clicking at the “subscribe” button below.

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Insurance Fraud Gets You Three Squares and a Cot

Posted on January 26, 2026 by Barry Zalma

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More from Excellence in Claims Handling Substack for Subscribers Only

You’re reading, until you reach the paywall, from the free part of Excellence in Claims Handling until you reach the paywall. You should consider joining as a paid member to get full access to articles for members only, to our news, analysis, insurance coverage, claims, insurance fraud and insurance webinars, by clicking at the “subscribe” button below.

Health Insurance Providers Are Attempting Insurance Fraud to Fund Retirement

Every insurer is required by its shareholders, members, state statutes and state regulations to do everything possible to deter and defeat attempts at insurance fraud. Most insurers, therefore, have a staff of fraud investigators working under their Special Investigative Unit (SIU) and the SIU works to train the claims handlers to recognize the indicators or red flags of fraud.

Much to the surprise ...

post photo preview
January 26, 2026
Insurance Fraud Gets You Three Squares and a Cot

Insurance Fraud Should Not be a Retirement Plan

More from Excellence in Claims Handling Substack for Subscribers Only

If you are a subscriber you can see the full article at https://lnkd.in/gafFt_x3, if not a subscriber you can see a preview at https://lnkd.in/gP9ETSVb, and at https://zalma.com/blog.

"You’re reading, until you reach the paywall, from the free part of Excellence in Claims Handling until you reach the paywall. You should consider joining as a paid member to get full access to articles for members only, to our news, analysis, insurance coverage, claims, insurance fraud and insurance webinars, by clicking at the “subscribe” button below."

Every insurer is required by its shareholders, members, state statutes and state regulations to do everything possible to deter and defeat attempts at insurance fraud. Most insurers, therefore, have a staff of fraud investigators working under their Special Investigative Unit (SIU) and the SIU works to train the claims handlers to ...

post photo preview
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