Originally Posted by rideabike
It doesn't matter what I used to do. I'm just trying to prevent someone from getting screwed.
Policies vary. The language might be under several different sections. It might be under the part which requires the insured to cooperate with the insurer. It might be in the caselaw litigating the meaning of the cooperation clause or perhaps another clause.
Adujsters operate under some general authority for property damage. When they get any kind of a claim, they consult with their supervisor and set a "reserve." An attorney can make sure that the reserve is set high enough so that there are not problems later in the claim. For the adjusters, personal injurie claims get bumped up to the supervisors who consult with house counsel. The adjuster still handles the claim but with guidance from house counsel.
Whatever you did, it wasn't for an insurance company. There are policy limits. There is the actual property damage. The adjuster determines the value of the injury claim based on the medical reports and/or IME. If they determine the value of this loss to be $6k, the claimant can plan on at least 1/3 of that going to his attorney. The reserve is simply a figure that is set based on exposure. It's more for accounting purposes, tracking exposure, and draft authority than anything else. I've never had a problem with reserves set too low or high in 10 years of handling subrogation claims.