C-56 A Reserve Computation Worksheet is used to calculate reserves. The David System will not allow additional payments if a claim's reserves go negative. Senior Account Clerk informs the adjuster of negative reserves on a claim. Adjusters must prepare a new Reserve Computation Worksheet after changing the level of reserves on a claim. Reserves are always examined when adjusters and their supervisors review a claim.
Files contain documentation when there has been a major change in reserve levels.
Auto-payments must be authorized by adjusters. All indemnity payments are processed by adjuster. Medical-only payments may be processed by clerks but are reviewed by supervisors at closure. Medical payments are paid according to a fee schedule established by the State. There are levels of authority for payment amounts.