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The Discoverability and Admissibility of Reserve Information

By Kirk A. Pasich

Insureds and insurance carriers typically dispute the discoverability and admissibility of evidence of a carrier's reserves. In Lipton v. Superior Court, 48 Cal. App. 4th 1599, 56 Cal. Rptr. 2d 341 (1996), the California Court of Appeal defined reserves, stating that they represent the amount anticipated to be sufficient to pay all obligations for which the insurance company may be responsible under the policy with respect to a particular claim. That amount necessarily includes expenses that are likely to be incurred in connection with the settlement or adjustment of the claim, as well as the legal fees and other costs required to defend the insured. Id. at 1613.

The Lipton court also stated that '[t]he main purpose of a loss reserve is to comply with statutory requirements and to reflect, as accurately as possible, the insured's potential liability.' Id. See also Cal. Ins. Code '923.5 ('reserves' are the amounts 'estimated in the aggregate to provide for the payment of all losses and claims for which the insurer may be liable and to provide for the expense of adjustment or settlement of losses and claims'); Treas. Reg. '1.832-4(b) (for federal tax purposes, insurance carrier reserves 'must be stated in amounts which, based upon the facts in each case and the company's experience with similar cases, represents a fair and reasonable estimate of the amount the company would be required to pay'); MacGregor Yacht Corp. v. State Comp. Ins. Fund, 63 Cal. App. 4th 448, 457, 74 Cal. Rptr. 2d 473 (1998) (an insurance carrier's standard for reserves that was based on a 'realistic evaluation of all information in the file which reflects the reasonably anticipated final costs' satisfies the carrier's duties under Insurance Code).

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