Frequently, claims managers, supervisors, adjusters or attorneys picked up a new claims file and question why a claimant acted in a certain manner. When working a claim, it is generally taken at face value. The facts are as they are in the file, unless some surprises turn up later.
When working as a casualty claims adjuster for a major insurance company, I carried blank drafts to settle claims. While there was a limit, I had the authority to settle the claim up to that dollar amount.
A business open to the public is expected to use reasonable care to maintain the premises in a reasonably safe condition and state. The issues revolve around the question of what the business did or did not do with respect to maintaining the premises in a reasonably safe condition.
Some claims disputes are simply unavoidable, and mediation may be necessary to reach a settlement. Even if a settlement agreement is not reached, it's useful to consider that valuable views and lessons may be gleaned.