Found this topic looking for the same solution. Kujina, you were right from the start! I was able to change the default size in wp-admin/includes/media.php, in the following section: (starting line 452)
$form_fields['image-size'] = array(
'label' => __('Size'),
'input' => 'html',
'html' => "
" . ( $thumb ? "<input type='radio' name='attachments[$post->ID][image-size]' id='image-size-thumb-$post->ID' value='thumbnail' />
<label for='image-size-thumb-$post->ID'>" . __('Thumbnail') . "</label>
" : '' ) . "<input type='radio' name='attachments[$post->ID][image-size]' id='image-size-medium-$post->ID' value='medium' checked='checked' />
<label for='image-size-medium-$post->ID'>" . __('Medium') . "</label>
<input type='radio' name='attachments[$post->ID][image-size]' id='image-size-full-$post->ID' value='full' />
<label for='image-size-full-$post->ID'>" . __('Full size') . "</label>",
);
just move the checked=’checked’ attribute to the option you want to be the default. You can also change the default image alignment, it’s a few lines up.
Hope that helps. It would be nice to see this as a configuration option in future releases ??