Justia Insurance Law Opinion SummariesArticles Posted in Supreme Court of Hawaii
Franco v. Reinhardt
The Supreme Court vacated the judgment of the intermediate court of appeals (ICA) reinstating the jury's verdict and judgment for Tiare Franco's family (the Francos) after granting Sabio Reinhardt's motion to set aside the jury verdict and judgment, holding that the ICA erred.The Francos brought a wrongful death lawsuit against Reinhardt for negligently crashing a truck and killing Tiare. National Interstate Insurance Company (NIIC), the truck's insurer, filed a declaratory judgment action claiming it had no duty to defend and indemnify Reinhardt under the policy. The circuit court granted summary judgment for NIIC, and the Francos successfully appealed. Before the ICA resolved the declaratory action appeal, the circuit court held a jury trial, and the jury returned a verdict in favor of the Francos. Counsel for Reinhardt moved to set aside the jury's verdict. The trial court granted the Francos' ensuing motion to disqualify counsel and Reinhardt's motion to set aside the jury verdict and judgment. The ICA reinstated the jury's verdict and judgment, holding that Reinhardt's counsel lacked authority to act as his lawyer. The Supreme Court vacated the ICA's judgment and affirmed the circuit court's orders, holding that the circuit court correctly denied the Francos' motion to disqualify counsel and did not abuse its discretion by granting Reinhardt's motion to set aside. View "Franco v. Reinhardt" on Justia Law
St. Paul Fire & Marine Insurance Co. v. Bodell Construction Co.
The Supreme Court held that, under Hawai'i law, an insurer may not seek reimbursement from an insured for defending claims when an insurance policy contains no excess provision for retirement, and furthermore, a reservation of rights letter will not do.At issue was whether an insurer may seek equitable reimbursement from an insured for defense fees and costs when the relevant insurance policy contains not express provision for such reimbursement but the insurer agrees to defend the insured under a reservation of rights, including reimbursement of defense fees and costs. The Supreme Court answered the question in the negative, holding that an insurer may not recover defense costs for defended claims unless the insurance policy contains an express right to reimbursement. View "St. Paul Fire & Marine Insurance Co. v. Bodell Construction Co." on Justia Law
Pflueger, Inc. v. AIU Holdings, Inc.
The Supreme Court vacated the opinion of the intermediate court of appeals (ICA) reversing the order of the circuit court granting summary judgment in favor of Defendant in this insurance broker malpractice case, holding that the circuit court and the ICA majority incorrectly analyzed Defendant's burden regarding the causation element.Plaintiff brought negligence and negligent malpractice claims against Defendant. In the original proceedings, judgment was granted for Plaintiff. The ICA remanded the case to the circuit court to include previously excluded testimony. On remand, the circuit court granted summary judgment for Defendant. The ICA reversed. The Supreme Court vacated the ICA"s order and remanded the case to the circuit court for further proceedings, holding (1) to negate the causation element of the negligence and negligent malpractice claims against it Defendant would need to demonstrate that Plaintiff's insurer (Insurer) would not have been legally obligated to advance Plaintiff's defense costs even if Plaintiff's grand jury subpoena matter were timely tendered to Insurer; and (2) the lower courts incorrectly analyzed Defendant's burden regarding the causation element, requiring remand. View "Pflueger, Inc. v. AIU Holdings, Inc." on Justia Law
Carvalho v. AIG Hawaii Insurance Co.
The Supreme Court affirmed in part and vacated in part the judgment of the intermediate court of appeals (ICA) in this dispute regarding payment of uninsured motorist (UM) and underinsured motorist (UIM) benefits to Plaintiff, holding that the circuit court properly excluded evidence related to an unleaded claim but erred in denying Plaintiff's motion to amend complaint solely on the basis of undue delay.Plaintiff, individually and as personal representative of the estate of her son, who died as a passenger in an automobile accident, brought this action seeking a declaratory judgment, arguing that Defendant improperly failed to recognize that UM and UIM coverages totaling $1.2 million were available to her. At issue before the Supreme Court was whether the circuit court erred in granting Defendant's motion to present evidence or in denying Plaintiff's motion to amend complaint. The ICA affirmed. The Supreme Court vacated in part, holding that the circuit court (1) did not abuse its discretion in granting Defendant's motion to preclude evidence; but (2) erred in concluding that Plaintiff could not amend her complaint due to undue delay. View "Carvalho v. AIG Hawaii Insurance Co." on Justia Law
Moranz v. Harbor Mall, LLC
In this case, the Supreme Court clarified the proper timing of Alvarado calculations, which determines the reimbursement due the insurer from a third-party settlement, and the reimbursement process for an insurer when the amount of workers' compensation (WC) benefits the insurer has already dispensed to the employee is less than the amount it owes the employee for its share of attorney's costs and fees for the third-party action.Petitioner received WC benefits from Respondent. Petitioner brought suit against the owner of the building in which she was injured and reached a settlement. Respondent then sought reimbursement of the WC benefits it had paid to Petitioner under Haw. Rev. Stat. 386-8 and Alvarado v. Kiewit Pacific Co., 993 P.2d 549 (Haw. 2000). At issue was whether certain WC benefits that Respondent owed Petitioner were properly classified as "paid compensation" and whether the process of Respondent's reimbursement of WC benefits exceeded the amount it had previously contributed to Petitioner as "paid compensation." The Supreme Court held (1) Alvarado calculations shall be performed based on the date on which the employee receives the third-party recovery; and (2) an insurer's "share" of the attorney's fees and costs the employee incurs while pursuing third-party recovery is based on the insurer's total WC liability. View "Moranz v. Harbor Mall, LLC" on Justia Law
State Farm Mutual Automobile Insurance Co. v. Mizuno
The Supreme Court answered a certified question by concluding that, under Hawai'i law, a permissive user of an insured vehicle, whose connection to the vehicle is permission to use the vehicle to run errands and drive to work, was entitled to uninsured motorist (UM) benefits under the chain-of-events test because he was injured by an uninsured motorist.The Supreme Court determined that the proper inquiry under the chain of events test was whether a permissive user has retained a sufficient connection to the insured vehicle. The Court then held that, under the chain of events test, the driver at issue was entitled to UM benefits because he was a permissive user of the insured vehicle during the chain of events resulting in his injury caused by an uninsured motor vehicle. View "State Farm Mutual Automobile Insurance Co. v. Mizuno" on Justia Law
Adams v. Hawaii Medical Service Ass’n
The Supreme Court reversed the judgment of the intermediate court of appeals (ICA) affirming the judgment of the circuit court that there were not genuine issues of material fact regarding whether Defendant, Hawaii Medical Service Association (HMSA), acted in bad faith in denying Brent Adams' claim for coverage of an allogenic transplant, holding that there were genuine issues of material fact as to whether HMSA fulfilled its duty of good faith and fair dealing in its handling of Brent's claim.After Brent was diagnosed with stage III multiple myeloma, a life-threatening form of bone marrow cancer, doctors determined that Brent's best chance of survival was first an autologous transplant and then an allogenic transplant. HMSA provided coverage for the first phase of the transplant but denied the claim as to the allogenic transplant. Brent subsequently died. Brent and his wife, Patricia, filed this action alleging that HMSA acted in bad faith in administering Brent's claim for the allogenic transplant. The Supreme Court reversed the lower courts' summary judgment rulings for HMSA, holding that evidence of HMSA's conduct during its relationship with Brent raised genuine issues of material fact as to whether HMSA unreasonably handled Brent's claim for an allogenic transplant. View "Adams v. Hawaii Medical Service Ass'n" on Justia Law
Yukumoto v. Tawarahara
Health insurers do not have a broad, unrestricted right of subrogation against third-party tortfeasors who cause injury to their insureds but, rather, are limited to reimbursement rights established by statute.In this personal injury case, the circuit court ruled that Haw. Rev. Stat. 663-10 and/or Haw. Rev. Stat. 431:13-103(a)(1) abrogated Hawai’i Medical Service Association’s (HMSA) contractual and common law rights in subrogation against a third-party tortfeasors responsible for injury to its insured. The Supreme Court affirmed, holding (1) a health insurer does not have equitable subrogation rights against a third-party tortfeasor in the context of personal injures; (2) a health insurer’s subrogation and reimbursement rights are limited by section 663-10 and section 431-13:103(a)(1); (3) any contractual provision that conflicts with section 663-10 is invalid; and (4) section 663-10 takes precedence over HMSA’s subrogation rights. View "Yukumoto v. Tawarahara" on Justia Law