The Hawaii Intermediate Court of Appeals overruled the District Court’s order granting summary judgment to an insured under the insurer’s automobile policy in Tasaki v. AIG Hawaii Ins. Co., 2008 Haw. App. LEXIS 366 (Haw. Ct. App. June 27, 2008). 

     After injuring his teeth, jaw and head in a motor vehicle accident, the insured received dental treatments from Appellee dentist.  The insured’s automobile policy issued by AIG included personal injury protection (PIP) coverage.  When the dentist sought payment from AIG, the claim was denied based on a record review by another dentist hired by AIG. 

     The dentist sued AIG.  The District Court granted the dentist’s motion for summary judgment after ruling AIG had hired a dentist to prepare a record review without the insured’s consent in violation of Haw. Rev. Stat. 431:10C-308.5(b).  The District Court ruled that because AIG had violated the statute, it could not rely on the record review to deny the dentist’s claim.  Therefore, judgment was entered in the dentist’s favor.

     Citing its prior decision in Gillan v. Gov’t Employees Ins. Co., 184 P.2d 780 (Haw. Ct. App. 2008), reviewed here, the Intermediate Court of Appeals reversed.  Although Haw. Rev. Stat. 431:10-308.5 (b) required mutual agreement between the insurer and claimant for an independent medical examiner, Gillan held a record review was not equivalent to an independent medical examination.  Therefore, AIG did not need mutual consent from the insured before it hired the dentist to perform the record review.  Further, because AIG did not violate Haw. Rev. Stat. 431:10C-308.5(b), the District Court erred in precluding AIG from relying on the report to support denial of the dentist’s claim.