A commentary on insurance coverage issues in Hawaii and beyond
The Hawaii Intermediate Court of Appeals reversed the trial court's grant of summary judgment to the health insurer, reinstating the insured's claims for bad faith and emotional distress. Groeger v. Kaiser Foundation Health Plan, Inc., 2023 Haw. App. LEXIS 308 (Haw. Ct. App. Aug. 29, 2023).
In March 2012, Christian…
Stanford Health Care's California lawsuit against Hawaii Medical Service Association (HMSA) was dismissed for lack of personal jurisdiction. Stanford Health Care v. Hawaii Med Service. Assoc., 2022 U.S. Dist. LEXIS 159192 (N.D. Cal. Sept 2, 2022).
Stanford and Anthem Blue Cross of California contracted for Stanford to provide medical services…
In an issue of first impression in Hawaii, the Hawaii Supreme Court ruled that an insurer's actions before an actual claim is submitted can be considered in determining whether the insurer acted in bad faith. Adams v. Hawaii Medical Service Ass'n, 2019 Haw. LEXIS 263 (Haw. Sept 30, 2019). Disclosure – our…
Handling the third appeal of the matter, the Hawaii Intermediate Court of Appeals rejected the insured's claim for bad faith based upon an untimely denial of the claim. Adams v. Haw. Med. Serv. Ass'n, 2018 Haw. App. LEXIS 245 (Haw. Ct. App. June 8, 2018) (Disclaimer – our office is co-counsel for…
The Hawaii Supreme Court held that a health insurer did not have subrogation rights against third-party tortfeasors who caused injury to its insureds. Yukumoto v. Tawarahara, 2017 Haw. LEXIS 92 (Haw. May 26 2017).
Gregory Yukumoto was injured while driving his moped and struck by Ruth Tawarahara, driving her SUV.
In addressing a certified question from the Eleventh Circuit, the Florida Supreme Court found that an insurer may not rely upon extrinsic evidence to salvage ambiguities in a policy. Wash. Nat'l Ins. Corp. v. Ruderman, 2013 Fla. LEXIS 1388 (Fla. July 3, 2013).
The case arose as a class suit against Washington…
The sad story of a woman who went ahead with liver surgery her insurer would not cover was considered by the Ninth Circuit in Conahan v. Sebelius, 2011 U.S. App. LEXIS 22071 (9th Cir. Nov. 1, 2011).
By way of background, Medical Advantage beneficiaries receivemedical services within the network of providers established by their…
We previously posted here and here on decisions by the Hawaii Intermediate Court of Appeal in Ahn v. Liberty Mutual Fire Ins. Co. and Kim v. Liberty Mutual Fire Ins. Co. As you recall, the issue in the two cases was whether the insured could seek administrative review when the insurer denied coverage or was the…
Thanks to the Health Express, a blog addressing health and medical information, for informing us we are among the Top 50 Health Insurance Blogs [post here]. The Health Express post states, "Hawaiian clients benefit from the expertise and diverse backgrounds of this Damon Key Leong Kupchak Hastert blog."
Thanks for the notice and
When sued by its insured, the health insurer sought to compel arbitration as part of the procedures under its policy for contesting a denial of coverage. In an opinion authored by newly seated Judge Ginoza, the Hawaii Intermediate Court of Appeals affirmed denial of the motion to compel because the insured's lawsuit was based on tort, not coverage…
