Hearing on petition.
(a) The court may adjourn or continue a hearing for failure to timely notify a spouse or reciprocal beneficiary, guardian, relative, or other person determined by the court to be entitled to notice, or for failure by the subject to contact an attorney as provided in section 334-60.4(b)(7) if the court determines the interests of justice so require.
(b) The time and form of the procedure incident to hearing the issues in the petition shall be provided by court rule. Unless the hearing is waived, the judge shall hear the petition as soon as possible and no later than ten days after the date the petition is filed unless a reasonable delay is sought for good cause shown by the subject of the petition, the subject's attorney, or those persons entitled to receive notice of the hearing under section 334-60.4.
(c) The subject of the petition shall be present at all hearings unless the subject waives the right to be present, is unable to attend, or creates conditions which make it impossible to conduct the hearing in a reasonable manner as determined by the judge. A waiver is valid only upon acceptance by the court following a judicial determination that the subject understands the subject's rights and is competent to waive them, or is unable to participate. If the subject is unable to participate, the judge shall appoint a guardian ad litem or a temporary guardian as provided in Article V of chapter 560, to represent the subject throughout the proceedings.
(d) Hearings may be held at any convenient place within the circuit. The subject of the petition, any interested person, or the court on its own motion may request a hearing in another circuit because of convenience to the parties, witnesses, or the court or because of the individual's mental or physical condition.
(e) The attorney general, the attorney general's deputy, special deputy, or appointee shall present the case for hearings convened under this chapter, except that the attorney general, the attorney general's deputy, special deputy, or appointee need not participate in or be present at a hearing whenever a petitioner or some other appropriate person has retained private counsel who will be present in court and will present to the court the case for involuntary hospitalization.
(f) Counsel for the subject of the petition shall be allowed adequate time for investigation of the matters at issue and for preparation, and shall be permitted to present the evidence that the counsel believes necessary to a proper disposition of the proceedings, including evidence as to alternatives to inpatient hospitalization.
(g) No individual may be found to require treatment in a psychiatric facility unless at least one physician or psychologist who has personally examined the individual testifies in person at the hearing. This testimony may be waived by the subject of the petition. If the subject of the petition has refused to be examined by a licensed physician or psychologist, the subject may be examined by a court-appointed licensed physician or psychologist. If the subject refuses and there is sufficient evidence to believe that the allegations of the petition are true, the court may make a temporary order committing the subject to a psychiatric facility for a period of not more than five days for the purpose of a diagnostic examination and evaluation. The subject's refusal shall be treated as a denial that the subject is mentally ill or suffering from substance abuse. Nothing in this section, however, shall limit the individual's privilege against self-incrimination.
(h) The subject of the petition in a hearing under this section has the right to secure an independent medical or psychological evaluation and present evidence thereon.
(i) If after hearing all relevant evidence, including the result of any diagnostic examination ordered by the court, the court finds that an individual is not a person requiring medical, psychiatric, psychological, or other rehabilitative treatment or supervision, the court shall order that the individual be discharged if the individual has been hospitalized prior to the hearing. If the court finds that the criteria for involuntary hospitalization under section 334-60.2(1) has been met beyond a reasonable doubt and that the criteria under sections 334-60.2(2) and 334-60.2(3) have been met by clear and convincing evidence, the court may issue an order to any police officer to deliver the subject to a facility that has agreed to admit the subject as an involuntary patient, or if the subject is already a patient in a psychiatric facility, authorize the facility to retain the patient for treatment for a period of ninety days unless sooner discharged. An order of commitment shall specify which of those persons served with notice pursuant to section 334-60.4, together with such other persons as the court may designate, shall be entitled to receive any subsequent notice of intent to discharge, transfer, or recommit.
(j) The court may find that the subject of the petition is an incapacitated or protected person, or both, under Article V of chapter 560, and may appoint a guardian of the person, or property, or both, for the subject under the terms and conditions as the court shall determine.
[L 1984, c 188, pt of '3; am L 1985, c 220, '1; gen ch 1985; am L 1994, c 58, '3; am L 1997, c 383, '47]
[[Chapter 334, AMental
Health, Mental Illness,
Drug Addiction, and Alcoholism@ (continued)]]
[[Part VIII, AInvoluntary Outpatient Treatment@]]
(a) Notice of the hearing shall be:
- Served personally on the subject of the petition pursuant to family court rules; and
- Delivered personally or mailed by certified or registered mail, return receipt requested, deliverable to addressee only, to as many as are known to the petitioner of the subject's spouse or reciprocal beneficiary, legal parents, adult children, and legal guardian, if one has been appointed.
Petitioner shall certify that such notices have been mailed, and to whom, but proof of receipt of such notices is not required. Notice shall also be served on any other person that the court designates.
(b) The notice shall include the following:
- The date, time, place of hearing, a clear statement of the purpose of the hearing and possible consequences to the subject, and a statement of the legal standard upon which involuntary outpatient treatment is authorized;
- A copy of the petition; and
- Notice that the subject of the petition is entitled to be represented by an attorney, and that the court will appoint a public defender or other attorney for the subject if the subject desires one and is indigent.
(c) The family court may continue a hearing for failure to timely notify a person entitled to be notified.
[L 1984, c 251, pt of '1; am L 1997, c 383, '48]
Rules of Court
Service of process, see HFCR rule 4.
[[Chapter 338, AVital Statistics@]]
[[No part of this Chapter directly mentions reciprocal beneficiaries, nor was the Chapter mentioned in the group of laws passed in 1997 establishing reciprocal-beneficiary rights and benefits. The Chapter deals with the keeping of certain statistics and records including such things as records of divorce. The annotation to the cover page of the Chapter says the following:]]
Reciprocal beneficiaries, see chapter 572C.
[[Chapter 351,ACrime Victim Compensation@]]
As used in this chapter, unless the context otherwise requires:
"Child" means an unmarried person who is under eighteen years of age and includes a stepchild or an adopted child;
"Commission" means the crime victim compensation commission established by this chapter;
ACrime" means those under section 351-32, and shall include an act of terrorism occurring outside the United States as defined in Title 18 United States Code section 2331, against a resident of this State;
ADependents" mean such relatives of a deceased victim who were wholly or partially dependent upon the victim's income at the time of the victim's death or would have been so dependent but for the incapacity due to the injury from which the death resulted and includes the child of the victim born after the victim's death;
ADesignated person" means a person who made payments for funeral, burial, and medical expenses on behalf of a victim;
AInjury" means actual bodily harm and, in respect of a victim, includes pregnancy and mental or nervous shock; and "injured" has a corresponding meaning;
APrivate citizen" means any natural person other than a police officer who is actively engaged in the performance of the police officer's official duties;
ARelative" means a victim's spouse or reciprocal beneficiary, parent, grandparent, stepparent, child, grandchild, stepchild, brother, sister, half brother, half sister, stepbrother, stepsister, or spouse's or reciprocal beneficiary's parents;
AResident" means every individual who:
- Intends to permanently reside in this State;
- Has a permanent abode in this State;
- Is a student at any institution of learning and claimed as a dependent of a Hawaii resident;
- Files a Hawaii income tax return; or
- Is registered to vote in this State;
- A person who is injured or killed by any act or omission of any other person coming within the criminal jurisdiction of the State;
- Any resident of the State who is injured or killed in another state by an act or omission of another person, which act or omission is within the description of any of the crimes specified in section 351-32; or
- A person who is a resident of this State who is injured or killed by an act of terrorism occurring outside the United States, as defined in Title 18 United States Code section 2331.
[L 1967, c 226, pt of '1; HRS '351-2; am L 1972, c 2, '13 and c 61, '1a; am L 1977, c 191, '2; am L 1983, c 124, '15; gen ch 1985; am L 1989, c 177, ''1 to 3; am L 1995, c 182, '1; am L 1997, c 383, '49; am L 1998, c 239, '1 and c 240, '3]
[[Chapter 352,AHawaii Youth Correctional Facilities@]]
The director shall provide the opportunity for intelligence and aptitude evaluation, psychological testing and counseling, prevocational and vocational training, and employment counseling to all persons committed to the youth correctional facilities. Counseling services shall be available for the committed person's family including a reciprocal beneficiary, during the term of commitment.
[L 1980, c 303, pt of '8(1); am L 1997, c 383, '50]
[[Chapter 353, ACorrections@]]
[[Part I, AAdministrative Structure, Institutions, and Services@]]
Committed persons, furlough, employment.
(a) The director or a designated agent may grant furloughs to committed persons with a minimum or lower security classification in any correctional facility of the department for the purpose of employment, social reorientation, education, or training, or any other valid purpose as determined by the director. Special out-of-state furloughs may be granted to those already otherwise furloughed, at no cost to the State, when death or critical illness or injury to the committed person's immediate family including a reciprocal beneficiary, occurs. Any committed person who is engaged in private employment, by contract or otherwise, not under the immediate custody of the State shall not be considered an agent or employee of the State. Any moneys earned from employment by such person shall be used to satisfy a restitution order and to reimburse the State for the cost of room and board. If any earned moneys remain after these expenses have been paid, that amount shall be held in an individual account for the committed person. When an inmate is granted a special out-of-state furlough, the director shall inform the authorities of the state to which the inmate is to be furloughed of the inmate's arrival.
(b) Full power to enforce the terms and conditions of furlough and to retake and reincarcerate a furloughed committed person is conferred upon the director or designated agent. The director or a designated agent, at any time, may issue a warrant authorizing the arrest and return to actual custody of any furloughed committed person for the purpose of ascertaining whether or not the terms and conditions of furlough have been violated so as to justify revoking the furlough and to retake and reincarcerate the furloughed committed person. The administrators of all of the correctional facilities of the State, the chief of police of each county, all police officers of the State, and all correctional facility officials shall execute any such warrant of arrest in like manner as an ordinary criminal process.
(c) Any furloughed committed person retaken and reincarcerated as provided in this chapter shall be confined according to the committed person's sentence for that portion of the committed person's term remaining unserved at the time of furlough, but subsequent furloughs, in the discretion of the director or designated agent, may be granted to a committed person during the life and in respect of sentence.
[L 1987, c 338, pt of '3; am L 1997, c 383, '51]
[[Chapter 386, AWorkers=
[[Part II, ACompensation@]]
[[Sub-Part B, AIncome and Indemnity Benefits@]]
[[Sub-Part 1, ADisability@]]
Payment after death.
Where an employee is entitled to weekly income and indemnity benefits for permanent total or permanent partial disability and dies from any cause other than the compensable work injury, payment of any unpaid balance of the benefits to the extent that the employer is liable therefor, but not to exceed the amount prescribed under section 386-32(a) for other cases, shall be made to the employee's dependents as provided herein.
If, at the time of the death, the employee is entitled to any benefits from the special compensation fund, the benefits shall also be paid to the employee's dependents as provided herein:
- To a dependent widow, widower, or reciprocal beneficiary, for the use of the widow, widower, or reciprocal beneficiary, and the dependent children, if any. The director of labor and industrial relations may from time to time apportion such compensation among the widow, widower, or reciprocal beneficiary, and any dependent children.
- If there be no dependent widow, widower, or reciprocal beneficiary, but one or more dependent children, then to such child or children to be divided equally among them if more than one.
- If there be no dependent widow, widower, reciprocal beneficiary, or child, but there be a dependent parent, then to such parent, or if both parents be dependent, to both of them, to be divided equally between them; or if there be no such parents, but a dependent grandparent, then to such grandparent, or if more than one, then to all of them to be divided equally among them.
- If there be no dependent widow, widower, reciprocal beneficiary, child, parent, or grandparent, but there be a dependent grandchild, brother, or sister, then to such dependent, or if more than one, then to all of them to be divided equally among them.
- If there be no such dependents, the unpaid balance of the compensation shall be paid in a lump sum into the special compensation fund.
[L 1963, c 116, pt of '1; Supp, '97-33; HRS '386-34; am L 1969, c 85, '1; am L 1972, c 42, '3; am L 1973, c 47, '2; gen ch 1985; am L 1997, c 383, '52]
Attorney General Opinions
Cited in discussion of hanai children. Att. Gen. Op. 93-1.
[[Chapter 386, AWorkers=
[[Part II, ACompensation@ (continued)]]
[[Sub-Part B, AIncome and Indemnity Benefits@ (continued)]]
[[Sub-Part 2, ADeath@]]
Entitlement to and rate of compensation.
(a) Funeral and burial allowance. Where a work injury causes death, the employer shall pay funeral expenses not to exceed ten times the maximum weekly benefit rate to the mortician and burial expenses not to exceed five times the maximum weekly benefit rate to the cemetery selected by the family including a reciprocal beneficiary or next of kin of the deceased or in the absence of such family including a reciprocal beneficiary or next of kin, by the employer. Such payments shall be made directly to the mortician and cemetery; provided that when the deceased has a pre-paid funeral and burial plan such payments for funeral and burial expenses, not to exceed the foregoing limits, shall be made directly to the surviving spouse or reciprocal beneficiary or the decedent's estate if there is no surviving spouse or reciprocal beneficiary.
(b) Weekly benefits for dependents. In addition, the employer shall pay weekly benefits to the deceased's dependents at the percentages of the deceased's average weekly wages specified below, taking into account not more than the maximum weekly benefit rate prescribed in section 386-31 divided by .6667 and not less than the minimum prescribed in the section divided by .6667. To the dependent widow, widower, or reciprocal beneficiary, if there are no dependent children, fifty per cent. To the dependent widow, widower, or reciprocal beneficiary, if there are one or more dependent children of the deceased, sixty-six and two-thirds per cent. The compensation to the widow, widower, or reciprocal beneficiary shall be for the use and benefit of the widow, widower, or reciprocal beneficiary and of the dependent children, and the director of labor and industrial relations from time to time may apportion the compensation between them in such way as the director deems best. If there is no dependent widow, widower, or reciprocal beneficiary, but a dependent child, then to the child forty per cent, and if there is more than one dependent child, then to the children in equal parts sixty-six and two-thirds per cent. If there is no dependent widow, widower, or reciprocal beneficiary, or child, but there is a dependent parent, then to the parent, if wholly dependent fifty per cent, or if partially dependent twenty-five per cent; if both parents are dependent, then one-half of the foregoing compensation to each of them; if there is no dependent parent, but one or more dependent grandparents, then to each of them the same compensation as to a parent. If there is no dependent widow, widower, or reciprocal beneficiary, child, parent or grandparent, but there is a dependent grandchild, brother, or sister, or two or more of them, then to those dependents thirty-five per cent for one dependent, increased by fifteen per cent for each additional dependent, to be divided equally among the dependents if more than one.
(c) Maximum weekly amounts. The sum of all weekly benefits payable to the dependents of the deceased employee shall not exceed sixty-six and two-thirds per cent of the employee's average weekly wages, computed by observing the limits specified in subsection (b), if necessary, the individual benefits shall be proportionally reduced.
(d) Liability in the absence of dependents. If there be no dependents who are entitled to benefits under this section, the employer shall pay an amount equal to twenty-five per cent of three hundred and twelve times the effective maximum weekly benefit rate provided in section 386-31, to the nondependent parent or parents. If there be no such parent or parents, the employer shall pay the sum into the special compensation fund, pursuant to an order made by the director. The employer, pursuant to an order made by the director, shall pay any remaining balance into the special compensation fund, if the weekly benefits to which dependents are entitled terminate without totalling the amounts as calculated above.
[L 1963, c 116, pt of '1; am L 1965, c 152, '1(b); Supp, '97-40; HRS '386-41; am L 1971, c 24, '1 and c 101, '1; am L 1972, c 42, '4; am L 1973, c 64, '1; am L 1974, c 153, '4; am L 1977, c 87, '1; am L 1982, c 52, '1; gen ch 1985; am L 1991, c 72, '1 and c 98, '1; am L 1997, c 383, '53]
Attorney General Opinions
Cited in discussion of hanai children. Att. Gen. Op. 93-1.
Cited: 43 H. 173, 175.
(a) The following persons, and no others, shall be deemed dependents and entitled to income, and indemnity benefits under this chapter:
A child who is
- unmarried and under eighteen years, or
- unmarried and under twenty years if the child is a full-time student at a high school, business school, or technical school, or unmarried and under twenty-two years if the child is a full-time undergraduate student at a college, or
- unmarried and incapable of self-support, or
- married and under eighteen years, if actually dependent upon the deceased;
The surviving spouse or reciprocal beneficiary, if either living with the deceased at the time of the injury or actually dependent upon the deceased;
A parent or grandparent, if actually dependent upon the deceased;
A grandchild, brother, or sister, if
- under eighteen years or incapable of self-support, and
- actually and wholly dependent upon the deceased.
(b) A person shall be deemed to be actually dependent upon the deceased, if he or she contributed all or a substantial portion of the living expenses of such person at the time of the injury.
(c) Alien dependents not residing in the United States at the time of the injury or leaving the United States subsequently shall maintain annual proof of such dependency as required by the director of labor and industrial relations.
[L 1963, c 116, pt of '1; Supp, '97-41; am L 1967, c 213, '1 and c 257, '1; HRS '386-42; am L 1971, c 87, '1; am L 1974, c 151, '1; gen ch 1985; am L 1997, c 383, '54]
Alien Japanese dependent upon leaving the United States loses all rights to benefits; "leaving the U. S." construed; an alien widow leaving the U.S. ceases to be a "dependent". 27 H. 431.
Nonresident alien. 32 H. 118.
Alien "actually residing". 32 H. 699.
Illegitimate children. 31 H. 814.
Citizen of Philippine Republic. 39 H. 258.
Actual dependency of parents on child. 43 H. 173.
Part-time students, as defined by each individual educational institution, are not entitled to compensation under subsection (a) and '386-43(a). 84 H. 390 (App.), 935 P.2d 105. Cited: 41 H. 442, 447.
Duration of dependents' weekly benefits.
(a) The weekly benefits to dependents shall continue:
To a surviving spouse or reciprocal beneficiary, until death, remarriage, marriage, or entry into a new reciprocal beneficiary relationship with two years' compensation in one sum upon remarriage, marriage, or entry into a new reciprocal beneficiary relationship.
To or for a child,
- so long as unmarried, until attainment of the age of eighteen, or
- so long as unmarried, until attainment of the age of twenty if the child is a full-time student at a high school, business school, technical school, or unmarried and under twenty-two years if the child is a full-time undergraduate student at a college, or
- so long as unmarried, until termination of the child's incapability of self-support, or
- until marriage, except that in the case of a married child under eighteen, weekly benefits shall continue during the period of actual dependency until attainment of the age of eighteen.
To a parent or grandparent, for the duration, whether continuous or not, of such actual dependency, provided that the amount of the weekly benefits shall at no time exceed the amount payable at the time of death.
To or for a grandchild, brother, or sister, for the period in which he or she remains actually and wholly dependent until attainment of the age of eighteen or termination of the incapability of self-support.
(b) The aggregate weekly benefits payable on account of any one death shall not exceed the product of 312 times the effective maximum weekly benefit rate prescribed in section 386-31, but this limitation shall not apply with respect to benefits to a surviving spouse or reciprocal beneficiary who is physically or mentally incapable of self-support and unmarried as long as he or she remains in that condition and to benefits to a child and to benefits to an unmarried child over eighteen incapable of self-support as long as he or she is otherwise entitled to such compensation.
(c) Upon the cessation under this section of compensation to or for any person, the benefits of the remaining dependents in the same class for any further period during which they are entitled to weekly payments shall be in the amounts which they would have received, had they been the only dependents entitled to benefits at the time of the employee's death.
[L 1963, c 116, pt of '1; Supp, '97-42; am L 1966, c 6, '2; am L 1967, c 257, '2; HRS '386-43; am L 1974, c 151, '2 and c 153, '5; am L 1975, c 4, '1; gen ch 1985; am L 1997, c 383, '55]
Part-time students, as defined by each individual educational institution, are not entitled to compensation under subsection (a) and '386-42(a). 84 H. 390 (App.), 935 P.2d 105.
Cited: 27 H. 431, 435.
[[Chapter 388, AWages
and Other Compensation, Payment of@]]
Payment of wages to relatives of deceased employees.
Where an employee dies leaving any wages, vacation, or sick leave pay due the employee, the employer shall, within thirty days after such death, whether or not a personal representative has been appointed, pay the wages, vacation, or sick leave pay in an amount not exceeding $2,000 to, and upon application by the surviving spouse or reciprocal beneficiary or, if none, by an adult child.
The employer shall require the applicant to show proof of his or her relationship to the deceased by affidavit and to acknowledge receipt of the payment in writing. Any such payment shall discharge the employer to the extent thereof and the employer shall not be liable to the decedent's estate.
Any person to whom payment is made shall be answerable therefor to anyone prejudiced by an improper distribution.
[L 1967, c 11, '1; HRS '388-4; am L 1984, c 174, '1; gen ch 1985; am L 1997, c 383, '56]
[[Chapter 398, AFamily Leave@]]
Family leave requirement.
(a) An employee shall be entitled to a total of four weeks of family leave during any calendar year upon the birth of a child of the employee or the adoption of a child, or to care for the employee's child, spouse or reciprocal beneficiary, or parent with a serious health condition.
(b) During each calendar year, the leave may be taken intermittently.
(c) Leave shall not be cumulative.
(d) If unpaid leave under this chapter conflicts with the unreduced compensation requirement for exempt employees under the federal Fair Labor Standards Act, an employer may require the employee to make up the leave within the same pay period.
(e) Nothing in this chapter shall entitle an employee to more than a total of four weeks of leave in any twelve-month period.
[L 1991, c 328, pt of '1; am L 1992, c 87, '6; am L 1997, c 383, '57]
Public employees; family leave, see '79-32.
[[Chapter 431, AInsurance
[[Sub-Chapter 431:10, AInsurance Contracts Generally@]]
[[Part II, AGeneral Rules@]]
Spouses' and reciprocal beneficiaries' right in life insurance policy.
(a) Every life insurance policy made payable to or for the benefit of the spouse or the reciprocal beneficiary of the insured, and every life insurance policy assigned, transferred, or in any way made payable to a spouse or reciprocal beneficiary, or to a trustee for the benefit of a spouse or a reciprocal beneficiary, regardless of how the assignment or transfer is procured, shall, unless contrary to the terms of the policy, inure to the separate use and benefit of such spouse or reciprocal beneficiary.
(b) Without the consent of one's spouse or reciprocal beneficiary, a married person or an individual who is registered as a reciprocal beneficiary, may contract, pay for, take out, and hold a policy on the life or health of one's spouse, reciprocal beneficiary, or children, or against loss by such spouse, or reciprocal beneficiary, or children due to disablement by accident. Premiums paid on the policy by a married person or reciprocal beneficiary shall be held to have been that person's separate estate, and the policy shall inure to the use and benefit of that person and that person's children, free from any claim by the spouse, or reciprocal beneficiary, or others.
[L 1987, c 347, pt of '2; am L 1997, c 383, '58]
[[Chapter 431, AInsurance
[[Sub-Chapter 431:10A, AAccident and Sickness Insurance Contracts@]]
[[Part I, AIndividual Accident and Sickness Policies@]]
Form of policy.
(a) A policy of accident and sickness insurance shall neither be delivered nor issued for delivery to any person in this State unless:
- The entire monetary and other considerations are expressed in the policy;
- The time at which the insurance takes effect and terminates is expressed in or determinable from the policy;
- It purports to insure only one person, except that a policy may provide family coverage as defined in section 431:10A-103 or reciprocal beneficiary family coverage as defined in section 431:10A-601;
- The style, arrangement, and overall appearance of the policy give no undue prominence to any portion of the text, and unless every printed portion of the text of the policy and of any endorsements or attached papers is plainly printed in light-faced type of a style in general use, the size of which shall be uniform and not less than ten point with a lower case unspaced alphabet length not less than one hundred and twenty point. The text shall include all printed matter except the name and address of the insurer, name or title of the policy, the brief description, if any, and captions and subcaptions;
- The exceptions and reductions of indemnity are set forth in the policy and, except the required and optional provisions set forth in section 431:10A-105 and section 431:10A-106, are printed, at the insurer's option, either included with the benefit provision to which they apply, or under an appropriate caption such as exceptions, or exceptions and reductions; provided that if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of the exception or reduction shall be included with the benefit provision to which it applies;
- Each policy form, including riders and endorsements, shall be identified by a form number in the lower left-hand corner of the first page; and
- It does not contain any provision purporting to make any portion of the charter, rules, constitution, or bylaws of the insurer a part of the policy unless such portion is set forth in full in the policy, except in the case of the incorporation of, or reference to, a statement of rates or classification of risks, or short-rate table filed with the commissioner.
(b) If any policy is issued by an insurer domiciled in this State for delivery to a person residing in a territory, district or another state of the United States, and if the official having responsibility for the administration of the insurance laws of such state, district or territory shall have advised the commissioner that the policy is not subject to approval or disapproval by the official, the commissioner may by ruling require that the policy meet the standards set forth in subsection (a) and in section 431:10A-105 and section 431:10A-106.
[L 1987, c 347, pt of '2; am L 1997, c 383, '5]
Coverage of newborn children.
(a) All policies providing family coverage, as defined in section 431:10A-103 and reciprocal beneficiary family coverage, as defined in section 431:10A-601, on an expense incurred basis shall provide that the benefits applicable for children shall be payable for newborn infants from the moment of birth; provided that the coverage for newly born children shall be limited to the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities. If payment of a specific premium is required to provide coverage for a child, the policy may require that notification of birth and payment of the required premium must be furnished the insurer within thirty-one days after the date of birth in order to have the coverage continue beyond the thirty-one-day period.
(b) This section shall not be construed to provide or include coverages for routine well-baby services. The requirements of this section shall apply to all policies delivered or issued for delivery in this State more than one hundred twenty days after June 12, 1974.
[L 1987, c 347, pt of '2; am L 1997, c 383, '6]
[[Note: this Section was not included in the original 1997 package of laws
establishing reciprocal beneficiaries. Instead, it was a new law added to the
HRS in 1999.]]
Medical foods and low-protein modified food products; treatment of inborn error of metabolism; notice.
(a) Each policy of accident and sickness insurance, other than life insurance, disability income insurance, and long-term care insurance, issued or renewed in this State, each employer group health policy, contract, plan, or agreement issued or renewed in this State, all health insurance policies issued or renewed in this State, all policies providing family coverages as defined in section 431:10A-103, and all policies providing reciprocal beneficiary family coverage as defined in section 431:10A-601, shall contain a provision for coverage for medical foods and low-protein modified food products for the treatment of an inborn error of metabolism for its policyholders or dependents of the policyholder in this State; provided that the medical food or low-protein modified food product is:
Coverage shall be for at least eighty per cent of the cost of the medical food or low-protein modified food product prescribed and administered pursuant to this subsection.
- Prescribed as medically necessary for the therapeutic treatment of an inborn error of metabolism; and
- Consumed or administered enterally under the supervision of a physician licensed under chapter 453 or 460.
(b) Every insurer shall provide notice to its policyholders regarding the coverage required by this section. The notice shall be in writing and prominently placed in any literature or correspondence sent to policyholders and shall be transmitted to policyholders during calendar year 2000 when annual information is made available to policyholders, or in any other mailing to policyholders, but in no case later than December 31, 2000.
(c) For the purposes of this section:
"Inborn error of metabolism" means a disease caused by an inherited abnormality of the body chemistry of a person that is characterized by deficient metabolism, originating from congenital defects or defects arising shortly after birth, of amino acid, organic acid, carbohydrate, or fat.
ALow-protein modified food product" means a food product that:
- Is specially formulated to have less than one gram of protein per serving;
- Is prescribed or ordered by a physician as medically necessary for the dietary treatment of an inborn error of metabolism; and
- Does not include a food that is naturally low in protein.
AMedical food" means a food that is formulated to be consumed or administered enterally under the supervision of a physician and is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.
[L 1999, c 86, '2]
[[Chapter 431, AInsurance
[[Sub-Chapter 431:10A, AAccident and Sickness Insurance Contracts@ (continued)]]
[[Part II, AGroup and Blanket Disability Insurance@]]
Coverage of newborn children.
All group or blanket policies providing family coverage, as defined in section 431:10A-103 and reciprocal beneficiary family coverage, as defined in section 431:10A-601, on an expense incurred basis shall provide coverage for newborn children in compliance with section 431:10A-115.
[L 1987, c 347, pt of '2; am L 1997, c 383, '7]
[[Chapter 431, AInsurance
[[Sub-Chapter 431:10A, AAccident and Sickness Insurance Contracts@ (continued)]]
[[Part VI, AMiscellaneous Provisions@]]
Reciprocal beneficiary family coverage defined; policyholder and employer responsibility for costs; availability.
(a) Any other law to the contrary notwithstanding, reciprocal beneficiary family coverage, as defined in subsection (b), shall be made available to reciprocal beneficiaries, as defined in chapter 572C, but only to the extent that family coverage, as defined in section 431:10A-103, is currently available to individuals who are not reciprocal beneficiaries.
(b) As used in this section, reciprocal beneficiary family coverage means a policy that insures, originally or upon subsequent amendment, a reciprocal beneficiary who shall be deemed the policyholder, the other party to the policyholder's reciprocal beneficiary relationship registered pursuant to chapter 572C, dependent children or any child of any other person dependent upon either reciprocal beneficiary.
(c) If a reciprocal beneficiary policyholder incurs additional costs or premiums, if any, by electing reciprocal beneficiary family coverage under this section, the employer may pay additional costs or premiums.
[L 1997, c 383, '4]
Attorney General Opinions
Section applied only to insurers, and not mutual benefit societies or health maintenance organizations. Att. Gen. Op. 97-5.
As provided by subsection (c), an employer does not violate the reciprocal beneficiaries act [L 1997, c 383] if it chooses not to pay any additional cost or premium incurred by the employee in electing reciprocal beneficiary family coverage. Att. Gen. Op. 97-10.
Section applied to all parts of article 10A if the category of policy under consideration included family coverage, as defined in '431:10A-103. Att. Gen. Op. 97-10.
The division will be responsible for enforcement of health insurance provisions of the reciprocal beneficiaries act [L 1997, c 383]; those provisions can only be enforced against insurers, not employers. Att. Gen. Op. 97-10.
The employer is not required to pay the additional costs incurred by an employee's election for reciprocal beneficiary coverage. The focus is on the insurance contract and the policyholder and recognizes that the reciprocal beneficiary, as policyholder, is the one who incurs the cost. Att. Gen. Op. 97-10.
The placement of this section in article 10A makes clear that the legislative intent was to mandate benefits that must be made available by insurers that write contracts of insurance providing family coverage; moreover, the statute specifies that the coverage be made available to reciprocal beneficiaries, not to employers. Att. Gen. Op. 97-10.
There is nothing in the reciprocal beneficiaries act [L 1997, c 383] that would prevent an insurer from making reciprocal beneficiary family coverage available in a policy separate from the policy it uses to make regular family coverage available. Att. Gen. Op. 97-10.
To the extent that the reciprocal beneficiaries act [L 1997, c 383] does impose obligations on insurers, it may provide a basis for affected persons to seek relief by, for example, seeking declaratory relief under chapter 632. Att. Gen. Op. 97-10.
[[Chapter 431, AInsurance
[[Sub-Chapter 431:10C, AMotor Vehicle Insurance@]]
[[Part I, AGeneral Provisions@]]
As used in this article:
"Accidental harm" means bodily injury, death, sickness, or disease caused by a motor vehicle accident to a person.
ACriminal conduct" means:
- The commission of an offense punishable by imprisonment for more than one year;
- The operation or use of a motor vehicle with the specific intent of causing injury or damage; or
- The operation or use of a motor vehicle as a converter without a good faith belief by the operator or user that the operator or user is legally entitled to operate or use such vehicle.
AEmergency medical condition" [For repeal on July 1, 2003, see L 1999, c 137, '15.] means a medical condition that manifests itself by acute symptoms of sufficient severity, including severe pain, that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in:
- Placing the health of the individual, including the health of a pregnant woman or her unborn child, in serious jeopardy;
- Serious impairment to bodily functions; or
- Serious dysfunction of any bodily organ or part.
AEmergency services" [For repeal on July 1, 2003, see L 1999, c 137, '15.] means:
- A medical screening examination, if required by federal law, that is within the capability of the emergency department of a hospital, including ancillary services routinely available to the emergency department, to evaluate an emergency medical condition; or
- Further medical examination and treatment, if required by federal law, that is within the capabilities of the staff and facilities available at the hospital, including any trauma and burn center of the hospital to stabilize an emergency medical condition.
AInjury" means accidental harm not resulting in death.
- The person identified by name as insured in a motor vehicle insurance policy complying with section 431:10C-301; and
- A person residing in the same household with a named insured, specifically:
A person resides in the same household if the person usually makes the person's home in the same family unit, which may include reciprocal beneficiaries, even though the person temporarily lives elsewhere.
- A spouse or reciprocal beneficiary or other relative of a named insured; and
- A minor in the custody of a named insured or of a relative residing in the same household with a named insured.
AInsured motor vehicle" means a motor vehicle:
- Which is insured under a motor vehicle insurance policy; or
- The owner of which is a self-insurer with respect to such vehicle.
AInsurer" means every person holding a valid certificate of authority to engage in the business of making contracts of motor vehicle insurance in this State. For purposes of this article, insurer includes reciprocal or inter-insurance exchanges.
AMaximum limit" means the total personal injury protection benefits payable for coverage under section 431:10C-103.5(a), per person on account of accidental harm sustained by the person in any one motor vehicle accident shall be $10,000, regardless of the number of motor vehicles or policies involved.
AMonthly earnings" means:
- In the case of a person regularly employed, one-twelfth of the average annual compensation before state and federal income taxes at the time of injury or death;
- In the case of a person regularly self-employed, one-twelfth of the average annual earnings before state and federal income taxes at the time of injury or death; or
- In the case of an unemployed person or a person not regularly employed or self-employed, one-twelfth of the anticipated annual compensation before state and federal income taxes that would have been paid from the time the person would reasonably have been expected to be regularly employed.
AMotor vehicle" means any vehicle of a type required to be registered under chapter 286, including a trailer attached to such a vehicle, but not including motorcycles and motor scooters.
AMotor vehicle accident" means an accident arising out of the operation, maintenance, or use of a motor vehicle, including an object drawn or propelled by a motor vehicle.
AMotor vehicle insurance policy" means an insurance policy that meets the requirements of section 431:10C-301.
AOperation, maintenance, or use with respect to a motor vehicle" includes occupying, entering into, and alighting from it, but does not include:
- Conduct in the course of loading or unloading the vehicle, unless the accidental harm occurs in the immediate proximity of the vehicle; and
- Conduct within the course of a business of repairing, servicing, or otherwise maintaining vehicles, unless the conduct occurs outside the premises of such business.
AOwner" means a person who holds the legal title to a motor vehicle; except that in the case of a motor vehicle which is the subject of a security agreement or lease with a term of not less than one year with the debtor or lessee having the right to possession, such term means the debtor or lessee. Whenever transfer of title to a motor vehicle occurs, the seller shall be considered the owner until delivery of the executed title to the buyer, from which time the buyer holding the equitable title shall be considered the owner.
APerson" means, when appropriate to the context, not only individuals, but corporations, firms, associations, and societies.
APerson receiving public assistance benefits" means:
- Any person receiving benefits consisting of direct cash payments through the department of human services; or
- Any person receiving benefits from the Supplemental Security Income Program under the Social Security Administration.
ARegulation" means any rule and regulation promulgated by the commissioner pursuant to chapter 91.
AReplacement vehicle" means a specific, comparable, and available vehicle in as good or better overall condition than the total loss vehicle.
ASelf-insurer, with respect to any motor vehicle," means a person who has satisfied the requirements of section 431:10C-105.
AStabilize" [For repeal on July 1, 2003, see L 1999, c 137, '15.] means the provision of medical treatment as may be necessary to assure, within reasonable medical probability, that no material deterioration of an individual's medical condition is likely to result from or occur during a transfer to another facility, if the medical condition could result in placing the health of the individual or the health of a pregnant woman or her unborn child in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.
AU-drive motor vehicle" means a motor vehicle which is rented or leased or offered for rent or lease to a customer from an operator of a U-drive rental business.
AU-drive rental business" means the business of renting or leasing to a customer a motor vehicle for a period of six months or less notwithstanding the terms of the rental or lease if in fact the motor vehicle is rented or leased for a period of six months or less.
AUnderinsured motor vehicle" means a motor vehicle with respect to the ownership, maintenance, or use for which sum of the limits of all bodily injury liability insurance coverage and self-insurance applicable at the time of loss is less than the liability for damages imposed by law.
AUninsured motor vehicle" means any of the following:
- A motor vehicle for which there is no bodily injury liability insurance or self-insurance applicable at the time of the accident; or
- An unidentified motor vehicle that causes an accident resulting in injury;
provided the accident is reported to the police or proper governmental authority, and the claimant notifies the claimant's insurer within thirty days or as soon as practicable thereafter, that the claimant or the claimant's legal representative has a legal action arising out of the accident.
AWithout regard to fault" means irrespective of fault as a cause of accidental harm, and without application of the principle of liability based on negligence.
[L 1987, c 347, pt of '2; am L 1989, c 195, '30; am L 1992, c 123, '2 and c 124, '2; am L 1997, c 251, '13 and c 383, '59; am L 1998, c 275, '4; am L 1999, c 137, '3]
See also notes at end of this chapter.
Provision excluding welfare recipients from receiving medical coverage under no-fault automobile insurance policies violated Medicaid provision of Social Security Act. 928 F.2d 898.
Vehicle was "uninsured" where vehicle operator's liability insurance did not cover injured passenger and vehicle owner had no insurance. 807 F. Supp. 98.
Households of plaintiff and spouse were separate and not a family unit for purposes of paragraph (11). 812 F. Supp. 1083.
Where named insured is a corporation, son of officer/shareholder of corporation is not an "insured" under paragraph (11). 816 F. Supp. 633.
Insurer not obligated to defend or indemnify insured, or otherwise pay any sums to defendants; defendant=s shooting was no accident from insured=s viewpoint or perspective. 834 F. Supp. 329.
Where insurer contended that plaintiff lacked standing to bring bad faith claim because plaintiff, a covered person under taxicab owner's insurance contract, was not defined as an insured in no-fault insurance statute, plaintiff, a third party beneficiary of taxicab owner's policy, was essentially an insured and to treat plaintiff otherwise made no sense. 947 F. Supp. 429.
Trial court erred in concluding that insurance company did not owe defendant duty to defend or indemnify on basis that shooting did not arise out of a motor vehicle "accident". 74 H. 620, 851 P.2d 321.
Car rental company not an "insurer" as defined under paragraph (5). 82 H. 351, 922 P.2d 964.
Where self-insurer rent-a-car company not an "insurer" as defined in this section, court erred in granting attorney's fees and costs under '431:10-242. 85 H. 243, 942 P.2d 507.
Insofar as Hawaii administrative rule '16-23-11 conflicted with paragraph (10)(B) (1987) by limiting survivors= benefits to $15,000 despite the presence of expanded no-fault coverage, '16-23-11 was void as a matter of law. 88 H. 344, 966 P.2d 1070.
Plaintiff not entitled to uninsured motorist benefits under Hawaii motor vehicle insurance law where an "uninsured motor vehicle" as defined in this section was not involved in causing plaintiff's injuries. 81 H. 110 (App.), 912 P.2d 607.
Pursuant to '431:10C-304(1)(B) (1987) and paragraph (10)(B) (1987), upon the death of an insured, the insurer is obligated to provide the insured=s survivor a survivor=s loss benefit of up to either
- $15,000 where the insured has purchased only the basic no-fault coverage, or
- the expanded limits of no-fault benefits where the insured has contracted for it under an optional additional coverage. 88 H. 345 (App.), 966 P.2d 1071.
[[Chapter 431, AInsurance
[[Sub-Chapter 431:10H, ALong-Term Care Insurance@]]
[[Part II, ALong-Term Care Insurance Model Regulation@]]
[[Note: this Section was not included in the original 1997 package of laws
establishing reciprocal beneficiaries. Instead, it was a new law added to the
HRS in 1999.]]
Continuation or conversion.
(a) Group long-term care insurance issued in this State beginning July 1, 2000, shall provide covered individuals with a basis for continuation or conversion of coverage.
(b) For purposes of this section, "a basis for continuation of coverage" means a policy provision that maintains coverage under the existing group policy when the coverage would otherwise terminate and which is subject only to the continued timely payment of premium when due. Group policies that restrict provision of benefits and services to, or contain incentives to use certain providers or facilities may provide continuation benefits that are substantially equivalent to the benefits of the existing group policy. The commissioner shall make a determination as to the substantial equivalency of benefits, and in doing so, shall take into consideration the differences between managed care and non-managed care plans, including but not limited to, provider system arrangements, service availability, benefit levels, and administrative complexity.
(c) For purposes of this section, "a basis for conversion of coverage" means a policy provision that entitles an individual, whose coverage under the group policy would otherwise terminate or has been terminated for any reason including discontinuance of the group policy in its entirety or with respect to an insured class, and who has been continuously insured under the group policy or any group policy that it replaced for at least six months immediately prior to termination shall be entitled to the issuance of a converted policy by the insurer under whose group policy the individual is covered, without evidence of insurability.
(d) For purposes of this section, "converted policy" means an individual policy of long-term care insurance providing benefits identical to or benefits determined by the commissioner to be substantially equivalent to or in excess of those provided under the group policy from which conversion is made. Where the group policy from which conversion is made restricts provision of benefits and services to, or contains incentives to use certain providers or facilities, the commissioner, in making a determination as to substantial equivalency of benefits, shall take into consideration the differences between managed care and non-managed care plans, including but not limited to, provider system arrangements, service availability, benefit levels, and administrative complexity.
(e) Written application for the converted policy shall be made and the first premium, if any, shall be paid as directed by the insurer no later than thirty-one days after termination of coverage under the group policy. The converted policy shall be issued effective on the day following the termination of coverage under the group policy, and shall be renewable annually.
(f) Unless the group policy from which conversion is made replaced previous group policy coverage, the premium for the converted policy shall be calculated on the basis of the insured's age at inception of coverage under the group policy from which conversion is made. Where the group policy from which conversion is made replaced a previous group coverage, the premium for the converted policy shall be calculated on the basis of the insured's age at inception of coverage under the group policy replaced.
(g) Continuation of coverage or issuance of a converted policy shall be mandatory, except where:
- Termination of group coverage resulted from an individual's failure to make any required payment of premium or contribution when due; or
- The terminating coverage is replaced not later than thirty-one days after termination by another group coverage effective on the day following the termination of coverage:
- Providing benefits or benefits determined by the commissioner to be identical substantially equivalent to or in excess of those provided by the terminating coverage; and
- The premium for which is calculated in a manner consistent with the requirements of subsection (f).
(h) Notwithstanding any other provision of this section, a converted policy issued to an individual who at the time of conversion is covered by another long-term care insurance policy that provides benefits on the basis of incurred expenses, may contain a provision that results in a reduction of benefits payable if the benefits provided under the additional coverage, together with the full benefits provided by the converted policy, would result in payment of more than one hundred per cent of incurred expenses. The provision shall only be included in the converted policy if the converted policy also provides for a premium decrease or refund which reflects the reduction in benefits payable.
(i) The converted policy may provide that the benefits payable under the converted policy, together with the benefits payable under the group policy from which conversion is made, shall not exceed those that would have been payable had the individual's coverage under the group policy remained in force and effect.
(j) Notwithstanding any other provision of this section, an insured individual whose eligibility for group long-term care coverage is based upon the individual's relationship to another person shall be entitled to continuation of coverage under the group policy upon termination of the qualifying relationship by death or dissolution of marriage or reciprocal beneficiary relationship.
(k) For purposes of this section "managed care plan" is a health care or assisted living arrangement designed to coordinate patient care or control costs through utilization review, case management, or use of specific provider networks.
[L 1999, c 93, pt of '2]