§431:10C-103 - Definitions.
§431:10C-103 Definitions. As used inthis article:
"Accidental harm" means bodilyinjury, death, sickness, or disease caused by a motor vehicle accident to aperson.
"Alternative care provider" means anyperson providing medical or rehabilitative services in section431:10C-302(a)(10) to a claimant covered by a motor vehicle insurance policy.
"Anesthetist" means a registerednurse-anesthetist who performs anesthesia services under the supervision of alicensed physician.
"Criminal conduct" means:
(1) The commission of an offense punishable byimprisonment for more than one year;
(2) The operation or use of a motor vehicle with thespecific intent of causing injury or damage; or
(3) The operation or use of a motor vehicle as aconverter without a good faith belief by the operator or user that the operatoror user is legally entitled to operate or use such vehicle.
"Injury" means accidental harm notresulting in death.
"Insured" means:
(1) The person identified by name as insured in amotor vehicle insurance policy complying with section 431:10C-301; and
(2) A person residing in the same household with anamed insured, specifically:
(A) A spouse or reciprocal beneficiary orother relative of a named insured; and
(B) A minor in the custody of a named insuredor of a relative residing in the same household with a named insured.
A person resides in the same household if theperson usually makes the person's home in the same family unit, which mayinclude reciprocal beneficiaries, even though the person temporarily liveselsewhere.
"Insured motor vehicle" means a motorvehicle:
(1) Which is insured under a motor vehicle insurancepolicy; or
(2) The owner of which is a self-insurer with respectto such vehicle.
"Insurer" means every person holdinga valid certificate of authority to engage in the business of making contractsof motor vehicle insurance in this State. For purposes of this article,insurer includes reciprocal or inter-insurance exchanges.
"Maximum limit" means the totalpersonal injury protection benefits payable for coverage under section431:10C-103.5(a), per person on account of accidental harm sustained by theperson in any one motor vehicle accident shall be $10,000, regardless of thenumber of motor vehicles or policies involved.
"Medical fee schedule" refers to theMedicare Resource Based Relative Value Scale System applicable to Hawaii, entitled "Workers' Compensation Supplemental Medical Fee Schedule".
"Monthly earnings" means:
(1) In the case of a person regularly employed,one-twelfth of the average annual compensation before state and federal incometaxes at the time of injury or death;
(2) In the case of a person regularly self-employed,one-twelfth of the average annual earnings before state and federal incometaxes at the time of injury or death; or
(3) In the case of an unemployed person or a personnot regularly employed or self-employed, one-twelfth of the anticipated annualcompensation before state and federal income taxes that would have been paidfrom the time the person would reasonably have been expected to be regularlyemployed.
"Motor vehicle" means any vehicle ofa type required to be registered under chapter 286, including a trailerattached to such a vehicle, but not including motorcycles and motor scooters.
"Motor vehicle accident" means anaccident arising out of the operation, maintenance, or use of a motor vehicle,including an object drawn or propelled by a motor vehicle.
"Motor vehicle insurance policy"means an insurance policy that meets the requirements of section 431:10C-301.
"Operation, maintenance, or use withrespect to a motor vehicle" includes occupying, entering into, andalighting from it, but does not include:
(1) Conduct in the course of loading or unloading thevehicle, unless the accidental harm occurs in the immediate proximity of thevehicle; and
(2) Conduct within the course of a business ofrepairing, servicing, or otherwise maintaining vehicles, unless the conductoccurs outside the premises of such business.
"Owner" means a person who holds thelegal title to a motor vehicle; except that in the case of a motor vehiclewhich is the subject of a security agreement or lease with a term of not lessthan one year with the debtor or lessee having the right to possession, such termmeans the debtor or lessee. Whenever transfer of title to a motor vehicleoccurs, the seller shall be considered the owner until delivery of the executedtitle to the buyer, from which time the buyer holding the equitable title shallbe considered the owner.
"Person" means, when appropriate tothe context, not only individuals, but corporations, firms, associations, andsocieties.
"Person receiving public assistancebenefits" means:
(1) Any person receiving benefits consisting ofdirect cash payments through the department of human services; or
(2) Any person receiving benefits from theSupplemental Security Income Program under the Social Security Administration.
"Regulation" means any rule andregulation promulgated by the commissioner pursuant to chapter 91.
"Replacement vehicle" means aspecific, comparable, and available vehicle in as good or better overallcondition than the total loss vehicle.
"Self-insurer, with respect to any motorvehicle", means a person who has satisfied the requirements of section431:10C-105.
"U-drive motor vehicle" means a motorvehicle which is rented or leased or offered for rent or lease to a customerfrom an operator of a U-drive rental business.
"U-drive rental business" means thebusiness of renting or leasing to a customer a motor vehicle for a period ofsix months or less notwithstanding the terms of the rental or lease if in factthe motor vehicle is rented or leased for a period of six months or less.
"Underinsured motor vehicle" means amotor vehicle with respect to the ownership, maintenance, or use for which sumof the limits of all bodily injury liability insurance coverage andself-insurance applicable at the time of loss is less than the liability fordamages imposed by law.
"Uninsured motor vehicle" means anyof the following:
(1) A motor vehicle for which there is no bodilyinjury liability insurance or self-insurance applicable at the time of theaccident; or
(2) An unidentified motor vehicle that causes anaccident resulting in injury; provided the accident is reported to the policeor proper governmental authority within thirty days or as soon as practicablethereafter.
"Without regard to fault" meansirrespective of fault as a cause of accidental harm, and without application ofthe principle of liability based on negligence. [L 1987, c 347, pt of §2; am L1989, c 195, §30; am L 1992, c 123, §2 and c 124, §2; am L 1997, c 251, §13 andc 383, §59; am L 1998, c 275, §4; am L 1999, c 137, §3; am L 2000, c 24, §4 andc 66, §1; am L 2004, c 10, §§13, 14, 18(3), (4)]
Case Notes
Provision excluding welfare recipients from receiving medicalcoverage under no-fault automobile insurance policies violated medicaidprovision of Social Security Act. 928 F.2d 898.
Vehicle was "uninsured" where vehicle operator'sliability insurance did not cover injured passenger and vehicle owner had noinsurance. 807 F. Supp. 98.
Households of plaintiff and spouse were separate and not afamily unit for purposes of paragraph (11). 812 F. Supp. 1083.
Where named insured is a corporation, son ofofficer/shareholder of corporation is not an "insured" underparagraph (11). 816 F. Supp. 633.
Insurer not obligated to defend or indemnify insured, orotherwise pay any sums to defendants; defendant's shooting was no accident frominsured's viewpoint or perspective. 834 F. Supp. 329.
Where insurer contended that plaintiff lacked standing tobring bad faith claim because plaintiff, a covered person under taxicab owner'sinsurance contract, was not defined as an insured in no-fault insurancestatute, plaintiff, a third party beneficiary of taxicab owner's policy, wasessentially an insured and to treat plaintiff otherwise made no sense. 947 F.Supp. 429.
Because police officer's injuries did not arise out of theuse of a vehicle, there was no uninsured motorist coverage under either of thetwo policies at issue. Officer had argued that officer's injuries arose outof three "uses" of automobiles, e.g., officer was "using" avehicle by trying to "secure" it. 187 F. Supp. 2d 1231.
Trial court erred in concluding that insurance company didnot owe defendant duty to defend or indemnify on basis that shooting did notarise out of a motor vehicle "accident". 74 H. 620, 851 P.2d 321.
Car rental company not an "insurer" as definedunder 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 grantingattorney's fees and costs under §431:10-242. 85 H. 243, 942 P.2d 507.
Insofar as Hawaii administrative rule §16-23-11 conflictedwith paragraph (10)(B) (1987) by limiting survivors' benefits to $15,000despite the presence of expanded no-fault coverage, §16-23-11 was void as amatter of law. 88 H. 344, 966 P.2d 1070.
Facts and circumstances of the case demonstrated thatplaintiff was temporarily absent from father's home while attending college inHawaii at the time of the accident; thus, trial court did not err in concludingthat plaintiff was a resident of plaintiff's father's, the named insured'shousehold in California and therefore a covered person under the insurancepolicy for underinsured motorist benefits. 107 H. 192, 111 P.3d 601.
Plaintiff not entitled to uninsured motorist benefits under Hawaii motor vehicle insurance law where an "uninsured motor vehicle" as definedin 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 theinsured's survivor a survivor's loss benefit of up to either (1) $15,000 wherethe insured has purchased only the basic no-fault coverage, or (2) the expandedlimits of no-fault benefits where the insured has contracted for it under anoptional additional coverage. 88 H. 345 (App.), 966 P.2d 1071.
Under paragraph (10)(A) (1993), no-fault benefits areexpenses which are appropriate, reasonable and necessarily incurred and are notrestricted to treatment characterized as "curative" as opposed to"palliative". 90 H. 213 (App.), 978 P.2d 179.
As motorcycles are excluded from the definition of"motor vehicle" under this section, appellant's accident with amotorcycle was not a "motor vehicle accident" under the definitionset forth in this section; appellant was thus not entitled to no-fault benefitsunder §431:10C-303(a) (1993). 91 H. 299 (App.), 983 P.2d 200.
Other than the named insured, the only persons residing inthe same household with a named insured who qualify as "insureds"under this section are "a spouse or reciprocal beneficiary or otherrelative of a named insured" and "a minor in the custody of a namedinsured or of a relative residing in the same household with a namedinsured"; as plaintiff was not a descendant of an ancestor common with theinsureds, nor adopted by or married to a daughter or other relative of them,plaintiff was not a "relative" of and could not qualify as an"insured" on the sole basis that plaintiff resided in the same householdwith the insureds. 113 H. 196 (App.), 150 P.3d 845.
Construing the language of §431:10C-301 and this sectiongoverning uninsured motorist (UM) and underinsured motorist (UIM) insuranceaccording to their plain and commonly understood meaning and in pari materiawith §§663-10.9 and 663-11, UM and UIM policies must provide coverage for alldamages which an insured is legally entitled to recover from the owner oroperator of an uninsured or underinsured motor vehicle, which necessarilyencompasses damages for which the owner or operator of an uninsured orunderinsured motor vehicle is jointly and severally liable pursuant to§§663-10.9 and 663-11. 120 H. 329 (App.), 205 P.3d 594.
To obtain underinsured motorist (UIM) coverage in Hawaii, theliability for damages must exceed the total amount of bodily injury liabilitylimits applicable at the time of the loss and the policy limits for uninsuredmotorist coverage and payments or settlements are not part of that analysis;thus, trial court correctly determined that the joint and several "damagesimposed by law" against the driver exceeded the cumulative limits ofdriver's bodily injury policies, driver met the statutory definition of an UIM,and the insurer therefore was obligated to pay victim UIM benefits to compensatevictim for the difference. 120 H. 329 (App.), 205 P.3d 594.