Haw. Rev. Stat. § 431C-50 — HI Code / Division 2 / Title 24 / Chapter 431C / Section 431C-50
Penalties.
Status: in_force

(a) The commissioner may levy a civil penalty not exceeding $10,000 and the amount of the claim for each violation upon any person, including those persons and their employees licensed pursuant to this chapter, who is found to have committed a fraudulent life settlement act or violated any other provision of this chapter.

(b) The license of a person licensed under this chapter who commits a fraudulent life settlement act shall be revoked for a period of at least one year.

(c) The penalties under this chapter are cumulative and may be imposed in addition to any other penalties authorized by law. [L 2012, c 256, pt of §1]
Haw. Rev. Stat. § 431C-15 — HI Code / Division 2 / Title 24 / Chapter 431C / Section 431C-15
Examiner; conflict of interest.
Status: in_force

(a) An examiner shall not be appointed by the commissioner if the examiner, either directly or indirectly, has a conflict of interest or is affiliated with the management of or owns a pecuniary interest in any person subject to examination under this chapter. This section shall not be construed to automatically preclude an examiner from being:

(1) An owner;

(2) An insured in a policy or life settlement contract; or

(3) A beneficiary in a policy that is proposed for a life settlement contract.

(b) Notwithstanding the requirements of this section, the commissioner may retain from time to time, on an individual basis, qualified actuaries, certified public accountants, or other similar individuals who are independently practicing their professions, even though these persons may from time to time be similarly employed or retained by persons subject to examination under this chapter. [L 2012, c 256, pt of §1]
Haw. Rev. Stat. § 431C-53 — HI Code / Division 2 / Title 24 / Chapter 431C / Section 431C-53
Authority to adopt rules.
Status: in_force

The commissioner may adopt rules to implement this chapter pursuant to chapter 91.
Haw. Rev. Stat. § 432C-3 — HI Code / Division 2 / Title 24 / Chapter 432C / Section 432C-3
Approval process.
Status: in_force

(a) No nonprofit entity may engage in a conversion without prior approval of the application for conversion by the commissioner. Any conversion without the commissioner's approval shall be voidable by the commissioner.

(b) Prior to approval of the conversion plan, the commissioner shall determine the fair market value of the assets of the nonprofit entity and shall ensure that the assets of the nonprofit entity are transferred to another nonprofit entity at the time of conversion pursuant to section [432C-5].

(c) After reviewing the report and plan for conversion of the nonprofit entity, if the commissioner finds any discrepancy in the valuation of the assets of the nonprofit entity, the commissioner may obtain an independent party to provide a valuation of the assets. The commissioner shall have the discretion of making a final determination of the valuation of the assets of the nonprofit entity; provided that any issues arising from valuation are brought forth during the public hearing.

(d) A public hearing shall be conducted pursuant to chapter 91 prior to approving or disapproving the conversion. Prior to approving or disapproving the conversion, the commissioner may investigate and consider any matter or issue raised at the public hearing.

(e) Within sixty days after the public hearing, the commissioner shall disapprove or approve the conversion or approve an amended conversion plan; provided that the commissioner may extend this period if the commissioner deems more time is needed to resolve any issues brought forth during the public hearing or upon mutual consent of the nonprofit entity and the commissioner.

(f) The commissioner shall approve the conversion if the commissioner finds all of the following have been met:

(1) The conversion plan is in compliance with section 432C-2;

(2) The plan is fair and reasonable and not contrary to law or to the interests of subscribers, contract holders, and the residents of the State; and

(3) Upon conversion, the for-profit corporation will meet the standards and conditions applicable to stock insurance companies, including minimum surplus requirements.

(g) The commissioner shall issue an order approving or disapproving the conversion or approving an amended conversion plan. [L 1998, c 260, pt of §2]
Haw. Rev. Stat. § 432E-40 — HI Code / Division 2 / Title 24 / Chapter 432E / Section 432E-40
[ §432E-40] Hold harmless for independent review organizations.
Status: in_force

[ §432E-40] Hold harmless for independent review organizations. No independent review organization or clinical reviewer working on behalf of an independent review organization or an employee, agent, or contractor of an independent review organization shall be liable in damages to any person for any opinions rendered or acts or omissions performed within the scope of the organization's or person's duties under the law during or upon completion of an external review conducted pursuant to this part, unless the opinion was rendered or the act or omission was performed in bad faith or involved gross negligence.
Haw. Rev. Stat. § 435E-27 — HI Code / Division 2 / Title 24 / Chapter 435E / Section 435E-27
Rights of members.
Status: in_force

Each member participating in an interindemnity arrangement shall have the right of access to, and the inspection of, the books and records of the interindemnity arrangement, subject to reasonable regulation by the board of trustees.
Haw. Rev. Stat. § 432D-27 — HI Code / Division 2 / Title 24 / Chapter 432D / Section 432D-27
Policies relating to domestic abuse cases.
Status: in_force

(a) No health maintenance organization shall deny or refuse to accept an application for insurance, refuse to insure, refuse to renew, cancel, restrict, or otherwise terminate a policy of insurance, or charge a different rate for the same coverage, on the basis that the applicant or enrollee is, has been, or may be a victim of domestic abuse.

(b) Nothing in this section shall prevent a health maintenance organization from taking any of the actions set forth in subsection (a) on the basis of loss history or medical condition, or for any other reason not otherwise prohibited by this section or any other law, regulation, or rule.

(c) Any form filed or filed after July 15, 1998 or subject to a rule adopted under chapter 91 may exclude coverage for losses caused by intentional or fraudulent acts of any enrollee.

(d) Nothing in this section prohibits a health maintenance organization from investigating a claim and complying with chapter 432D.

(e) As used in this section, "domestic abuse" means:

(1) Physical harm, bodily injury, assault, or the infliction of fear of imminent physical harm, bodily injury, or assault between family or household members;

(2) Sexual assault of one family or household member by another;

(3) Stalking of one family or household member by another family or household member;

(4) Intentionally, knowingly, or recklessly causing damage to property so as to intimidate or attempt to control the behavior of another household member; or

(5) Coercive control, as defined in section 586-1, between family or household members. [L 1998, c 171, §5; am L 2004, c 122, §92; am L 2020, c 20, §4]

Revision Note

"July 15, 1998" substituted for "the effective date of this section" pursuant to §23G-15.
Haw. Rev. Stat. § 432D-5 — HI Code / Division 2 / Title 24 / Chapter 432D / Section 432D-5
Annual and quarterly reports.
Status: in_force

(a) Every health maintenance organization shall file annually, on or before March 1, a report verified by at least two principal officers covering the preceding calendar year. Each health maintenance organization shall file quarterly with the commissioner, on or before the forty-fifth day after each quarter, a copy of its quarterly report verified by at least two principal officers. These reports shall comply with sections 431:3-301 and 431:3-302. The commissioner may prescribe the forms on which the reports are to be filed. In addition, the health maintenance organization annually shall file with the commissioner the following by the dates specified:

(1) An audit, by an independent certified public accountant or an accounting firm designated by the health maintenance organization of the financial statements, reporting the financial condition and results of operations of the health maintenance organization on or before June 1, or a later date as the commissioner upon request or for cause may specify. The health maintenance organization, on an annual basis and prior to the commencement of the audit, shall notify the commissioner in writing of the name and address of the person or firm retained to conduct the annual audit. The commissioner may disapprove the health maintenance organization's designation within fifteen days of receipt of the health maintenance organization's notice, and the health maintenance organization shall be required to designate another independent certified public accountant or accounting firm. The audit required by this paragraph shall be prepared in accordance with the National Association of Insurance Commissioners' accounting practices and procedures manual and rules adopted by the commissioner following the practices and procedures prescribed by the National Association of Insurance Commissioners;

(2) A list of the providers who have executed a contract that complies with section 432D-8(d) on or before March 1; and

(3) A description of the available grievance procedures, the total number of grievances handled through those procedures, a compilation of the causes underlying those grievances, and a summary of the final disposition of those grievances on or before March 1.

(b) The commissioner may require additional reports as are deemed necessary and appropriate to enable the commissioner to carry out the commissioner's duties under this chapter.

(c) The commissioner may suspend or revoke the certificate of authority of any health maintenance organization who fails to file any of the documents required under subsection (a). In lieu or in addition to the suspension or revocation of the certificate of authority of any health maintenance organization, the commissioner may fine the health maintenance organization not less than $100 and not more than $500 for each day of delinquency. [L 1995, c 179, pt of §1; am L 1999, c 247, §1; am L 2000, c 74, §4; am L 2003, c 212, §125; am L 2010, c 116, §3]
Haw. Rev. Stat. § 435C-3 — HI Code / Division 2 / Title 24 / Chapter 435C / Section 435C-3
Joint underwriting plan, establishment.
Status: in_force

(a) A joint underwriting plan is established, consisting of all insurers authorized to write and engaged in writing casualty insurance in this State on a direct basis. Each insurer shall be a member of the plan and shall maintain membership as a condition of its licensure to transact such insurance in this State. The purpose of the plan shall be to provide medical malpractice insurance on a self-supporting basis. The plan shall be the exclusive agency through which medical malpractice insurance may be written in this State on a primary basis for physicians and hospitals.

(b) The plan shall, pursuant to the provisions of this chapter and the plan of operation with respect to medical malpractice insurance, have the power on behalf of its members:

(1) To issue, or to cause to be issued policies of insurance to applicants, including incidental coverages and subject to limits as specified in the plan of operation but not to exceed $100,000 for each claimant under one policy in any one year;

(2) To appoint service companies to underwrite such insurance and to adjust and pay losses with respect thereto;

(3) To assume reinsurance from its members; and

(4) To cede reinsurance.

(c)(1) The commissioner shall, after consultation with the joint underwriting plan, representatives of the public, the Hawaii Medical Association and other affected individuals and organizations, promulgate a plan of operation consistent with the provisions of this chapter within sixty days after the creation of the plan. The plan of operation shall become effective and operational upon order of the insurance commissioner.

(2) The plan of operation shall provide for economic, fair and nondiscriminatory administration and for the prompt and efficient provision of medical malpractice insurance, and shall contain other provisions including, but not limited to, preliminary assessment of all members for initial expenses necessary to commence operation, establishment of necessary facilities, management of the plan, assessment of members to defray losses and expenses, commission arrangements, reasonable and objective underwriting standards, acceptance and cession of reinsurance, appointment of servicing carriers and standards, and procedures for determining amounts of insurance to be provided by the plan.

(3) The plan of operation shall provide that any profit achieved by the plan be added to the reserves of the plan or returned to the policyholders as a dividend.

(4) Amendments to the plan of operation may be made by the directors of the plan, subject to the approval of the insurance commissioner, or shall be made at the direction of the insurance commissioner. [L 1975, c 161, pt of §1; am L 1976, c 219, §5; am L 1984, c 232, §2]
Haw. Rev. Stat. § 431C-17 — HI Code / Division 2 / Title 24 / Chapter 431C / Section 431C-17
Investigative authority of the commissioner.
Status: in_force

The commissioner may investigate suspected fraudulent life settlement acts and persons engaged in the business of life settlements.
Haw. Rev. Stat. § 431K-1.5 — HI Code / Division 2 / Title 24 / Chapter 431K / Section 431K-1.5
Financial responsibility.
Status: in_force

Whenever pursuant to the laws of this State or any county of this State a demonstration of financial responsibility is required as a condition for obtaining a license or permit to undertake specified activities, if any such requirement may not be satisfied by obtaining insurance from an insurance company not authorized in this State, then such requirement may not be satisfied by purchasing insurance from a risk retention group not chartered in this State.
Haw. Rev. Stat. § 432E-13 — HI Code / Division 2 / Title 24 / Chapter 432E / Section 432E-13
Annual report.
Status: in_force

The commissioner shall submit annually to the legislature a report that shall contain the number of external review hearing cases reviewed, the type of cases reviewed, a summary of the nature of the cases reviewed, and the disposition of the cases reviewed. The identities of the plan and the enrollee shall be protected from disclosure in the report.
Haw. Rev. Stat. § 431P-18 — HI Code / Division 2 / Title 24 / Chapter 431P / Section 431P-18
Exemption for Hawaiian home lands.
Status: in_force

Nothing in this chapter shall prohibit or limit any person from obtaining insurance for property subject to the Hawaiian Homes Commission Act of 1920, as amended, from any insurer other than the fund if such insurance is deemed sufficient by the commissioner.
Haw. Rev. Stat. § 432D-21 — HI Code / Division 2 / Title 24 / Chapter 432D / Section 432D-21
Confidentiality of medical information.
Status: in_force

Any data or information pertaining to the diagnosis, treatment, or health of any enrollee or applicant obtained from such person or from any provider by any health maintenance organization shall be held in confidence and shall not be disclosed to any person except to the extent that it may be necessary to carry out the purposes of this chapter, upon the express consent of the enrollee or applicant, pursuant to statute or court order for the production of evidence or the discovery thereof, or in the event of a claim or litigation between such person and the health maintenance organization wherein such data or information is pertinent. A health maintenance organization shall be entitled to claim any statutory privileges against disclosure which the provider who furnished the information to the health maintenance organization is entitled to claim.
Haw. Rev. Stat. § 435E-26 — HI Code / Division 2 / Title 24 / Chapter 435E / Section 435E-26
Involuntary termination of a member.
Status: in_force

The board of trustees shall have the right to terminate the membership of a participating member where the board of trustees determines that such termination is in the best interests of the interindemnity arrangement even though such person has complied with all of the provisions of the trust agreement. Such a termination may be effected only if at least two-thirds of the members of the board of trustees indicate in writing their decision so to terminate. If the board of trustees proposes to terminate a member, the member shall have the right to call a special meeting of all participating members for the purpose of voting on whether or not the member shall be so terminated. The member shall not be terminated if at least two-thirds of the participating members present indicate that the member should not be terminated. In the event a member is terminated, the person may elect either:

(1) To request the return of his or her initial contribution, in which case the same shall be repaid and the indemnity coverage shall thereupon terminate as to all claims then pending against such person and in respect to all occurrences prior to the date of such termination of membership. However, in the event the interindemnity arrangement is then providing legal defense services to such person, the interindemnity arrangement shall continue to provide those services for a period of thirty days to enable such person to assume his or her own defense; or

(2) To release all rights to the return of the initial contribution, in which case the indemnity coverage shall continue for the benefit of the member in respect of occurrences during the time the person was a participating member and the person shall have no responsibility for assessments levied following such termination. [L 1977, c 182, pt of §1]
Haw. Rev. Stat. § 435E-32 — HI Code / Division 2 / Title 24 / Chapter 435E / Section 435E-32
Prospective member.
Status: in_force

Each physician or surgeon solicited to become a participating member in an interindemnity arrangement shall receive in writing, at least forty-eight hours prior to the execution by the prospective participating member of the trust agreement, and at least forty-eight hours prior to the payment by the prospective participating member of any consideration in connection with such interindemnity arrangements, the following information:

(1) A copy of the articles of incorporation and bylaws of the cooperative corporation and a copy of the form of trust agreement to be executed by such prospective participating member.

(2) A disclosure statement regarding the interindemnity arrangement. The disclosure statement shall contain on the first or cover page a legend in boldface type reading substantially as follows:

"THE INTERINDEMNITY ARRANGEMENT CONTEMPLATED HEREIN PROVIDES THAT PARTICIPATING MEMBERS HAVE UNLIMITED PERSONAL LIABILITY FOR ASSESSMENTS WHICH MAY BE LEVIED TO PAY FOR THE PROFESSIONAL NEGLIGENCE LIABILITIES COVERED BY THIS ARRANGEMENT. NO ASSURANCES CAN BE GIVEN REGARDING THE AMOUNT OR FREQUENCY OF ASSESSMENTS WHICH MAY BE SO LEVIED, OR THAT ALL PARTICIPATING MEMBERS WILL MAKE TIMELY PAYMENT OF THEIR ASSESSMENTS TO COVER THE PROFESSIONAL NEGLIGENCE LIABILITY OF A PARTICIPATING MEMBER."

(3) The disclosure statement shall further contain all of the following information:

(A) The amount, nature, and terms and conditions of the professional negligence coverage available under the interindemnity arrangement.

(B) The amount of the initial contribution required of each participating member and a statement of the minimum number of members and aggregate contributions required for the interindemnity arrangement to commence.

(C) The names, addresses, and professional experience of each member of the board of trustees.

(D) The requirements for admission as a participating member.

(E) A statement of the services to be provided under the interindemnity arrangement to each participating member.

(F) A statement regarding the obligation of each member to pay assessments and the consequences for failure to do so.

(G) A statement of the rights and obligations of a participating member in the event the member dies, retires, becomes disabled, or terminates participation for any reason, or the interindemnity arrangement terminates for any reason.

(H) A statement regarding the claims administration services to be provided, indicating whether these services will be delegated to others pursuant to a contractual arrangement.

(I) A statement of the voting rights of the members and the circumstances under which participation of the member may be terminated and under which the interindemnity arrangement may be terminated.

(J) If any statement of estimated or projected financial information for the interindemnity arrangement is issued, a statement of the estimation or projection and a summary of the data and assumptions upon which it is based.

(4) A list with the names and addresses of all then current participating members of the interindemnity arrangement. [L 1977, c 182, pt of §1]
Haw. Rev. Stat. § 432E-4 — HI Code / Division 2 / Title 24 / Chapter 432E / Section 432E-4
Enrollee participation in treatment decisions.
Status: in_force

(a) An enrollee shall have the right to be informed fully prior to making any decision about any treatment, benefit, or nontreatment.

(b) In order to inform enrollees fully, the provider shall:

(1) Discuss all treatment options with an enrollee, as provided by section 671-3, including the option of no treatment at all;

(2) Ensure that persons with disabilities have an effective means of communication with the provider and other members of the managed care plan; and

(3) Discuss all risks, benefits, and consequences to treatment and nontreatment, as provided by section 671-3(b).

(c) The provider shall discuss with the enrollee and the enrollee's immediate family both [advance] health-care directives, as provided for in chapter 327E, and durable powers of attorney in relation to medical treatment.

(d) A managed care plan shall be prohibited from imposing any type of prohibition, disincentive, penalty, or other negative treatment upon a provider for discussing or providing any information regarding treatment options and medically necessary or appropriate care, including no treatment, even if the information relates to services or benefits not provided by the managed care plan. [L 1998, c 178, pt of §2; am L 2003, c 114, §1; am L 2005, c 22, §30; am L 2014, c 22, §3]
Haw. Rev. Stat. § 431K-13 — HI Code / Division 2 / Title 24 / Chapter 431K / Section 431K-13
Rules.
Status: in_force

The commissioner may adopt rules under chapter 91, relating to risk retention groups as may be necessary or desirable to carry out this chapter.
Haw. Rev. Stat. § 432E-2 — HI Code / Division 2 / Title 24 / Chapter 432E / Section 432E-2
Conflict with other laws.
Status: in_force

If there is a conflict with any other law, this chapter shall prevail to the extent that this chapter offers greater protection or rights to the enrollee.
Haw. Rev. Stat. § 432G-22 — HI Code / Division 2 / Title 24 / Chapter 432G / Section 432G-22
Rules; adoption by commissioner.
Status: in_force

[§432G-22 Rules; adoption by commissioner.] The commissioner may adopt rules under chapter 91 for the implementation and administration of this chapter.

Revision Note

This section, enacted as §432G-2(e), was redesignated pursuant to §23G-15.
Haw. Rev. Stat. § 432E-44 — HI Code / Division 2 / Title 24 / Chapter 432E / Section 432E-44
Rules.
Status: in_force

The insurance commissioner shall adopt rules pursuant to chapter 91 to effectuate the purpose of this part including requirements for forms to request external review and expedited external review, to request approval by independent review organizations, and for disclosure of conflicts of interest by enrollees and health carriers.
Haw. Rev. Stat. § 432D-20 — HI Code / Division 2 / Title 24 / Chapter 432D / Section 432D-20
Filings and reports as public documents.
Status: in_force

Notwithstanding chapter 92F and any other laws to the contrary, all applications and filings required under this chapter shall be treated as public, except for trade secrets or privileged or confidential quality assurance, commercial, or financial information; provided that any annual financial statement that may be required under section 432D-5 shall be public.
Haw. Rev. Stat. § 432D-12 — HI Code / Division 2 / Title 24 / Chapter 432D / Section 432D-12
Powers of insurers and hospital and medical service corporations.
Status: in_force

(a) An insurance company licensed in this State, or a hospital or medical service corporation authorized to do business in this State, either directly or through a subsidiary or affiliate, may organize and operate a health maintenance organization under the provisions of this chapter. Notwithstanding any other law to the contrary, any two or more insurance companies, hospital or medical service corporations, or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance organization. The business of insurance is deemed to include the providing of health care by a health maintenance organization owned or operated by an insurer or a subsidiary thereof.

(b) Notwithstanding any contrary provision of laws pertaining to insurance or hospital or medical service corporations, an insurer or a hospital or medical service corporation may contract with a health maintenance organization to provide insurance or similar protection against the cost of care provided through health maintenance organizations and to provide coverage in the event of the failure of the health maintenance organization to meet its obligations. The enrollees of a health maintenance organization constitute a permissible group under such laws. Among other things, under such contracts, the insurer or hospital or medical service corporation may make benefit payments to health maintenance organizations for health care services rendered by providers. [L 1995, c 179, pt of §1]
Haw. Rev. Stat. § 432D-18 — HI Code / Division 2 / Title 24 / Chapter 432D / Section 432D-18
Penalties and enforcement.
Status: in_force

(a) The commissioner, in lieu of suspension or revocation of a certificate of authority, may impose an administrative fine pursuant to section 432D-14(b).

(b) If the commissioner, for any reason, has cause to believe that any violation of this chapter has occurred or is threatened, the commissioner may give notice to the health maintenance organization and to the representatives, or other persons who appear to be involved in such suspected violation, to arrange a conference with the alleged violators or their authorized representatives for the purpose of attempting to ascertain the facts relating to such suspected violation and, in the event it appears that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing such violation. Proceedings under this subsection shall not be governed by any formal procedural requirements, and may be conducted in such manner as the commissioner may deem appropriate under the circumstances. However, unless consented to by the health maintenance organization, no order may result from a conference until the requirements of this section are satisfied.

(c) The commissioner may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any act or practice in violation of the provisions of this chapter. Any person aggrieved by an order of the commissioner under this section may obtain judicial review of the order in the manner provided for by chapter 91.

(d) In the case of any violation of the provisions of this chapter, if the commissioner elects not to issue a cease and desist order, or in the event of noncompliance with a cease and desist order issued pursuant to subsection (c), the commissioner may institute a proceeding to obtain injunctive or other appropriate relief in any court of competent jurisdiction.

(e) Notwithstanding any other provisions of this chapter, if a health maintenance organization fails to comply with the net worth requirement of this chapter, the commissioner may take appropriate action to assure that the continued operation of the health maintenance organization will not be hazardous to its enrollees. [L 1995, c 179, pt of §1]
Haw. Rev. Stat. § 431P-11 — HI Code / Division 2 / Title 24 / Chapter 431P / Section 431P-11
Underlying policy required; hurricane coverage shall be provided.
Status: in_force

(a) Any eligible property for which coverage is sought from the fund shall already be insured by an underlying policy of property insurance as defined in section 431:1-206 or article 21 of chapter 431 but excluding the covered event. Every underlying policy of property insurance provided by an unauthorized insurer shall be subject to the procedures, guidelines and surcharges as provided in the plan of operation.

(b) Except for:

(1) Applicants who are otherwise able to procure hurricane property insurance from insurers authorized to transact business in the State; and

(2) Properties that are deemed ineligible pursuant to the plan of operation,

the fund shall not deny any application for hurricane property insurance on any property eligible under subsection (a).

(c) The fund shall renew any policy provided payment of the applicable renewal premium is received by the fund on or before the expiration date stated in the policy. The fund may nonrenew a policy on the grounds the property is no longer covered by a companion policy. The policy issued by the fund shall not provide coverage in the event that there is no companion policy at the time of loss. In such case, any unearned premiums shall be returned to the policyholder on a pro rata basis. Limits of coverage under a policy issued by the fund shall not exceed the limits of comparable coverages for fire and windstorm under the companion policy. The statute of limitations for actions under a policy of hurricane property insurance shall be one year. [L 1993, c 339, pt of §2; am L 1998, c 106, §5; am L 2025, c 296, §15]