Title: Jou v. Government Employees Insurance Company

State: hawaii

Issuer: Hawaii Supreme Court

Document:

NOT FOR PUBLICATION IN WEST'S HAWAII REPORTS AND PACIFIC REPORTER ***

 

No. 26311
IN THE SUPREME COURT OF THE STATE OF HAWAT'T

 

EMERSON M.F, JOU, M.D. and as to Some Claims, on Behalf of the
Class of Others Similarly Situated, Plaintiff-Appellant,

GOVERNMENT EMPLOYEES INSURANCE COMPANY, LARRY M. REIFURTH,? BSQ.,

DIRECTOR, Department of Commerce and Consumer Affairs,
Defendants-Appellees,

Te woe

and
JOHN DOES 1-10, DOE CORPORATIONS 1-10, DOE PARTNERSHIPS Wal an‘
DOE ENTITIES 1-10, Defendants.

 
 
 
 

APPEAL FROM THE FIRST CIRCUIT COURT
(CIV. NO. 02~1-1603-07)

alenny! oz

(ey: Moon, c.d., Levinson, Wakayama, Recba, and Duffy, 39.)
Plaintstf-Appellant Enerson M.P. Jou, 4.0. (*¥eu")

appeals from the anended judgment of the Circuit Court of the
First circuit? (Tedreuit court”) filed on Decenber 10, 2003. on
appeal, Jou raises five points of error: (1) the eireuit court
erred in granting efendant-appellee Government Exployees Ins.
Co.'s (hereinafter “GEICO") motion to dismiss, or, in the
alternative, for summary judgment;? (2) the presiding judge, the
Honorable Gary M. 8. Chang (hereinafter “Judge Chang"), exred by
refusing to disqualify himself upon Jou's actions (3) the efrcuit

court erroneously denied Jou’s motion to amend his second amended

» og, PUtANE to Nawas"t Roles of Appellate Procedure ("HRAP*) Rule
43(c) (2000), Lawrence M. Reifurth has been substituted acs party to the
instant appeal in place of Mark £. Recktermald, in his officiel capscity.

 

 

+ the Honorable Gary W. B. Chang presided.

specify whether it was tresting or
ary jodgnent or for dismissal.

 

> the eizeult court is
ruling upon the motion es one for

  

aaa
TT NOTFOR PUBLICATION IN WEST'S HAWAII REPORTS AND PACIFIC REPORTER °°°
complaint; (4) the circuit court erred in granting the Defendant-
Appellee Lawrence M. Reifurth’s (in his official capacity as
Director of the Dep't of Conmerce and Consumer Affairs, State of
Hawai'i) (hereinafter “the DCCA Director”) motion for summary

judgment or dismissal, which the circuit court construed as a

 

motion for sunmary judgment; and (5) the final judgment appealed
from does not comport with the requirements of Jenkins v. Cades
Schutte Fleming & Wright, 76 Hawai'i 115, 869 P.2d 1334 (1994).

Additionally, the DCCA Director, within its Answering
Brief, moves for damages and costs under Hawai'i Rules of
Appellate Procedure ("HRAP”) Rule 38 (2000) on the ground that
Jou's appeal is frivolous.

Upon carefully reviewing the record and the briefs
submitted by the parties and having given due consideration to
the arguments advanced and the issues raised, we hold as follows:

(1) With respect to Jou’s fifth point of error,
regarding the existence of this court's appellate jurisdiction,
we hold that the December 10, 2003 amended final judgment
complied with Jenkins. 76 Hawai'i at 119, 869 P.2d at 1338.
Thus, we have jurisdiction over the instant appeal.

(2) With respect to Jou’s first point of error, the
circuit court did not err in granting GEICO’s motion, which was
Gencminated as being for dismissal or summary judgment. Because
the record reveals that matters outside the pleading were
introduced on summary judgment which were expressly considered by

the circuit court in making its ruling, we note that GEICO’s

‘WRAP Rule 38 provides: “If a Haxas't appellate court determines
that on appeal decided by it was frivolous, it may, after a separately filed
otich of notice from the appellate court and reasonable cppertunity te
respond, snare darages, inciusing reasonable attorneys’ fees and costs, to the
appellee.”

 

 
bead eet er TA ZEEE sees set tt Sea
motion was converted into a motion for summary judgment. See
@.a., HRCP Rule 12(b) (2000); Gamino v. Greenwell, 2 Haw. App.
59, 62, 625 P.2d 1055, 1058 (1961); and Au v. Au, 63 Haw. 210,
213-14, 626 P.2d 173, 176-77 (1981). Upon careful review, we
discern two cognizable contentions by Jou: that (a) Jou should
have prevailed on his abuse of process claim, and (b) this
court’s decision in Moss v, Am, Int'l Adjustment Co., Inc., 86
Hawai'i 59, 947 P,2d 371 (1997) did not serve to preclude hin
from filing a lawsuit in circuit court.

We first hold that summary judgment in favor of GEICO
was proper as to the abuse of process claim. See e.a.,
Orthoredic Assocs. of Hawai'i, Inc. v. Hawaiian Ins. & Guar. Co
Ltd., 109 Hawai'i 185, 194, 124 P.3d 930, 939 (2008). We discern
neither any ulterior motive nor any wilful act for the purpose of
misusing or otherwise manipulating the State Department of
Conmerce and Consumer Affairs’ ("OCCA") Insurance Division's
administrative hearing process via GEICO seeking (in 2000) a
declaratory ruling as to whether formal written denial of claim
notices ere required to be sent to a provider of services (e.g.
a physician) where a submitted no-fault insurance claim is
approved and paid, but where a dispute between the insurer end
provider of services with respect to the proper amount payable
remains, See Wong v, Panis, 7 Haw. App. 414, 420-21, 772 P.2d
695, 699-700 (1989), abrooated on other grounds by Hac v. Univ.
of Hawai'i, 102 Hawas's 92, 105-07, 73 P.3d 46, 59-62 (2003).* In
that 2000 administrative declaratory proceeding, involving GEICO
as petitioner and the DCCA as respondent, the hearing officer

  

* See slec, eae, Haxai's Revised Statutes (“HRS”) §6 431:10¢-206
supp. 2000) end # ‘Supp. 2000 & Supp. 2006) (with respect to the

    
   

HAWAII REPORTS AND PACIFIC REPORTER

answered in the negative, and in doing so expressly reaffirmed a
preexisting advisory opinion by the Insurance Commissioner which
took the same position on the same subject matter in 1999.
Thus, not only was there no abuse of process as a matter of law,
there was also nothing GEICO could have obtained by initiating
the dectaratory proceeding, inasmuch as (1) the Insurance
Commissioner had already issued his advisory memorandum opinion
to all insurers on that issue months before GEICO initiated the
declaratory proceeding, and (2) for all intents and purposes, it
was the Insurance Commissioner, the original proponent of the
position, and not GEICO who ultimately “benefitted” from the
formal ruling on the matter. Accordingly, Jou’s contention that
he should have been granted sunmary judgment on his abuse of
process claim is without merit.

As to Jou's other contention, that Mose was
inapplicable to the instant case, we hold to the contrary. The
key Moss-related issue in this case, as pointed out by both the
circuit court and GEICO, was Jou’s having concurrent proceedings
before both the Insurance Comissicner and this court (in the
instant case), where both proceedings concerned medical claims
submitted as to the same ten patients. Jou did not and does not
discernibly contest or otherwise challenge the circuit court's or
GEICO’s understanding that Jou's initiated proceeding before
circuit court in the instant case was concurrent with the

administrative proceeding and also arose from the sane dispute.

 

+ solely in parsing, we cbserve, but do not hold of ctherwise find

er decide, that in any event, Jou's 1999 soministrative proceeding sn the
Insurance Divieicn adjudicated partially in hie favor war not affected by the
Geclaratery ruling "obtained" by GEICO, because it appeare from the record
that no payment determination or requect for information was ever issued By
GELCOae to specific subset cf clains submitted by Jeu.

 

 

4
   

NOT FOR PUBLICATION IN WEST'S HAWAI REPORTS AND PACIFIC REPORTER.
And in the absence of any such challenge, this court declines to
sua sponte second-guess the circuit court’s understanding that
Jou’s circuit court lawsuit was concurrent and based upon the
same subject matter. Further, after careful review, we hold that
Jou has not presented any cognizable argument with respect to
either (1) whether the instant case and Moss involved
fundamentally different types of claims such that Moss was
distinguishable, or (2) Jou’s contention that Hawai'i agencies
have no jurisdiction to hear claims sounding in tort. See e.a.,
HRAP Rule 28(b) (7) (2004); Hawai'i Ventures, LLC v. Otaka, Inc.

, 2007 WL 1346603 at *29 (May 9, 2007); and Kienker
Ye Bauer, 110 Hawai'i 97, 104 n.12, 129 P.3d 1125, 1132 n.12

n+ P.3d -

 

(2006). Thus, we affirm the circuit court’s grant of summary
judgment in favor of GEICO.

(3) Regarding Jou’s second point of error, Judge Chang
did not abuse his discretion in declining to disqualify or recuse
himself from the instant case. See Found, Int'l, Inc. v. ET
Ise Constr., Inc., 102 Hawai'i 487, 503, 78 P.3d 23, 39 (2003)
(quoting State v. Ross, 89 Hawai'i 371, 375-76, 974 P.2¢ 11,
15-16 (1998)); Office of Hawaiian Affairs v. State, 110 Hawai's
338, 351, 133 P.3d 767, 780 (2006). We find no colorable
argument or record support from Jou establishing such an abuse of
discretion, and therefore Judge Chang's denial of Jou’s motion to
disqualify him is affirmed.

(4) Regarding Jou's third point of error, the circuit
court did not abuse its discretion in denying Jou’s motion for
leave to amend his second amended complaint. Office of Hawaiian
Affairs, 110 Hawai'i at 351, 133 P.3d at 780. On appeal, Jou

does not challenge the circuit court's express oral finding of
 

+++ NOT FOR FI

 

UBLICATION IN WEST'S HAWAI REPORTS AND PACIFIC REPORTER,
“unreasonable delay” in Jou’s bringing the motion for leave to
amend. Such a finding of delay is a specific exception to the
general rule that leave to amend a complaint should be freely
given, Triz$ Corp, v, WW. World Ins, Co., 110 Hawai'i 473, 490,
135 P.3d 82, 99 (2006). Accordingly, the circuit court’s motion
Genying Jou's motion for leave to amended his second amended
complaint is affirmed.

(3) Regarding Jou’s fourth point of error, the circuit
court did not err in granting summary judgment in favor of the
DCCA Director. In his second amended complaint, Jou challenges
the OCcA’s jurisdiction to hear “controversies involving issues
relating to automobile insurance” by seeking a declaration that
certain agency rules are invalid. However, the DCCA, as a
creature of statute, derives its jurisdiction from legislative
enactment, not agency rule.’ As such, Jou’s thirteenth claim is
without 2 valid legal basis. Thus, the circuit court’s grant of
summary judgment in favor of the DCCA Director is affirmed.

(6) Jou's remaining arguments (those not addressed
above) are waived for (a) lack of legally cognizable argument
and/or (b) lack of demonstrated or apparent nexus to Jou's five
points of error. See HRAP Rule 28(b) (7), Hawai'i Ventures and
Kisnker, supra.

(7) The DCCA Director's motion for damages and costs
for frivolous appesl under HRAP Rule 38 is denied.

‘Therefore,

 

Hee, gia, HRS § 26-9 (Supp. 2006) (establishing the DCCA! HRS §
431:2-101 (1983) [establishing the Insurance Division within the DOCAl; RS §
4 2 (Supp. 2000) (establishing the office of the insurance
Ceanissioner);'ané HRS $ 431:2-201 (Supp. 2003) (setting forth the general
Poners and cuties ef the Insurance Conmiseicner!

        

 

6
 

NOT FOR PUBLICATION IN WEST'S HAWAII REPORTS AND PACIFIC REPORTER

 

IT IS HEREBY ORDERED that (1) the Decenber 10, 2003
anended judgnent of the circuit court is affirmed, and (2) the
DCCA Director’s HRAP Rule 38 motion for damages and costs is
denied.

DATED: Honolulu, Hawai'l, July 26, 2007.
on the briefs:

Stephen shaw, for
Plaineifiappellant

Emerson M. Fe Ou, M.D.

Kathy K. Higham, (of Kessner ERC nse —

Duca Unebayashi Bain &
Mateunaga, A Law Corporation)
for Defendant-Appellee Pretec CNet re
Government Employees Ins. Co.,

Inc. (ON

David A. febber, Deborah Day
Pactson, Eases depety Ynca
Attorneys General, for tbo we
Sefenuene-Appeiiee

Penrence Me Resfuren,

Innis efticiel capacity as

Dizectors Dep't of Comerce

tnd Consimer Affaire, seete