Title: Dias v. Stender

State: hawaii

Issuer: Hawaii Supreme Court

Document:

*** NOT_FOR PUBLICATION IN WEST'S HAWAII REPORTS AND PACIFIC REPORTER ™"

 

no. 25763
IN THE SUPREME COURT OF THE STATE OF HAWA'T

—
FRANCIS §. DIAS, JR., Plaintiff-appeliant; 8
OSWALD STENDER, Defendant-Appellee, 5
and 8

 

JOHN DOES 1-10; JANE DOES 1-10; DOE CORPORATIONS 1-10; DOE
PARTNERSHIPS 1-107 DOE NON-PROFIT ENTITIES 1-10; and DOE
GOVERNMENTAL ENTITIES 1-10, Defendants.

 

 

APPEAL FROM THE FIRST CIRCUIT COURT
(civ. NO. 02-1-0091)

(By: Moon, ¢.9., Levinson, Nakayama, Neobe, and Duffy, 33.)

Plainti¢¢-Appediant Francis 8. Dias, Je. ("048s")
sppeais fron the Judgnent of the Circuit Court of the First
circuit? (“circuit court”) filed on March 10, 2002, following the
arant of summary judgnent in favor of Defendant-Appellee Oswald
Stender ("Stender").

on appeal, Dias argues thet: (1) the cizouit court
exred in granting summary judgnent due to the existence of
genuine issues of material fact as to whether (a) Dias had
accumulated medicel-rehabilitative expenses tor his 1997 motor
vehicle accident injuries in excess of $13,900 as required by

Hawas'i Revised Statutes ("HRS") § 431:10C-306(b) (2) (1993)? and

 

‘The Honorable Eden Elizabeth Hifo presided.

 

rs § ¢31:200~306 (198

+ in ef
appeal, provides in pertinest pare

 

lot at the tine of the instant

(a) Except ae provided in subsection (b), this art

 

belie

 

act
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Hawai'i Administrative Rules ("HAR") § 16-23-10 (1999),° and (b)

 

tort Liability of the following persons with respect to accidental
ham arising Zeon acter venicie accidents occurring in this steve:
(1) omer, operator or user of an insured motor vehicle

(o)_ Tort lability ie not abolished as to the following persons,
their personal representatives, or their legal guardians in the
following circumstances

 

 

ae.
(8) Injury occurs to such person which consists, in
whole or in part, in a significant permanent less of
Use of a part or function of the body.

(2) Inu »

accident in which the amount caid of accrued exceeds the
edisel-pengb: licative Jamit established in section

‘G110C= 208 tor expenses provided in section
GROG TOTS end (Ss rovided that the excenses paid
‘shall be presumed tc be ceascnable and necessary in

Seteblishing the medicals cr a

(Emphases added.) HRS § ¢31:10C-308 (2993) and HRS $ 431:10C-103(10) (Supp
1995) are izrelevant in the present appeal, inasmuch as the first statute
nerely sets forth policies and procedures for the insurance commissioner to
Seploy in annually revising the meaical-renabilitative expenses threshold, and
the second statute merely defines “(nJo-fault benefits” (it is undisputed in
the present appeal that the expenses in question are no-fault benefits)

 

23-10 (1999) provides in pertinent part:

 

WAR § 3

[a)_ The nedicel-rehabsiitetive limit established for the purpose
of prescribing the rort threshold limit pursuant to section
431110c-306(bi (2), HRS, ie repealed on January 1, 1998 by 1937
Sik, Act 281. Ie does not preciude the person from receiving
no-fault nedical-rehabilitetive benefits in excess of the amount,
Eubject te the no-fault benefite aggregate Limit of $20,000, for
policies effective prior to January 1, 1998

 

 

 

(b)_ The medicel-renabilitetive linite estebliched for previous
years shall continue to renain in full force and effect, and shall
Ee applicable co claims for tort recovery for secidental harm
sustained in those respective years. The medicsl-rehabilitative
Tinie set forth in subsection (b) shall not apply to accidental
harm eusteines prier to ite effective date.

 

 

(c) The megicel-renabilitetive limite for previous years ar
eontinced.

 
 

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Dias had suffered 2 “significant pezmanent loss of use of a part
or function of the body under HRS § 431:10C~306(b) (1) (B),* such
that in either case Dias had overcome the general abolition
and (2) the

 

against tort liability in motor vehicle accidents,
circuit court erred in denying Dias’ motion for reconsideration
as to the grant of sunmary judgment, in that new evidence
presented within the motion met two of the specific exceptions to
the general abolition of motor vehicle tort liability, namely (a)
the $13,900 medical-rehabilitative expenses threshold set forth
(0c-306(b) (2) and HAR § 16-23-10 (c), and (b) the

  

in HRS § 43)
“significant pezmanent loss of use of @ part or function of the
0¢~306(b) (2) (8).

upon carefully reviewing the record and the briefs

 

body” exception set forth in HRS § 43:

submitted by the parties and having given due consideration to
the arguments advanced and the issues raised, we hold as follows:
(2) Diast first argunent has merit. In supporting his
motion for sunmary judgment, Stender attached s declaration fron
Diane Lun ("Lun"), an employee of ACS Healthcare Solutions
(AaCS"), the claims administrator for the State of Hawai'i
Department of Human Services ("DHS"), and a “medical recap sheet”
from ACE showing that both accrued medical bills and actual DS

payments were below the $13,900 threshold. In opposing summary

>(.,-continved)
$14,200 for accidents betusen Seotenber 1, 1297 = Decanter 3
ist

[Bxphasie added.)

‘$28 sumza note 2.
 

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judgment, Dias attached @ “counter-declaration” from Lun and an
updated medical recap sheet from ACS which stated that $14,497.10
in medical expenses had been incurred, although only # small
portion of those expenses had been paid by DHS. The updated
medical recap sheet contained additional medical billings and OHS

 

Payments, and no medical billing was more recent than any on the

 

“old version” of the recap sheet. When viewing the evidence in
the most favorable light to Dias, there exists a genuine issue of
material fact as to whether the $13,900 medical-rehabilitative
expense threshold was reached, inasmuch the amount of Dias’
medical bills was in excess of that threshold. In’ Cochran va
Pfluecer Autos., Inc., 72 Haw. 460, 621 P.2d 934 (1991), this
court addressed this “amount of medical expenses billed versus
amount paid by DHS” situation in the context of HRS § 294-6
(1985),* the predecessor statute to HRS § 431:10C-306(b) (2).
Therein, this court noted that plaintiff-appellant had incurred
medical bills in excess of $3,000.00, which was the medical-
rehabilitative expense threshold at the time, although only
$2,289.65 in DHS benefits had actually been paid, such that she

 

*  tow-repeaied HRS § 296-6 (abolition of tort liability), which wes
recodified af HRS § ¢3110C-306 (gag 1967 Haw. Sees. Lae Act 341, $°2 at i67~
66), reads in pertinent part

 

Tort l4ability of the owner . . . of an insured motor vehicle
is ebolishes, except... 26 the following circumstances

(2) Injury eccure to euch person in a motor vehicle
accident in which the ancunt paid or accrued exceeds the
Recicsl-rehabilstative limit . .. provided that the
‘expenses paid shall be preatned to be ree:

Becessary'in establishing the mesicel-rehs

 
 

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had met the exception to the general abolition of tort liability:

initially, we conclude that (plaintiff-appellant] reached the
Rs § 284-e(a)(2)), threshold when her medical bills exceeded
$51000.00 despite the fact that DNS ultimately paid a lesser
ancunt, Since HAS § 294-36(b) is 2 remedial statute cimes
at putting welfare recipients on an equal footing with other
Sccldent victine, we will not penalize poblic assistance payments
Because ONE pays lesser ancunte in payment to health care
provigers. pares se sb

 

 

 

 

testo shat oa or
= a
‘Sitimately ceva esaer ue
See Cochran, 72 Haw. at 461-63, 821 P.2d at 935-936 (emphasis
added). The same analysis controls the instant appeal.
Stender’s citation of How. Leftwich, 88 Hawai'i 251,
965 P.2d 793 (1998) in support of its contention that Dias was
required to present expert testinony proving that the unpaid
portion of the his unpaid medical expenses were “reasonable and
necessary” is inapposite. Leftwich involved 2 plaintiff-
appellant injured in a motor vehicle accident who appealed fron a
directed verdict in favor of defendant-appellee at the end of
trial. ig., 86 Hawai'l at 255, 965 P.26 at 798 (emphasis added).
‘The trial court granted a directed verdict because, in its words,
“there hasn‘t been sufficient evidence produced to the jury” that
the “{medical] expenses [claimed] were reasonably incurred” in
excess of the medical-rehabilitative expense threshold. See
dd (enphasis added). This court ultimately held, inter alia, that
in the absence of any “expert testimony establishing that the

[unpaid] expenses were reasonable and necessary|(,]”" the

 

 

«this court ultinately held pleintiff-appeliant's claim to be tine-
borred, however. fae dd; 12 Haw, at 464, 821 F.2d at 336, HRS § 294-36 vas
Peceditied se ARS $ €3110C-315. See i0., 72 Haw, at 464 0.2, 621 P.2d at 934

 

   
 

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plaintift-appellant could not meet the medicel-rehabilitative
expense threshold under HRS § 431:10C-306. See ig. at 259-60,
965 P.2d at 801-02.

Weftuich is readily distinguishable for two reasons.
First, in Leftwich, the matter had already proceeded to trial,
and the plaintiff-appellant had already fully presented her case
and evidence, See id. 88 Hawai'i at 254, 965 P.2d at 796.
Second, and more importantly, on a motion for summary judgment,
~ . .
non-mevind party, In other words, we must view al] of the
Suidence and the inferences drawn therefrom in the light most
Thronas, 107 Hawai'i 48, 56, 108 P.3d 689, 697 (2005) (emphasis
added) (citations omitted) (brackets in original). In other
words, Stender confuses the less stringent burden of production
that Dias must carry in resisting summary judgment with the more
stringent burden of proof thet Dias must carry in order to
prevail at tril. lihen viewing the updated medical recap sheet
in a Light most favorable to Dias, it can certainly be inferred
that Dias accrued allowable, albeit unpaid, medical-
rehabilitative expenses in excess of $13,900, such that his
claims must be allowed to proceed under the principles set forth
in Cochran. Thus, we hold that the circuit court erred in
Granting summary judgment for Stender.
(2) Because we hold that the circuit court erred in

Granting summary judgment for Stender due to the existence of a

  
 

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genuine issue of material fact as to whether Dias had accumulated
nedical-rehabilitative expenses for his 1997 motor vehicle
accident injuries in excess of $13,900 as required by HRS §
431:10C-306(b) (2) (1993) and HAR § 16-23-10, we need not address
Dias’ remaining arguments.

Therefore,

17 19 MERESY ORDERED that the judgment of the circuit
court is vacsted, and that the case be remanded to the circuit
court for further proceedings.

DRTED: Honolulu, Hawai'i, October 11, 2006.

on the briefs: re

Tan L. Mattoch, and

Jonathan §. Kuba, (of Law Be Phornen—

Offices of Ian L. Nattoch)

for Plaintiff-appellant
. patient Pe ON are

Francis S. Dias,
Jonathan L. Ortiz, Wade J
Katano, and Allison M. G ~

Fujita, (of Ortiz & Katano}

for Defendant~Appellee Conon €. Buses be

Oswald Stender