reglab/statecodes huggingface dataset:
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-208 Access to records.

§431:2-208 Access to records.
(a) Every person and its officers, employees, and representatives subject to investigation or examination by the commissioner, shall produce and make freely accessible to the commissioner the accounts, records, documents, and files in the person's possession or control relating to the subject of the investigation or examination, and shall otherwise facilitate the investigation or examination.
(b) If the commissioner finds the accounts to be inadequate, improperly kept, or improperly posted, the commissioner may employ experts to rewrite, post, or balance the accounts at the expense of the person being examined, if the person has failed to correct the accounting records after the commissioner has given the person written notice and a reasonable opportunity to do so.
(c) An insurer or licensee shall issue a written response with reasonable promptness, in no case more than fifteen working days, to any written inquiry made by the commissioner regarding a claim, consumer complaint, or sales or marketing practice. The response shall be more than an acknowledgment that the commissioner's communication has been received, and shall adequately address the concerns stated in the communication. [L 1987, c 347, pt of §2; am L 1997, c 83, §1; am L 2004, c 122, §4; am L 2010, c 116, §1(3)]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-210 Copies and certificates as evidence.

§431:2-210 Copies and certificates as evidence.
(a) Copies of records or documents in the commissioner's office certified to by the commissioner shall be received as evidence in all courts in the same manner and to the same effect as if they were the originals.
(b) When required for evidence in court, the commissioner shall furnish the commissioner's certificate as to the authority of an insurer or other licensee in this State on any particular date, and the court shall receive the certificate in lieu of the commissioner's testimony. [L 1987, c 347, pt of §2]
Cross References
Requirement of original, see §626-1, rule 1002.
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-211 Annual report.

§431:2-211 Annual report.
The commissioner, as early each year as accurate preparation enables, shall prepare and submit to the legislature a report which shall contain:
(1) The condition of all insurers authorized to do business in this State during the preceding year.
(2) A summary of abuses and deficiencies in benefit payments, the complaints made to the commissioner and their disposition, and the extent of compliance and noncompliance by each insurer with the provisions of this code.
(3) Such additional information and comments relative to insurance activities in this State as the commissioner deems proper. [L 1987, c 347, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-212 Interstate cooperation.

§431:2-212 Interstate cooperation.
(a) The commissioner shall to the extent the commissioner deems useful for the proper discharge of the commissioner's responsibilities under this code:
(1) Consult and cooperate with the public officials having supervision over insurance in the other states.
(2) Share jointly with any one or more of the other states in the employment of actuaries, statisticians, and other insurance technicians, whose services or the products thereof are made available and are useful to the participating states and to the commissioner.
(3) Share jointly with any one or more of the other states in establishing and maintaining offices and clerical facilities for purposes useful to the participating states and to the commissioner.
(b) All arrangements made jointly with any one or more of the other states under subsection (a) shall be in writing executed on behalf of this State by the commissioner. Any such arrangement, as to participation of this State therein, shall be subject to termination by the commissioner at any time upon reasonable notice.
(c) For the purposes of this code the National Association of Insurance Commissioners means that voluntary organization of the public officials having supervision of insurance in the respective states, districts, and territories of the United States, whatever other name the organization may hereafter adopt, and in the affairs of which each of the public officials are entitled to participate subject to the constitution and bylaws of the organization. [L 1987, c 347, pt of §2; am L 2004, c 122, §6]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-214 The commissioner's education and training fund.

§431:2-214 The commissioner's education and training fund.
(a) The commissioner may establish a separate fund designated as the commissioner's education and training fund.
(b) This fund may be used to compensate or reimburse staff and personnel of the insurance division for education and training. Upon approval by the commissioner, staff and personnel may be compensated or reimbursed for:
(1) Actual travel expenses in amounts customary for these expenses;
(2) A reasonable living expense allowance at a rate customary for these expenses;
(3) Per diem compensation at a customary rate; and
(4) Any fees or charges necessary to attend educational and training conferences, workshops, seminars, and any other event of this nature.
(c) Any person receiving reimbursement or compensation from the commissioner's education and training fund shall submit to the commissioner, for approval, a detailed account of all expenses and compensation necessarily incurred on account of any education and training for the insurance division.
(d) The commissioner's education and training fund may be used to pay the cost of consumer education and information, including publication of information, brochures, and consumer guides and costs related to conferences, workshops, seminars, and any other event of this nature which the commissioner sponsors or in which the commissioner or insurance division staff participates. [L 1987, c 348, §1; am L 1989, c 195, §11; am L 1993, c 205, §3]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-216 Assessments of health insurers.

§431:2-216 Assessments of health insurers.
(a) Each mutual benefit society under article 1 of chapter 432, health maintenance organization under chapter 432D, and any other entity offering or providing health benefits or services under the regulation of the commissioner, except an insurer licensed to offer accident and health or sickness insurance under article 10A, shall deposit with the commissioner by July 1 of each year an assessment of $10,000 for the first seventy thousand private, nongovernment members the entity covers and an additional assessment on a pro rata basis to be determined and imposed by the commissioner for covered members exceeding seventy thousand; provided that in the third year and each year thereafter, assessments shall be borne on a pro rata basis. The aggregate annual assessment shall not exceed $1,000,000. This assessment shall be credited to the compliance resolution fund. If assessments are increased, the commissioner shall provide to any organization or entity subject to the increased assessment, justification for the increase.
(b) The assessments shall be used to defray any administrative costs, including personnel costs, associated with the programs of the division, and costs incurred by supporting offices and divisions. Any law to the contrary notwithstanding, the commissioner may use the moneys from assessments to employ or retain, by contract or otherwise, without regard to chapter 76, hearings officers, attorneys, investigators, accountants, examiners, and other necessary professional, technical, administrative, and support personnel to implement and carry out the purposes of title 24 as it relates to accident and health or sickness insurance; provided that any position, except any attorney position, that was subject to chapter 76 prior to July 1, 1999, shall remain subject to chapter 76.
(c) Moneys credited to the compliance resolution fund that are not used for insurance regulation, general administration purposes, or as otherwise allowed pursuant to section 26-9(o) shall not revert to the general fund nor shall be used for other purposes.
(d) The commissioner may suspend any assessment made against any mutual benefit society under article 1 of chapter 432, health maintenance organization under chapter 432D, and any other entity offering or providing health benefits or services under the regulation of the commissioner if the commissioner determines that the entity may reach insolvency or other financial difficulty if the assessment is made against the entity. [L 1999, c 127, §1; am L 2000, c 243, § §6, 11(2) and c 253, §150; am L 2002, c 39, § §6, 7; am L 2003, c 3, §20, c 197, §4, and c 212, § §16, 131; am L 2006, c 154, §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-217 Trade name.

§431:2-217 Trade name.
(a) Prior to the use or change of a trade name to sell, solicit, or negotiate insurance in this State, the licensee shall register the trade name with the department of commerce and consumer affairs pursuant to part II of chapter 482.
(b) Upon registration of the trade name with the department of commerce and consumer affairs, the licensee may apply, on a form approved by the commissioner, to add or remove a trade name on a license. The applicant shall provide proof of registration of a trade name to the commissioner.
(c) If the commissioner finds the application for use or change of a trade name is substantially identical to another trade name registered with the department of commerce and consumer affairs, or substantially identical to a legal name or trade name of a revoked license, the commissioner shall deny use of the trade name on a license issued pursuant to this chapter.
(d) A licensee shall inform the commissioner, by any means acceptable to the commissioner, of any change of status of a trade name registered with the department of commerce and consumer affairs within thirty days of the change. [L 2019, c 70, §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-301 Purpose.

§431:2-301 Purpose.
The purpose of this part is to provide an effective and efficient system for examining the activities, operations, financial condition, and affairs of all persons transacting the business of insurance in this State and all persons otherwise subject to the jurisdiction of the commissioner. The provisions of this part are intended to enable the commissioner to adopt a flexible system of examinations that directs resources as may be deemed appropriate and necessary for the administration of the insurance and insurance-related laws of this State. [L 1987, c 347, pt of §2; am L 1993, c 321, §5]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-301.5 Examiner defined. For purposes of this part, "examiner" means any individual or firm authorized by the commissioner to conduct an examination under the insurance code. [L 1993, c 321, pt of §2]

§431:2-301.5
Examiner defined.
For purposes of this part, "examiner" means any individual or firm authorized by the commissioner to conduct an examination under the insurance code. [L 1993, c 321, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-301.6 Conflict of interest. (a) No examiner may 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 part. This section shall not be construed to automatically preclude an examiner from being: (1) A policyholder or claimant under an insurance policy; (2) A grantor of a mortgage or similar instrument on the examiner's residence to a regulated entity if done under customary terms and in the ordinary course of business; (3) An investment owner in shares of regulated diversified investment companies; or (4) A settlor or beneficiary of a "blind trust" into which any otherwise impermissible holdings have been placed. (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 those persons from time to time may be similarly employed or retained by persons subject to examination under the insurance code. [L 1993, c 321, pt of §2]

§431:2-301.6
Conflict of interest.
(a) No examiner may 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 part. This section shall not be construed to automatically preclude an examiner from being:
(1) A policyholder or claimant under an insurance policy;
(2) A grantor of a mortgage or similar instrument on the examiner's residence to a regulated entity if done under customary terms and in the ordinary course of business;
(3) An investment owner in shares of regulated diversified investment companies; or
(4) A settlor or beneficiary of a "blind trust" into which any otherwise impermissible holdings have been placed.
(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 those persons from time to time may be similarly employed or retained by persons subject to examination under the insurance code. [L 1993, c 321, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-301.8 Immunity from liability. (a) No cause of action shall arise nor shall any liability be imposed against any examiner appointed or otherwise designated as an examiner by the commissioner for any statements made or conduct performed in good faith while carrying out the provisions of the insurance code. (b) No cause of action shall arise, nor shall any liability be imposed against any person, for the act of communicating or delivering information or data to the commissioner or the commissioner's authorized representative or examiner pursuant to an examination made under the insurance code, if the act of communication or delivery was performed in good faith and without fraudulent intent or the intent to deceive. (c) This section does not abrogate nor modify in any way common law or statutory privilege or immunity heretofore enjoyed by any person identified in subsection (a). (d) A person identified in subsection (a) shall be entitled to an award of attorneys' fees and costs if the person is the prevailing party in a civil cause of action for libel, slander, or any other relevant tort arising out of activities in carrying out the insurance code, and the party bringing action is not substantially justified to do so. For the purposes of this section, a proceeding is substantially justified if it has a reasonable basis in law or fact at the time that it is initiated. [L 1993, c 321, pt of §2; am L 2006, c 189, §2]

§431:2-301.8
Immunity from liability.
(a) No cause of action shall arise nor shall any liability be imposed against any examiner appointed or otherwise designated as an examiner by the commissioner for any statements made or conduct performed in good faith while carrying out the provisions of the insurance code.
(b) No cause of action shall arise, nor shall any liability be imposed against any person, for the act of communicating or delivering information or data to the commissioner or the commissioner's authorized representative or examiner pursuant to an examination made under the insurance code, if the act of communication or delivery was performed in good faith and without fraudulent intent or the intent to deceive.
(c) This section does not abrogate nor modify in any way common law or statutory privilege or immunity heretofore enjoyed by any person identified in subsection (a).
(d) A person identified in subsection (a) shall be entitled to an award of attorneys' fees and costs if the person is the prevailing party in a civil cause of action for libel, slander, or any other relevant tort arising out of activities in carrying out the insurance code, and the party bringing action is not substantially justified to do so. For the purposes of this section, a proceeding is substantially justified if it has a reasonable basis in law or fact at the time that it is initiated. [L 1993, c 321, pt of §2; am L 2006, c 189, §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-302 Authority, scope, and scheduling of examinations.

§431:2-302 Authority, scope, and scheduling of examinations.
(a) The commissioner or any authorized examiner may conduct an examination of any company as often as the commissioner deems appropriate, but, at a minimum, shall conduct an examination of each domestic insurer at least once every five years. In scheduling and determining the nature, scope, and frequency of the examinations, the commissioner shall consider such matters as the results of financial statement analyses and ratios, changes in management or ownership, actuarial opinions, reports of independent certified public accountants, and other criteria as set forth in the examiners' handbook adopted by the National Association of Insurance Commissioners and in effect, when the commissioner exercises discretion under this section.
(b) For purposes of completing an examination of any insurer, the commissioner may examine or investigate any person, or the business of any person, insofar as such examination or investigation is, in the sole discretion of the commissioner, necessary or material to the examination of the insurer.
(c) In lieu of an examination of any foreign or alien insurer licensed in this State, the commissioner may accept an examination report on the insurer as prepared by the state regulatory agency for insurance for the insurer's state of domicile or port-of-entry state until January 1, 1994. Thereafter, such reports may only be accepted under the following conditions:
(1) The state's regulatory agency for insurance was, at the time of the examination, accredited under the National Association of Insurance Commissioners' Financial Regulation Standards and Accreditation Program; or
(2) The examination was performed:
(A) Under the supervision of an accredited state regulatory agency for insurance; or
(B) With the participation of one or more examiners who are employed by an accredited state regulatory agency for insurance and who, after a review of the examination workpapers and report, state under oath that the examination was performed in a manner consistent with the standards and procedures required by their state regulatory agency for insurance. [L 1987, c 347, pt of §2; am L 1989, c 195, §12; am L 1993, c 321, §6; am L 2005, c 132, §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-303 Examination of producers, adjusters, promoters, and independent bill reviewers.

§431:2-303 Examination of producers, adjusters, promoters, and independent bill reviewers.
For the purpose of ascertaining its condition, or compliance with this code, the commissioner may as often as the commissioner deems advisable examine the insurance accounts, records, documents, and transactions of:
(1) Any insurance producer, adjuster, or independent bill reviewer, including insurance agencies and surplus lines agencies; or
(2) Any person engaged in, proposing to be engaged in, or assisting in the promotion or formation of a domestic insurer, a stock corporation to finance a domestic mutual insurer or the production of its business, or a corporation to be attorney-in-fact for a domestic reciprocal insurer. [L 1987, c 347, pt of §2; am L 2000, c 288, §3; am L 2001, c 216, §3]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-304 Examination of guaranty associations.

§431:2-304 Examination of guaranty associations.
(a) The Hawaii Insurance Guaranty Association shall be subject to examination and regulation by the commissioner. The board of directors shall submit, not later than March 30 of each year, a financial report for the preceding calendar year in a form approved by the commissioner.
(b) The Hawaii Life and Disability Insurance Guaranty Association shall be subject to examination and regulation by the commissioner. The board of directors shall submit to the commissioner each year not later than one hundred twenty days after the association's fiscal year, a financial report in a form approved by the commissioner and a report of its activities during the preceding fiscal year. [L 1987, c 347, pt of §2; am L 2003, c 212, §17]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-306 Examination expense.

§431:2-306 Examination expense.
(a) Examinations of:
(1) Any insurer;
(2) Any person subject to examination under section 431:2-303(2); or
(3) Any insurance guaranty fund established pursuant to article 16;
shall be at the expense of the insurer, person, or guaranty fund examined. Examination expenses shall include fees, mileage, and expenses incurred as to witnesses or any other person, as defined in article 1, subject to an examination by the commissioner.
(b) The insurer, person, or guaranty fund examined and liable therefor shall pay to the commissioner's examiners upon presentation of an itemized statement, their actual travel expenses, their reasonable living expense allowance, and their per diem compensation at a reasonable rate approved by the commissioner, incurred on account of the examination. All payments collected by the commissioner shall be remitted to:
(1) The compliance resolution fund; or
(2) The captive insurance administrative fund if independent contractor examiners or captive staff examiners were employed for a captive insurer's examination.
The commissioner or the commissioner's examiners shall not receive or accept any additional emolument on account of any examination.
(c) The commissioner may assess all examination costs of any person subject to examination under section 431:2-303(1) and article 16 when there is a premium trust fund shortage due to substantial noncompliance with section 431:9A-123.5. [L 1987, c 347, pt of §2; am L 1995, c 232, §9; am L 1997, c 261, §3; am L 1998, c 71, §1; am L 1999, c 163, §11; am L 2002, c 39, §8; am L 2006, c 189, §3]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-307.5 Reimbursement and compensation of examiners; source of funds; disposition of receipts.

§431:2-307.5 Reimbursement and compensation of examiners; source of funds; disposition of receipts.
(a) All moneys necessary for the compensation and reimbursement of independent contractor examiners and insurance division staff examiners for actual travel expenses, reasonable living expenses, and per diem expenses, at customary rates approved by the commissioner shall be allocated by the legislature through appropriations out of the state compliance resolution fund. The department shall include in its budgetary request for each upcoming fiscal period, the amounts necessary to effectuate the purposes of this section.
(b) All moneys, fees, and other payments received by the commissioner under this part shall be deposited to the credit of the state compliance resolution fund. [L 1995, c 61, §1 as superseded by c 232, §1; am L 1999, c 163, §15(1); am L 2002, c 39, §9]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-308 Administrative procedure act applies.

§431:2-308 Administrative procedure act applies.
(a) The rules, notices, hearings, orders, and appeals provided for in this code are in all applicable respects subject to chapter 91, unless it is expressly provided otherwise.
(b) The commissioner shall hold a hearing if required by this code. The commissioner may hold other hearings as the commissioner deems necessary for such purposes as are within the scope of this code.
(c) The hearings shall be held at a place designated by the commissioner and, at the commissioner's discretion, may be open to the public.
(d) Application for a hearing made to the commissioner pursuant to this code shall be in writing and shall specify in what respects the person so applying was aggrieved and the grounds to be relied upon as a basis for the relief to be demanded at the hearing. Where the commissioner has used the authority contained in section 431:9-235 or section 431:9A-112 to suspend, revoke, or refuse to extend a license subject to the right of the licensee to have a hearing and has suspended the license pending the hearing, the commissioner shall hold the hearing within thirty days after the commissioner's receipt of the application unless postponed by mutual consent.
(e) Any appeal made from a decision by the commissioner shall be made pursuant to chapter 91. [L 1987, c 347, pt of §2; am L 1994, c 128, §1; am L 2003, c 212, §18; am L 2006, c 154, §3]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-401 Definitions.

§431:2-401 Definitions.
As used in this part:
"Branch" means the insurance fraud investigations branch of the insurance division of the department of commerce and consumer affairs.
"Insurance policy" means a contract issued by an insurer or other licensee.
"Intentionally" shall have the same meaning as under section 702-206.
"Knowingly" shall have the same meaning as under section 702-206.
"Licensee" means an entity licensed under and governed by title 24, including an insurer governed by chapter 431, a mutual benefit society governed by article 1 of chapter 432, a fraternal benefit society governed by article 2 of chapter 432, or a health maintenance organization governed by chapter 432D, and their respective agents and employees engaged in the business of the licensee.
"Person" means any individual, company, association, organization, group, partnership, business, trust, or corporation; but shall exclude:
(1) Insurers, as defined in section 431:1-202, and other licensees, as defined in this part; and
(2) Licensed attorneys acting in their capacity as attorneys for a claimant other than the licensed attorney. [L 2009, c 149, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-402 Insurance fraud investigations branch.

§431:2-402 Insurance fraud investigations branch.
(a) There is established in the insurance division the insurance fraud investigations branch for the purposes set forth in this part.
(b) The branch shall:
(1) Conduct a statewide program for the prevention of insurance fraud under title 24, including chapters 431, 432, and 432D; provided that the branch shall not have jurisdiction over workers' compensation under chapter 386;
(2) Notwithstanding any other law to the contrary, investigate and prosecute in administrative hearings and courts of competent jurisdiction all persons involved in insurance fraud violations; and
(3) Promote public and industry-wide education about insurance fraud.
(c) The branch may review and take appropriate action on complaints of fraud relating to insurance under title 24, including chapters 431, 432, and 432D, but excluding workers' compensation insurance under chapter 386.
(d) The commissioner shall employ or retain, by contract or otherwise, attorneys, investigators, investigator assistants, auditors, accountants, physicians, health care professionals, paralegals, consultants, experts, and other professional, technical, and support staff as necessary to promote the effective and efficient conduct of the branch's activities. The commissioner may hire these employees without regard to chapters 76 or 89.
(e) Notwithstanding any other law to the contrary, an attorney employed or retained by the branch may represent the State in any criminal, civil, or administrative proceeding to enforce all applicable state laws relating to insurance fraud, including criminal prosecutions, disciplinary actions, and actions for declaratory and injunctive relief. The attorney general may designate an attorney as a special deputy attorney general for purposes of this subsection.
(f) Investigators appointed and commissioned under this part shall have and may exercise all of the powers and authority of a police officer or of a deputy sheriff.
(g) Funding for the branch shall come from the compliance resolution fund established by section 26-9(o). [L 2009, c 149, pt of §2; am L 2014, c 186, §6]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-404 Restitution

§431:2-404 Restitution
. Any person convicted under this part shall be ordered by a court to make restitution to any insurer, person, or licensee for any financial loss sustained by that insurer, person, or licensee that was caused by the act or acts for which the person was convicted. [L 2009, c 149, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-405 Insurance fraud; administrative penalties

§431:2-405 Insurance fraud; administrative penalties
. (a) In addition to or in lieu of criminal penalties under section 431:2-403(b), any person who commits insurance fraud as defined under section 431:2-403, may be subject to the administrative penalties in this section.
(b) If a person is found to have knowingly committed insurance fraud under this part, the commissioner may assess any or all of the following penalties:
(1) Restitution to any insurer or any other person of benefits or payments fraudulently received or other damages or costs incurred;
(2) A fine of not more than $10,000 for each violation; and
(3) Reimbursement of attorneys' fees and costs of the party sustaining a loss under this part; provided that the State shall be exempt from paying attorneys' fees and costs to other parties.
(c) Administrative actions brought for insurance fraud under this part shall be brought within six years after the insurance fraud is discovered or by exercise of reasonable diligence should have been discovered and, in any event, no more than ten years after the date on which a violation of this part is committed. [L 2009, c 149, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-406 Administrative procedures

§431:2-406 Administrative procedures
. (a) An administrative penalty may be imposed upon a judgment by a court of competent jurisdiction or upon an order by the commissioner.
(b) The commissioner shall hold a hearing in accordance with chapter 91, prior to imposing any administrative remedy. [L 2009, c 149, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-408 Civil cause of action for insurance fraud; exemption

§431:2-408 Civil cause of action for insurance fraud; exemption
. (a) An insurer or other licensee shall have a civil cause of action to recover payments or benefits from any person who has violated section 431:2-403; provided that no recovery shall be allowed if the person has made restitution pursuant to section 431:2-404 or 431:2-405(b)(1).
(b) A person, insurer, or other licensee, including an insurer's or other licensee's adjusters, bill reviewers, producers, representatives, or common-law agents shall not be subject to civil liability for providing information, including filing a report, furnishing oral, written, audiotaped, videotaped, or electronic media evidence, providing documents, or giving testimony concerning suspected, anticipated, or completed insurance fraud to:
(1) A court;
(2) The commissioner;
(3) The branch;
(4) The National Association of Insurance Commissioners;
(5) The National Insurance Crime Bureau;
(6) Any federal, state, or county law enforcement or regulatory agency; or
(7) Another insurer or other licensee,
if acting without actual malice and if the information is provided for the purpose of preventing, investigating, or prosecuting insurance fraud, except if the person commits perjury.
(c) Civil actions for insurance fraud under this part shall be filed within six years after the insurance fraud is discovered or should have been discovered by exercise of reasonable diligence; provided that no civil action shall be filed more than ten years after the date on which a violation of this part is committed. [L 2009, c 149, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-409 Mandatory reporting

§431:2-409 Mandatory reporting
. (a) Within sixty days of an insurer or other licensee's employee or agent discovering credible information indicating a violation of section 431:2-403, or as soon thereafter as practicable, the insurer or licensee shall provide to the branch information, including documents and other evidence, regarding the alleged violation of section 431:2-403. The insurance fraud investigations branch shall work with the insurer or licensee to determine what information shall be provided.
(b) Information provided pursuant to this section shall be protected from public disclosure to the extent authorized by chapter 92F and section 431:2-209; provided that the branch may release the information in an administrative or judicial proceeding to enforce this part to federal, state, or local law enforcement or regulatory authorities, the National Association of Insurance Commissioners, the National Insurance Crime Bureau, or an insurer or other licensee aggrieved by the alleged violation of section 431:2-403. [L 2009, c 149, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2-410 Deposit into the compliance resolution fund

§431:2-410 Deposit into the compliance resolution fund
. All moneys that have been recovered by the department of commerce and consumer affairs as a result of prosecuting insurance fraud violations pursuant to this part, including civil fines, criminal fines, administrative fines, and settlements, but not including restitution made pursuant to section 431:2-404, 431:2-405(b)(1), or 431:2-408, shall be deposited into the compliance resolution fund established pursuant to section 26-9(o). [L 2009, c 149, pt of §2]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2D-101 Legislative intent.

§431:2D-101 Legislative intent.
The purpose of this article is to establish a framework for insurance division market conduct actions, including:
(1) Processes and systems for identifying, assessing, and prioritizing market conduct problems that have a substantial adverse impact on consumers, policyholders, and claimants;
(2) Market conduct actions by the commissioner to substantiate those market conduct problems and a means to remedy significant market conduct problems; and
(3) Procedures to communicate and coordinate market conduct actions among states to foster the most efficient and effective use of resources. [L 2007, c 227, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2D-104 Market analysis procedures.

§431:2D-104 Market analysis procedures.
(a) The commissioner shall gather information from data currently available to the insurance division, as well as surveys and required reporting requirements, information collected by the National Association of Insurance Commissioners and a variety of other sources in both the public and private sectors, information from within and outside the insurance industry from objective sources, information from websites for insurers, agents, and other organizations, and information from other sources; provided that prior to use, the sources are published at least annually in a bulletin or circular.
The information shall be analyzed to develop a baseline understanding of the marketplace and to identify for further review insurers or practices that deviate significantly from the norm or that may pose a potential risk to the insurance consumer. The commissioner shall use procedures that are substantially similar to the National Association of Insurance Commissioners' guidelines on market analysis as one resource in performing this analysis.
The commissioner shall use the following policies and procedures in performing the analysis required under this section:
(1) Identify key lines of business for systematic review; and
(2) Identify companies for further analysis based on available information.
(b) If the analysis compels the commissioner to inquire further into a particular insurer or practice, the following continuum of market conduct actions may be considered prior to conducting a targeted, on-site market conduct examination. The action selected shall be made known to the insurer in writing. These actions may include but are not limited to:
(1) Correspondence with the insurer;
(2) Insurer interviews;
(3) Information gathering;
(4) Policy and procedure reviews;
(5) Interrogatories; and
(6) Review of insurer self-evaluation and compliance programs, including membership in an organization such as a best-practice organization that has as its central mission the promotion of high ethical standards in the marketplace.
(c) The commissioner shall select a market conduct action that is cost-effective for the insurance division and the insurer, while still protecting the insurance consumer.
(d) The commissioner shall take those steps reasonably necessary to:
(1) Eliminate requests for information that duplicate:
(A) Information provided as part of an insurer's annual financial statement, the annual market conduct statement of the National Association of Insurance Commissioners, or other required schedules, surveys, or reports that are regularly submitted to the commissioner; or
(B) Data requests made by other states if that information is available to the commissioner, unless the information is state-specific; and
(2) Coordinate market conduct actions and findings with other states. [L 2007, c 227, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2D-105 Protocols for market conduct actions.

§431:2D-105 Protocols for market conduct actions.
(a) Market conduct actions taken as a result of a market analysis shall focus on the general business practices and compliance activities of insurers, rather than identifying infrequent or unintentional random errors that do not cause consumer harm.
(b) The commissioner may determine the frequency and timing of such market conduct actions. The timing shall depend upon the specific market conduct action to be initiated, unless extraordinary circumstances indicating a risk to consumers require immediate action.
If the commissioner has information that more than one insurer is engaged in common practices that may violate the law, the commissioner may schedule and coordinate multiple examinations simultaneously.
(c) The insurer shall be notified of any practice or procedure which is to be the subject of a market conduct action and shall be given an opportunity to resolve such matters that arise as a result of a market analysis to the satisfaction of the commissioner before any additional market conduct actions are taken against the insurer. If the insurer has modified the practice or procedure as a result of a market conduct action taken by the insurance commissioner of another state, the commissioner shall accept appropriate documentation that the insurer has satisfactorily modified the practice or procedure and made similar modification to such practice or procedure in this State. [L 2007, c 227, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2D-108 Market conduct surveillance personnel.

§431:2D-108 Market conduct surveillance personnel.
(a) Market conduct surveillance personnel shall be qualified by education, experience, and, where applicable, professional designations. The commissioner may supplement the in-house market conduct surveillance staff with qualified outside professional assistance if the commissioner determines that assistance is necessary.
(b) Market conduct surveillance personnel have a conflict of interest, either directly or indirectly, if they are affiliated with the management, have been employed by, or own a pecuniary interest in the insurer subject to any examination under this article within the most recent five years prior to the use of the personnel. This section shall not be construed to automatically preclude an individual from being:
(1) A policyholder or claimant under an insurance policy;
(2) A grantee of a mortgage or similar instrument on the individual's residence from a regulated entity if done under customary terms and in the ordinary course of business;
(3) An investment owner in shares of regulated diversified investment companies; or
(4) A settlor or beneficiary of a "blind trust" into which any otherwise permissible holdings have been placed. [L 2007, c 227, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2D-109 Immunity for market conduct surveillance personnel.

§431:2D-109 Immunity for market conduct surveillance personnel.
(a) No cause of action shall arise nor shall any liability be imposed against the commissioner, the commissioner's authorized representatives, or an examiner appointed by the commissioner for any statements made or conduct performed in good faith while carrying out this article.
(b) No cause of action shall arise, nor shall any liability be imposed against any person for the act of communicating or delivering information or data to the commissioner, the commissioner's authorized representative, or the examiner pursuant to an examination made under this article, if the act of communication or delivery was performed in good faith and without fraudulent intent or the intent to deceive.
(c) A person identified in subsection (a) shall be entitled to an award of attorney's fees and costs if the person is the prevailing party in a civil cause of action for libel, slander, or any other relevant tort arising out of activities in carrying out this article and the party bringing the action was not substantially justified in doing so. For the purposes of this section, a proceeding is "substantially justified" if it had a reasonable basis in law or fact at the time that it was initiated.
(d) This section shall not abrogate or modify in any way any common law or statutory privilege or immunity heretofore enjoyed by any person identified in subsection (a). [L 2007, c 227, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2D-110 Fines and penalties.

§431:2D-110 Fines and penalties.
(a) Fines and penalties levied pursuant to this article or other provisions of this chapter shall be consistent, reasonable, and justified.
(b) The commissioner shall take into consideration actions taken by insurers that maintain membership in best-practice organizations that exist to promote high ethical standards of conduct in the marketplace, and insurers that self-assess, self-report, and remediate problems detected to mitigate fines levied pursuant to this article. [L 2007, c 227, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2D-111 Data collection and participation in national market conduct databases.

§431:2D-111 Data collection and participation in national market conduct databases.
(a) The commissioner shall collect and report market data to the market information systems of the National Association of Insurance Commissioners, including the complaint database system, the examination tracking system, and the regulatory information retrieval system, or other comparable successor products as determined by the commissioner. In addition to complaint data, the accuracy of insurer-specific information reported to the National Association of Insurance Commissioners to be used for market analysis purposes or as the basis for market conduct actions shall be reviewed by appropriate personnel in the insurance division and by the insurer.
(b) Information collected and maintained by the insurance division shall be compiled in a manner that meets the requirements of the National Association of Insurance Commissioners.
(c) After completion of any level of market analysis, prior to further market conduct action, the commissioner shall contact the insurer to review the analysis.
(d) An insurer responding to a commissioner's request to produce information shall produce it as it is kept in the usual course of business or shall organize and label it to correspond with the categories in the demand.
If a commissioner's request does not specify the form or forms for producing electronically stored information, an insurer responding to the request shall produce the information in a form or forms in which the insurer ordinarily maintains it or in a form or forms that are reasonably usable.
An insurer responding to an information request need not produce the same electronically stored information in more than one form.
An insurer responding to an information request need not provide the electronically stored information from sources that the insurer identifies as not reasonably accessible because of undue burden or cost. [L 2007, c 227, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2D-112 Coordination with other states through the National Association of Insurance Commissioners.

§431:2D-112 Coordination with other states through the National Association of Insurance Commissioners.
The commissioner shall share information and coordinate the insurance division's market analysis and examination efforts with other states through the National Association of Insurance Commissioners. [L 2007, c 227, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2D-113 Additional duties of the commissioner.

§431:2D-113 Additional duties of the commissioner.
(a) At least once per year, or more frequently if deemed necessary, the commissioner shall make available in an appropriate manner to insurers and other entities subject to the scope of this chapter, information on new laws and rules, enforcement actions, and other information the commissioner deems pertinent to ensure compliance with market conduct requirements.
(b) The commissioner shall designate a specific person or persons within the insurance division whose responsibilities shall include the receipt of information from employees of insurers and licensed entities concerning violations of laws, as defined in this section. The person or persons shall be provided with proper training on the handling of the information, which shall be deemed a confidential communication for the purposes of this section.
(c) For any change made to a work product referenced in this article, which materially changes the way in which market analysis, market conduct actions, or market conduct examinations are conducted, the commissioner shall give notice and provide parties with an opportunity for a public hearing pursuant to chapter 91. [L 2007, c 227, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:2D-114 Data calls.

§431:2D-114 Data calls.
Whether through market analysis, market conduct action, or in response to another regulatory request, any information provided in response to a data call from the commissioner or the commissioner's designee, shall be treated as confidential and privileged. It shall not be subject to subpoena and shall not be subject to discovery or admissible in evidence in any private civil action. No waiver of privilege or confidentiality shall occur as a result of responding to a data call. [L 2007, c 227, pt of §1]
2023 Hawaii Revised Statutes › Title 24. Insurance › 431. Insurance Code › 431:3-106 Mutual insurer.

§431:3-106 Mutual insurer.
A mutual insurer means an incorporated insurer without capital stock, the governing body of which is elected by its policyholders. The policyholders, who are the insurer's owners, are known as members. [L 1987, c 347, pt of §2]