Opinion ID: 871144
Heading Depth: 1
Heading Rank: 3

Heading: background of these consolidated cases

Text: These cases arose from Liberty Mutual Fire Insurance Company’s (Liberty Mutual) denial of PIP benefits to Chung Mi Ahn (Ahn) and Kee Sun Kim (Kim) (collectively Insureds) for treatments after motor vehicle accidents in 2004 and 2005. After the denials, Insureds each sought administrative reviews with the Insurance Division of the Department of Commerce and Consumer Affairs (DCCA) pursuant to HRS § 431:10C-212, which allows -13-  FOR PUBLICATION IN W EST’S HAW AII REPORTS AND PACIFIC REPORTER  insureds to seek administrative review of PIP denials. Based upon our holding in Wilson, Liberty Mutual filed motions for summary judgment, contending that Insureds were not real parties in interest to pursue PIP benefits, and that the claims had to be pursued directly by the providers. The Insurance Commissioner’s Final Orders granting the motions were filed on November 23, 2005, and May 12, 2006, respectively.
Insureds appealed to the Circuit Court of the First Circuit (circuit court) pursuant to HRS § 91-14. After a consolidated hearing in October of 2006, the circuit court concluded that Act 198 of 2006, effective June 14, 2006, had “legislatively overruled” Wilson. The circuit court concluded that Insureds were real parties in interest to challenge Liberty Mutual’s denials despite having reached the tort threshold.
Both Liberty Mutual and the Insurance Commissioner appealed the circuit court’s ruling to the ICA. In a published opinion in Kim v. Liberty Mut. Fire Ins. Co., 124 Hawai#i 415, 416, 245 P.3d 488, 489 (App. 2010), the ICA upheld the circuit court, stating: In this appeal, we must determine the impact that Act 198 and its legislative history have on Wilson v. AIG’s realparty-in-interest analysis. We conclude that the Legislature, through Act 198 and its accompanying legislative history, has clarified its intent and the nature of an insured claimant’s interest in enforcing his or her medical provider’s claim for payment, such that Kim qualifies as a real party in interest. Accordingly, we hold that Kim is a real party in interest and is entitled to pursue her administrative action which challenged Liberty -14-  FOR PUBLICATION IN W EST’S HAW AII REPORTS AND PACIFIC REPORTER  Mutual’s refusal to pay Kim’s medical provider for the acupuncture treatments provided to Kim. The ICA analyzed our decision in Wilson, Act 198 of 2006, and the legislative history of Act 198 in reaching this conclusion. See generally 124 Hawai#i at 418-24, 245 P.3d at 491-97. The ICA then ruled in favor of Ahn through a summary disposition order based on its opinion in Kim. See Ahn v. Liberty Mut. Fire Ins. Co., No. 28314 (App. Jan. 25, 2011) (SDO).
Liberty Mutual filed applications for writs of certiorari in both cases.17 Liberty Mutual argues the ICA gravely erred in concluding that HRS § 431:10C-308.5(e), as amended by Act 198 of 2006, conferred real party in interest status on Insureds. It argues that the statute governs fee disputes, not complete denials, and that the ICA’s decision conflicts with our holding in Wilson. We accepted certiorari and consolidated the cases for oral argument and disposition.