Court Opinion

ID: 9631966
Source: CourtListenerOpinion
Date Created: 2023-08-22 10:57:24.219935+00
Date Added: 2024-06-11T18:08:05.104782
License: Public Domain

DISSENTING OPINION OF WAKATSUKI, J.
I respectfully dissent.
The majority decides, as between the no-fault insurance carrier and the United States government, that the insurance carrier should shoulder the burden of paying for the medical treatment provided to the serviceman injured in an automobile accident. This decision, in my opinion, strains the language of our no-fault statute *301to reach a policy decision that neither the state legislature nor Congress has chosen.
A plain reading of the language of Hawaii’s no-fault statutes convinces me that the United States government is not an “insured person” who suffered “loss from accidental harm” therefore, the government should not be entided to any no-fault benefits under the contract between Strathman and Allstate.
A.
Section 294-3(a), Hawaii Revised Statutes (HRS), provides:
If the accident causing accidental harm occurs in this state, every person, insured under this chapter, and the person’s survivors, suffering loss from accidental harm arising out of the operation, maintenance or use of a motor vehicle has a right to no-fault benefits.
In Wong v. Hawaiian Insurance Companies, 64 Haw. 189, 637 P.2d 1144 (1981), this court, finding the above language to be “plain and clear”, stated that “[t]he no-fault claimant who is entitled to benefits must himself or herself sustain the ‘accidental harm’ giving rise to the loss for which the claim is being made.” Id. at 191, 637 P.2d at 1145.
The majority concedes that the language of HRS § 294-3 appears to preclude the payment of the no-fault benefits to the government. Supra at 9. But the majority is of the opinion that “[a] denial of benefits [to the government] cannot be squared with the comprehensive scheme” of the no-fault law. Supra at 9. I disagree.
It is not the objective of the “comprehensive scheme” of the no-fault statute to make insurers pay for all losses arising out of motor vehicle accidents. Rather, the treatment of victims injured in automobile accidents and the reduction of economic hardships to these victims are the primary public policy objectives which led to enactment of the no-fault laws. See Legislative Auditor, A Study of Hawaii’s Motor Vehicle Insurance Program, 8-14 (1972).
In Barcena v. Hawaiian Insurance & Guaranty Co., Ltd., 67 Haw. 97, 678 P.2d 1082 (1984), this court held that the physical therapy Mrs. Barcena, the accident victim, required as a result of an auto accident would be paid for either by way of public aid or no-fault *302insurance. The primary objective recognized by this court was that Mrs. Barcena receive the necessary treatment with minimal hardship to herself. Public aid and no-fault insurance benefits were the means of fulfilling that objective. In recognizing “[t]he legislative will ... that ‘every insured person suffering loss from accidental harm arising out of the operation ... of a motor vehicle has a right to no-fault benefits’..id. at 104, 678 P.2d at 1089, this court did not thereby hold that no-fault insurance benefits were the primary or sole means of achieving the objectives of treatment for injuries and reduction of hardships.
Regardless of the existence of our no-fault statutes, Strathman would have received, and did receive, adequate and timely medical care from the government without cost to him. Under those facts, the decision of the majority does nothing to enhance the public policy objective of affording treatment to the accident victim without economic burden to him. Further, the plain and clear language of our no-fault statute does not provide for reimbursement to the government for its cost of treating Strathman at Tripler Hospital, a government institution.
Another stated goal of our no-fault statute is the reduction of motor vehicle insurance costs. See Parker v. Nakaoka, 68 Haw_, _, 722 P.2d 1028, 1030 (1986). Since increases in the pay-out of no-fault insurance benefits will, in the long run, result in increases in the cost of no-fault insurance premiums, I find the decision to be contrary to legislative intent of reducing motor vehicle insurance costs.
B.
The majority likens reimbursement to the government in this case to the practice of reimbursement to Kaiser Foundation Health Plan. The distinction is that each insured under the Kaiser plan bargains and pays for the medical care provided by Kaiser Hospital and Medical Group. See Heusle v. National Mutual Insurance Co., 628 F.2d 833, 840 (3d Cir. 1980). On the other hand, the government, by statute, is charged with providing medical treatment to active duty military personnel. The benefit is not bargained for in the usual sense. Further, the inability of Kaiser to recoup payment for *303services from no-fault insurers would “injure” the accident victim in terms of higher premiums being assessed to all members. To the contrary, failure to reimburse the government will not result in lower benefits or higher charges to the serviceman on active duty.
C.
The majority contends that a denial of reimbursement to the government would create a windfall in Allstate’s favor. But I concur with the Third Circuit Court of Appeals that “[t]he concept of ‘windfall’ is misleading because ultimately one large group or the other [premium payers or taxpayers] (and they overlap) must shoulder the burden.” Heusle, 628 F.2d at 838.
It must be kept in mind that any “windfall” for Allstate is not at Strathman’s expense. Further, it is not as if Allstate collected a premium for a policy which provided no benefits. If Strathman obtained treatment at a hospital other than a federal one (as he did for a short period at Castle Hospital), or if the accident had injured a pedestrian or passenger, Allstate would be obligated to make payments under the policy. See Sanner v. Government Employees Insurance Company, 150 N.J. Super. 488, 496, 376 A.2d 180, 184-85 (1977).
If Allstate is indeed receiving a windfall because the premiums for policies covering those entitled to treatment in government facilities is too high, it is a matter for the insurance commissioner, see HRS § 294-13, or the legislature to address, and not this court. Sanner, 150 N.J. Super, at 496, 376 A.2d at 184.
Further,
Congress is free to consider . . . whether the burden of paying medical expenses should be borne by the large group of premium payers or by the large group of taxpayers. The legislative branch can best decide whether the federal government’s interest outweighs the state’s aim of reducing the cost of auto insurance.
Heusle, 628 F.2d at 838.
To date, Congress has chosen, as a matter of policy, to subrogate the government’s claim only when liability for medical expenses for active duty servicemen flows from tort. Heusle, 628 F.2d *304at 838. On the other hand, when government renders medical care to veterans for non-service connected disability, Congress has allowed the government to seek reimbursement from no-fault insurance carriers. 38 U.S.C. § 3629. See also United States v. Dairyland Insurance Co., 644 F.Supp. 702 (N.D. Ga. 1986). It is up to Congress then, to change the policy to allow the government to seek reimbursement from no-fault insurance carriers if that is deemed to be in the public interest.
D.
For the reasons stated, I would answer the certified question in the negative.