Haw. Rev. Stat. § 431:10C-304
For purposes of this section, the term "personal injury protection insurer" includes personal injury protection self-insurers. Every personal injury protection insurer shall provide personal injury protection benefits for accidental harm as follows:
provided that this paragraph shall not apply in the case of injury to or death of any operator or passenger of a motorcycle or motor scooter as defined in section 286-2 arising out of a motor vehicle accident, unless expressly provided for in the motor vehicle policy;
HRS § 431:10C-304
Section entitles motorcycle passenger to claim no-fault benefits against automobile driver's policy for passenger's injuries received in accident between driver's vehicle and motorcycle. 81 H. 302, 916 P.2d 1203. Term "any person" in paragraph (1)(A)(i) includes motorcycle passengers.81 Haw. 302,916 P.2d 1203. In light of the unambiguous mandatory language of paragraph (3)(B), an insurer is required to provide written notice of its denial--in whole or in part--of the claim for benefits; written notice to the claimant is required where the denial or partial denial relates to the treatment service and/or the charges therefor; where the denial or partial denial involves treatment services, the insurer must also provide written notice to the provider. 109 H. 185, 124 P.3d 930. Where insurer's denial of plaintiff's claim for no-fault benefits was based upon an open question of law--whether "the reasons" as used in paragraph (3)(B) means "all reasons"--there was no bad faith on the part of insurer for not having stated all the reasons for its denial of plaintiff's claim.109 Haw. 537,128 P.3d 850. Hawaii's no-fault legislative scheme did not establish doctor's status as a third party beneficiary as a matter of law. 116 H. 159, 172 P.3d 471. Paragraph (1)(B) (1987) created a statutory right to survivors' loss benefits.88 Haw. 345 (App.),966 P.2d 1071. Pursuant to paragraph (1)(B) (1987) and § 431:10C-103(10)(B) (1987), upon the death of an insured, the insurer is obligated to provide the insured's survivor a survivor's loss benefit of up to either (1) $15,000 where the insured has purchased only the basic no-fault coverage, or (2) the expanded limits of no-fault benefits where the insured has contracted for it under an optional additional coverage.88 Haw. 345 (App.),966 P.2d 1071. The plain language of paragraph (1) requires a causal connection between a motor vehicle accident and any injury for which a claim for no-fault insurance benefits is made. 101 H. 21 (App.), 61 P.3d 532. Insurer violated the time requirements of paragraph (3)(C) (1993) when it delayed granting or denying insured's claim for no-fault benefits pending (1) receipt of answers from insured's treating physicians to insurer's questions regarding the underlying cause of the medical condition that required insured to undergo bypass surgery a few days after a motor vehicle accident, and (2) insured's undergoing two independent medical examinations; however, the commissioner wrongly concluded that insurer's violation of these time requirements procedurally barred insurer from contesting the substantive merits of insured's claim. 101 H. 311 (App.), 67 P.3d 810. Under paragraph (5), an award of attorney's fees and costs is mandatory if a claimant prevails in a settlement or suit for no-fault benefits; and under § 431:10C-211(a), an award of attorney's fees and costs may, in the exercise of a court's or the commissioner's discretion, be awarded to a nonprevailing claimant, as long as the claim is not determined to be unreasonable, fraudulent, excessive, or frivolous.104 Haw. 375 (App.),90 P.3d 267. Paragraph (3)(B) (1993) applies to billing disputes and this section's notice requirement is triggered by a partial denial of claims in the form of reduced or partial payments by an insurer; thus, trial court erred in finding that insurer was not required to issue a formal notice of denial of benefits pursuant to paragraph (3)(B) (1993) after it made both reduced and partial payments on physician's claims. 117 H. 477 (App.), 184 P.3d 792. Paragraph (4) (1993) is applicable when a payment due is delayed in conjunction with a billing dispute; thus, physician was entitled to interest on the balance withheld by insurer thirty days after physician submitted physician's billing statements and demand for payment; insurer was not permitted to withhold payment for an indeterminate period of time, without interest, while it sought additional information from physician.117 Haw. 477 (App.),184 P.3d 792. The doctrine of equitable tolling cannot be applied to expand the two-year statute of limitations period in § 431:10C-315 (1993) based solely on an issuer's failure to provide a formal notice of denial required pursuant to paragraph (3) (1993) in conjunction with a reduced or partial payment. 117 H. 502 (App.), 184 P.3d 817.