Iaea v. TIG Insurance Co.

90 P.3d 267, 104 Haw. 375
CourtHawaii Intermediate Court of Appeals
DecidedApril 14, 2004
Docket24787
StatusPublished
Cited by6 cases

This text of 90 P.3d 267 (Iaea v. TIG Insurance Co.) is published on Counsel Stack Legal Research, covering Hawaii Intermediate Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Iaea v. TIG Insurance Co., 90 P.3d 267, 104 Haw. 375 (hawapp 2004).

Opinions

Opinion of the Court by

WATANABE, Acting C.J.

In this secondary appeal, Claimant-Appellant-Appellant Christopher Iaea (Iaea) challenges a November 23, 2001 order of the Circuit Court of the First Circuit2 (the circuit court) that affirmed the June 25, 2001 Commissioner’s Final Order entered by Ap-pellee-Appellee Insurance Commissioner, Department of Commerce and Consumer Affairs, State of Hawaii (the Commissioner) regarding Iaea’s claim against Respondent-Appellee-Appellee TIG Insurance Company (TIG) for no-fault motor vehicle insurance benefits and related attorney’s fees.

Iaea argues on appeal that the circuit court erred in affirming the Commissioner’s Final Order because: (1) the Commissioner improperly placed the burden of proof on Iaea to show that TIG’s denial of benefits was improper, and (2) the Commissioner improperly denied him the attorney’s fees and costs to which he was statutorily entitled.

We disagree with Iaea’s first contention but agree with his second contention. Accordingly, we affirm in part, vacate in part, and remand to the circuit court for further proceedings consistent with this opinion.

BACKGROUND

On May 19, 1997, Iaea was involved in an accident while operating an automobile insured under a no-fault insurance policy issued by TIG. He was taken to the emergency room of St. Francis Medical Center, where he was diagnosed with neck and back strain and x-rays showed significant degenerative changes in both of his knees and his cervical and lumbar spine. A review of Iaea’s medical history revealed that he had sustained numerous previous injuries.

On July 9, 1997, Dr. Robert Lindberg (Dr. Lindberg) performed an independent medical [377]*377examination (IME) of Iaea and determined that the May 1997 accident “did cause a temporary aggravation of [Iaea’s] preexisting condition, but that aggravation has long since passed” and would have resolved itself “in three to six weeks[.]” Dr. Lindberg apportioned ten percent of Iaea’s current condition to the May 1997 accident, forty percent to Iaea’s previous injuries, and fifty percent to degenerative disc disease and degenerative joint disease changes in Iaea’s various joints. TIG adopted Dr. Lindberg’s findings and covered only ten percent of the treatment services provided to Iaea following the accident.

Iaea requested an administrative hearing before the Insurance Division of the Department of Commerce and Consumer Affairs, State of Hawai'i, and following a January 12, 2000 hearing, a hearings officer issued Findings of Fact, Conclusions of Law and Recommended Order (the Hearings Officer’s Recommended Order). The hearings officer concluded, in relevant part, as follows:

The Hearings Officer agrees with Dr. Lindberg that the accident caused a temporary aggravation of the preexisting condition, but that aggravation has long since passed, and the injury conditions would have resolved in three to six weeks. Thus, [TIG] had a reasonable basis on August 4, 1997 to issue a denial of benefits, however, the Hearings Officer finds that [Iaea] has established by a preponderance of the evidence entitlement of 20% of the contested benefits, and therefore, the Hearings Officer concludes that [TIG’s] denial was improper.

The hearings officer recommended that the Commissioner find and conclude that Iaea “has established by a preponderance of the evidence that he was entitled to 20% of treatments and that the denial should therefore be rejected.” The hearings officer also recommended that “the parties bear1 their own attorney’s fees and costs incurred in this matter.”

The Commissioner adopted the Hearings Officer’s Recommended Order as the Commissioner’s Final Order on June 25, 2001.

On July 20, 2001, Iaea appealed to the circuit court, claiming that the burden of proof was improperly placed upon him by the Commissioner since a statutory presumption existed that medical treatments incurred by a claimant following a motor vehicle accident are appropriate and reasonable. Iaea also argued that the Commissioner abused his discretion in denying Iaea attorney’s fees and costs because an unpublished memorandum opinion by the Hawai'i Supreme Court collaterally estopped the Commissioner from denying Iaea attorney’s fees and costs.

On November 23, 2001, the circuit court entered an Order Affirming Commissioner’s Final Order, stating, in relevant part, as follows:

It is not disputed that Iaea initiated the administrative proceedings below, pursuant to [Hawai'i Revised Statutes (HRS) ] § 431:100-212. Accordingly, the Commissioner correctly ruled that Iaea bore the burden of proof of this claim by a preponderance of the evidence. HRS § 91-10(5); Hawai'i [sic] Administrative Rule (“HAR”) § 16-201-21(d).
The court finds and concludes that there is no presumption of validity of a claim for payment of motor vehicle insurance benefits that applies to claims under HRS § 43L10C-212. [Iaea] has not identified as clearly erroneous any finding of fact made in [the Hearings Officer’s Recommended Order], and has demonstrated no clear error in any of the findings.
On October 29, 2001, the court heard further argument on the issue of attorney’s fees and costs. [The Hearings Officer’s Recommended Order] adopted by [the Commissioner’s Final Order], ruled that the parties must each bear their own fees and costs. Iaea contends that this ruling was an abuse of discretion and that as a matter of law, he is entitled to an award of attorney’s fees and costs. Iaea cites as authority only the unpublished memorandum opinion of the Hawai'i Supreme Court in Spangler v. Pacific Insurance Company, Ltd., No. 17403 [92 Hawai'i 628, 994 P.2d 560 (1999) ], decided March 30, 1999. Memorandum decisions of the [s]upreme [c]ourt may not be cited in any other action or proceeding, with certain exceptions not shown to apply here. Haw. R.App. P. [378]*378[Rule] 35(c). Iaea argues that the Span-gler decision collaterally estops the Commissioner from denying his claim for attorney’s fees and costs in this case, but makes no showing to establish the basis for the application of the doctrine of collateral es-toppel. The court finds no abuse of discretion, and no error of law, in the denial of attorney’s fees and costs as provided by [the Commissioner’s Final Order].

A separate judgment in favor of TIG and the Commissioner was entered on November 23, 2001, and this secondary appeal by Iaea followed.

STANDARD OF REVIEW

The interpretation of statutory provisions is a question of law, which this court reviews de novo under the right/wrong standard. State v. Kotis, 91 Hawai'i 319, 327, 984 P.2d 78, 86 (1999). This court is thus free to review the correctness of the circuit court’s and the Commissioner’s construction of statutory provisions. Id.

Additionally, although deference will ordinarily be given to the Commissioner with respect to decisions within the Commissioner’s expertise, this “rule of judicial deference ...

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Bluebook (online)
90 P.3d 267, 104 Haw. 375, Counsel Stack Legal Research, https://law.counselstack.com/opinion/iaea-v-tig-insurance-co-hawapp-2004.