In Re Claim of Maldonado

687 P.2d 1, 67 Haw. 347, 1984 Haw. LEXIS 124
CourtHawaii Supreme Court
DecidedSeptember 5, 1984
DocketNO. 9323
StatusPublished
Cited by18 cases

This text of 687 P.2d 1 (In Re Claim of Maldonado) is published on Counsel Stack Legal Research, covering Hawaii Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In Re Claim of Maldonado, 687 P.2d 1, 67 Haw. 347, 1984 Haw. LEXIS 124 (haw 1984).

Opinions

OPINION OF THE COURT BY

PADGETT, J.

We granted certiorari in this appeal by a wage earner inj'ured in an automobile accident. The Intermediate Court of Appeals affirmed a circuit court judgment upholding the refusal, by the no-fault insurance carrier involved, to pay him his actual wage loss of $602.34 per month resulting from the accident. We reverse.

Petitioner Ruperto Maldonado, a bus driver earning $1,534 a month, was injured in an accident while driving an MTL bus on North King Street in Honolulu. Because of his injuries, he was disabled, and could not continue to work. The workers’ compensation benefits payable to him were $931.66 a month. Thus, he experienced an actual monthly wage loss of $602.34.

He made a claim for that amount to Transport Indemnity, the no-fault insurer of the bus. It denied his claim. Petitioner then requested a review by the Insurance Division of the Department of Commerce & Consumer Affairs (formerly the Department of Regulatory Agencies). The assigned hearings officer ruled in peti[348]*348tioner’s favor, but the Insurance Commissioner reversed and held in favor of the insurance company. On appeal, the First Circuit Court and the Intermediate Court of Appeals affirmed her action.

The facts are not disputed, and the question is plainly one of law. That question is how are the applicable provisions of HRS Chapter 294, the Hawaii No-Fault Insurance Law, to be construed?

The insurance company’s position, adopted. by the Intermediate Court of Appeals, the First Circuit Court and the Insurance Commissioner, is that HRS § 294-5(b) (which has been repeatedly amended) exempted it from paying any wage loss benefits, whatsoever, to the injured worker because he was receiving workers’ compensation disability payments in excess of $800 a month.

Section 294-5(b), as it read at the time of the accident, provided:

§ 294-5 Payment from which insurer. . . .
(b) All no-fault benefits shall be paid secondarily and net of any benefits a person is entitled to receive because of the accidental harm from social security laws or workers’ compensation laws; provided however, that this section shall be inapplicable to benefits payable to a surviving spouse and any surviving dependent as provided under section 294-4. If the person does not collect such benefits under such laws by reason of the contest of his right to so collect by the person or organization responsible for payment thereof, the injured person, if otherwise eligible, shall, nevertheless, be entitled to receive no-fault benefits and upon payment thereof the no-fault insurer shall be subrogated to the injured person’s rights to collect such benefits.1 The hearings officer, looking at Senate Standing Committee

Report No. 9832 filed in connection with the 1980 amendment to that section, quoted the following language:

“... several insurance carriers have taken the position under this section that a claimant who suffers monthly earnings loss caused by a motor vehicle accident is not entitled to earnings loss benefits provided under a basic no-fault insurance policy [349]*349coverage if the claimant earned an amount equal to or over $800 a month. For example, if a claimant was earning $1,600 per month but as a result of the accidental harm, his earnings were reduced to $800 per month, the question is raised as to whether the claimant is entitled to receive $800 to make up the loss in his monthly earnings.”

The hearings officer then noted that the committee had stated that it:

“... believes that the claimant under the above circumstances is in fact entitled to the $800 per month earnings loss benefits, and to rule otherwise would be incongruous with the intent of the no-fault statute. If the amount, if any, the claimant actually lost during a monthly period is equal to or less than the amount of applicable coverage, it is our intent that the no-fault carrier is required to pay for such monthly earnings loss.”

On the other hand, the Intermediate Court of Appeals quoted the Statement in Conference Committee Report No. 28, in the 1974 Senate Journal at 780 that “all benefits a victim may receive from .. . workmen’s compensation,.. . shall be deducted from no-fault benefits which are due.”

We point out that the language in question here was part of the originally enacted legislation, and the statements quoted above dealt with later amendments which did not change that language.

Senate Conference Committee Report No. 4, 1973 Senate Journal at 637, in explaining § 294-5(b) stated that “the amount paid would be reduced by any benefit from other sources paid to cover the same loss.”

Is the amount of wages, which the petitioner actually lost each month, that is the difference between his wages and his workers’ compensation disability benefits, the “same loss” as that for which the workers’ disability benefits were paid?

To answer this question, we look first to HRS § 294-3(a) which deals with the “right to no-fault benefits.” It provides:

If the accident causing accidental harm occurs in the State, every person, insured under this chapter, and his 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.
The language just quoted above clearly gives petitioner a right [350]*350to no-fault benefits.
What are those benefits in connection with lost wages?
HRS § 294-2(10)(C)(i) provides:
(10) “No-fault benefits” with respect to any accidental harm shall be subject to an aggregate limit of $15,000 per person or his survivor and means:
(C) Monthly earnings loss measured by an amount equal to the lesser of:
(i) $800 per month, or ... .

(Emphasis added.)

In this case, petitioner has suffered a monthly earnings loss of $602.34, over and above his workers’ compensation disability payments, and apparently the $15,000 maximum has not been reached. Therefore, he would be entitled to the benefits claimed since he did have a loss, unless HRS § 294-5(b) bars him. That section however, as its title “Payment from which insurer”, and its provisions plainly show, deals not with the claimant’s right to benefits (which, as we have noted, is the subject matter of HRS § 294-3), but with priority, as to payments, among insurers.

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Cite This Page — Counsel Stack

Bluebook (online)
687 P.2d 1, 67 Haw. 347, 1984 Haw. LEXIS 124, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-claim-of-maldonado-haw-1984.