No-Fault Insurance in Hawaii: PIP Benefits, Claims, and Deadlines

Under Hawaii’s no-fault insurance system, your own auto insurer pays your accident-related medical bills up to your Personal Injury Protection (PIP) limit, no matter who caused the crash. Every registered vehicle must carry at least $10,000 in PIP coverage per person.1Justia. Hawaii Revised Statutes 431:10C-103.5 – Personal Injury Protection Benefits; Defined; Limits No-fault only covers personal injuries, though. Vehicle damage stays a fault-based claim, so the driver who caused the crash is on the hook for repairing the other person’s car.

What Every Hawaii Driver Must Carry

Hawaii law requires three coverages on every registered vehicle. Getting any of them wrong can trigger fines, license suspension, and registration problems.

Uninsured and underinsured motorist coverages are optional in Hawaii. If you buy them, the minimum available is $20,000 per person.3Hawaii DCCA. Motor Vehicle Insurance Information A serious crash can easily exceed the at-fault driver’s minimum limits, so these are worth considering even though the state doesn’t require them.

What PIP Actually Pays For

The base $10,000 covers medical treatment: hospital stays, surgery, dental work, chiropractic care, physical therapy, psychiatric services, ambulance transport, X-rays, prosthetics, and therapeutic massage when prescribed by a doctor.1Justia. Hawaii Revised Statutes 431:10C-103.5 – Personal Injury Protection Benefits; Defined; Limits The treatment has to be appropriate, reasonable, and directly caused by the accident.

This is where drivers get caught out. Wage loss benefits, funeral expenses, and death benefits are not included in the base PIP policy. They are optional add-ons that a policyholder has to specifically elect.4Hawaii.gov. Hawaii Administrative Rules Chapter 23 – Motor Vehicle Insurance Law If you never selected wage loss coverage, your PIP will not reimburse lost income after an accident.

Available wage loss tiers range from $500 per month with a $3,000 per-accident cap up to $2,000 per month with a $12,000 cap. Funeral benefits, if purchased, cover up to $2,000.5Hawaii DCCA. Exhibits for HAR Chapter 23 – Motor Vehicle Insurance Law Insurers must offer these, but the decision to buy them is yours. If you’re unsure, check your declarations page or call your insurer.

Who Is Covered by PIP

PIP reaches beyond the people inside the insured vehicle. Pedestrians and bicyclists injured by a motor vehicle can claim PIP under the policy covering the vehicle that hit them.4Hawaii.gov. Hawaii Administrative Rules Chapter 23 – Motor Vehicle Insurance Law The injured person doesn’t need to own a car or carry auto insurance.

Motorcycles and motor scooters are the major exception. If you’re injured operating or riding on a motorcycle or motor scooter, you generally cannot claim PIP under a standard auto policy unless that policy specifically includes the coverage. Motorcycle policies carry their own liability requirement ($20,000 per person, $40,000 per accident) and offer optional medical payments coverage up to $10,000.6Justia. Hawaii Revised Statutes 431:10g-301 – Required Motorcycle and Motor Scooter Policy Coverage

How to File a PIP Claim

Notify your insurer as soon as possible after an accident. Hawaii’s administrative rules require written notice within a “reasonable time” after the accident or after you first become aware of an injury from it.4Hawaii.gov. Hawaii Administrative Rules Chapter 23 – Motor Vehicle Insurance Law The statute doesn’t set a fixed number of days, but insurers routinely use delay as a reason to challenge claims. Include the date, location, and circumstances along with a description of your injuries.

Once you file, the insurer must pay PIP benefits within 30 days of receiving reasonable proof of the treatment and its cost.7Justia. Hawaii Revised Statutes 431:10C-304 – Obligation to Pay Personal Injury Protection Benefits Submit medical records, bills, and receipts showing your treatment is tied to the accident. If the insurer denies all or part of your claim, it must send a written notice of denial explaining why.4Hawaii.gov. Hawaii Administrative Rules Chapter 23 – Motor Vehicle Insurance Law

Independent Medical Examinations

Insurers sometimes request an independent medical examination (IME) to evaluate whether your treatment is necessary and related to the accident. Hawaii law places limits on this. The examiner must be a licensed Hawaii provider unless you consent to someone out of state, and the examiner must practice the same specialty as the doctor whose treatment is being reviewed.8Justia. Hawaii Revised Statutes 431:10C-308.5 – Limitation on Charges You have the right to obtain all records and charges related to the examination.

When You Can Sue the At-Fault Driver

Hawaii’s no-fault system limits your right to sue the other driver in most cases. You can step outside the no-fault framework and file a tort claim only if one of these is true:

Clear one of those thresholds and you can pursue damages PIP doesn’t cover, including pain and suffering. Hawaii follows a modified comparative negligence rule: you can recover damages as long as you were less than 51 percent at fault. At 51 percent or more, you recover nothing.

Deadlines You Cannot Miss

Hawaii sets separate deadlines for PIP benefit disputes and tort lawsuits. Confusing them can cost you the case.

Two years sounds generous until you factor in gathering medical records, finishing treatment, and negotiating with insurers. Waiting until the last few months routinely wrecks otherwise strong claims.

Fighting a Denied PIP Claim

Most PIP disputes come down to whether a treatment was reasonable and necessary. If you can’t resolve it directly with your insurer, Hawaii law allows any party to submit the dispute to arbitration by filing a written request with the circuit court clerk where the accident occurred. Arbitrator costs are split equally unless the arbitrator decides otherwise, and either side can appeal to circuit court.12Justia. Hawaii Revised Statutes 431:10C-213 – Arbitration

Attorney fees often tip these disputes. If you prevail in a settlement or lawsuit over denied PIP benefits, the insurer must pay your reasonable attorney fees directly to your attorney, separate from the benefit amount.13Justia. Hawaii Revised Statutes 431:10C-211 – Attorney’s Fees Even if you don’t prevail, a court or the insurance commissioner may still award fees unless your claim is found unreasonable, fraudulent, or frivolous. That structure makes it harder for insurers to stonewall legitimate claims through litigation cost alone.

Property Damage Is Not No-Fault

No-fault does not touch vehicle damage. If another driver caused the crash, their liability insurance is responsible for repairing or replacing your vehicle, up to their policy’s property damage limit of at least $10,000.2Justia. Hawaii Revised Statutes 431:10C-301 – Required Motor Vehicle Policy Coverage You file a third-party claim against their insurer or use your own collision coverage if you carry it.

That $10,000 minimum is low against the cost of modern vehicles. If the at-fault driver carries only the state minimum and your car is totaled, the gap comes out of your pocket unless you carry collision or uninsured/underinsured motorist property damage coverage on your own policy.

Penalties for Driving Without Coverage

Operating without required insurance is a separate offense each time. The fine for a first offense of having no policy in effect is $500. Later offenses within five years carry a minimum fine of $1,500, and the overall statutory range for any violation is $100 to $5,000.14Justia. Hawaii Revised Statutes 431:10C-117 – Penalties You also face driver’s license suspension and vehicle registration revocation.

Getting your license back takes more than paying the fine. You will need a policy that meets state minimums and an SR-22 certificate filed by your insurer to prove you carry coverage. That SR-22 typically stays in place for three years, and any lapse restarts the process. SR-22 status also signals higher risk to insurers, which usually means higher premiums for the duration.