1.  You Don’t Reach the Tort Threshold

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As has been discussed on many of our website pages, to claim pain and suffering, No-Fault Insurance has to pay at least $5,000 of your medical bills.  The $5,000 amount is known as the “Tort Threshold”.  Hawaii state law has abolished tort liability in all cases involving less than $5,000 in medical bills paid by the No-Fault Insurance.  Click here for the Hawaii Statute, which abolished tort liability.  This Statute indicates that there is no more extended tort liability in Hawaii except in a few specific circumstances.  One of these circumstances is when the No-Fault insurance pays at least $5,000 in medical bills. 

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Sometimes it can be challenging to reach the “tort threshold”.  One situation may be if the No-Fault insurance pays a tiny percentage of the medical bill.  For example, your emergency room bill may be $10,000, but perhaps the No-Fault insurance may only pay $1,000 of the bill.   Each No-Fault insurance company is different.  Some will pay the entire $10,000 bill, while others will pay only a portion.  Remember that the tort threshold is based on bills paid, not just the total billed amount.   

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Some rental car companies are notorious for paying only a tiny portion of the bill. For example, we recently had a rental car company that only paid $1,500 of the $24,000 ER bill. Needless to say, we are having a tough time reaching the tort threshold in that case.  

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Another situation that causes significant issues in a case is when the medical provider refuses to bill the No-Fault insurance.  For example, the Queen’s Medical Center has recently changed its policy regarding active duty military personnel.  Queen’s refuses to bill their No-Fault insurance.  They will only bill Tricare.  Then, they expect Tricare to submit their bill to the No-Fault insurance for reimbursement.  The problem with this scenario is that Tricare pays a tiny portion of the medical bill.  Therefore, even if the No-Fault insurance pays Tricare, they must pay only about 10% of the bill.   

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Going to the emergency room is one of the best ways to reach the tort threshold.  ER bills are usually about $5,000 or more.  Assuming you have a good No-Fault insurance company (also known as Personal Injury Protection) that pays a fair amount of the ER bill, you should quickly reach the tort threshold.  If you don’t go to the ER or go to cheap urgent care, you may have difficulty reaching the tort threshold.  You will then end up having to get extensive physical therapy, massage therapy, chiropractic care, etc., in order to try to reach the tort threshold.   These therapies are only about $100 per treatment, so you can imagine how many treatments it would take to get up to $5,000 in bills.  One good way to incur larger medical bills is to undergo an MRI.  MRIs are usually about $1,000.  

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Some people may have a very difficult time attending a lot of therapy. This is understandable, considering the employment and family obligations they may have. However, you should keep in mind that attending therapy will not only help you reach the threshold of tolerance, which could result in an injury settlement, but it will also help you recover fully from your injuries.  

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2.  You Have Extensive Medical Liens On Your Case

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Although medical liens don’t technically cause you to lose your injury case, they can have a similar effect.  Medical liens can either be due to unpaid medical bills or medical insurance companies wanting to be reimbursed for the bills they paid.  

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Sometimes medical liens can prevent you from settling your case.  Some insurance adjusters may insist that medical liens are resolved at the time of the settlement.  Some adjusters are overly worried about “super liens,” such as those supported by Federal or State Law.  The medical liens backed by Federal law are for Medicare, Medicaid, Tricare, etc.  Federal law requires that these entities be paid back for the bills paid for injuries related to the accident.  Not only can these Federal liens take up a large part of the settlement proceeds, but they can also take a very long time for these Federal agencies to even tell us how much their lien is.  Medicare uses an outside agency to handle the liens, which usually only takes 3-4 months.  Tricare, on the other hand, can take one to two years.   How ironic is it that these Federal agencies insist on getting a chunk of the settlement proceeds, but they are in no hurry to tell us how much they want?  

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Not only do these agencies take forever to tell us how much their lien is, but they can also be unreasonable when it comes to being willing to reduce their liens.  They don’t understand that if they aren’t willing to reduce their lien, the case may not even settle because it wouldn’t make sense for someone to settle their case and then have to give a large portion of the proceeds back to the government.  

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Hawaii State law also requires that Med-Quest be reimbursed for any payments made. Thankfully, the state doesn’t take long to tell us how much they’ve paid—it usually only takes about a month. Also, under state law, they must reduce their lien by a third to help pay the attorney fees.  

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Here we’ve discussed only a few ways your good Hawaii car accident case can go from good to bad.  Check out some of our other pages to learn more about how our Honolulu auto accident lawyers can help you get the maximum compensation you deserve for your auto collision injuries. 

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What You Don't Know About Car Accident Cases In Hawaii

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Many aspects of Hawaii’s injury cases are common sense.  Everyone knows that the person who hit you is responsible for fixing your car, reimbursing you for your medical bills, and paying you for your pain and suffering.  Of course, this is usually all paid by their insurance company.

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Here is something that many people don’t know about car accident claims in Hawaii:

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You must pay your health insurance company back when settling your injury claim.

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This comes as a shock to many people. Most people who have been injured in an accident have no idea that their health insurance company wants to be paid back for the bills they paid for their treatment related to the accident. The prominent health insurance companies in Honolulu and throughout Hawaii even hire companies that specialize in obtaining reimbursement for the medical bills they pay.

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As Hawaii injury lawyers, we receive many phone calls from these companies and respond to their letters. Their agents receive a commission for the funds they recover, which allows them to be aggressive.

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Don’t worry, you only need to reimburse your health insurance company if you receive a settlement for your injuries.  If you decide not to pursue the matter and don’t get a settlement, you don’t need to pay back the insurance company.

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This phenomenon of medical insurance companies wanting to be reimbursed is somewhat new.  Many years ago, this was not an issue.  Now, their right to be compensated when the injured person gets a settlement is explained in the insurance contract.  These contracts indicate that the insureds must cooperate with the medical insurance company and ensure they are paid back when their case is settled.

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This is a good reason to hire a Honolulu accident injury lawyer with many years of experience. Attorneys without experience with car accident claims may not even know that the medical insurance company will want to be paid back.

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It is essential to know the amount that needs to be paid back so that you can consider it when accepting a settlement amount.  You should not take a settlement amount until you have considered how much the settlement will be paid to the medical insurance company and how much will be paid for the attorney fees.  You don’t want to be surprised if you discover that you receive less than you thought.

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An experienced injury lawyer will also know how to negotiate with the medical insurance company to get them to reduce the amount they request.  For example, we can usually get them to reduce it by the percentage paid for attorney fees.  After all, the client had to hire a lawyer and pay attorney fees to get compensated, so why should the health insurance company not have to reduce their balance by at least the same percentage that the client had to pay for their attorney fee?

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The laws in this area are constantly evolving.  This is an issue that is continually being challenged in the courts.  Recently, injury lawyers have been successful against health insurance companies that are seeking reimbursement.  The Supreme Court of Hawaii and the Federal District Court of Hawaii have both ruled in favor of the injury lawyers and against the health insurance companies.  This is great news for victims of injuries in Hawaii; however, the fight is not over yet.  The health insurance companies have vowed to continue to fight the issue in court and have indicated that they will appeal the cases to higher courts.

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To hear the oral arguments in one of the recent lawsuits against one of the health insurance companies in Hawaii, click here.  To read the court decision, click here.

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Understandably, they would want to be reimbursed for some of what they have paid.  For example, if someone received a million-dollar settlement because their medical bills were hundreds of thousands, it would be reasonable for the health insurance company to receive some of the settlement.  However, the problem is that these health insurance companies are often very unreasonable.  For example, most people in Hawaii only have the minimum car insurance of $20,000.  So most settlements for injuries are $20,000 or less.

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The health insurance company sometimes paid $15,000 in medical bills, but our client only received the policy limits of $20,000.  After our client paid the attorney fees of $6,600, they had $13,300 left of the settlement.  Then the health insurance company asks for all our clients' money in the settlement.  How ridiculous is that?  Even if our client got to keep all the $13,300, they still didn’t receive all the compensation they deserved because of the low policy limits.  In this example, paying the insurance company back about $3,000 would be reasonable.  Unfortunately, they aren’t usually very reasonable.  They almost always want to be fully compensated.

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In a perfect world, the policy limit requirements in Hawaii would be at least $100,000. That would enable most people injured in accidents to receive the compensation they deserve. However, it wouldn’t be possible to pay back the health insurance company for what they paid.

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As long as we live in a world with small policy limits of $20,000, it is reasonable for personal health insurance companies to be paid back for what the injury victim receives after paying his/her attorney fees.  This would be reasonable.  Until the health insurance companies decide to be more sensible, we will continue fighting tooth and nail to get our clients maximum compensation for their injuries.

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This is just one aspect of injury claims in Hawaii that many people may not be aware of.  Check out our other Honolulu injury resources webpages for more critical information about auto accident cases.​​

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Understanding how Hawaii’s insurance laws work is one of the most important parts of successfully navigating a car accident claim in Honolulu or anywhere on Oahu. Many people are shocked to discover that even a case that seems simple or straightforward can quickly become complicated once medical bills, No-Fault requirements, tort threshold rules, and insurance liens come into play. One of the reasons injury victims consistently turn to Hawaii Car Crash Injury Lawyer David W. Barlow is because Hawaii’s laws are unique—far different from many mainland states—and having an attorney who deals with these issues every day can dramatically affect the outcome of a case.

 

Hawaii is a no-fault state, which creates an entirely different set of rules compared to at-fault states. Many people relocating to Hawaii or visiting for vacation assume their claim will work the same way it does back home. Unfortunately, operating under incorrect assumptions can cost victims thousands of dollars or even their entire right to pursue a claim. This is why understanding the details of No-Fault Insurance (PIP), how the $5,000 tort threshold applies, how medical billing works in Hawaii, and how insurance companies evaluate claims is crucial. These issues don’t just affect the size of your settlement—they determine whether you are even legally allowed to pursue a settlement at all.

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Below is extended information to help Hawaii injury victims understand how these rules work, why so many people unintentionally jeopardize their cases, and how a knowledgeable Oahu car accident lawyer can prevent these pitfalls before they become major problems.

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Why So Many Accident Victims in Hawaii Don’t

Realize They’re at Risk of Losing Their Entire Claim

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One of the most common situations that Honolulu car accident lawyers encounter is an injured person who believes they have a strong case—only to discover that the way medical bills were handled prevents them from pursuing pain and suffering. This is extremely frustrating for victims because many of them had no idea that their medical provider’s billing practices could stop their claim cold.

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Many people mistakenly believe that “I was hurt, therefore I get a settlement.” But in Hawaii, injury severity alone does not automatically entitle a person to compensation for pain and suffering. If certain insurance requirements are not met—particularly the No-Fault threshold—your case simply cannot proceed, no matter how injured you are.

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This is why Hawaii Car Crash Injury Lawyer David W. Barlow spends so much time explaining how the tort threshold works. Even people with legitimate injuries—broken ribs, concussion symptoms, herniated discs—can lose their rights if the No-Fault insurer pays too little.

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Just as frustrating, many people do not know that certain providers refuse to bill No-Fault. As your original content mentioned, Queen’s Medical Center now handles billing differently for active-duty members, causing major problems for military families stationed at Pearl Harbor, Schofield Barracks, or Marine Corps Base Hawaii.

When medical providers do not bill No-Fault directly, patients may incorrectly assume everything is being handled properly. But weeks or months later, they discover nothing was billed to the right place, leaving their No-Fault policy barely used and preventing them from reaching Hawaii’s tort threshold.

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This is not a small issue. These situations happen every week to people on Oahu.

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Why the Tort Threshold Matters So Much in Hawaii

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Hawaii’s tort threshold law is one of the strictest in the country. It is designed to limit lawsuits, and insurance companies know this. In fact, the tort threshold saves insurance companies money because it blocks many claims.

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When you cross that $5,000 mark in No-Fault paid medical bills, your entire case changes. At that point, you have the legal right to pursue the at-fault driver for pain and suffering.

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Before you cross the threshold, the at-fault driver's insurance company:

• Does not have to negotiate with you

• Does not have to offer a settlement

• Does not have to consider your pain or injuries

• May simply tell you, “Call us when you reach $5,000”

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Because of this, reaching the tort threshold is the gateway to a real settlement in Hawaii.

This is why the guidance from your medical providers, your No-Fault adjuster, and your attorney makes all the difference.

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How Delays in Treatment Hurt Your Case

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Another common mistake injury victims make is delaying treatment. Many people hope their pain will go away, or they don’t want to sit in an ER for hours, or they assume urgent care is “good enough.”

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But in Hawaii, especially on Oahu, delaying treatment creates several major issues:

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1. It Makes It Harder to Reach the Tort Threshold

ER bills are usually large enough to quickly use up the No-Fault benefits. But if a person skips the ER and waits a week to see a chiropractor, they may only be billed $100–$150 per visit. That path takes dozens of appointments to hit $5,000—something many people never reach, especially if they have busy work schedules.

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2. Insurance Adjusters Use the Delay Against You

The at-fault insurer may argue:

• The injury is not serious

• The injury was caused by something else

• The victim waited too long to see a doctor

• The victim must not have been in pain

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Insurance companies love delays because they give them ammunition.

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3. Medical Providers May Not Bill Correctly

Urgent care clinics often do not understand No-Fault billing rules, leading to denials or delays that prevent the No-Fault insurance from paying. Again, this can stop your case from ever reaching the tort threshold.

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4. You Put Your Health at Risk

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Delaying care means a delayed diagnosis. Many Hawaii residents with car crash injuries are later found to have:

• Concussions

• Torn ligaments

• Hairline fractures

• Herniated or bulging discs

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These types of injuries worsen without immediate treatment.

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An experienced Honolulu car crash lawyer understands how dangerous it is to delay care, both medically and legally.

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Why Medical Liens Are One of the Biggest Surprises in Hawaii Car Accident Cases

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Most people assume, “My insurance paid my bills, so I’m good.” Unfortunately, that’s not how insurance companies see it. They have a contractual right to reimbursement—sometimes even when the amount they request is unreasonable.

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These medical liens create several major challenges:

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1. They Reduce Your Final Settlement

Some accident victims expect a certain amount of money, only to discover their health insurance company wants thousands of dollars back. Without proper negotiation, victims may walk away with little to nothing.

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2. They Can Delay Settlement for Months or Years

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This is especially true with Federal liens like:

• Medicare

• Medicaid

• Tricare

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Imagine your settlement money sitting there waiting for approval from an agency that takes 18 months to respond—that is the reality for many Hawaii car crash victims.

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3. They Can Block Settlement Entirely

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If the lien amount is unreasonably high, your attorney may need to negotiate aggressively before the case can settle. Some adjusters will refuse to issue a settlement check until all liens are resolved.

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Working with a skilled Hawaii injury lawyer who knows how to reduce these liens is one of the most valuable parts of hiring an attorney.

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Why Hiring an Experienced Hawaii Car Crash Lawyer Makes a Huge Difference

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Many people injured in car accidents first try to handle their claim themselves. It is understandable—nobody wants to give part of their settlement to an attorney. But almost always, people who try to handle their cases alone run into problems they did not expect.

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A typical person does not know:

• How to ensure the No-Fault insurer pays enough to reach the tort threshold

• How to verify medical providers billed No-Fault correctly

• How to negotiate medical liens

• How to gather the medical evidence adjusters want

• How to prevent the at-fault insurer from denying liability

• How to avoid making statements to adjusters that can be used against them

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Insurance companies love it when victims are unrepresented. It saves them money.

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They know that people who do not hire a lawyer:

• Do not understand the tort threshold rules

• Do not know how to collect medical evidence

• Do not fight lien reductions

• Do not know how to appeal a No-Fault denial

• Do not know how to increase the value of their claim

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This is why injury victims consistently receive significantly more compensation with a lawyer than without one—even after attorney fees.

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Why David W. Barlow Is One of the Most Trusted Hawaii Car Crash Injury Lawyers

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Attorney David W. Barlow has handled thousands of car accident claims in Hawaii. His experience with Honolulu insurance adjusters, medical providers, and No-Fault laws gives his clients a major advantage. While many lawyers handle a few personal injury cases here and there, David Barlow’s entire practice is focused on Hawaii auto injury law.

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Clients appreciate that he:

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• Understands the practical realities of Hawaii’s insurance system

• Works directly with clients instead of passing cases off to inexperienced staff

• Communicates frequently and clearly

• Knows the local adjusters, billing departments, and medical providers

• Has years of experience negotiating lien reductions

• Understands how to reach the tort threshold efficiently

• Knows how to maximize settlements even with low policy limits

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When people search for a Hawaii Car Crash Injury Lawyer or Honolulu Auto Accident Attorney, they want someone who knows the system inside and out—someone who can anticipate problems before they occur. This is why so many Oahu residents choose David W. Barlow.

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How Insurance Companies Minimize Claims in Hawaii

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Insurance companies in Hawaii use several strategies to avoid paying full value:

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1. Downplaying Your Injuries

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They might claim:

• The collision was minor

• You had pre-existing conditions

• You didn’t need the treatment you received

• You recovered “too quickly” to be seriously injured

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2. Attacking Gaps in Treatment

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Even a small delay can be used against you.

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3. Arguing You Didn’t Reach the Tort Threshold

If No-Fault payments fall short—even by $200—they simply refuse to negotiate.

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4. Exploiting Hawaii’s Low Policy Limits

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Because many drivers carry only $20,000 in bodily injury coverage, adjusters often try to settle cases for the minimum amount even when injuries are severe.

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5. Blaming You for the Accident

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Comparative negligence rules can reduce your claim if the insurer can shift some blame onto you.

A knowledgeable Hawaii car accident lawyer knows how to counter these tactics effectively.

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How to Protect Your Case Immediately After a Crash in Hawaii

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Here are important steps to follow after a car accident on Oahu or any Hawaiian island:

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1. Call 911 and Get a Police Report

Insurance companies rely heavily on police reports when determining fault.

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2. Go to the Emergency Room

This protects your health and your legal rights.

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3. Tell Every Doctor the Truth About Your Symptoms

Never downplay injuries out of pride or embarrassment. Adjusters will use your medical records against you.

4. Contact a Hawaii Car Crash Injury Lawyer Early

Early guidance prevents mistakes that harm your case.

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5. Do Not Talk to the At-Fault Insurance Company

They are trained to get statements that reduce your claim.

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6. Make Sure Providers Bill No-Fault

If they don’t, you may never reach the tort threshold.

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7. Follow Your Doctor’s Recommendations

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Treatment gaps severely damage your case.

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How Long Do Hawaii Car Accident Cases Usually Take

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Every case is different, but in general:

• Minor injuries: 4–8 months

• Moderate injuries: 8–14 months

• Severe injuries: 1–2+ years

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Cases take longer when:

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• Medical treatment continues for a long period

• Liens need to be negotiated

• No-Fault billing is delayed

• Federal agencies take months to respond

• Insurance companies dispute fault

• Multiple parties are involved

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A skilled Oahu car accident lawyer helps keep the process moving as quickly as possible.

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Why Policy Limits in Hawaii Cause Many Compensation Problems

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Hawaii’s minimum bodily injury policy limit is only $20,000 per person. Many people carry only this minimum policy. When someone suffers injuries worth more than $20,000—which is extremely common—this becomes a major issue.

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Even if your injury is worth $75,000 or $100,000, the insurance company is only legally required to pay the policy limit. As your original content pointed out, this leaves injured people unable to recover full compensation.

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This is one reason why an injury lawyer’s ability to reduce liens and maximize the settlement is so important. Every dollar saved in liens is a dollar the client gets to keep.

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Why You Should Not Accept the First Offer From an Insurance Company

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Adjusters often make a quick, low offer to close the case before the victim understands the value of their injuries. These offers are almost never fair and often come before:

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• All injuries have been diagnosed

• All medical records have been gathered

• The tort threshold has been reached

• The victim has finished treatment

• All liens are calculated

• Lost wages have been documented

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Accepting an early offer can permanently damage your financial recovery. Once you sign release forms, you cannot go back for more money—ever.

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Contact a Hawaii Car Crash Injury Lawyer for Help

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Anyone injured in a car accident in Honolulu, Oahu, or anywhere in Hawaii should consult with an experienced lawyer who understands No-Fault insurance, medical liens, tort threshold rules, low policy limits, and the complexities of Hawaii’s accident system.

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David W. Barlow has helped thousands of Hawaii residents and visitors successfully navigate their claims. Whether you are dealing with unpaid medical bills, low insurance limits, lien problems, a slow No-Fault adjuster, or a difficult at-fault insurer, having an experienced Honolulu car accident lawyer on your side can dramatically increase the compensation you receive.

If you or a loved one has been injured in a car crash, do not wait—Hawaii’s laws are complicated, and early mistakes can permanently damage your case. Contact Hawaii Car Crash Injury Lawyer David W. Barlow for a free consultation and guidance on the next steps.