# HI Commissioner's Memorandum 2002-7A: Coverage of Emergency Services

> Hawaii · Agency guidance · Expired

URL: https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-7A

## Section

- **Citation:** HI Commissioner's Memorandum 2002-7A
- **Heading:** Coverage of Emergency Services
- **Jurisdiction:** Hawaii
- **Kind:** Agency guidance
- **Status:** Expired
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Hawaii Insurance Division Commissioner's Memoranda / Coverage of Emergency Services

## Text

August 15, 2002

Memorandum 2002-7A

TO:
All Licensed Motor Vehicle Insurers in the State of Hawaii

FR:
Wayne Metcalf

Insurance Commissioner

RE:
Coverage of Emergency Services

Questions have recently arisen concerning the definition of “emergency services” and what
constitutes an “emergency medical condition” in the adjustment of personal injury protection ("PIP")
claims. Please note that §431:10C-103, Hawaii Revised Statutes ("HRS"), provides guidance on this
matter:

""Emergency medical condition” means a medical condition that manifests itself
by acute symptoms of sufficient severity, including severe pain, that a prudent layperson,
who possesses an average knowledge of health and medicine, could reasonably expect
the absence of immediate medical attention to result in:
(1)
Placing the health of the individual, including the health of a pregnant
woman or her unborn child, in serious jeopardy;
(2)
Serious impairment to bodily functions; or
(3)
Serious dysfunction of any bodily organ or part.

"Emergency services" means:
(1)
A medical screening examination, if required by federal law, that is within the
capability of the emergency department of a hospital, including ancillary
services routinely available to the emergency department, to evaluate
an emergency medical condition; or

(2)
Further medical examination and treatment, if required by federal law, that is
within the capabilities of the staff and facilities available at the hospital, including
uired by federal law, that is within the
capability of the emergency department of a hospital, including ancillary
services routinely available to the emergency department, to evaluate
an emergency medical condition; or

(2)
Further medical examination and treatment, if required by federal law, that is
within the capabilities of the staff and facilities available at the hospital, including

Memorandum 2002-7A
August 15, 2002
Insurance Commissioner Wayne Metcalf
State of Hawaii
Page 2

any trauma and burn center of the hospital to stabilize an emergency medical
condition. (Emphasis added)

“Stabilize" means the provision of medical treatment as may be necessary to
assure, within reasonable medical probability, that no material deterioration of an
individual’s medical condition is likely to result from or occur during a transfer to
another facility, if the medical condition could result in placing the health of the individual
or the health of a pregnant woman or her unborn child in serious jeopardy, serious
impairment to bodily functions, or serious dysfunction of any bodily organ or part."

PIP claims, therefore, shall be adjusted in accordance with the above definitions and in
accordance with applicable provisions of the Title 16, Chapter 23, Hawaii Administrative Rules
("HAR"). Charges and treatment rendered for emergency services during the initial seventy-two hours
following the motor vehicle accident resulting in injury shall not be subject to HAR Subchapter 17,
Chapter 23, Title 16.

However, the charges for emergency treatment shall not exceed the health care or alternative
care provider’s usual and customary fee and shall be appropriate, reasonable, and necessarily incurred.
Charges for treatment of a primarily palliative nature shall be subject to the requirements of HAR
Subchapter 17, Chapter 23, Title 16, in the same manner as any other treatment
pter 23, Title 16.

However, the charges for emergency treatment shall not exceed the health care or alternative
care provider’s usual and customary fee and shall be appropriate, reasonable, and necessarily incurred.
Charges for treatment of a primarily palliative nature shall be subject to the requirements of HAR
Subchapter 17, Chapter 23, Title 16, in the same manner as any other treatment.

Should further clarification be needed, please contact the Insurance Division at the above
address or at (808) 586-2790.

## Nearby sections

- [HI Commissioner's Memorandum 2002-1E memo](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-1E.md)
- [HI Commissioner's Memorandum 2002-2A memo](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-2A.md)
- [HI Commissioner's Memorandum 2002-3L memo](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-3L.md)
- [HI Commissioner's Memorandum 2002-4A USA Patriot Act of 2001](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-4A.md)
- [HI Commissioner's Memorandum 2002-5A New Cost for Peer Review / No-Fault Challenges](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-5A.md)
- [HI Commissioner's Memorandum 2002-6L ins commissioners memorandum 6l](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-6L.md)
- [HI Commissioner's Memorandum 2002-7A Coverage of Emergency Services](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-7A.md)
- [HI Commissioner's Memorandum 2002-8A Self-Insured Automobiles](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-8A.md)
- [HI Commissioner's Memorandum 2002-9R ins memorandum 2000 9r](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-9R.md)
- [HI Commissioner's Memorandum 2002-10R Annual Publication of Motor Vehicle Insurers and Premiums](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-10R.md)
- [HI Commissioner's Memorandum 2002-11E memo](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-11E.md)
- [HI Commissioner's Memorandum 2002-12E memo](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-12E.md)
- [HI Commissioner's Memorandum 2002-13H memo](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-13H.md)
- [HI Commissioner's Memorandum 2002-14E memo](https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-14E.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/HI_INS_CM_2002-7A. Check the current official text before relying on it. Not legal advice.
