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HI Claims Adjuster: Casualty Loss Adjusting

HI Claims Adjuster · Work through your exam, one topic at a time.

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Casualty Loss Adjusting

Proving negligence

A casualty claim rests on duty, breach, causation, and damages. Establish the standard of care, then the breach, then the causal link to the harm. On premises claims, the entrant's status - invitee, licensee, or trespasser - still shapes the duty in Hawaii, though the modern trend folds status into ordinary reasonable care.

Fault and damages

Hawaii applies modified comparative fault: a claimant's recovery is reduced by their percentage of fault and is barred if that fault exceeds the defendant's (aggregated where there are multiple defendants). Hawaii has largely abolished joint and several liability, so each defendant generally pays only its proportionate share, subject to statutory exceptions. Damages include past and future medical expenses, wage loss and loss of earning capacity, general damages, and, where supported, loss of consortium.

Hawaii framework

Hawaii's no-fault law (HRS 431:10C) has PIP pay medical and wage-loss benefits up to $10,000 regardless of fault; tort claims for pain and suffering require the statutory threshold. Workers' compensation is generally the exclusive remedy against an employer, with a lien against third-party recoveries. Personal injury and property damage actions carry a two-year statute of limitations.

Worked example

A pedestrian suffers $100,000 in damages and is 30% at fault. Because 30% does not exceed the driver's 70%, the pedestrian recovers $70,000; PIP and workers' compensation liens are then satisfied from that recovery.

Traps

  • Settling before liens are identified.
  • Treating a reservation of rights as a denial of defense.
  • Assuming UM/UIM limits match the liability limits without checking the declarations.

Rule of thumb

Liability, damages, coverage, then money - always in that order, never reversed.