Most websites for Hawaii injury law firms simply tell you to “hire a lawyer because injury law is complicated.” That’s true — but it doesn’t actually explain why the laws are complicated. At the Law Offices of David W. Barlow, we believe our clients deserve real answers.

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Hawaii’s personal injury laws are complex because they combine no-fault insurance rules, federal lien laws, and state-specific health insurance reimbursement rights. These overlapping systems create traps for the unwary — especially when it comes to medical liens, one of the most confusing and frustrating parts of any Hawaii auto accident case.

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Understanding Medical Liens in Hawaii Car Accident Cases

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Most people assume that when their health insurance company pays their medical bills, that’s the end of it. You pay your monthly premiums, your insurer pays the doctors, and you move on with your life. Unfortunately, after a car accident in Hawaii, that’s not always the case.

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Major Hawaii health insurance carriers such as HMSA, Kaiser Permanente, and HMAA often include reimbursement clauses in their insurance contracts. These clauses allow them to seek repayment if you later recover money for your injuries — either through an insurance settlement or a personal injury lawsuit.

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In simple terms, if you’re injured in an auto accident and later receive compensation from the at-fault driver or your own insurance company, your health insurer can demand to be paid back for the bills it covered. Understandably, most people think this seems unfair — you already paid for your health insurance coverage! But the insurance companies argue that they should be reimbursed because they paid for medical care caused by someone else’s negligence.

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How Health Insurers and Collection Companies Pursue Reimbursement

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Most health insurance companies don’t handle lien recovery themselves. Instead, they hire collection agencies that specialize in recovering accident-related payments. These agencies — often based on the mainland — receive commissions based on how much money they recover.

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Their main strategy is to gather as much information as possible about your auto insurance claim, then send lien notices to your car insurance company. Once that lien notice is filed, the insurance adjuster handling your car accident claim typically cannot issue payment until the lien is resolved. The insurer must withhold enough money from your settlement to pay the lien holder.

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That’s why having an experienced Honolulu auto accident lawyer like David W. Barlow on your side can make such a big difference. He negotiates aggressively with lienholders and understands how to minimize or eliminate unnecessary repayment claims so you can keep more of your settlement.

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Negotiating and Reducing Medical Liens

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If the collection company has already placed your car insurance company on notice of its lien, negotiating a reduction becomes much harder. The lienholder knows they are in a position of leverage — your case can’t settle until the lien is addressed. In these cases, they often agree to only small reductions, usually around 10% at most.

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However, if the collection company has not yet placed the insurance company on notice, your attorney can often negotiate from a much stronger position. In that situation, David W. Barlow can settle your case, hold the disputed amount in his client trust account, and continue to negotiate the lien after the case resolves. This approach frequently leads to reductions of up to one-third, significantly increasing your net recovery.

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These lien negotiations can take weeks or months, but careful strategy and persistence can save clients thousands of dollars in repayment obligations. Every dollar that stays out of the hands of a collection company is a dollar that goes back to the person who was actually injured.

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The Law Continues to Evolve

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Hawaii’s medical lien laws are constantly changing. A recent Hawaii Supreme Court decision limited how much certain health insurers can recover for medical payments. Whether your health plan is governed by ERISA (a federal law that regulates employee benefit plans) can dramatically affect how much must be reimbursed.

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This means that two people injured in similar car accidents could owe very different amounts depending on whether their coverage was through HMSA, Kaiser, HMAA, or an employer-sponsored ERISA plan. A knowledgeable Hawaii personal injury attorney can analyze your plan and determine how to minimize reimbursement obligations.

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“Super Liens” – Medicaid, Medicare, Tricare, and Med-QUEST

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Certain government programs, such as Medicaid, Medicare, Tricare, and Hawaii’s Med-QUEST, have what are known as “super liens.” These liens are supported by federal or state law, meaning they must be repaid before you can finalize your settlement.

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The good news for Med-QUEST beneficiaries is that Hawaii law requires these liens to be automatically reduced by one-third, recognizing that injured people should not bear the full cost of reimbursement. Federal liens, such as those from Medicare or Tricare, must also be honored but often can be negotiated for a reduction if handled properly.

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Each program — and each insurance company — has its own forms, timelines, and departments for handling lien reductions. Missing a step or misunderstanding a rule can delay your settlement or even expose you to repayment demands after your case closes.

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Why You Need an Experienced Honolulu Auto Accident Lawyer

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Navigating medical liens after a car accident in Hawaii is not something you should face alone. Every insurance company and government agency has its own playbook, and the rules change frequently.

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Attorney David W. Barlow has years of experience dealing with these lien issues for clients across Honolulu, Oahu, and throughout Hawaii. His firm understands how to protect your settlement from unnecessary reductions, negotiate effectively with lienholders, and comply with both Hawaii’s insurance statutes and federal reimbursement laws.

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When you hire the Law Offices of David W. Barlow, you get more than a lawyer — you get a strategic advocate who knows how to navigate Hawaii’s complex insurance system and maximize your recovery after a serious car accident.

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Is Getting Injured In An Accident Like Hitting The Jackpot?

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For some reason, there is the belief in our culture that if you get hurt in an accident, you are going to get a huge settlement and you’ll be set for life.  Who knows exactly where this belief comes from?  It may be from the intriguing news stories involving big settlements.  It may simply be due to the fact that we are a greedy culture.  After all, capitalism is based on greed.  It’s okay to be “greedy” as long as you are going after something you deserve.  However, if you are seeking more than you deserve, then greed can end up backfiring.

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Long gone are the days when Hawaii auto accident insurance companies were afraid of lawyers and the court system.  Those days when insurance companies would just throw money at settlements to try to resolve claims are gone.  Insurance companies are a huge business.  Over the last couple of decades, they have worked hard to figure out how to pay out as little as possible on injury claims.  They have settlement and jury award information on millions of cases to compare.  They have powerful computer programs to compute how much a case should settle for.  After all, the less money they can spend on settling claims, the more money they will have to make entertaining TV commercials to try to get as many paying policyholders as possible.

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Getting injured in an accident is NOT like hitting the jackpot.  It is not a windfall of money.  It is not a way to be set for life.  The system involving insurance companies, courts, and injury lawyers is set up to hopefully get you the compensation to make you “whole” after an accident.  After settling cases, we very rarely have clients celebrating because they got tons of money that they weren’t expecting.  Often, our clients are glad that the process is over and that they got a fair auto accident settlement to compensate them for their pain, suffering, wage loss, medical bills, etc.

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The clients who expect more than they deserve end up doing themselves a big disservice.  They end up dragging out their case longer than necessary.  They end up going through much more stress than they need to.  Sometimes they even end up going through the legal process to try to get more than they deserve.  This process involves attending depositions that could last 5-10 hours.  They could end up having to attend an arbitration, which could last 3-6 hours.  Finally, they could even have to sit through a jury trial, which could last 3-5 days.   Each step of this process can be very stressful.  Sadly, some people go through this process and end up receiving about the same amount that was offered by the insurance company years prior.

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Too often, people get caught up in their case and don’t take a step back and think about how it must look to a casual observer.  For example, we have had many clients over the years who were involved in very minor accidents, yet they expected huge settlement amounts.  We’re talking about accidents with very light damage to the bumper.  A casual observer would look at pictures of the damage and wonder how anyone could possibly be injured in such an accident.  Yet, our clients are making it sound like some sort of massive collision with incredible amounts of damage.  The bottom line is that if there is very little damage to your vehicle, then you should be very reasonable about the amount you expect for a settlement.  Don’t get caught up in the excitement of the Honolulu car accident claim process and try to get something you don’t deserve.  In the end, you will just be causing yourself a lot of stress for nothing.

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Most people have not been involved in car accidents in Hawaii.  Therefore, most people on a jury will not have been in a car accident.  Most people on a jury pay for car insurance.  Many people who pay for car insurance think that their insurance premiums are high because of frivolous lawsuits and injury lawyers.  How do you think your case will be decided by a jury of 12 random people who haven’t been injured in an accident?  It won’t go well.  If you want to take your case in front of a jury, you'd better have a case that will make the jury feel bad for you.  Jurors are human.  If you have a very tragic case involving fractured bones, surgeries, and scars, they will be generous, and they will want to punish the bad driver.  But if you don’t have a serious car accident that will make the jury feel bad for you, then they may be inclined to punish you for wasting their time.

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Many jurors will be missing work to sit on the jury for a week.  Some of them may be getting paid.  Others who are self-employed or work on commission will be upset that they are sitting there for a week, losing money.  You'd better give them a reason not to be upset at you.  If you have a tragic case, then they may not mind and will award you a fair amount.  If you have a silly case with very little damage to the vehicles, then you will most likely regret your decision to take your case to court.

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So, in the end, it all comes down to whether or not you are willing to accept the settlement offer from the insurance adjuster.  Most of the time, the settlement offer is somewhat reasonable.  Yes, there are some settlement offers that are below a reasonable amount, and there are even some that are above a reasonable amount.  If the settlement offer is very unreasonable, then you will want to consider taking the matter to court.  Here’s a great idea: get some advice from your lawyer.  Sincerely ask for his or her advice.  Don’t ask for advice expecting to hear the answer you want to hear.  After all, you are paying for your lawyer to give you advice, whether it’s something you want to hear or not. We’ve always found it strange how rarely clients will ask us for advice.  They decide what amount they want, and that’s what they expect, regardless of whether it’s reasonable or not.  Needless to say, this strategy is not effective.  It all comes down to the amount that the adjuster determines to be the value of the claim after reviewing your medical records, medical bills, and wage loss documentation.