Sections
Part I Generally 266-1 – 266-30
Part II Special Facility Projects 266-51 – 266-56

Terms Used In Hawaii Revised Statutes > Chapter 266 - Harbors

  • Accidental harm: means bodily injury, death, sickness, or disease caused by a motorcycle or motor scooter accident to a person. See Hawaii Revised Statutes 431:10G-101
  • Acquittal:
    1. Judgement that a criminal defendant has not been proved guilty beyond a reasonable doubt.
    2. A verdict of "not guilty."
     
  • active course of treatment: includes treatment of a covered person on a regular basis by a provider being removed from or leaving the network. See Hawaii Revised Statutes 431:26-101
  • Adjourn: A motion to adjourn a legislative chamber or a committee, if passed, ends that day's session.
  • Administrator: means the chief executive officer of the Hawaii employers' mutual insurance company. See Hawaii Revised Statutes 431:14A-102
  • Adverse action: means an adverse determination or a final adverse determination. See Hawaii Revised Statutes 432E-1
  • Adverse determination: means a determination by a health carrier or its designated utilization review organization that an admission, availability of care, continued stay, or other health care service that is a covered benefit has been reviewed and, based upon the information provided, does not meet the health carrier's requirements for medical necessity, appropriateness, health care setting, level of care, or effectiveness, and the requested service or payment for the service is therefore denied, reduced, or terminated. See Hawaii Revised Statutes 432E-1
  • Adverse result: includes one or more of the following possible consequences:

         (1)  Danger to the life or physical safety of an individual;

         (2)  A flight from prosecution;

         (3)  The destruction of, potential loss of, or tampering with evidence;

         (4)  The intimidation of potential witnesses; or

         (5)  Jeopardy to an investigation or undue delay of a trial. See Hawaii Revised Statutes 806D-1

  • Advertisement: means any material designed to create public interest in a product, or induce the public to purchase, increase, modify, reinstate, borrow on, surrender, replace, or retain a policy, as more specifically defined in the rules and operating procedures of the commission. See Hawaii Revised Statutes 431:30-102
  • Advice and consent: Under the Constitution, presidential nominations for executive and judicial posts take effect only when confirmed by the Senate, and international treaties become effective only when the Senate approves them by a two-thirds vote.
  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • Affirmed: In the practice of the appellate courts, the decree or order is declared valid and will stand as rendered in the lower court.
  • Affordable Care Act: refers to the Patient Protection and Affordable Care Act (42 U. See Hawaii Revised Statutes 431:26-101
  • Allegation: something that someone says happened.
  • Ambulatory review: means a utilization review of health care services performed or provided in an outpatient setting. See Hawaii Revised Statutes 432E-1
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
  • Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
  • Appeal: means a request from an enrollee to change a previous decision made by the health carrier. See Hawaii Revised Statutes 432E-1
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Appellate: About appeals; an appellate court has the power to review the judgement of another lower court or tribunal.
  • Applicant: means :

         (1)  In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; and

         (2)  In the case of a group long-term care insurance policy, the proposed certificate holder. See Hawaii Revised Statutes 431:10H-104

  • Applicant: means a law enforcement officer, prosecuting attorney or deputy prosecuting attorney, attorney general or deputy attorney general, or defense attorney who is seeking criminal process under § 806D-2. See Hawaii Revised Statutes 806D-1
  • Appointed representative: means a person who is expressly permitted by the enrollee or who has the power under Hawaii law to make health care decisions on behalf of the enrollee, including:

         (1)  A person to whom an enrollee has given express written consent to represent the enrollee in an external review;

         (2)  A person authorized by law to provide substituted consent for an enrollee;

         (3)  A family member of the enrollee or the enrollee's treating health care professional, only when the enrollee is unable to provide consent;

         (4)  A court-appointed legal guardian;

         (5)  A person who has a durable power of attorney for health care; or

         (6)  A person who is designated in a written advance directive;

    provided that an appointed representative shall include an "authorized representative" as used in the federal Patient Protection and Affordable Care Act. See Hawaii Revised Statutes 432E-1

  • Appraisal: A determination of property value.
  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Arraignment: A proceeding in which an individual who is accused of committing a crime is brought into court, told of the charges, and asked to plead guilty or not guilty.
  • Arrest: Taking physical custody of a person by lawful authority.
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • attendance: means a student is physically present in school after enrollment. See Hawaii Revised Statutes 302A-101
  • Attorney general: means the attorney general of the State of Hawaii, the department of the attorney general, or an authorized representative of the attorney general. See Hawaii Revised Statutes 846E-1
  • authority: means the director, or any licensing board or commission under the administrative control of the director pursuant to § 26-9(c), authorized by statute to grant or to deny licenses. See Hawaii Revised Statutes 436B-2
  • Authorized representative: means :

         (1)  A person to whom a covered person has given express written consent to represent the covered person;

         (2)  A person authorized by law to provide substituted consent for a covered person; or 

         (3)  The covered person's treating health care professional only when the covered person or persons authorized pursuant to paragraphs (1) and (2) of this definition are unable to provide consent. See Hawaii Revised Statutes 431:26-101

  • Bail: Security given for the release of a criminal defendant or witness from legal custody (usually in the form of money) to secure his/her appearance on the day and time appointed.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • benefits: means those health care services to which an enrollee is entitled under the terms of a health benefit plan. See Hawaii Revised Statutes 432E-1
  • Bequest: Property gifted by will.
  • Best evidence: means evidence based on:

         (1)  Randomized clinical trials;

         (2)  If randomized clinical trials are not available, cohort studies or case-control studies;

         (3)  If the trials in paragraphs (1) and (2) are not available, case-series; or

         (4)  If the sources of information in paragraphs (1), (2), and (3) are not available, expert opinion. See Hawaii Revised Statutes 432E-1

  • Board: means the board of directors of the Hawaii hurricane relief fund. See Hawaii Revised Statutes 431P-1
  • Board: means the board of directors of the Hawaii employers' mutual insurance company. See Hawaii Revised Statutes 431:14A-102
  • Board: means any board or commission which is created and authorized by statute to issue a professional or vocational license, and is established within or transferred to the department for administrative purposes or subject to the administrative control or supervision of the director. See Hawaii Revised Statutes 436B-2
  • Broker: means a person who, on behalf of an owner and for a fee, commission, or other valuable consideration, offers or attempts to negotiate life settlement contracts between an owner and providers, represents only the owner, and owes a fiduciary duty to the owner to act according to the owner's instructions, and in the best interest of the owner, notwithstanding the manner in which the broker is compensated. See Hawaii Revised Statutes 431C-2
  • Business of life settlements: means an activity involved in but not limited to offering to enter into the soliciting, negotiating, procuring, effectuating, monitoring, or tracking of life settlement contracts. See Hawaii Revised Statutes 431C-2
  • Bylaws: means those bylaws established by the commission for its governance, or for directing or controlling the commission's actions or conduct. See Hawaii Revised Statutes 431:30-102
  • carrier: includes an accident and health or sickness insurer that issues health benefit plans under part I of article 10A of this chapter, a mutual benefit society under article 1 of chapter 432, and a health maintenance organization under chapter 432D. See Hawaii Revised Statutes 431:26-101
  • Case management: means a coordinated set of activities conducted for individual patient management of serious, complicated, protracted, or other health conditions. See Hawaii Revised Statutes 432E-1
  • Case-series: means an evaluation of patients with a particular outcome, without the use of a control group. See Hawaii Revised Statutes 432E-1
  • Certificate: means a certificate issued pursuant to a group policy. See Hawaii Revised Statutes 431C-2
  • Certificate: means , for the purposes of this article, any certificate issued under a group long-term care insurance policy, which policy has been delivered or issued for delivery in this State. See Hawaii Revised Statutes 431:10H-104
  • Certification: means a determination by a health carrier or its designated utilization review organization that an admission, availability of care, continued stay, or other health care service has been reviewed and, based on the information provided, satisfies the health carrier's requirements for medical necessity, appropriateness, health care setting, level of care, and effectiveness. See Hawaii Revised Statutes 432E-1
  • Chief of police: means the county chief of police, the county police department, or an authorized representative of the chief of police. See Hawaii Revised Statutes 846E-1
  • Chronically ill: means :

         (1)  Being unable to perform at least two activities of daily living, such as eating, toileting, transferring, bathing, dressing, or continence;

         (2)  Requiring substantial supervision to protect the individual from threats to health and safety due to severe cognitive impairment; or

         (3)  Having a level of disability similar to that described in paragraph (1) as determined by the United States Secretary of Health and Human Services. See Hawaii Revised Statutes 431C-2

  • Civil forfeiture: The loss of ownership of property used to conduct illegal activity.
  • Clean record: means no conviction for a felony or covered offense, if placed on probation or parole, completion of probation or parole without more than one revocation, and, for sex offenders, successful completion of an appropriate sex offender treatment program, if such program was ordered. See Hawaii Revised Statutes 846E-1
  • Clinical review criteria: means the written screening procedures, decision abstracts, clinical protocols, and practice guidelines used by a health carrier to determine the necessity and appropriateness of health care services. See Hawaii Revised Statutes 432E-1
  • Commission: means the interstate insurance product regulation commission established by this compact. See Hawaii Revised Statutes 431:30-102
  • Commissioner: means the insurance commissioner. See Hawaii Revised Statutes 431C-2
  • Commissioner: means the insurance commissioner as defined in § 431:2-102. See Hawaii Revised Statutes 431P-1
  • Commissioner: means the insurance commissioner. See Hawaii Revised Statutes 431:14G-102
  • Commissioner: means the insurance commissioner. See Hawaii Revised Statutes 432E-1
  • Commissioner: means the insurance commissioner. See Hawaii Revised Statutes 431:22-101
  • Commissioner: means the insurance commissioner of the State. See Hawaii Revised Statutes 431:26-101
  • Commissioner: means the chief insurance regulatory official of a state. See Hawaii Revised Statutes 431:30-102
  • Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
  • Compacting state: means any state that has enacted this compact legislation and that has not withdrawn pursuant to § 431:30-119, or been terminated pursuant to § 431:30-120. See Hawaii Revised Statutes 431:30-102
  • Companion policy: means a policy of property insurance issued by a servicing facility in conjunction with a fund policy of hurricane property insurance that provides, at a minimum, coverage equivalent to a standard fire policy for the peril of fire and windstorm and, after considering all exclusions and endorsements, that provides insurance for wind related losses or damage created by a weather system that has not resulted in the declaration and definition of a hurricane watch or warning. See Hawaii Revised Statutes 431P-1
  • Company: means the Hawaii employers' mutual insurance company established by this article. See Hawaii Revised Statutes 431:14A-102
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Complaint: means an expression of dissatisfaction, either oral or written. See Hawaii Revised Statutes 432E-1
  • Concurrent resolution: A legislative measure, designated "S. Con. Res." and numbered consecutively upon introduction, generally employed to address the sentiments of both chambers, to deal with issues or matters affecting both houses, such as a concurrent budget resolution, or to create a temporary joint committee. Concurrent resolutions are not submitted to the President/Governor and thus do not have the force of law.
  • Concurrent review: means a utilization review conducted during a patient's hospital stay or course of treatment. See Hawaii Revised Statutes 432E-1
  • Continuance: Putting off of a hearing ot trial until a later time.
  • Conviction: A judgement of guilt against a criminal defendant.
  • Conviction: means a judgment on the verdict, or a finding of guilt after a plea of guilty or nolo contendere, excluding the adjudication of a minor, and occurs on the date judgment is entered. See Hawaii Revised Statutes 846E-1
  • Council: means the Hawaii employers' mutual insurance company oversight council. See Hawaii Revised Statutes 431:14A-102
  • county: includes the city and county of Honolulu. See Hawaii Revised Statutes 1-22
  • Covered benefit: means those health care services to which a covered person is entitled under the terms of a health benefit plan. See Hawaii Revised Statutes 431:26-101
  • Covered event: means each hurricane that directly causes windstorm damage in the State. See Hawaii Revised Statutes 431P-1
  • Covered offender: means a "sex offender" or an "offender against minors" as defined in this section. See Hawaii Revised Statutes 846E-1
  • Covered offense: means a criminal offense that is:

         (1)  A crime within the definition of "crimes against minors" in this section; or

         (2)  A crime within the definition of "sexual offense" in this section. See Hawaii Revised Statutes 846E-1

  • Covered person: means a policyholder, subscriber, enrollee, or other individual participating in a health benefit plan, offered or administered by a person or entity, including but not limited to an insurer governed by this chapter, a mutual benefit society governed by article 1 of chapter 432, and as a health maintenance organization governed by chapter 432D. See Hawaii Revised Statutes 431:26-101
  • Criminal process: means a search warrant or legal process issued pursuant to chapters 28, 621, 622, and 803; the Hawaii rules of penal procedure; and any other legal process signed by a judge or clerk of the district or circuit court and issued in a criminal matter that allows the search for or commands production of records that are in the actual or constructive possession of the recipient, regardless of whether the recipient or the records are physically located within the State. See Hawaii Revised Statutes 806D-1
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
  • Department: means the department of commerce and consumer affairs. See Hawaii Revised Statutes 431P-1
  • Department: means the department of education. See Hawaii Revised Statutes 302A-101
  • Department: means the department of commerce and consumer affairs. See Hawaii Revised Statutes 436B-2
  • Dependent: A person dependent for support upon another.
  • Devise: To gift property by will.
  • Director: means the director of finance. See Hawaii Revised Statutes 431P-1
  • Director: means the director of commerce and consumer affairs. See Hawaii Revised Statutes 436B-2
  • Discharge planning: means the formal process for determining, prior to discharge from a facility, the coordination and management of the care that an enrollee receives following discharge from a facility. See Hawaii Revised Statutes 432E-1
  • Disclose: means to release, transfer, or otherwise divulge protected health information to any person other than the individual who is the subject of the protected health information. See Hawaii Revised Statutes 432E-1
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Dismissal: The dropping of a case by the judge without further consideration or hearing. Source:
  • Domestic insurance holding company system: means an insurance holding company system that consists of an ultimate controlling person formed in this State prior to January 1, 2000, and its insurer affiliates, all of which are domestic insurers authorized to transact insurance business only in this State. See Hawaii Revised Statutes 431:11-102
  • Eligible property: means :

         (1)  Real property of one to four units used for residential purposes and which is in insurable condition, and which may include tangible personal property located therein or thereon and other structures at the insured location, as provided in the plan of operation or any manual of rules and rates adopted under the plan of operation;

         (2)  Real property used for business, commercial, or industrial purposes which is in insurable condition, and which may include tangible personal property located therein or thereon, as provided in the plan of operation or any manual of rules and rates adopted under the plan of operation;

         (3)  Tangible personal property owned by an occupant of and located in or on real property of the types described in paragraph (1), as provided in the plan of operation or any manual of rules and rates adopted under the plan of operation; provided that the owner of the tangible personal property does not own the real property in or on which the tangible personal property is located; and

         (4)  Tangible personal property owned by an occupant of and located in or on real property of the types described in paragraph (2) as provided in the plan of operation or any manual of rules and rates adopted under the plan of operation; provided that the owner of the tangible personal property does not own the real property in or on which the tangible personal property is located. See Hawaii Revised Statutes 431P-1

  • Embezzlement: In most states, embezzlement is defined as theft/larceny of assets (money or property) by a person in a position of trust or responsibility over those assets. Embezzlement typically occurs in the employment and corporate settings. Source: OCC
  • Emergency services: means services provided to an enrollee when the enrollee has symptoms of sufficient severity, including severe pain, such that a layperson could reasonably expect, in the absence of medical treatment, to result in placing the enrollee's health or condition in serious jeopardy, serious impairment of bodily functions, serious dysfunction of any bodily organ or part, or death. See Hawaii Revised Statutes 432E-1
  • Employees: includes compensated officers, managers, and employees of a firm, corporation, partnership, sole proprietor, trust, estate, or members of an unincorporated association or nonprofit organization. See Hawaii Revised Statutes 431:12-101
  • Employer: includes any firm, corporation, partnership, sole proprietorship, trust, estate, and unincorporated association or nonprofit organization; it also includes the State, any county, any municipal corporation, and any governmental unit, agency, or department thereof. See Hawaii Revised Statutes 431:12-101
  • Enrollee: means a person who enters into a contractual relationship under or who is provided with health care services or benefits through a health benefit plan. See Hawaii Revised Statutes 432E-1
  • Enterprise: includes any sole proprietorship, partnership, corporation, association, and any union or group of individuals associated for a particular purpose although not a legal entity. See Hawaii Revised Statutes 842-1
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Escheat: Reversion of real or personal property to the state when 1) a person dies without leaving a will and has no heirs, or 2) when the property (such as a bank account) has been inactive for a certain period of time. Source: OCC
  • Escrow: Money given to a third party to be held for payment until certain conditions are met.
  • Ex officio: Literally, by virtue of one's office.
  • Executive officer: means chief executive officer, chief operating officer, chief financial officer, treasurer, secretary, controller, or any other individual performing functions corresponding to those performed by the foregoing officers under whatever title. See Hawaii Revised Statutes 431:11-102
  • Expert opinion: means a belief or interpretation by specialists with experience in a specific area about the scientific evidence pertaining to a particular service, intervention, or therapy. See Hawaii Revised Statutes 432E-1
  • External review: means a review of an adverse determination (including a final adverse determination) conducted by an independent review organization pursuant to this chapter. See Hawaii Revised Statutes 432E-1
  • Extradition: The formal process of delivering an accused or convicted person from authorities in one state to authorities in another state.
  • Facility: means an institution providing health care services or a health care setting, including but not limited to, hospitals and other licensed inpatient centers, ambulatory surgical or treatment centers, skilled nursing centers, residential treatment centers, diagnostic, laboratory and imaging centers, and rehabilitation and other therapeutic health settings. See Hawaii Revised Statutes 432E-1
  • Facility: means an institution providing health care services or a health care setting, including hospitals and other licensed inpatient centers, ambulatory surgical or treatment centers, skilled nursing centers, residential treatment centers, urgent care centers, diagnostic facilities, laboratories, and imaging centers, and rehabilitation and other therapeutic health settings licensed or certified by the department of health under chapter 321. See Hawaii Revised Statutes 431:26-101
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • federally tax-qualified long-term care insurance contract: means an individual or group insurance contract that meets the requirements of § 7702B(b) of the Internal Revenue Code of 1986, as amended, as follows:

         (1)  The only insurance protection provided under the contract is coverage of qualified long-term care services. See Hawaii Revised Statutes 431:10H-104

  • Final adverse determination: means an adverse determination involving a covered benefit that has been upheld by a health carrier or its designated utilization review organization at the completion of the health carrier's internal grievance process procedures, or an adverse determination with respect to which the internal appeals process is deemed to have been exhausted under § 432E-33(b). See Hawaii Revised Statutes 432E-1
  • Financing entity: means an underwriter, placement agent, lender, purchaser of securities, purchaser of a policy or certificate from a provider, credit enhancer, or any entity that has a direct ownership in a policy or certificate that is the subject of a life settlement contract, but:

         (1)  Whose principal activity related to the transaction is providing funds to effect the life settlement contract or purchase of one or more policies; and

         (2)  Who has an agreement in writing with one or more providers to finance the acquisition of life settlement contracts. See Hawaii Revised Statutes 431C-2

  • Financing transaction: means a transaction in which a licensed provider obtains financing from a financing entity including, without limitation, any secured or unsecured financing, any securitization transaction, or any securities offering that is either registered or exempt from registration under federal and state securities law. See Hawaii Revised Statutes 431C-2
  • Fixed Rate: Having a "fixed" rate means that the APR doesn't change based on fluctuations of some external rate (such as the "Prime Rate"). In other words, a fixed rate is a rate that is not a variable rate. A fixed APR can change over time, in several circumstances:
    • You are late making a payment or commit some other default, triggering an increase to a penalty rate
    • The bank changes the terms of your account and you do not reject the change.
    • The rate expires (if the rate was fixed for only a certain period of time).
  • Foreclosure: A legal process in which property that is collateral or security for a loan may be sold to help repay the loan when the loan is in default. Source: OCC
  • Foreign conviction: means a conviction under the laws of:

         (1)  Canada, United Kingdom, Australia, or New Zealand; or

         (2)  Any other foreign country, if the United States Department of State, in its Country Reports on Human Rights Practices, has concluded that an independent judiciary vigorously enforced the right to a fair trial in that country during the year in which the conviction occurred and enforces the right to a fair trial to the same or higher standard as the countries listed in paragraph (1). See Hawaii Revised Statutes 846E-1

  • forfeiture: means the immediate and automatic termination or cancellation without any prior consultation with the licensee of a license issued by a board, caused by a licensee's voluntary or involuntary failure to comply with the requirements for maintaining or renewing a license. See Hawaii Revised Statutes 436B-2
  • Fraud: Intentional deception resulting in injury to another.
  • Fund: means the Hawaii hurricane relief fund established by this chapter. See Hawaii Revised Statutes 431P-1
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • Grand jury: agreement providing that a lender will delay exercising its rights (in the case of a mortgage,
  • Group long-term care insurance: means a long-term care insurance policy which is delivered or issued for delivery in this State and issued to:

         (1)  One or more employers or labor organizations, or a trust or to the trustees of a fund established by one or more employers or labor organizations, or a combination thereof, for employees or former employees or a combination thereof or for members or former members or a combination thereof, of the labor organizations; or

         (2)  Any professional, trade, or occupational association for its members or former or retired members, or combination thereof, if the association:

              (A)  Is composed of individuals all of whom are or were actively engaged in the same profession, trade, or occupation; and

              (B)  Has been maintained in good faith for purposes other than obtaining insurance; or

         (3)  An association or a trust or the trustees of a fund established, created, or maintained for the benefit of members of one or more associations. See Hawaii Revised Statutes 431:10H-104

  • Group-wide supervisor: means the regulatory official authorized to engage in conducting and coordinating group-wide supervision activities who is determined or acknowledged by the commissioner under § 431:11-107. See Hawaii Revised Statutes 431:11-102
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Habeas corpus: A writ that is usually used to bring a prisoner before the court to determine the legality of his imprisonment. It may also be used to bring a person in custody before the court to give testimony, or to be prosecuted.
  • Health benefit plan: means a policy, contract, certificate or agreement offered or issued by a health carrier to provide, deliver, arrange for, pay or reimburse any of the costs of health care services. See Hawaii Revised Statutes 432E-1
  • Health benefit plan: means a policy, contract, certificate, or agreement entered into, offered by, or issued by a health carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services pursuant to chapter 87A, 431, 432, or 432D. See Hawaii Revised Statutes 431:26-101
  • Health care professional: means an individual licensed, accredited, or certified to provide or perform specified health care services in the ordinary course of business or practice of a profession consistent with state law. See Hawaii Revised Statutes 432E-1
  • Health care professional: means a physician or other health care practitioner licensed, accredited, or certified to perform specified health care services consistent with the practitioner's scope of practice under state law. See Hawaii Revised Statutes 431:26-101
  • Health care services: means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Hawaii Revised Statutes 432E-1
  • Health care services: means services for the diagnosis, prevention, treatment, cure, or relief of a physical, mental, or behavioral health condition, illness, injury, or disease, including mental health and substance use disorders. See Hawaii Revised Statutes 431:26-101
  • Health carrier: means an entity subject to the insurance laws and rules of this State, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including a sickness and accident insurance company, a health maintenance organization, a mutual benefit society, a nonprofit hospital and health service corporation, or any other entity providing a plan of health insurance, health benefits or health care services. See Hawaii Revised Statutes 432E-1
  • Health maintenance organization: means a health maintenance organization as defined in § 432D-1. See Hawaii Revised Statutes 432E-1
  • Hearsay: Statements by a witness who did not see or hear the incident in question but heard about it from someone else. Hearsay is usually not admissible as evidence in court.
  • Hurricane: means a storm that has been declared and defined by the Central Pacific Hurricane Center of the National Weather Service to be a hurricane. See Hawaii Revised Statutes 431P-1
  • Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. Source: FDIC
  • Independent review organization: means an independent entity that conducts independent external reviews of adverse determinations and final adverse determinations. See Hawaii Revised Statutes 432E-1
  • Indictment: The formal charge issued by a grand jury stating that there is enough evidence that the defendant committed the crime to justify having a trial; it is used primarily for felonies.
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Injury: means accidental harm not resulting in death. See Hawaii Revised Statutes 431:10G-101
  • Insurance holding company system: consists of two or more affiliated persons, one or more of which is an insurer. See Hawaii Revised Statutes 431:11-102
  • Insured: means the person covered under the policy being considered for sale in a life settlement contract. See Hawaii Revised Statutes 431C-2
  • Insurer: means an insurer authorized to transact the business of motor vehicle, property, and casualty insurance in the State. See Hawaii Revised Statutes 431:12-101
  • Insurer: means any entity licensed by a state to issue contracts of insurance for those lines of insurance covered by this article. See Hawaii Revised Statutes 431:30-102
  • Intermediary: means a person authorized to negotiate and execute provider contracts with health carriers on behalf of health care providers or on behalf of a network, if applicable. See Hawaii Revised Statutes 431:26-101
  • Internal review: means the review under § 432E-5 of an enrollee's complaint by a health carrier. See Hawaii Revised Statutes 432E-1
  • Internationally active insurance group: means an insurance holding company system that:

         (1)  Includes Hawaii Revised Statutes 431:14A-102

  • Juror: A person who is on the jury.
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
  • License: means the permission to engage in a profession or vocation granted by the applicable licensing authority to a person who has satisfied every requirement for licensure, and shall include any registration, certificate, or other document issued by the licensing authority reflecting proof of permission. See Hawaii Revised Statutes 436B-2
  • Licensed property and casualty insurer: means :

         (1)  Any insurer licensed to transact any one or more classes of insurance authorized in § 431:3-204 where premiums written within such authority are required to be reported in the "Exhibit of Premiums and Losses" for this State in the National Association of Insurance Commissioners fire and casualty annual statement convention blank that is required to be filed with the commissioner under § 431:3-302; and

         (2)  The Hawaii Property Insurance Association created in article 21 of chapter 431. See Hawaii Revised Statutes 431P-1

  • Licensee: means the person in whose name the licensing authority grants a license. See Hawaii Revised Statutes 436B-2
  • Licensing laws: means the applicable chapter providing for the regulation, licensing, and practice of a profession or vocation by the licensing authority. See Hawaii Revised Statutes 436B-2
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Life expectancy: means the arithmetic mean of the number of months the insured under the policy to be settled can be expected to live as determined by a life expectancy company considering medical records and appropriate experiential data. See Hawaii Revised Statutes 431C-2
  • Life insurance producer: means any person licensed in this State as a resident or nonresident insurance producer who has received qualification for life insurance pursuant to article 9A of chapter 431. See Hawaii Revised Statutes 431C-2
  • Life settlement contract: means :

      (a)(1)  A written agreement entered into between a provider and an owner, establishing the terms under which compensation or any thing of value will be paid, which compensation or thing of value is less than the expected death benefit of the owner's policy or certificate, in return for the owner's assignment, transfer, sale, devise, or bequest of the death benefit or any portion of the policy or certificate for compensation, where the minimum value of the contract is greater than a cash surrender value or accelerated death benefit available under the policy or certificate at the time of an application for a life settlement contract;

         (2)  The transfer for compensation or value of ownership or beneficial interest in a trust or other entity that owns such policy or certificate if the trust or other entity was formed or availed of for the principal purpose of acquiring one or more life insurance contracts, which life insurance contract insures the life of a person residing in this State; or

         (3)  (A)  A written agreement for a loan or other lending transaction, secured primarily by an individual or group policy; or

              (B)  A premium finance loan made for a policy on or before the date of issuance of the policy where:

                   (i)  The loan proceeds are not used solely to pay premiums for the policy and any costs or expenses incurred by the lender or the borrower in connection with the financing;

                  (ii)  The owner receives on the date of the premium finance loan a guarantee of the future life settlement value of the policy; or

                 (iii)  The owner agrees on the date of the premium finance loan to sell the policy or any portion of its death benefit on any date following the issuance of the policy. See Hawaii Revised Statutes 431C-2

  • Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
  • Long-term care insurance: means any insurance policy or rider advertised, marketed, offered, or designed to provide coverage for not less than twelve consecutive months for each covered person on an expense incurred, indemnity, prepaid, or other basis, for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services, provided in a setting other than an acute care unit of a hospital. See Hawaii Revised Statutes 431:10H-104
  • Loss mitigation: means actions undertaken to reduce losses that may result from a hazard. See Hawaii Revised Statutes 431:22-101
  • Managed care plan: means any plan, policy, contract, certificate, or agreement, regardless of form, offered or administered by any person or entity, including but not limited to an insurer governed by chapter 431, a mutual benefit society governed by chapter 432, a health maintenance organization governed by chapter 432D, a preferred provider organization, a point of service organization, a health insurance issuer, a fiscal intermediary, a payor, a prepaid health care plan, and any other mixed model, that provides for the financing or delivery of health care services or benefits to enrollees through:

         (1)  Arrangements with selected providers or provider networks to furnish health care services or benefits; and

         (2)  Financial incentives for enrollees to use participating providers and procedures provided by a plan;

    provided that for the purposes of this chapter, an employee benefit plan shall not be deemed a managed care plan with respect to any provision of this chapter or to any requirement or rule imposed or permitted by this chapter that is superseded or preempted by federal law. See Hawaii Revised Statutes 432E-1

  • mandatory deductible: means the amount of loss assumed by the policyholder that is not included in the coverages provided by the fund. See Hawaii Revised Statutes 431P-1
  • Mass merchandise: means to sell and "mass merchandising" means a sale of insurance wherein:

         (1)  The insurance is offered to employees of particular employers, and

         (2)  The employer has agreed to, or otherwise affiliated itself with, the sale of such insurance to its employees. See Hawaii Revised Statutes 431:12-101

  • Mass merchandising agreement: means an agreement between an insurer and an employer for the sale of insurance to the employees of the employer on a mass merchandising basis. See Hawaii Revised Statutes 431:12-101
  • Medical director: means the person who is authorized under a health carrier and who makes decisions for the health carrier denying or allowing payment for medical treatments, services, or supplies based on medical necessity or other appropriate medical or health plan benefit standards. See Hawaii Revised Statutes 432E-1
  • Medical necessity: means a health intervention that meets the criteria enumerated in § 432E-1. See Hawaii Revised Statutes 432E-1
  • Medical or scientific evidence: means evidence found in the following sources:

         (1)  Peer-reviewed scientific studies published in or accepted for publication by medical journals that meet nationally-recognized requirements for scientific manuscripts and that submit most of their published articles for review by experts, who are not part of the editorial staff;

         (2)  Peer-reviewed medical literature, including literature relating to therapies reviewed and approved by a qualified institutional review board, biomedical compendia, and other medical literature that meet the criteria of the National Institutes of Health's National Library of Medicine for indexing in Index Medicus and Elsevier Science Ltd. See Hawaii Revised Statutes 432E-1

  • Member: means the commissioner of a compacting state, as its representative to the commission, or the commissioner's designee. See Hawaii Revised Statutes 431:30-102
  • month: means a calendar month; and the word "year" a calendar year. See Hawaii Revised Statutes 1-20
  • Mortgage: means every transfer of an interest in real property, except fixtures, made as security for the performance of another act or subject to defeasance upon the payment of an obligation, whether the transfer is made in trust or otherwise. See Hawaii Revised Statutes 431P-1
  • Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
  • Mortgagee: The person to whom property is mortgaged and who has loaned the money.
  • Mortgagor: The person who pledges property to a creditor as collateral for a loan and who receives the money.
  • Motor scooter: has the meaning prescribed by § 286-2. See Hawaii Revised Statutes 431:10G-101
  • Motor vehicle: means a vehicle of a type required to be registered under chapter 286, including a vehicle with less than four wheels or a trailer. See Hawaii Revised Statutes 431:12-101
  • Motorcycle: has the meaning prescribed by § 286-2. See Hawaii Revised Statutes 431:10G-101
  • Network: means the group or groups of participating providers providing services under a network plan. See Hawaii Revised Statutes 431:26-101
  • Network plan: means a health benefit plan that either requires a covered person to use, or creates incentives, including financial incentives, for a covered person to use, health care providers managed, owned, under contract with, or employed by the health carrier. See Hawaii Revised Statutes 431:26-101
  • Nolo contendere: No contest-has the same effect as a plea of guilty, as far as the criminal sentence is concerned, but may not be considered as an admission of guilt for any other purpose.
  • oath: includes a solemn affirmation. See Hawaii Revised Statutes 1-21
  • Oath: A promise to tell the truth.
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Offender against minors: means a person who is not a "sex offender" as defined in this section, and is or has been:

         (1)  Convicted at any time, whether before or after May 9, 2005, of a "crime against minors" as defined in this section; or

         (2)  Charged at any time, whether before or after May 9, 2005, with a "crime against minors" as defined in this section and who is found unfit to proceed and is released into the community or who is acquitted due to a physical or mental disease, disorder, or defect pursuant to chapter 704 and is released into the community. See Hawaii Revised Statutes 846E-1

  • Operating procedures: means procedures adopted by the commission implementing a rule, uniform standard, or a provision of this compact. See Hawaii Revised Statutes 431:30-102
  • Organized crime: means any combination or conspiracy to engage in criminal activity as a significant source of income or livelihood, or to violate, aid, or abet the violation of criminal laws relating to prostitution, gambling, loan sharking, drug abuse, illegal drug distribution, counterfeiting, extortion, labor trafficking, unlicensed sale of liquor, or corruption of law enforcement officers or other public officers or employers. See Hawaii Revised Statutes 842-1
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Owner: means the owner of a policy or a certificate holder under a group policy, with or without a terminal illness, who enters or seeks to enter into a life settlement contract, but shall not be limited to an owner of a policy or a certificate holder under a group policy that insures the life of an individual with a terminal or chronic illness or condition, except where specifically addressed. See Hawaii Revised Statutes 431C-2
  • Owner: means a person who holds the legal title to a motorcycle or motor scooter; except that when a motorcycle or motor scooter is the subject of a security agreement or lease with a term of not less than one year, with the debtor or lessee having the right of possession, the term owner shall mean the debtor or lessee. See Hawaii Revised Statutes 431:10G-101
  • Parent: means a parent, legal guardian, or a person who has a substantial familial or hanai relationship with the minor. See Hawaii Revised Statutes 846E-1
  • Participating provider: means a licensed or certified provider of health care services or benefits, including mental health services and health care supplies, who has entered into an agreement with a health carrier to provide those services or supplies to enrollees. See Hawaii Revised Statutes 432E-1
  • Participating provider: means a provider who, under a contract with the health carrier or with the health carrier's contractor or subcontractor, has agreed to provide health care services to covered persons with an expectation of receiving payment, other than coinsurance, copayments, or deductibles, directly or indirectly from the health carrier. See Hawaii Revised Statutes 431:26-101
  • Permanent residence: means a building, permanent structure or unit therein, or watercraft where the covered offender resides and intends to reside indefinitely, or at least for the next one hundred eighty days, and which the offender owns, rents, or occupies with the consent of the owner. See Hawaii Revised Statutes 846E-1
  • Person: means any natural person or legal entity, including but not limited to a partnership, limited liability company, association, trust, or corporation. See Hawaii Revised Statutes 431C-2
  • Person: means an individual, a corporation, a limited liability company, a partnership, an association, a joint stock company, a trust, an unincorporated organization, and any similar entity or any combination of the foregoing acting in concert, but shall not include any joint venture partnership exclusively engaged in owning, managing, leasing, or developing real or tangible personal property, or a securities broker performing only the usual and customary broker's function. See Hawaii Revised Statutes 431:11-102
  • Person: means , when appropriate to the context, not only individuals, but corporations, firms, associations, and societies. See Hawaii Revised Statutes 431:10G-101
  • Person: includes any individual or entity capable of holding a legal or beneficial interest in property and includes nonresident aliens. See Hawaii Revised Statutes 842-1
  • Person: means an individual, a corporation, a partnership, an association, a joint venture, a joint stock company, a trust, an unincorporated organization, any similar entity, or any combination of the foregoing. See Hawaii Revised Statutes 431:26-101
  • Person: includes an individual, partnership, joint venture, corporation, association, business, trust, or any organized group of persons or legal entity, or any combination thereof. See Hawaii Revised Statutes 436B-2
  • Plaintiff: The person who files the complaint in a civil lawsuit.
  • plan: means a program, design, or scheme of the insurance to be mass merchandised, including terms, coverages, and premiums. See Hawaii Revised Statutes 431:12-101
  • plan: means a health plan as defined in § 431:10A, or chapter 432 or 432D, regardless of form, offered or administered by a health care insurer, including but not limited to a mutual benefit society or health maintenance organization, or voluntary employee beneficiary associations, but shall not include disability insurers licensed under chapter 431. See Hawaii Revised Statutes 431:14G-102
  • Plan of operation: means the plan for providing hurricane property insurance as adopted by the board of directors of the Hawaii hurricane relief fund, and any amendments thereto, under § 431P-7. See Hawaii Revised Statutes 431P-1
  • Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
  • Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
  • Policy: means an individual or group policy, certificate, contract, or arrangement of life insurance owned by a resident of this State, regardless of whether delivered or issued for delivery in this State. See Hawaii Revised Statutes 431C-2
  • Policy: means , for the purposes of this article, any policy, contract, subscriber agreement, rider, or endorsement delivered or issued for delivery in this State by an insurer; fraternal benefit society; nonprofit health, hospital, or medical service corporation; prepaid health plan; health maintenance organization; or any similar organization. See Hawaii Revised Statutes 431:10H-104
  • Policy of hurricane property insurance: means a policy or endorsement of insurance issued by the fund insuring only against damage or loss to eligible property caused by a covered event in excess of the deductible and up to:

         (1)  $750,000 per risk on real property of one to four units used for residential purposes and the personal property located therein or thereon and other structures at the insured location, subject to the limits defined by the plan of operation or any manual of rules and rates adopted under the plan of operation; and

         (2)  $500,000 per risk on real and personal property used for business, commercial, or industrial purposes, subject to the limits defined by the plan of operation or any manual of rules and rates adopted under the plan of operation; provided that the board may designate an association of property owners or cooperative housing corporation to be a commercial risk;

    provided that this policy or endorsement shall not include coverage for business interruption and other similar coverages. See Hawaii Revised Statutes 431P-1

  • Policy of property insurance: means a policy providing "property insurance" as defined in § 431:1-206. See Hawaii Revised Statutes 431P-1
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Premium finance loan: means a loan made primarily for the purposes of making premium payments on a policy, which loan is secured by an interest in such policy. See Hawaii Revised Statutes 431C-2
  • Presentence report: A report prepared by a court's probation officer, after a person has been convicted of an offense, summarizing for the court the background information needed to determine the appropriate sentence. Source: U.S. Courts
  • Primary care: means health care services for a range of common conditions provided by a physician or nonphysician primary care professional. See Hawaii Revised Statutes 431:26-101
  • Primary care professional: means a participating health care professional designated by the health carrier to supervise, coordinate, or provide initial care or continuing care to a covered person, and who may be required by the health carrier to initiate a referral for specialty care and maintain supervision of health care services rendered to the covered person. See Hawaii Revised Statutes 431:26-101
  • Probable cause: A reasonable ground for belief that the offender violated a specific law.
  • Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
  • Probation officers: Screen applicants for pretrial release and monitor convicted offenders released under court supervision.
  • Product: means the form of a policy or contract, including any application, endorsement, or related form that is attached to and made a part of the policy or contract, and any evidence of coverage or certificate, for an individual or group annuity, life insurance, disability income, or long-term care insurance product that an insurer is authorized to issue. See Hawaii Revised Statutes 431:30-102
  • Program: means any regulatory program in which the director is authorized by law to grant or to deny a license to a person seeking permission to engage in a profession or vocation. See Hawaii Revised Statutes 436B-2
  • Properly served: means delivery by hand or in a manner reasonably allowing for proof of delivery if delivered by United States mail, overnight delivery service, or facsimile to the recipient addressee of criminal process. See Hawaii Revised Statutes 806D-1
  • Property insurance: means policies, riders, or endorsements of insurance that provide indemnity, in whole or in part, for the loss, destruction, or damage of eligible property. See Hawaii Revised Statutes 431P-1
  • Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
  • Prospective review: means utilization review conducted prior to an admission or a course of treatment. See Hawaii Revised Statutes 432E-1
  • Protected health information: means health information as defined in the federal Health Insurance Portability and Accountability Act and related federal rules. See Hawaii Revised Statutes 432E-1
  • Provider: means a person, other than an owner, who enters into or effectuates a life settlement contract with an owner. See Hawaii Revised Statutes 431C-2
  • provider: means a health care professional. See Hawaii Revised Statutes 432E-1
  • provider: means a health care professional, pharmacy, or facility. See Hawaii Revised Statutes 431:26-101
  • Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
  • Purchaser: means a person who pays compensation or anything of value as consideration for a beneficial interest in a trust that is vested with, or for the assignment, transfer, or sale of, an ownership or other interest in a policy or a certificate that has been the subject of a life settlement contract. See Hawaii Revised Statutes 431C-2
  • Qualified actuary: means a member of the American Academy of Actuaries who is either a fellow of the Casualty Actuarial Society or an Associate of the Casualty Actuarial Society who has five or more years of experience. See Hawaii Revised Statutes 431:14A-102
  • Quorum: The number of legislators that must be present to do business.
  • Racketeering activity: means any act or threat involving but not limited to murder, kidnapping, gambling, criminal property damage, robbery, bribery, extortion, labor trafficking, unlicensed sale of liquor, theft, or prostitution, or any dealing in narcotic or other dangerous drugs that is chargeable as a crime under state law and punishable by imprisonment for more than one year. See Hawaii Revised Statutes 842-1
  • Rate: means every rate, charge, classification, schedule, practice, or rule. See Hawaii Revised Statutes 431:14G-102
  • Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
  • Recipient: means a person, as defined in § 701-118, or a business, as defined in § 487J-1, that has conducted business or engaged in transactions or activities occurring at least in part in the state from which process was issued upon whom process is properly served. See Hawaii Revised Statutes 806D-1
  • Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. Source: FDIC
  • Registration information: means the information specified in § 846E-2(d) and (e). See Hawaii Revised Statutes 846E-1
  • Related provider trust: means a titling trust or other trust established by a licensed provider or a financing entity for the sole purpose of holding the ownership or beneficial interest in purchased policies in connection with a financing transaction, that includes a written agreement with the licensed provider under which the licensed provider is responsible for ensuring compliance with all statutory and regulatory requirements and under which the trust agrees to make all records and files relating to life settlement transactions available to the insurance division as if those records and files were maintained directly by the licensed provider. See Hawaii Revised Statutes 431C-2
  • Release: means release from:

         (1)  Imprisonment;

         (2)  Imprisonment and placed on parole;

         (3)  Imprisonment and placed on furlough;

         (4)  Any form of commitment, custody, or confinement resulting from an order made pursuant to chapter 704; or

         (5)  A halfway house or other equivalent facility,

    whichever is later. See Hawaii Revised Statutes 846E-1

  • Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
  • renewal: means the permission to engage in a profession or vocation granted by the applicable licensing authority to a licensee who has applied for an extension of a current and valid license. See Hawaii Revised Statutes 436B-2
  • Repeat covered offender: means :

         (1)  A person who is or has been convicted at any time, whether before or after May 9, 2005, of more than one covered offense as defined in this section, except that a conviction for multiple counts within a single charging document that allege covered offenses against the same victim and that allege the same date of the covered offense against that single victim shall be considered, for the purposes of this definition, a single covered offense; or

         (2)  A person who is or has been charged at any time, whether before or after May 9, 2005, with more than one covered offense as defined in this section and who has been, more than once, either:

              (A)  Convicted;

              (B)  Found unfit to proceed pursuant to chapter 704; or

              (C)  Acquitted due to a physical or mental disease, disorder, or defect pursuant to chapter 704. See Hawaii Revised Statutes 846E-1

  • Rescission: The cancellation of budget authority previously provided by Congress. The Impoundment Control Act of 1974 specifies that the President may propose to Congress that funds be rescinded. If both Houses have not approved a rescission proposal (by passing legislation) within 45 days of continuous session, any funds being withheld must be made available for obligation.
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • restoration: means the permission to engage in a profession or vocation granted by the applicable licensing authority to a person whose license has been previously forfeited by the licensing authority. See Hawaii Revised Statutes 436B-2
  • Retrospective review: means a review of medical necessity conducted after services that have been provided to a patient, but does not include the review of a claim that is limited to an evaluation of reimbursement levels, veracity of documentation, accuracy of coding, or adjudication for payment. See Hawaii Revised Statutes 432E-1
  • Reviewer: means an independent reviewer with clinical expertise either employed by or contracted by an independent review organization to perform external reviews. See Hawaii Revised Statutes 432E-1
  • Right of rescission: Right to cancel, within three business days, a contract that uses the home of a person as collateral, except in the case of a first mortgage loan. There is no fee to the borrower, who receives a full refund of all fees paid. The right of rescission is guaranteed by the Truth in Lending Act (TILA). Source: OCC
  • Rule: means a statement of general or particular applicability and future effect adopted by the commission, including a uniform standard developed pursuant to § 431:30-112 of this compact, designed to implement, interpret, or prescribe law or policy or describing the organization, procedure, or practice requirements of the commission, which shall have the force and effect of law in the compacting states. See Hawaii Revised Statutes 431:30-102
  • Second opinion: means an opportunity or requirement to obtain a clinical evaluation by a provider other than the one originally making a recommendation for a proposed health care service to assess the clinical necessity and appropriateness of the initial proposed health care service. See Hawaii Revised Statutes 432E-1
  • Sequester: To separate. Sometimes juries are sequestered from outside influences during their deliberations.
  • Serious acute condition: means a disease or condition for which the covered person is currently requiring complex ongoing care, such as chemotherapy, post-operative visits, or radiation therapy. See Hawaii Revised Statutes 431:26-101
  • Service of process: The service of writs or summonses to the appropriate party.
  • Servicing facility: means any insurer engaged in writing direct property insurance in this State and licensed in this State, and any other party authorized to act in like capacity on behalf of the fund. See Hawaii Revised Statutes 431P-1
  • Settled policy: means a policy or certificate that has been acquired by a provider pursuant to a life settlement contract. See Hawaii Revised Statutes 431C-2
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Sex offender: means :

         (1)  A person who is or has been convicted at any time, whether before or after May 9, 2005, of a "sexual offense"; or

         (2)  A person who is or has been charged at any time, whether before or after May 9, 2005, with a "sexual offense" and is or has been found unfit to proceed and is or has been released into the community or who is acquitted due to a physical or mental disease, disorder, or defect pursuant to chapter 704 and is released into the community. See Hawaii Revised Statutes 846E-1

  • Sexual offense: means an offense that is:

         (1)  Set forth in § 707-730(1), 707-731(1), 707-732(1), 707-733(1)(a), 707-733. See Hawaii Revised Statutes 846E-1

  • Special purpose entity: means a corporation, partnership, trust, limited liability company, or other legal entity formed solely to provide either directly or indirectly access to institutional capital markets for a financing entity or provider in connection with a transaction in which the securities in the special purpose entity:

         (1)  Are acquired by the owner or by a "qualified institutional buyer" as defined in Rule 144A of the Securities Act of 1933, as amended; or

         (2)  Pay a fixed rate of return commensurate with established asset-backed institutional capital markets. See Hawaii Revised Statutes 431C-2

  • Specialist: includes a subspecialist who has additional training and recognition above and beyond the subspecialist's specialty training. See Hawaii Revised Statutes 431:26-101
  • Specialty care: means advanced medically necessary care and treatment of specific health conditions or health conditions that may manifest themselves in particular ages or subpopulations that are provided by a specialist, preferably in coordination with a primary care professional or other health care professional. See Hawaii Revised Statutes 431:26-101
  • Specifically excluded: means that the coverage provisions of the health care plan, when read together, clearly and specifically exclude coverage for a health care service. See Hawaii Revised Statutes 432E-1
  • State: includes any state, territory, or possession, of the United States, the Commonwealth of Puerto Rico, and the District of Columbia. See Hawaii Revised Statutes 836-1
  • State: means any state, district, or territory of the United States of America. See Hawaii Revised Statutes 431:30-102
  • Statement: means information required to be filed with the commissioner pursuant to §§ 431:11-104, 431:11-105, and 431:11-106, and guidelines set forth on a form or in a format approved by the commissioner. See Hawaii Revised Statutes 431:11-102
  • Statute: A law passed by a legislature.
  • Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
  • Stranger-originated life insurance: means a practice or plan to initiate a policy for the benefit of a third party investor who, at the time of policy origination, has no insurable interest in the insured, and includes:

         (1)  Arrangements in which life insurance is purchased with resources or guarantees from or through a person or entity who at the time of policy inception, could not lawfully initiate the policy by oneself or itself, and where, at the time of inception, there is an arrangement or agreement, whether verbal or written, to directly or indirectly transfer the ownership of the policy, the policy benefits, or both, to a third party; and

         (2)  Trusts created to give the appearance of insurable interest and used to initiate policies for investors. See Hawaii Revised Statutes 431C-2

  • Subpoena: A command to a witness to appear and give testimony.
  • Subpoena duces tecum: A command to a witness to produce documents.
  • Summons: includes a subpoena ad testificandum and subpoena duces tecum, order, or other notice requiring the appearance of a witness. See Hawaii Revised Statutes 836-1
  • Summons: Another word for subpoena used by the criminal justice system.
  • Telehealth: means health care services provided through telecommunications technology by a health care professional who is at a location other than where the covered person is located. See Hawaii Revised Statutes 431:26-101
  • Temporary residence: means a building, permanent structure or unit therein, watercraft, emergency shelter, or transitional housing facility where the covered offender resides, but does not intend to reside for more than one hundred eighty days. See Hawaii Revised Statutes 846E-1
  • Temporary restraining order: Prohibits a person from an action that is likely to cause irreparable harm. This differs from an injunction in that it may be granted immediately, without notice to the opposing party, and without a hearing. It is intended to last only until a hearing can be held.
  • Terminally ill: means having an illness or sickness that can reasonably be expected to result in death in twenty-four months or less. See Hawaii Revised Statutes 431C-2
  • Testify: Answer questions in court.
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • Tier: means specific groups of providers and facilities identified by a network and to which different provider reimbursement, covered person cost-sharing, provider access requirements, or any combination thereof, apply for the same services. See Hawaii Revised Statutes 431:26-101
  • Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • Trust account: A general term that covers all types of accounts in a trust department, such as estates, guardianships, and agencies. Source: OCC
  • Ultimate controlling person: means a person who is not controlled by any other person. See Hawaii Revised Statutes 431:11-102
  • Uniform Commercial Code: A set of statutes enacted by the various states to provide consistency among the states' commercial laws. It includes negotiable instruments, sales, stock transfers, trust and warehouse receipts, and bills of lading. Source: OCC
  • Uniform standard: means a standard adopted by the commission for a product line, pursuant to § 431:30-112 of this compact, and shall include all of the product requirements in aggregate; provided that each uniform standard shall be construed, whether express or implied, to prohibit the use of any inconsistent, misleading, or ambiguous provisions in a product and the form of the product made available to the public shall not be unfair, inequitable, or against public policy as determined by the commission. See Hawaii Revised Statutes 431:30-102
  • Unlawful debt: means a debt incurred or contracted in an illegal gambling activity or business or which is unenforceable under state law in whole or in part as to principal or interest because of the law relating to usury. See Hawaii Revised Statutes 842-1
  • Uphold: The decision of an appellate court not to reverse a lower court decision.
  • Usury: Charging an illegally high interest rate on a loan. Source: OCC
  • Utilization review: means a set of formal techniques designed to monitor the use of, or evaluate the clinical necessity, appropriateness, efficacy, or efficiency of, health care services, procedures, or settings. See Hawaii Revised Statutes 432E-1
  • Utilization review organization: means an entity that conducts utilization review other than a health carrier performing a review for its own health benefit plans. See Hawaii Revised Statutes 432E-1
  • Venue: The geographical location in which a case is tried.
  • Verdict: The decision of a petit jury or a judge.
  • Voting security: shall include any security convertible into or evidencing a right to acquire a voting security. See Hawaii Revised Statutes 431:11-102
  • Wind resistive devices: means devices, techniques, and residential safe rooms, as identified and determined in accordance with § 431:22-104(b), that increase a building's or structure's resistance to damage from wind forces. See Hawaii Revised Statutes 431:22-101
  • Witness: includes a person whose testimony is desired in any proceeding or investigation by a grand jury or in a criminal action, prosecution, or proceeding. See Hawaii Revised Statutes 836-1
  • Writ: A formal written command, issued from the court, requiring the performance of a specific act.