HONOLULU (KHON2) — A Hawaii Supreme Court ruling could give patients better access to care and give doctors more autonomy to decide what they need, while still protecting the rights of insurance companies on certain contract terms.
In the case “Nitta vs. HMSA”, a Big Island doctor sued the insurer over denied claims that he and several patients say caused delays and even death.
The Supreme Court says not all disagreements over what gets covered can be forced to go to arbitration.
A lawyer for the advocacy group “Hawaii Medical Association” explains the impact.
“This case is very important because it emphasizes patient access to medical care, and it also gives physicians, you know, contracts are important, but they can be challenged,” says Clay Kekina. “I think ultimately that’s what we all want, is for all patients to have access to care, for doctors to feel they have the freedom to practice medicine in Hawaii without their hands being tied.”
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The ruling still allows arbitration in certain circumstances, but makes clear that such clauses in insurance contracts would be reviewed for fairness to the doctor and patient before determining if a case can proceed straight to litigation.