Anywhere from $0 to well over $50,000 can come off the top, depending on who paid your bills.

To figure out your real number, gather the proof first:

• Every medical bill tied to the crash
• Your auto policy showing Hawaii no-fault/PIP coverage and payments made
• Any Explanation of Benefits (EOBs) from your health insurer
• A current Medicare conditional payment letter if Medicare paid anything
• Any Med-QUEST payment records if QUEST covered treatment
• Hospital balance statements and any written lien or reimbursement claim
• The Honolulu Police Department crash report or report number
• Settlement paperwork showing the gross offer, costs, and fees

In Hawaii auto cases, your own PIP/no-fault insurer usually pays the first $10,000 in medical and rehab benefits, regardless of fault. That matters because you need to know what was paid by PIP, what was paid by health insurance, and what is still unpaid.

Medicare will usually demand repayment for crash-related treatment it covered. That amount is not a guess; it comes from Medicare's payment summary. If the summary is wrong, dispute the unrelated charges fast.

Med-QUEST can also seek reimbursement from a liability recovery. You need the agency's payment history, not just a hospital bill.

Private health insurance is trickier. Some plans, especially ERISA self-funded plans, may demand strong reimbursement rights. Other plans have weaker claims. The plan document and reimbursement language decide that.

Hospitals in Honolulu may send collection notices or try to get paid from settlement funds, but don't assume every hospital bill is a valid lien. Ask for an itemized statement, payment history, and proof the balance is still owed after PIP and insurance adjustments.

Summer Oahu crashes on the H-1, rental-car wrecks near Waikiki, and tire-blowout cases often involve multiple payers. Until you match each bill to the payer, you do not know what you keep.