How CCRP Works

(A) Applicant submits Request for Determination (RFD) Application

(B) CCRP Secretariat reviews Application & confirms prevailing requirements fulfilled by Applicant. CCRP Secretariat will approach Respondent to obtain agreement. Payment will only be requested from Applicant once Respondent agrees to participate.

(C) Secretariat reviews Application to ascertain whether the determination sought by parties can be made through CCRP

(D) If suitable, Formation of CCRP Panel to be assigned to the case

(E) Review & Determination of Outcome by CCRP Panel

(F) Notification of Outcome

If not suitable, parties to be advised on alternative avenues

Applicant

IP Policyholder (Patient)
Medical Practitioner / Institution
IP Insurer

Eligibility Criteria Overview

Respondent
Doctor/Medical Institution
IP Insurer
Requirements
(Parties should attempt to resolve the disputes amongst themselves at first instance.)
  • Over-charging
  • Over-servicing
Not Applicable
  • Over-charging
  • Over-servicing
  • Deviations from practice norms
Determination of whether a procedure was medically necessary
Non-payment of claim for medically necessary treatments/procedures
Not Applicable
The disputes filed with the CCRP should be within six (6) months after:

1. IP insurer's (respondent) final reply to the policyholder (patient); or
2. Medical practitioner/Medical institutions’ (respondent) reply to the IP insurer; or
3. IP Insurer’s (respondent) final reply to the Medical practitioner/ Medical institution

Eligibility Criteria Overview

Applicant
IP Policyholder (Patient)
Doctor/Medical Institution
  • Over-charging
  • Over-servicing
IP Insurer
Determination of whether a procedure was medically necessary
Requirements (Parties should attempt to resolve the disputes amongst themselves at first instance.)
The disputes filed with the CCRP should be within six (6) months after:
1. IP insurer's (respondent) final reply to the policyholder (patient); or
2. Medical practitioner/Medical institutions’ (respondent) reply to the IP insurer; or
3. IP Insurer’s (respondent) final reply to the Medical practitioner/ Medical institution
Applicant
Medical Practitioner / Institution
Doctor/Medical Institution
Not Applicable
IP Insurer
Non-payment of claim for medically necessary treatments/procedures
Requirements (Parties should attempt to resolve the disputes amongst themselves at first instance.)
The disputes filed with the CCRP should be within six (6) months after:
1. IP insurer's (respondent) final reply to the policyholder (patient); or
2. Medical practitioner/Medical institutions’ (respondent) reply to the IP insurer; or
3. IP Insurer’s (respondent) final reply to the Medical practitioner/ Medical institution
Applicant
IP Insurer
Doctor/Medical Institution
  • Over-charging
  • Over-servicing
  • Deviations from practice norms
IP Insurer
Not Applicable
Requirements (Parties should attempt to resolve the disputes amongst themselves at first instance.)
The disputes filed with the CCRP should be within six (6) months after:
1. IP insurer's (respondent) final reply to the policyholder (patient); or
2. Medical practitioner/Medical institutions’ (respondent) reply to the IP insurer; or
3. IP Insurer’s (respondent) final reply to the Medical practitioner/ Medical institution

Prevailing Requirements

CCRP is a voluntary process. Parties therefore need to enter a contractual agreement to have their dispute be heard and resolved by the CCRP and be bound by its decision, failing which either party may commence civil (court) action for breach of contract.

(A) Case Eligibility

Parties should attempt to resolve the disputes amongst themselves at first instance.


  • For example, policyholders with clinical-related issues against the IP insurers’ decision to turn down their claim, should show that they have not been able to resolve the dispute with the IP insurer before filing a request with the CCRP.

  • This is because all IP insurers have claims and complaints management capability that can deal with specific issues from an individual’s purchased IP Plan

The Application request must be filed with CCRP within 6 months after the IP insurer's final reply to the medical practitioner, medical institution or policyholder.

Timeframe example for a Case

IP Policyholder (Patient) / Medical Practitioners / Institutions / Clinic / IP Insurers / Corporate Entities

Disputes not eligible (IP Insurer’s final reply dated before 1 May 2021)

1 May 2021

1st incident (unresolved)

Dispute eligible to be filed for CCRP evaluation (within 6 months from IP Insurer’s final reply)

1 Nov 2021

RFD Submitted on

IP Policyholder (Patient) / Medical Practitioners / Institutions / Clinic / IP Insurers / Corporate Entities

Disputes not eligible (IP Insurer’s final reply dated before 1 May 2021)

1 May 2021

1 May 2021

1st incident (unresolved)

Dispute eligible to be filed for CCRP evaluation (within 6 months from IP Insurer’s final reply)

1 Nov 2021

RFB Submitted on

(B) Evaluation & Review Process

Evaluation will be via an anonymous document-based review of statements and case materials submitted by the parties involved, i.e., parties need not be present.

Evaluation and decision will be made by an appointed CCRP panel (de-conflicted and anonymised to each other).

The CCRP Panel will comprise of 3 medical specialists from Academy of Medicine, Singapore (AMS) and 2 medical directors from selected IP insurer recommended by Life Insurance Association (LIA), and 1 non-voting layperson representative from Consumers Association Singapore (CASE).

CCRP Panel’s decision is final and there is no avenue for appeal.