Issues raised for resolution under CCRP

01

Non-payment of clinically indicated* claims to an insured policyholder

*Clinically indicated means procedures/investigations are medically necessary for the condition.

02

Non-payment of fees or charges to a Medical Practitioner, Medical Institution or Clinic for any treatment or procedure necessary to treat a medical condition

03

Over-servicing or over-charging by a Medical Practitioner, Medical Institution or Clinic

Out Of Purview

For cases falling outside of the scope, parties would be advised to approach the appropriate platform for dispute resolution.

The CCRP would not accept cases that are already the subject of court, arbitral, regulatory, criminal or other adjudicatory proceedings, i.e.

  • Cases under criminal investigation
  • Cases under court proceedings
  • Cases with Regulators (e.g., SMC, MOH)

The following are also out of CCRP’s Purview:

  • Disputes involving contractual terms
  • Disputes involving unfair amendment of terms

Additionally, please also take note that CCRP can dismiss a request without evaluation in various situations, including where:

  • It is frivolous or vexatious in the opinion of the CCRP; or
  • There are other compelling reasons why it is inappropriate for CCRP to deal with the case.

What We Cannot Do

  • Help to claim for compensation
  • Order any medical practitioner/institution/clinic to provide the medical treatments required
  • Order any medical practitioner/institution/clinic to give access to the records