LIA backs government’s new process for claims disputes

The Clinical Claims Resolution Process was established on 9 November.

The Life Insurance Association of Singapore (LIA) has expressed their approval for the newly established Clinical Claims Resolution Process (CCRP) that aims to resolve claim disputes of a clinical nature between private Integrated Shield Plan (IP) policyholders, IP insurers, medical practitioners and medical institutions. 

According to LIA, the CCRP is the first platform to bring together medical professionals and private payers to jointly assess clinically related IP claims disputes

“This is an important step toward the long-term sustainability of IPs in Singapore. The structured approach provided by the CCRP can help to ensure proper and consistent resolution of clinically related IP claims disputes, which would be to the benefit of all stakeholders,” LIA said in a statement.

Established through the recommendation of Multilateral Healthcare Insurance Committee (MHIC), the CCRP will help to facilitate the resolution of clinically related IP claim disputes, including concerns on unfair rejection of claims for medically appropriate treatment or procedures, concerns on over-charging by medical practitioners and medical institutions, and concerns on over-servicing by medical practitioners. The CCRP will be administered by a secretariat from the Academy of Medicine, Singapore (AMS), and will be the main resolution channel for IP disputes of a clinical nature, complementing the Financial Industry Disputes Resolution Centre (FIDReC).

LIA said that prior to the establishment of the MHIC, IP insurers have been active in expanding their preferred provider panels. 

“There has been significant growth in the size of panels since the start of this year, and insurers have since committed at the MHIC that they will aim to have panels of at least 500 private sector specialists by the end of 2021. This will help to ensure that policyholders have access to sufficient specialists to meet the majority of their need,” LIA added.

LIA said it remains committed to working with the MHIC to help ensure the long-term sustainability of the IP ecosystem for the good of policyholders.