In today’s increasingly complex health care environment, disputes among patients, private hospitals, and payers such as insurance and takaful operators have become more frequent.
These conflicts often arise from unexpected medical outcomes, disputed treatment decisions, unclear billing practices, rejected claims, or perceived lack of informed consent.
For many patients, such disputes are emotionally distressing, financially burdensome, and psychologically exhausting. At the same time, hospitals and medical professionals face reputational risks, rising legal costs, and operational pressures.
Traditionally, these disputes are resolved through court litigation. However, litigation is slow, costly, and adversarial. Cases may take years to conclude, and by then, trust between the parties is often irreparably damaged.
Judges may also lack specialised medical and financial knowledge, leaving complex matters to competing expert witnesses. This frequently leads to confusion rather than clarity and contributes to dissatisfaction among all parties.
In response, alternative dispute resolution mechanisms, particularly arbitration, have gained prominence. Yet private arbitration can also be expensive and heavily dependent on external experts. A more accessible, knowledge-based approach is therefore required.
One promising solution is the establishment of university-based arbitration centres that leverage peer-to-peer expertise to resolve health care disputes. Inspired by the Hamid Sultan Abu Backer University cum Court Annexed Arbitration (UCAA) concept, this model integrates academic knowledge, legal structure, and professional ethics into a unified system of justice.
It offers a credible pathway toward fairness, efficiency, and trust in resolving disputes over private hospital treatment and costs.
The Nature Of Health Care Disputes
Health care disputes differ fundamentally from ordinary commercial conflicts. They involve matters of life, health, dignity, and human vulnerability.
Patients often enter hospitals during moments of fear and dependence, trusting doctors, institutions, and payers to act in their best interests.
When outcomes fall short or claims are rejected, disappointment and frustration can quickly escalate into conflict.
Common sources of dispute include allegations of medical negligence, disagreements over treatment options, excessive or unexpected charges, insurance-related conflicts, and inadequate communication.
Many patients feel powerless when facing large institutions supported by legal teams and insurers. Conversely, doctors and hospitals often feel unfairly blamed for complications that may be unavoidable.
Policyholders may also incur substantial costs when claims are rejected on technical grounds.
When such disputes enter the courtroom, the process often intensifies hostility. Parties become adversaries rather than partners in problem-solving.
The focus shifts from understanding and improvement to winning and losing. This adversarial environment damages relationships and weakens public confidence in health care systems.
The Concept Of University-Based Arbitration
University-based arbitration, as proposed by Hamid Sultan Abu Backer, offers an alternative model grounded in knowledge, neutrality, and cooperation.
Under this approach, universities establish specialised arbitration centres to handle disputes in sectors such as health care, engineering, finance, and technology.
These centres may operate independently or in partnership with courts under a court-annexed framework.
The UCAA model highlights the role of academic institutions as neutral platforms for justice. Universities are uniquely positioned for this role because they bring together experts from law, medicine, ethics, economics, and social sciences.
They are also widely perceived as institutions committed to integrity, research, and public service.
In health care and insurance payment disputes, this model enables cases to be heard by multidisciplinary panels comprising legal professionals, medical academics, and ethicists.
These individuals share professional and intellectual backgrounds with the parties involved, enabling peer-to-peer evaluation of the evidence and conduct.
Rather than relying solely on external expert witnesses, expertise is embedded within the arbitration process.
How The Model Operates
When a dispute arises, patients, hospitals, and insurers may agree to submit their case to a university arbitration centre. This agreement may be incorporated into hospital admission forms, insurance policies, or post-dispute arrangements. Courts may also refer appropriate cases.
Once accepted, an arbitration panel is appointed. It typically includes a legally trained arbitrator, a relevant medical specialist, and an ethics or policy expert. All members must disclose potential conflicts of interest and comply with professional standards.
The process begins with a preliminary conference to clarify issues, procedures, and timelines. Parties then exchange documents, medical records, billing statements, and expert reports.
Hearings are conducted in a structured yet flexible manner, allowing both sides to present arguments and respond to panel questions. After deliberation, the panel issues a written award that is binding and enforceable under arbitration law.
This structure combines legal certainty with academic depth and professional sensitivity.
Benefits Of The University-Based Arbitration Model
One of the model’s greatest strengths is its technical and intellectual competence. Medical and financial disputes are highly specialised.
Academic clinicians and researchers are well equipped to assess standards of care, evaluate treatment decisions, and interpret medical data. Their involvement reduces misunderstandings and improves the quality of decisions.
Fairness and trust represent another major advantage. Universities are widely viewed as neutral institutions.
When disputes are resolved in an academic environment, parties are more likely to believe that outcomes are based on evidence and principles rather than power or influence. This perception strengthens public confidence.
Cost and time efficiency further distinguish this model from traditional litigation. Arbitration proceedings are generally faster and involve fewer procedural delays.
Legal fees, expert costs, and administrative expenses are lower. This makes justice more accessible, particularly for patients with limited resources.
The model also generates educational and social value. Law, medical, and ethics students can observe real-world dispute-resolution processes. Researchers can analyse anonymised case data to improve health care policy. Regulators and hospitals can learn from recurring patterns of conflict.
Confidentiality is another important benefit. Unlike court proceedings, arbitration hearings are private. Sensitive medical and financial information can be handled discreetly, protecting dignity and professional reputation.
The proposed university arbitration centre can also function alongside the Financial Ombudsman Centre through coordinated referrals, shared jurisdictional guidelines, and complementary dispute-resolution roles.
This ensures that health care-related financial complaints are resolved efficiently without overlapping authority or conflicting decisions.
Challenges And Limitations
Despite its promise, this model faces several challenges.
First, university arbitration must operate within clearly defined legal jurisdiction and comply with national arbitration laws. Its authority must be supported by valid arbitration agreements, statutory recognition, and judicial oversight.
Transparent procedures and appeal safeguards are essential to ensure enforceability and prevent legal complications.
Secondly, impartiality is crucial. Universities often collaborate with teaching hospitals through research, training, and funding. These relationships may create perceived or actual conflicts of interest.
Strong governance structures and transparent processes for appointing panels are therefore necessary.
Thirdly, procedural standardisation remains a concern. Without clear rules, practices may vary between institutions, undermining consistency and predictability. National or regional guidelines may be required.
Fourthly, resource constraints may limit implementation. Arbitration centres require trained personnel, administrative systems, and secure data platforms. Smaller universities may struggle without external support.
Finally, stakeholder resistance should not be underestimated. Some hospitals and insurers may prefer traditional litigation, whereas some patients may fear losing their right of appeal.
Insurers are often cautious about new mechanisms. Building confidence requires pilot projects, transparent reporting, and demonstrated success.
Cost Management And Funding
To keep costs low, university arbitration centres can use existing campus facilities, shared administrative staff, and digital platforms for virtual hearings and case management.
Law and medical faculty may serve as part-time arbitrators in their academic service. Graduate students can assist under supervision. Standardised procedures and fixed-fee schedules can further prevent excessive charges.
Funding may come from government grants, judicial support programmes, modest case-filing fees, hospital and insurance industry contributions, university endowments, and corporate social responsibility initiatives by health care providers and financial institutions.
Conclusion: Towards A More Humane System Of Justice
The university-based arbitration model, inspired by the Hamid Sultan Abu Backer UCAA concept, represents an innovative response to disputes in health care treatment and financing.
By integrating legal discipline, medical expertise, and ethical reflection, it offers a more balanced and humane alternative to conventional litigation.
This model recognises that health care disputes are not merely legal contests. They are human experiences involving pain, trust, and responsibility. Resolving them requires more than technical rules; it requires understanding, wisdom, and integrity.
While challenges remain, they are not insurmountable. With proper governance, legal support, and stakeholder engagement, university-based arbitration can become a vital pillar of health care justice.
It can reduce conflict, promote learning, strengthen trust, and contribute to a more compassionate and accountable health care system.
In an era where knowledge is power and trust is fragile, placing justice within institutions of learning may be one of the most meaningful innovations of our time.
Dr Mohamed Rafick Khan is a trained physician with 12 years of experience in military medical services and over 22 years of experience in the assurance industry. He retired as the CEO of a multinational reinsurance company in 2019 and remains active as an independent international assurance industry consultant.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
