Commercial Arbitration and Issues Related to Health Insurance

January 31, 2026

1. Health Insurance Law in Vietnam

The legal framework governing health insurance in Vietnam has been relatively comprehensively established, with the core regulation being the Law on Health Insurance 2008, as amended and supplemented in 2014, together with guiding decrees and circulars issued by the Government and the Ministry of Health.
Under the law, health insurance is compulsory for certain groups and voluntary for others, aiming to provide community healthcare based on the principle of risk sharing.

The Law clearly stipulates:

The rights and obligations of health insurance participants;
The responsibilities of social insurance agencies;
The obligations of medical examination and treatment facilities that enter into health insurance service contracts;
The scope of coverage, benefit levels, and procedures for payment and settlement of medical expenses.

In addition to state-organized social health insurance, commercial health insurance provided by insurance enterprises has become increasingly popular. This is the area where disputes of a commercial nature most frequently arise and where arbitration may be applied.

2. Common Disputes Related to Health Insurance

In practice, health insurance disputes arise in various forms, mainly involving the following issues:

First, disputes over the scope and level of health insurance benefits.
Insured persons may claim that their lawful benefits are improperly restricted, while insurance enterprises or social insurance agencies refuse payment on the grounds that the medical services fall outside the coverage scope.

Second, disputes over refusal or delayed payment of medical expenses.
This is a common type of dispute, occurring when claim settlement is prolonged or denied due to differing interpretations of insurance conditions.

Third, disputes between medical service providers and insurance organizations.
Medical facilities may lodge complaints regarding partial or non-payment, reimbursement rejections, or allegations of abuse of the health insurance fund.

Fourth, disputes arising from commercial health insurance.
These disputes typically relate to insurance contract terms, disclosure obligations, exclusion clauses, and the interpretation of policy provisions.

3. The Role of Arbitration in Resolving Health Insurance Disputes

Commercial arbitration is an alternative dispute resolution mechanism outside the court system, based on the parties’ agreement and governed by the Law on.

Commercial Arbitration 2010. In the insurance sector—particularly commercial health insurance—arbitration has increasingly demonstrated its importance.

First, arbitration ensures flexibility and high professional expertise. Parties may appoint arbitrators with in-depth knowledge of insurance, healthcare, and finance, enabling more accurate and practical dispute resolution.

Second, confidentiality is a significant advantage of arbitration. Information relating to health conditions, medical records, and personal financial data is better protected than in public court proceedings.

Third, expedited proceedings and the finality of arbitral awards allow parties to stabilize their operations promptly, avoiding prolonged disputes that may adversely affect patients’ rights and insurers’ reputations.

However, it should be noted that arbitration is only applicable where the parties have a valid arbitration agreement, typically incorporated into commercial health insurance contracts.

4. Notable Health Insurance Disputes

In practice, numerous health insurance disputes have attracted public attention, including cases involving:

Insurance enterprises refusing to pay medical treatment costs on the grounds of pre-existing conditions or policy exclusions;
Medical facilities being required to reimburse billions of VND in health insurance payments due to alleged improper medical indications;
Commercial health insurance contract disputes between individuals and insurance enterprises concerning the interpretation of contractual terms.

Several of these cases have been resolved through negotiation, mediation, or arbitration, demonstrating the effectiveness of alternative dispute resolution mechanisms in this sensitive field.

5. Protection of the Rights of Health Insurance Participants

To better safeguard the rights and interests of health insurance participants, the following measures should be emphasized:

Further improvement of the legal framework on health insurance to ensure transparency, consistency, and accessibility for the public;
Enhancing legal awareness among insured persons, particularly regarding their rights, obligations, and the terms of commercial health insurance contracts;
Encouraging the use of alternative dispute resolution methods, including arbitration, to reduce the burden on courts and protect the legitimate interests of all parties;
Strengthening the accountability of insurance enterprises and medical service providers to ensure compliance with legal regulations and contractual commitments.

6. Settlement of Disputes through the Bigboss International Commercial Arbitration Center (BBIAC)

To resolve disputes by commercial arbitration at BBIAC, the parties may include one of the following clauses in their contract:

6.1. Standard Arbitration Clause

“Any dispute arising out of or in connection with this contract shall be finally resolved by arbitration at the Bigboss International Commercial Arbitration Center (BBIAC) in accordance with its Rules of Arbitration.”

The parties may additionally specify:

(a) the number of arbitrators: [one or three];
(b) the place of arbitration: [city and/or country];
(c) the governing law of the contract: [ ];
(d) the language of arbitration: [ ].

Notes:

Applicable only to disputes involving foreign elements;
Applicable to disputes involving foreign elements or where at least one party is a foreign-invested enterprise.

6.2. Arbitration Clause under Expedited Procedure

“Any dispute arising out of or in connection with this contract shall be resolved by arbitration at the Bigboss International Commercial Arbitration Center (BBIAC) in accordance with its Rules of Arbitration. The parties agree that the arbitral proceedings shall be conducted under the Expedited Procedure as provided in Article 37 of the BBIAC Arbitration Rules.”

The parties may additionally specify:

(a) the place of arbitration: [city and/or country];
(b) the governing law of the contract: [ ];
(c) the language of arbitration: [ ].

Notes:

Applicable only to disputes involving foreign elements;
Applicable to disputes involving foreign elements or where at least one party is a foreign-invested enterprise.

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