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Third-party funders in arbitration

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ABSTRACT

Ayurveda is among the oldest systems of medicine in the world and has established its presence as part of the modern health care (HC) system, especially within the context of HC governance. Over the past few decades, there has been a significant increase in the formalisation (i.e., institutionalisation) of Ayurvedic practice in India through regulation, educational reform, and incorporation into public health programs, which has raised several important issues relating to patient safety, professional accountability, and quality of HC. While public trust in Ayurveda is high, as is political support for it, there are continuing concerns about issues such as: informed consent; false or misleading evidence for therapeutic benefit; standardisation of treatment protocols; and liability for malpractice. This article reviews the existing legal and regulatory framework applicable to Ayurveda in India, with a focus on comparing it to a sample of other approaches to regulating traditional or complementary medicine internationally. This research uses a doctrinal and comparative policy analysis to assess the effectiveness of current laws, professional regulatory systems, and ethical guidelines for protecting patients. The article also examines how the National Commission for the Indian System of Medicine, consumer protection laws, and the development of health care law have influenced accountability in the practice of Ayurvedic medicine. The study concludes that Ayurveda’s future legitimacy will depend on its continued reliance on its traditional foundation and its ability to meet the current expectations for transparency and evidence-based practice, informed consent, and patient-centred care. The article ends with a proposal for reforms to strengthen the regulatory framework while maintaining the cultural and therapeutic values associated with traditional healthcare systems.

KEYWORDS:

Ayurveda, Healthcare Regulation, Patient Protection, Medical Ethics, Legal Governance,
Traditional Medicine, AYUSH, Professional Liability

INTRODUCTION

The use of traditional forms of medicine is an important aspect of health care systems around the
world and the World Health Organisation (WHO) recognises that traditional and complementary
forms of medicine are key components of health care systems in many countries, especially
developing areas in which availability and cultural acceptability have a considerable bearing on
health care choices. Ayurveda, one of the many forms of traditional healthcare, is considered to be
one of the most comprehensive and longstanding forms of medical treatment.

India has made extensive efforts to develop and regulate Ayurvedic practice through legal and
regulatory organisations, quality of education requirements, licensing criteria and integration with
the public health care system. Although there continues to be widespread interest and use of
Ayurvedic medicine, the rapid growth of the Ayurvedic market and services has shown deficiencies
in the regulatory oversight of medical and therapeutic products, ethical compliance and safety and
protection of patients. There are increasing and significant demands for legal scrutiny regarding
issues related to the professional negligence of practitioners, informed consent policies, advertising
standards and testing for scientific validation of practitioners of Ayurvedic medicine.1

This article examines whether the existing legal framework adequately protects patients while
facilitating the growth of Ayurveda as a recognised healthcare system.

RESEARCH OBJECTIVES

To examine the legal framework governing Ayurveda in India.
To evaluate ethical accountability mechanisms applicable to Ayurvedic practitioners.
To compare Indian regulatory approaches with selected international models.
To assess challenges relating to patient protection and professional liability.
To propose policy reforms for strengthening regulatory governance.

LITERATURE REVIEW

The most recent literature has shown that there is a move from a system of regulating Ayurveda
strictly through education and professional registration. This new governance system consists of
four elements: patient safety, ethical accountability, quality assurance, and evidence-based
healthcare delivery. Most of the previous regulatory systems focused on the credentialing of
practitioners and standardising educational curricula; however, the current healthcare governance
model requires the use of legal mechanisms to ensure transparency, clinical competence,
accountability, and protection of patients’ rights. In addition, this movement reflects the increasing
integration of Ayurveda into national health systems and the increasing expectation that all forms
of traditional health care will conform with internationally recognised principles of professional
regulation and clinical governance.2

The WHO Benchmarks for the Practice of Ayurveda (2022) mark an important point in the
development of Ayurveda. They establish internationally acknowledged minimal competency
requirements for Ayurvedic practitioners, healthcare facilities and infrastructure; Medicaid records
or similar clinical documentation; informed consent from patients; patient confidentiality; a written
referral process; and regulatory oversight of this practice. The Benchmarks provide guidelines for
the integration of traditional medical practices with modern legal and ethical standards, while also
protecting and preserving Ayurvedic principles. The NCISM Act of 2020 has also strengthened
regulatory governance of all systems of medicine in India, including Ayurveda, through the
promotion of competency-based education, institutional accreditation, standardised professional
practices, and more accountable delivery of Ayurvedic healthcare.

The most current evidence supports the need for accountability through professional ethics in the
regulation of Ayurveda. The latest research demonstrates that professional ethics should include
both traditional values as well as aspects of contemporary professional ethics such as: informed
consent, patient autonomy, confidentiality, appropriate documentation, responsible prescribing,
and compliance with defined standards of care. Additionally, pharmacovigilance, quality control
of Ayurvedic products, adverse event reporting, and evidence-based clinical practice guidelines
are now viewed as important tools to enhance patient safety and build confidence in Ayurveda. As
stated in recent policy analyses, key components to improving the governance of Ayurveda include: implementing mandatory accreditation, using electronic patient records, having
standardised clinical practice guidelines, developing a mechanism for ongoing professional
education, having strong systems for monitoring the safety of medications, being non-partisan
when handling disciplinary procedures, and having credible legal systems to provide oversight.3

RESEARCH METHODOLOGY

This study adopts a doctrinal and comparative legal research methodology. Primary sources
include statutory enactments, governmental regulations, judicial decisions, and policy documents.
Secondary sources include scholarly articles, books, reports of international organisations, and
academic commentaries. Comparative analysis is undertaken with regulatory frameworks
governing traditional and complementary medicine in selected jurisdictions including China, the
United Kingdom, and Australia.

LEGAL GOVERNANCE OF AYURVEDA IN INDIA 4 5 6

Evolution of Regulations in Ayurveda Through History

The regulation of Ayurveda as a formal body has undergone many changes from when Ayurveda
was first recognised by colonists/colonial governments as an indigenous form of medicine to a
contemporary statutory regulatory framework. The government has developed several
initiatives since 1947 encouraging the development of a code of ethics to protect traditional
knowledge-based systems while still providing for the regulation, standardisation, and
professionalisation of Ayurvedic and other traditional healing systems.

National Commission For Indian Medicine Act (NCISM) 2020

There has been substantial reform to Ayurvedic governance with the National Commission for
Indian Medicine Act 2020. The statute streamlined previously existing regulations; this
act created standards for education, licensure as a practitioner, and oversight of the delivery of
Ayurvedic services.
The NCISM Act aims to increase transparency, accountability, and quality assurance regarding
services delivered under the Indian system of medicine; however, challenges remain related to the
implementation and enforcement of this legislation.

The Ministry of AYUSH As The Primary Governmental Authority

The Ministry of AYUSH serves as the primary government entity charged with the formation of
policies and regulations, promoting research, and coordinating with institutions that work with
Ayurveda and other forms of traditional medicine.

ETHICAL ACCOUNTABILITY IN AYURVEDA 7

Ethics and Responsibilities of Practitioners

Practitioners must maintain the following top priorities: the welfare of the patient, confidentiality,
competence and professional integrity. As the practice of Ayurveda continues to evolve, so too do
all the ethical standards that have been established for modern healthcare observers.

Informed Consent and Autonomy of Patients

Obtaining informed consent is becoming an essential principle within the field of health care law.
Patients are to be informed about their condition, available options, the benefits, disadvantages,
and risks of the identified options.
Patients do not fully understand the requirements of informed consent and conditions associated
with using Ayurvedic remedies. Since most patients view Ayurvedic remedies as “natural” and
thus, “safe”, a lack of disclosure about possible adverse consequences or side effects of
Ayurvedic methods is more common than with conventional methods

Fraudulent Advertising & Misleading Therapies

As the market for Ayurvedic therapy grows, so does the concern over the existence of exaggerated
therapeutic claims made by practitioners. Ethical regulatory oversight and guidance require the
use of legitimate data to support marketing initiatives and to genuinely promote Ayurvedic
therapies without misleading prospective customers.

PATIENT PROTECTION AND LEGAL LIABILITY 8

CONSUMER PROTECTION – LAWS THAT PROTECT CONSUMERS OF
HEALTHCARE

The Consumer Protection Act 2019 provides a mechanism for addressing the grievances of
consumers concerning healthcare services; therefore, Ayurveda practitioners can be liable for
claims made by patients as a result of failures or deficiencies in the health services provided.

PROFESSIONAL NEGLIGENCE BY AYURVEDA PRACTITIONERS

The issue of determining whether professional negligence has occurred in traditional medicine is
complicated legally. In making this determination, courts must apply both traditional healing
practices and contemporary standards of reasonable professional conduct of the practitioner.

Professional liability may arise from:

  • Failure to diagnose correctly;
  • Providing the wrong treatment;
  • Failure to obtain consent from patients prior to treatment;
  • Failing to maintain legible and accurate records; and
  • Making representations to patients regarding their chances of success or perceived benefit from
  • a treatment.


CURRENT TRENDS IN JUDICIAL DECISIONS

Comparative perspectives 9 10

China

China has created an integrated regulatory system in that it combines traditional Chinese medicine
with mainstream health care. The various types of regulatory oversight include practitioner
licensing, research standards and methods of quality control.

United Kingdom

The United Kingdom takes a relatively cautious stance on the regulation of traditional and
complementary therapies. Its regulatory structure is built on the premise of providing consumer
protection, professional registration, and truthful advertising.

Australia

Australia provides national regulation for complementary medicine through health care and
consumer protection laws. There is a strong emphasis placed on supporting evidence for making
claims about treatments and consumer safety.

The comparative analysis shows that the effective regulation of traditional and complementary
therapies requires:

  • Specific licensing standards;
  • Strong protections for patients’ rights;
  • Transparent regulatory mechanisms for disciplining practitioners;
  • Scientific evidence supporting the therapeutic claims made by practitioners; and
  • Strong mechanisms for consumers to pursue their complaints against practitioners.

ISSUES THAT POLICY MAKERS WILL ENCOUNTER IN THE 21ST
CENTURY

Almost all regulations regarding the use of Ayurvedic medicine will need to be improved upon in
order to address the following issues:

  • The absence of standard operating procedure (SOP) for performing treatments
  • The low rate of integration of informed consent throughout the continuum of care
  • A lack of public knowledge regarding their rights as patients
  • A significant lack of monitoring of advertisements and commercial claims for Ayurvedic products
  • Variability in the quality and competency level of the education received by Ayurvedic
  • practitioners.

By addressing these issues, we will build public trust in Ayurvedic medicine, as well as improve
health outcomes.

POLICY RECOMMENDATION

  1. Creation of an Adult Informed Consent Policy Method Specific to Ayurveda
  2. Use of Independent Grievance Resolution Processes for Patients Receiving Allopathic Medicine
  3. Strengthening Regulation and Oversight over all Advertising of Health Care Products and on the Internet and Providing Alternatives for Electronic Marketing
  4. Promotion of Evidence-Based Clinical Research into All Types of Health Care While Respecting Traditional Knowledge Systems
  5. Increase the Availability of Ethics Training in Ayurveda Education and Workforce
  6. Creation of National Standards for the Maintenance of Patient Records and Clinical Documentation
  7. Greater Coordination between AYUSH Regulators and Agencies Responsible for Consumer Protection.

CONCLUSION

The importance of Ayurveda in India’s health care system and cultural identity will remain as long
as there are strong legal and ethical protections. For traditional medical systems to continue
to be recognised as both legitimate and sustainable in the 21st century, and to serve as responsible
health care providers, they must operate within a framework that values patient autonomy,
accountability, transparency, and safety.


India has made gains in its ability to regulate Ayurveda through formalised legislative changes and
the establishment of institutional regulations. However, serious issues remain regarding issues
such as professional liability, informed consent, advertisements, and safeguarding patients.
Overall, these issues could benefit from more relevant legislation and policy. The experience of
other places shows that successfully regulating traditional medicine is not necessarily
detrimental to the body of evidence that supports it. Instead, good governance of traditional healing methods and their practitioners could contribute to enhancing public trust and improving
Ayurveda’s role in today’s health care system.

 

 

 

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Third-party funders in arbitration play a vital role in ensuring access to justice, arbitral awards cannot be enforced against them: Delhi High Court

Third-party funders in arbitration

Table of Contents

Who are third-party funders

In arbitration, third-party funders are organizations or people who lend money to one of the parties in exchange for a percentage of the eventual award or settlement. These funders support one of the parties financially to pay the costs of the arbitration proceedings even though they are not personally involved in the dispute. In recent years, third-party funding in arbitration has grown in popularity and is frequently employed by claimants who lack the financial resources to prosecute their claims on their own.

Third-party funders in arbitration - Image 1
source – Bar and Bench

Specialized finance corporations, investment firms, private equity funds, or even individual investors, can act as third-party funders. Before choosing to offer to fund, they evaluate the claim’s merits and prospective worth. They might provide financial aid to cover a range of costs, including attorney fees, expert witness fees, and administrative charges, third-party funders often get a share of the winnings in exchange for their financial support.

This portion may be determined as a multiple of the invested monies or as a percentage of the award or settlement. The financed party and the funder typically enter into a contract outlining the precise terms and circumstances of the funding agreement and tribunal fees, if they think the claim has a good probability of being successful.

It’s crucial to remember that third-party funding agreements in arbitration are governed by particular laws and ethical standards, which may differ depending on the country. By maintaining openness and safeguarding the interests of all parties concerned, these rules seek to uphold the arbitral process’s fairness and integrity.

The Impact of Third-Party Funding on Arbitration: Challenges and the Necessity for Disclosure

Undoubtedly, arbitration has experienced significant growth and importance on the global stage. It has become a widely used method for resolving international disputes. However, the cost of arbitration has been rapidly increasing, posing challenges to its accessibility. To address this, third-party funding (TPF) has emerged as a means of making arbitration more affordable and available to a wider range of individuals. TPF has expanded the accessibility of arbitration and provided investment opportunities.

Third-party funders in arbitration
source – Live law

Third-party funders invest in arbitration proceedings in the hopes of making money. While the amount of money has increased, there are now worries about potential conflicts of interest. Conflicts of interest have the potential to compromise the fairness of the arbitration process. The dynamics of arbitration processes are strongly impacted by the presence of third-party funding, notably the interaction between the parties, funders, and arbiters or tribunals. This relationship is crucial since it has a significant impact on the fairness of the proceedings. Funders’ involvement can raise questions about the impartiality and independence of arbitrators.

Conflicts of interest among arbitrators pose a threat to the overall fairness of the proceedings, hindering the pursuit of justice. To address this issue, one possible solution is the disclosure of third-party funding. This involves revealing the existence of third-party funding, identifying the funders, and potentially disclosing the terms of the funding arrangement. Such transparency measures can help regulate the impact of third-party funding on the arbitration process.

The obligation to disclose third-party funding (TPF) is rooted in the goal of ensuring justice through impartial means. Each party has the right to be fully informed about the relationships and potential consequences that may arise from such funding arrangements. This information enables them to assess the impartiality and independence of their arbitrator. Moreover, disclosing the identity of funders at the outset saves time and resources, as arbitrators are not required to investigate funders for each case.

The tribunal can avoid additional expenses and responsibilities by reporting TPF early on in the proceedings. To avoid having to go through the full procedure just to have the award declared unlawful later, the proceedings might be canceled at the outset if there is a conflict of interest. Arbitrators have occasionally expressed their support for full disclosure. For instance, the Arbitral Tribunal compelled the claimants to disclose the contents of the Funding Agreement in the case of Manuel Garcia Armas and others v. Venezuela, citing a need to preserve the integrity of the process.

Regulation and Disclosure of Third-Party Funding in International Arbitration: Striking a Balance for Transparency and Impartiality

Third-party funding (TPF) in international arbitration is a widely recognized practice, but its regulation remains insufficient. While arbitration rules, such as those by UNITRAL and ICC, cover various aspects of arbitral proceedings, areas like third-party funding are not strictly regulated. This is concerning, given the significant role TPF plays in maintaining confidentiality, transparency, and the independence and impartiality of arbitrators.

The requirement of third-party funding disclosure is, nonetheless, gaining popularity. By making disclosure mandatory, conflicts of interest are less likely to arise and future challenges to awards are avoided. It supports the parties’ right to information about their interactions with funders and arbitrators and encourages transparency in proceedings.

The international community has varied perspectives on the disclosure of TPF in arbitration. Concerns about the privacy and confidentiality of parties and their funding agreements have led to debates about striking a balance between full disclosure and protecting privacy. Nonetheless, finding a middle ground is crucial, and many institutions have been making progress in this regard. Notably, in cases like Sehil v. Turkmenistan, SAS v. Bolivia, and Guaracachi v. Bolivia, tribunals ordered full disclosure to prevent potential conflicts of interest and uphold the principles of independence, impartiality, and justice.

In several countries, including Hong Kong and Singapore, steps have been taken to provide tribunals the right to request information about funding and even to mandate full disclosure of third-party funding. These changes are a result of ongoing attempts to deal with the disclosure problem and guarantee impartiality in arbitration procedures.

Challenges and Considerations in Third-Party Funding for International Arbitration

In international arbitration, third-party funding (TPF) is expanding quickly, drawing a range of financial institutions, law firms, and insurance companies to participate as funding parties. TPF, however, runs into issues and practical difficulties that limit its growth while being widely accepted in arbitration cases around the world. While parties engaging in TPF agreements might also find themselves at a disadvantage, third-party funders do experience some drawbacks.

The absence of regulation is one of the biggest problems TPF is facing. While many nations are accepting and regulating arbitration, there is still no domestic or international regulation of third-party funding. The regularity and legitimacy of TPF practices are unknown as a result of the absence of regulations. The protection of privacy and secrecy is a major issue with third-party funding in arbitration. As part of their agreements, parties seeking finance frequently have to divulge information to the funders, which may jeopardize the party’s interests and confidentiality.

Another important consideration is the disclosure of third-party funding. While it is vital for a party to reveal the presence of TPF in order to resolve any potential conflicts of interest, the party is also within their rights to keep from the arbitrator or tribunal the specifics of their agreement with the funders. Finding a middle ground between taking inflexible positions on disclosure and deciding what information should be released could safeguard the rights of the financed party as well as the fairness of the arbitration process.

The sheer presence of a third-party funder presents difficulties as well. The funder may use its position to exert control over the claim, forcing parties seeking TPF to agree to unfavorable conditions. It is a continuous battle to limit the impact of commercial institutions and sponsors, especially to prioritize the welfare of the party. Funders frequently prioritize maximizing profits and getting a sizeable percentage of the claim, which might take precedence over the goals of dispute resolution and amicable settlement.

The difficulties associated with third-party funding generally cover a wide range of issues, including disclosure, regulation, and upholding the party’s interests throughout the funding process. It is essential to address these issues if we want international arbitration to treat TPF in a fair and impartial manner.

Conclusion

As a process that is constantly changing, arbitration is increasingly coming under more regulation, with an emphasis on helping the parties rather than hurting them. Similarly to this, other institutions and nations are beginning to acknowledge third-party sponsorship. To balance its intended use with any potential hazards, though, is absolutely essential. So far, third-party funding has shown that it can assist parties who are unable to pay the high costs of arbitration in receiving justice.

In addition to making arbitration more accessible and affordable, by resolving the issues with third-party funding in international arbitration, the arbitration will also ensure that the fundamental principle of justice is upheld, as is emphasized by the proverb “Justice delayed is justice denied.”

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