Sneaky" Prudential? Netizens Slam Insurer Over Rejected Brain Surgery Claim

A 45-year-old woman has lost her lawsuit against Prudential Assurance Company Singapore after the court rejected her claim for more than $108,000 over a brain aneurysm surgery she underwent in 2023.

Cai Yanhong had suffered a stroke caused by a ruptured aneurysm and underwent endovascular repair at the National University Hospital.

However, Prudential rejected her insurance claim because her policy defined covered brain aneurysm surgery as a surgical craniotomy and expressly excluded endovascular procedures.

Cai had argued that the exclusion was a "single, buried clause" in the policy and that she was not given a choice over the type of surgery performed. She also said endovascular repair was a modern, minimally invasive treatment for her condition.

However, in a written judgment on 3 Sep 2026, District Judge Teo Guan Kee dismissed her claim, saying it was not fair to characterise the clause as hidden or buried.

The judge said the policy had to be read as a whole and that there was no room for doubt that endovascular repair was not covered under the policy.

Prudential had also argued that the terms of the policy had been explained to Cai when she purchased it through Standard Chartered Bank in 2016.

The insurer said its policies had different approaches to endovascular repair in 2016, and that some of its current critical illness policies, including one launched in March 2026, now cover the procedure.

Under Prudential's current Critical Illness FAQ, coverage under existing policies is not automatically updated to include new conditions or treatments.

Instead, coverage is based on the medical knowledge, diagnostic standards and treatment practices considered when the policy was developed, while newer policies may include updated definitions and treatments.

This approach is not unique to Prudential.

According to the General Insurance Association (GIA) of Singapore, insurance coverage is generally determined by the terms of the policy. This means newer medical treatments are not necessarily covered under older policies unless the policy is subsequently amended or the insurer provides for the updated treatment.