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Stroke survivor calls policy ‘convoluted’ as insured navigates through four sections to find full exclusions
Cai Yanhong, a stroke survivor suing Prudential Assurance Company Singapore, questioned the insurer's head of life claims in a Singapore district court on 28 April 2026, arguing that the policy document's exclusions were buried, ambiguous, and inconsistent with the language used throughout the contract.
The Online Citizen29 Apr 2026
Tania Cai at Singapore State Courts on 28 April 2026
Cai Yanhong, a 45-year-old stroke survivor, continued her unrepresented legal challenge against Prudential Assurance Company Singapore (Prudential) in the Singapore District Court on 28 April 2026, directly examining the insurer's head of life claims over the language, structure, and consistency of her critical illness policy.
The case is being heard before District Judge Teo Guan Kee. At issue is whether Prudential was right to deny Cai a payout of S$108,500 following her stroke in 2023, on the basis that the surgery she underwent did not meet the policy's definition of covered brain aneurysm surgery.
Cai suffered a stroke caused by a ruptured brain aneurysm in 2023. Her attending physician recommended endovascular repair, a minimally invasive procedure increasingly used in clinical practice to treat aneurysms. Prudential declined the claim, arguing that the relevant policy clause defined covered brain aneurysm surgery as surgical craniotomy — an open-skull operation — and that endovascular repair was therefore excluded.
Policy exclusions scattered across different sections of the Policy Document
Much of the day's proceedings focused on the structural layout of the policy document. Cai argued that a policyholder seeking to understand what was and was not covered would need to navigate at least four separate sections of the document.Tan Kah Tin, Prudential's head of life claims, confirmed under cross-examination that the exclusion applicable to Cai's claim was not found in the main benefits section of the policy. She acknowledged that it was embedded within the definitions of the conditions themselves, located in Section 32 of the policy document.
Tan told the court that placing all exclusions in Section 17, the primary claims benefits section, would make that section "convoluted." She added that all exclusions depended on the intent of coverage and how the product had been priced.
Cai pressed her: "So the patient has to look at four different parts of the policy document to find out she is not covered. The exclusion is not in the main section, but in a later section."
Repeated references to "payout upon diagnosis"
Cai directed Tan's attention to multiple sections of the policy document where payouts were described as being triggered by diagnosis rather than by a specific type of treatment. She claimed to have identified over 80 references across the document to language such as "financial protection upon diagnosis" and "if diagnosis is made."Tan confirmed that both Section 17 and Section 33 of the policy contained multiple references to payout being linked to diagnosis. She acknowledged that, on a plain reading of Section 17.6, which states that a surgical procedure must be certified by a specialist and represents the standard of care in Singapore, the language did not explicitly list any exclusions.
"In terms of the English language, it is not listed," Tan said when asked whether the endovascular procedure was excluded under that particular clause. She clarified that the exclusion was to be found in Section 32, under the definition of stroke.
Inconsistency in coverage for aorta versus brain aneurysm
Cai also drew Tan's attention to what she described as an inconsistency between the treatment of aortic aneurysm and brain aneurysm within the same policy document. She noted that Section 17, Item 28, explicitly included minimally invasive surgery for aortic aneurysm.She asked why the same language was not used for brain aneurysm, listed as Item 27.
Tan said she was unable to comment on drafting decisions as she was not involved in preparing the policy wording, adding that different conditions used different definitions. "Language does not have to be the same," she told the court.
When Cai pressed whether this meant minimally invasive surgery for a heart aneurysm was covered but not for a brain aneurysm, Tan again said the matter of language would need to be addressed by another witness responsible for product design.
Witness confirms most customers would not grasp surgical distinctions
In what may prove a significant moment in the proceedings, Tan agreed, after the judge overruled a defence objection, that most customers would not be medically trained and would not understand distinctions between surgical techniques when purchasing a policy.The exchange arose after Cai argued that she had been unconscious when rushed to hospital and was in no position to make her own medical decisions. She put it to Tan that her attending physician had recommended the endovascular procedure, and asked whether it was fair for a stroke patient to navigate four sections of a policy in order to determine what was covered.
Tan said she could not answer from a customer's perspective, as she was representing the insurer.
Witness confirms policy complexity; hedges on surgical distinctions
Tan confirmed under cross-examination that the policy document was a complex one. When asked whether she would agree the document was complex, she responded: "Define complexity. If it refers to many pages" — and then agreed that it was.
A separate exchange addressed whether most customers would understand surgical distinctions. Cai put to Tan that most customers were not medically trained and would not understand the difference between surgical techniques when purchasing a policy. Prudential's counsel objected, but the judge overruled the objection.
Tan initially said yes. When Cai sought to follow up, Tan said the question was confusing. District Judge Teo corrected her, noting that the question contained two propositions and that she could answer yes, no, or that she did not know. Tan replied that she did not know.
Glossary and acknowledgement pages challenged
Earlier in the session, Cai challenged the adequacy of the acknowledgement process at the point of sale. She referred to the proposal form and a product summary running from pages 300 to 309, which Tan confirmed did not contain the detailed definitions or exclusions that formed the basis of Prudential's claim denial.Tan acknowledged that the detailed terms and exclusions were in subsequent pages of the document, and that a notice on page 309 stated the proposer acknowledged receipt of all materials and confirmed that their content had been explained to her satisfaction.
Cai put it to Tan that this acknowledgement did not mean that specific exclusions had been brought to her attention. Tan replied that she could not comment, as she had not been present at the time.
Cai also raised the fact that she had been given a 14-day window to review the policy document, and asked whether Prudential had made any contact with her during that period to verify that she had understood the terms.
Tan said this was not within her knowledge.
Prudential maintains position, says document was unambiguous
Prudential, represented by Joavan Pereira of Virtus Law, maintained that the claim was without merit. When cross-examination resumed after the lunch break, Tan reiterated that the policy document was "consistent and unambiguous."Pereira had earlier argued that Cai's case was, at its core, a claim that the treatment she underwent should have been covered — and that the policy stated clearly it was not.
District Judge Teo intervened at several points during proceedings to clarify lines of questioning, direct Cai to frame her questions precisely, and caution her against repetition. At one stage, the judge told Cai that her questioning, even with allowances made for her unrepresented status, was not reaching issues that would be relevant to a judicial decision.
The trial continues with further witnesses, including those with knowledge of the product's design and the sale meeting in August 2016.Editor's note: This article has been updated following clarification sought after publication.
