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https://mothership.sg/2026/03/woman-sues-prudential-brain-surgery/
A woman has sued Prudential after she underwent a brain surgery following a stroke, but had her claim denied.
Cai Yanhong, 45, said that the insurer denied her claim because of a "buried clause".
The clause stated that the type of surgery she underwent — an endovascular repair — was not covered by the policy.
She would only have been covered if she underwent a different surgery, a surgical craniotomy, instead.
Cai argued that she was not given a choice of what surgery would be performed, reported CNA.
She added that the surgery that Prudential covered was riskier, more invasive, and had higher mortality rates.
In its defence, Prudential argued that the contract had "made it very clear" that the surgery Cai underwent was not covered in the policy.
Cai said she had purchased an early critical illness policy from Prudential in 2016, the Prulife Multiplier insurance policy.
She was 35 at the time with no medical history.
Cai said she believed that the policy was "one of the most premium products" available on the marketplace, and thus decided to purchase it.
She claimed that the exclusions to the medical conditions, apart from exclusions for pre-existing conditions, were not explained to her during the sales process.
The policy covers death, disability, terminal illness, and critical illness.
She was taken to the hospital by ambulance, she said.
At the National University Hospital, an emergency operation was performed on her by the head of neurosurgery.
This surgery was an endovascular repair, which is a minimally invasive procedure that helps prevent rupture or re-bleeding.
Cai spent 21 days in the hospital, including eight days in the intensive care unit.
She said she recovered "miraculously well" and added that many patients with her condition do not survive or end up suffering neurological deficits.
This is an open-skull procedure where part of the skull is removed to reach the brain.
Her claim for her surgery was denied.
Cai claimed that she had no choice as to what surgery she went for, and that the endovascular repair she underwent was a modern, minimally invasive, and evidence-based first-line treatment for her condition.
She also alleged that surgical craniotomies are riskier and more invasive, with higher mortality rates.
During the trial, Cai argued that Prudential had "manipulated" the language of the contract by defining "brain aneurysm surgery" only as surgical craniotomy.
Other insurers do not specify the need for a particular type of procedure to have taken place when defining the condition of a brain aneurysm, she claimed.
Lawyers for the firm said Cai's argument is that she should be paid based on the confirmation of the diagnosis, not the treatment.
But this runs counter to the express terms of the contract, they said.
In an email about the policy sent to Cai around the time of purchase, the definitions of critical illnesses that would entitle her to payment were set out and highlighted.
This included the definition of brain aneurysm surgery, which was defined only as surgical craniotomy, and not endovascular repair.
Furthermore, when a representative explained the policy to her in person, she did not raise any concerns about not being able to understand and signed the first 10 pages as an acknowledgement.
Addressing her allegation that Prudential was a "market outlier", they said this was "disingenuous and false".
Furthermore, the entire sales process was carried out by representatives from Standard Chartered — which had a partnership with Prudential at the time — and not representatives of Prudential.
Prudential has called for the claim to be dismissed with costs.
She has also sought a refund of two years' premiums paid in 2023 and 2024, and a waiver of the remaining premiums under the policy.
The latter totals around S$12,000, according to CNA.
Cai, who was unrepresented, said that she was filing the suit in hopes that no one else would have to do the same.
She said she wanted to shed light on "these unfair practices" and "force insurers to be transparent about their exclusions".
"I cannot imagine what another person would do in my shoes – say someone who is later in age, suffering a stroke in their 50s or 60s, losing the ability to work, unable to collect on their policy payments, and not in a position to take Prudential to court," she said.
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https://mothership.sg/2026/03/woman-sues-prudential-brain-surgery/
S'pore woman, 45, sues Prudential after S$100,000 brain surgery claim denied
She said she wanted to shed light on "these unfair practices" and "force insurers to be transparent about their exclusions".A woman has sued Prudential after she underwent a brain surgery following a stroke, but had her claim denied.
Cai Yanhong, 45, said that the insurer denied her claim because of a "buried clause".
The clause stated that the type of surgery she underwent — an endovascular repair — was not covered by the policy.
She would only have been covered if she underwent a different surgery, a surgical craniotomy, instead.
Cai argued that she was not given a choice of what surgery would be performed, reported CNA.
She added that the surgery that Prudential covered was riskier, more invasive, and had higher mortality rates.
In its defence, Prudential argued that the contract had "made it very clear" that the surgery Cai underwent was not covered in the policy.
The policy
The trial opened on Mar. 18, CNA reported.Cai said she had purchased an early critical illness policy from Prudential in 2016, the Prulife Multiplier insurance policy.
She was 35 at the time with no medical history.
Cai said she believed that the policy was "one of the most premium products" available on the marketplace, and thus decided to purchase it.
She claimed that the exclusions to the medical conditions, apart from exclusions for pre-existing conditions, were not explained to her during the sales process.
The policy covers death, disability, terminal illness, and critical illness.
Brain aneurysm
In 2023, Cai suffered a stroke from a ruptured brain aneurysm and collapsed while on the bus.She was taken to the hospital by ambulance, she said.
At the National University Hospital, an emergency operation was performed on her by the head of neurosurgery.
This surgery was an endovascular repair, which is a minimally invasive procedure that helps prevent rupture or re-bleeding.
Cai spent 21 days in the hospital, including eight days in the intensive care unit.
She said she recovered "miraculously well" and added that many patients with her condition do not survive or end up suffering neurological deficits.
Not covered by policy
However, she later learnt that Prudential's policy only makes payouts when brain aneurysms are treated by surgical craniotomy.This is an open-skull procedure where part of the skull is removed to reach the brain.
Her claim for her surgery was denied.
Cai claimed that she had no choice as to what surgery she went for, and that the endovascular repair she underwent was a modern, minimally invasive, and evidence-based first-line treatment for her condition.
She also alleged that surgical craniotomies are riskier and more invasive, with higher mortality rates.
During the trial, Cai argued that Prudential had "manipulated" the language of the contract by defining "brain aneurysm surgery" only as surgical craniotomy.
Other insurers do not specify the need for a particular type of procedure to have taken place when defining the condition of a brain aneurysm, she claimed.
"Untrue and baseless"
In its opening statement, Prudential called Cai's claims "untrue and baseless".Lawyers for the firm said Cai's argument is that she should be paid based on the confirmation of the diagnosis, not the treatment.
But this runs counter to the express terms of the contract, they said.
Prudential added that the policy document also "made it very clear" that this exclusion existed.
In an email about the policy sent to Cai around the time of purchase, the definitions of critical illnesses that would entitle her to payment were set out and highlighted.
This included the definition of brain aneurysm surgery, which was defined only as surgical craniotomy, and not endovascular repair.
Furthermore, when a representative explained the policy to her in person, she did not raise any concerns about not being able to understand and signed the first 10 pages as an acknowledgement.
"Disingenuous and false"
The lawyers also rejected her other claims.Addressing her allegation that Prudential was a "market outlier", they said this was "disingenuous and false".
Furthermore, the entire sales process was carried out by representatives from Standard Chartered — which had a partnership with Prudential at the time — and not representatives of Prudential.
Prudential has called for the claim to be dismissed with costs.
"Suffering in silence"
Cai is seeking the full claim amount of S$108,500 under the early crisis cover multiplier, with accruing interest.She has also sought a refund of two years' premiums paid in 2023 and 2024, and a waiver of the remaining premiums under the policy.
The latter totals around S$12,000, according to CNA.
Cai, who was unrepresented, said that she was filing the suit in hopes that no one else would have to do the same.
She said she wanted to shed light on "these unfair practices" and "force insurers to be transparent about their exclusions".
"I cannot imagine what another person would do in my shoes – say someone who is later in age, suffering a stroke in their 50s or 60s, losing the ability to work, unable to collect on their policy payments, and not in a position to take Prudential to court," she said.
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