Woman loses Prudential lawsuit over brain surgery payout after judge rejects ‘buried clause’ argument

Cai Yunhong collapsed on a bus after suffering a stroke caused by a ruptured brain aneurysm in 2023. She underwent an emergency endovascular repair at Singapore’s National University Hospital and spent 21 days in hospital, including eight in intensive care.

The 45-year-old later sought more than S$108,000 from Prudential Assurance Company Singapore under the Early Crisis Cover Multiplier attached to her PruLife Multiplier Policy. She also sought interest, a refund of two years of premiums and a waiver of the remaining premiums, bringing the additional sums to about S$12,000.

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single, buried clause

Cai argued that Prudential had denied her claim because of a “single, buried clause” that limited brain aneurysm surgery coverage to surgical craniotomy. That procedure involves removing part of the skull to reach the brain, and she described it as more invasive and riskier than the treatment she received. She said she had not been given a choice of procedure and learned only later about the policy’s definition.

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not a fair one

In a written judgment, District Judge Teo Guan Kee rejected that characterisation. He said the policy had to be read as a whole and that “there was no room for doubt about the coverage afforded”. The policy defined the covered treatment as the “actual undergoing of surgical craniotomy” and expressly stated that endovascular repair or procedures were not covered.

Prudential also denied failing to disclose the relevant terms. Cai bought the policy through a sales channel operated by Standard Chartered Bank, and the insurer said the terms had been explained to her. The court agreed with Prudential’s interpretation and dismissed the claim.

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there was no room for doubt about the coverage afforded